What is Anxiety?
In general, anxiety is the tendency to worry leading to physical symptoms such as a racing heart, shortness of breath, nausea, and restlessness. Anxiety can feel like fear, dread, or a sense of impending doom. It could be a few minutes of worrying, or it could be all day long out of control panic, or anything in between.
It is very normal to experience anxiety- it is an emotion all humans have for a reason. Anxiety alarms us, it gives us the energy to prepare, and it allows us to protect ourselves and others in the face of a life-threatening situation. This was something humans needed to survive in our hunting and gathering days, and now it keeps us alert while driving, or camping, or hiking, or whatever the potentially dangerous scenario might be.
However, anxiety can sometimes go to extremes that feel hard to manage and may not be triggered by actual life-threatening experiences. Disordered anxiety can lead you to constantly feel like the worst thing possible might happen at any second, and it may leave you wondering why you are so anxious. I hear very often from my clients, “I really don’t know why I’m this anxious!” It is a frustrating thing to not know why your heart is racing 500 beats per minute, or to feel like you might throw up but want to eat everything at the same time, or wonder why your hands are freezing but also sweating. Known triggers could be things like fear of rejection, public speaking, job performance, taking tests, driving, and much more… Things that don’t present immediate danger, and yet your body is reacting like a bear is about 5 seconds from mauling you.
Anxiety Disorders
You know you have an anxiety disorder when the anxiety is chronic, when its interfering with your ability to function on a regular basis, when it lasts for a long period of time, and when it feels too difficult to manage on your own.
There are several different types of anxiety disorders ranging from trigger specific anxiety to general anxiety:
Phobias: Phobias are an extreme fear or aversion to something like spiders, driving, heights, tight spaces, social settings, etc. In these cases, anxiety is triggered by interacting with the specific phobia.
Panic Disorders: Individuals who experience regular and unexpected anxiety attacks have a panic disorder. Anxiety attacks are sometimes mistaken for a heart attack. The individual experiences sudden racing heart or irregular heartbeats, shakiness, struggling to breathe, vertigo, etc.
Generalized Anxiety Disorder: This is a consistent and chronic form of anxiety which can include racing thoughts, excessive worrying, irritability, difficulty concentrating, trouble sleeping, etc, and is experienced on a daily basis.
Treating Anxiety
If you do a Google search on anxiety treatments the first things that will come up are Cognitive Behavior Therapy, Medications, and Mindfulness. These interventions are helpful and can definitely take the edge off.
The most common medications to treat anxiety are
SSRIs (Selective Serotonin Reuptake Inhibitor)- these increase the brains production of serotonin which are neurotransmitters responsible for regulating mood, sleep, and more)
SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)- like SSRIs but also target production of norepinephrine- a neurotransmitter responsible for blood pressure, helping the brain function under stress, and more.
Benzodiazepines- fast acting drugs common in treatment of panic disorders that are essentially sedatives that work to relieve anxiety and tension in the body, and help you sleep
Medication will help anxiety symptoms feel more manageable, but they never fully make the anxiety stop. I always recommend therapy in combination with medication for a more wholesome approach.
Why CBT isn’t always the most effective
Cognitive Behavior Therapy (CBT) is a specific psychotherapy approach that targets thinking patterns, and is very commonly used to treat anxiety. It requires the individual to analyze their thoughts, identify negative thinking patterns, challenge the thoughts, and come up with more positive and adaptive thoughts. There are components of CBT that I believe are essential for everyone to learn. Challenging your thoughts and understanding that every thought you have does not need to be believed or acted upon are crucial concepts for mental wellbeing. I always teach CBT as a skill to add to your toolbox. However, I believe that there is much more to anxiety than negative thoughts. Anxiety is something you experience in your mind and your body. Your body experiences anxiety somatically just as much as your mind experiences the anxious thoughts. And I believe the most effective treatment requires full body and mind attunement. Anxiety is deeply tied to the autonomic nervous system, which controls involuntary responses in the body, including the "fight, flight, or freeze" reaction to perceived threats. When we experience anxiety, the sympathetic branch of the nervous system is activated, triggering physiological responses like increased heart rate, rapid breathing, and muscle tension. These physical sensations can occur even when there is no real danger, and while cognitive strategies like changing your thoughts can help reduce worry, they don’t always immediately calm the body’s automatic responses. This is because the autonomic nervous system operates independently from conscious thought, and once it’s activated, the body may remain in a heightened state of alertness even if we rationally know there's nothing to fear. That’s why calming the body through techniques like deep breathing, grounding exercises, or progressive muscle relaxation is often necessary to complement cognitive approaches when managing anxiety.
I believe CBT is a tool for your toolbox, but not the root of the issue.
Other therapy approaches I have found to be helpful
Mindfulness is one of my most favorite skills for managing anxiety, and it gets closer to addressing the whole mind and body. Mindfulness is a practice that can take just a few minutes of your time, but can also be a mindset you embrace throughout the day. Mindfulness is generally taught (initially) as a combination of breath work while consciously observing the breath and incorporating concepts including present-focused awareness, being non-judgmental of your experience, acceptance, and self-compassion. The easiest way to start this is to listen to some guided mindfulness meditations. My favorite app for this is called Insight Timer. Other common apps include Headspace, and Calm.
Through my own personal experience, and, by being a therapist working with anxious clients on a daily basis, I have found the most successful intervention to be a combination of EMDR (Eye Movement Desensitization and Reprocessing) and IFS (Internal Family Systems). EMDR uses bilateral stimulation like tapping, sound, or eye movement to stimulate the right and left side of your brain allowing for thorough processing. IFS is an approach that identifies “parts” of self, like maybe inner child that experienced attachment wounds, and goes through the process of “reparenting” those parts through showing compassion, love, and support. In other words, you create feelings of safety within yourself and heal the unresolved childhood traumas. Using EMDR and IFS together to treat anxiety is a more comprehensive and life altering approach to truly shift your brain and your body’s experience. Being able to access feelings of inner safety allow you to confidently navigate the roots of the anxiety and resolve the subconscious wounds leaving your body to feel the only way to get through life is to live in a state of panic.
Conclusion
If you struggle with anxiety, I hope you reach out today to book a session and get the healing experience you deserve. Comment below with some of your most favorite coping strategies for anxiety. Please also visit my page for further explanations of EMDR and IFS as well as handouts on the best coping skills to manage anxiety in the moment.
Here is one helpful handout.
