Anxiety – What kind?
When someone comes in for stress counselling or anxiety counselling I find myself spending a lot of time at the outset understanding what, exactly, this means for the person. That’s because anxiety is multi-layered and complex; there’s many different kinds of anxiety with many different causes. For example, anxiety can be a side effect of medication. I’ve had that before with some allergy medication I took which produced a constant simmering anxiety peppered with paranoia and panic attacks. Good times. As soon as I stopped taking the meds though – which admittedly took some time to figure out – the anxiety ceased.
But anxiety can be caused by a whole host of things. It can arise through life events like relationship problems, work issues, financial concerns, illness. It can come up through performance (public speaking, being in the spotlight, exams) and through creative acts of expression like writing or painting. If this is a shorter term circumstance, usually the anxiety will go away when the situation resolves itself. You just ride it out, develop strategies for coping, and do the best you can in the meantime.
And then there’s the chronic kind. Some people have been anxious for years, if not their entire lives. That’s because anxiety can also be caused by trauma or childhood deprivation on physical, emotional and mental levels. It can also be caused by learning to be anxious from parents – anxiety runs in families. Over time, the body becomes hard wired to move straight into anxiety whenever you get stressed. This can be accompanied by a deep seated feeling that life isn’t safe; other people aren’t safe.
So that’s what I mean – anxiety has myriad causes and expressions. It’s not all exactly the same, though we tend to call it by the same name. This is why an important initial step in anxiety management is figuring out “what kind” of anxiety you have to begin with. Aside from this, there also some other actions you can take in managing your anxiety. I’ve found that these can help:
The word anxiety’s origins are not entirely clear, but it has been linked to the Indo-Germanic angh, which means to narrow, constrict, or to strangulate, as well as the Greek word anchein, which means to strangle, suffocate, or press shut.(1)
This is indeed how anxiety can feel; as if you’re choked and breathless. The body, especially the chest and throat, feels constricted and tight. When it’s really bad, you feel like you’re dying.
Correct breathing, and practicing breath work are important in counteracting these sensations. When we’re in anxiety, our breath is shallow and rapid. We’re breathing into the top of the lungs only. In order to oxygenate the brain and calm ourselves down, we need to take deeper, slower breaths, filling the diaphragm and lungs fully.
Think of the elements of Earth, Air, Fire and Water. Anxiety is an overabundance of Fire (nervous energy) and Water (emotions, like fear). To manage anxiety we need Air and Earth to calm us down, and bring us back to a regulated state. We need to be grounded and feel internally spacious in order to transition back to calm.
One exercise to try is Belly Breathing:
- Sit upright in a chair. Imagine there are roots growing from the bottom of your feet that connect into the Earth (it’s okay if you’re not on the ground floor, just imagine the roots moving down through the building into the Earth). Imagine forging a connection with the Earth through these roots. When you can feel this, place one hand on your stomach and one hand on your chest so you can feel how you’re breathing. Make sure your shoulders are down and relaxed.
- Breathe in slowly and deeply through your nose. First feel your stomach and diaphragm expanding as you fill this area with air. Next feel your chest expand as you fill your lungs with air.
- Now exhale slowly through your mouth. If you want, you can purse your lips slightly so that you hear a soft whooshing noise as you exhale. Keep your jaw loose. Draw out your exhalation in a long, sloooow outbreath.
- Do this for at least 10 breaths.
Try doing this exercise at least once a day. No excuses – everyone can spare a minute or two! What you’re aiming for is to initiate a relaxation response, and also to train your body to remember to breath this way. People with chronic anxiety tend to breath shallowly all the time, and this exercise can help correct the habit.
Nutrition and Lifestyle
According to the Anxiety Disorders Association of America (ADAA), anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality and life events. You may have no control over many of these factors, but you do have control over diet and exercise.
You are what you eat. We’ve all heard this before, but the truth is nutrition plays an important role in anxiety. A healthy, balanced diet is best because it reduces the stress put on the body during digestion and nutrient absorption. Food and drink can either aggravate or reduce symptoms of anxiety. I know this first hand; when I gave up caffeine, I gave up a lot of anxiety with it. Some things to consider:
- Your intake of stimulants such as caffeine and nicotine. Is it possible to either reduce or give up entirely? For example, it’s optimal to reduce caffeine consumption to less than 100mg/day. This equates to one cup of coffee, or 4 cups of caffeinated tea with a one minute brew.
- Be aware of your blood sugar. The symptoms of hypoglycaemia perfectly mirror those of a panic or anxiety attack. Also try to limit processed foods and drinks, especially those which have high amounts of refined sugar and other sweeteners.
- Notice not just what you’re eating, but how you’re eating it. Eating too fast or on the run? Eating too much in one meal? Not chewing food at least 15-20 times per mouthful? You want to reduce stress on the body during digestion.
- Some helpful supplements for anxiety: B vitamin complex, Vitamin C, Calcium, Magnesium. People with anxiety may need to take additional amounts of these supplements. Certain amino acids can also be beneficial, such as tryptophan, GABA, DLPA, and tyrosine. Make sure to consult with a doctor or specialist first before taking anything.
- Exercise. Aerobic or anaerobic, it doesn’t matter – studies have demonstrated that either form of exercise is helpful in decreasing anxiety. Even 5 minutes of aerobic activity, performed over the course of 17 weeks, was shown to reduce symptoms. If yoga is more your thing, there are increasing numbers of studies being conducted on demonstrating its benefits for anxiety reduction. For more detailed information on why exercise is beneficial for anxiety, see this article.
Discover your triggers
When are you anxious? Is there a particular time of day that it’s better or worse? Are there particular situations, people, and life events that trigger your anxiety? You may want to make a written list, being as specific as possible when identifying your triggers. You might even rank them according to the intensity of anxiety they produce.
Getting it all down in front of you can help with monitoring the anxiety from a more objective perspective. This process brings in awareness and space, which is vital for anxiety management. Here I think therapy can be beneficial, helping to develop strategies for coping, and allowing exploration of triggers in greater depth in a safe place. You need to be nice to yourself here: work around your triggers until you can work through them. Get to know them first, and explore your relationship with them.
For example, one theory states that there are four traits that perpetuate anxiety: (2)
- Excessive need for approval
- Tendency to ignore physical and psychological signs of stress
- Excessive need for control
Do any of these traits resonate with you and your identified triggers? Do you agree or disagree with these four traits?
An Irritable Heart
Within the medical community, there has long been an association between anxiety and the cardiovascular system. Research detailing this link began in the mid-19th century, and one of the most famous studies was Da Costa’s 1871 study on American Civil War soldiers. DaCosta identified something he called ‘irritable heart syndrome’ (also known as ‘soldier’s heart’). The veterans were seen to suffer from heart pain, palpitations, shortness of breath, and tachycardia (rapid heart rate). What’s interesting was Da Costa’s finding that this syndrome was not actually military specific; many of the solders had these symptoms before the war, and Da Costa also observed that these symptoms were present in many civilians. (3) This research provided the early origins for the basis of modern day clinical diagnoses of General Anxiety Disorder and Panic Disorder, mostly due to the tachycardia and shortness of breath experienced during periods of anxiety.
The history is interesting, but I’m most attracted to the emotional component of ‘irritable heart syndrome’. It makes me wonder about the experiences in life that have hurt us, decreasing our ability to tolerate stress and increasing the occurrence of anxiety.
Do you have an irritable heart? I don’t mean this in a literal way.
This is about entering more deeply into the origins of your anxiety. Not the origins of genetics, or brain chemistry, but the origins of your personality and life events. It may be time to explore any trauma in your background, and face any painful parts of your past. Once again, be kind to yourself: if it’s not time yet, that’s okay too.
Some questions to consider:
- What is your relationship to your anxiety? What is it doing to you? If the anxiety had an image, what would it be? If you found yourself alone in a room with your anxiety, what would happen next?
- Is your anxiety directly related to someone in your family of origin? Have you taken on someone else’s anxiety at some point and now it’s become your own?
- Have you taken your frustration towards your anxiety out on yourself? How?
- Are there any memories from your past that remain unhealed? You’ll know if you think about them and find there’s still an emotional charge. You’ll also know this is the case if you know what the memories are but don’t want to go there.
In getting to the heart of the matter, this is the kind of work that takes time and requires much self-compassion and patience. Here I think counselling and psychotherapy for anxiety can be very helpful in looking at these questions in a safe, private space.
Baptist preacher and writer Charles Spurgeon wrote “our anxiety does not empty tomorrow of its sorrows, but only empties today of its strengths.” It’s true. If left unchecked, anxiety becomes a thief – stealing away not only precious time but draining one’s energies and resources in the process.
Managing anxiety is a step (or a series of small steps) in moving towards living life with more freedom and happiness. It’s about alignment; making those small decisions day by day that, over time, lead to a more balanced state of health and wellbeing.
1) Glas, G. (2003). A Conceptual History of Anxiety and Depression. Handbook of Anxiety and Depression. Edited by S. Kasper, J.A. den Boer, J.M.A. Sitsen. NY, NY: Marcel Dekker Inc. (2nd Ed.).
2) Bourne, E.J. (2002) The Anxiety and Phobia Workbook. Oakland, CA: Harbinger Publishing (3rd Ed.).
3) Byrne, D.G. & Rosenman, R.H. (1990). Anxiety and the Heart. Hemisphere Publishing.
Image: Edvard Munch, Despair