All of we humans at times experience a feeling we may label as anxiety. Some of us may also experience acute anxiety or even what we may term as panic attacks which we can experience as paralyzing. We may know the cause of our anxious feelings. We may be fearful of an academic test, an emotional test, a particular emotional or a physical situation. At times, especially with panic attacks, we may not be able to identify the cause or etiology of our anxiety or fear. One minute we are fine and the next we are paralyzed emotionally and physically. We might even suddenly wake up with a feeling of panic even though there is no obvious cause or reason to be anxious/fearful. If this happens with any regularity we may go to a physician who them does blood work and possibly other tests in an attempt to identify some possible physical cause. We will also be questioned about what medications we are taking and any other drugs, including alcohol and caffeine, which we are taking/self-prescribing/administrating. The physician will also ask us about any life situations which may be resulting in worry or fear.
If the physician cannot determine the cause, we may be referred for psychological help to a professional counselor or psychiatrist who will explore in more depth the possible cause or reason for our distress and/or to learn techniques for managing the anxiety or panic. If an alcohol or drug abuse problem is determined to be the issue we may be referred to an addiction counselor, a treatment facility or a 12 Step facility. If withdrawal from a self-administered drug/alcohol, or a drug interaction is diagnosed one may be referred to the hospital or a facility which specializes in helping people detox or withdraw. When one is having an allergic reaction then the appropriate medical regimen will be implemented.
If the cause is determined to be psychological, we may feel shameful or embarrassed because we often think of psychological or emotional as something we "should" be able to control. We may have been taught to think that there is a clear distinction between physical and psychological reasons for an imbalance in our body. After all, if we have a medical problem we go to a medical doctor and if we have a psychological problem we go to a shrink/doctor/counselor/therapist/counselor. The fact that the "shrink" is a psychiatrist who has an MD or DO degree and license does not usually diminish the feeling that the problem is in our head and, thus, a problem we caused.
The truth, as scientists are increasingly able to demonstrate, is that all "diseases" and "dis eases" are the result of something physical. If I experience fear or any other emotion something physical is going on even if the cause is as “simple” as someone pointing a gun at me. In that case, I "know" that a person threatening to shoot me is a dangerous situation. The feeling of fear/anxiety is the result of my brain running to my internal file cabinet, retrieving information about guns, pointing and danger, bringing that information back to my conscious mind and then signaling other parts of my body to take a defensive position/stance. If I then discover that the gun is a toy gun which cannot harm me I will then have to run back to my internal file cabinet, retrieve information about toy guns and send that information to my conscious mind which then sends new instructions to other parts of my body. This entire process may only take seconds and requires very little conscious thought.
What if, on the other hand, we cannot retrieve any information from our internal file cabinet about the "cause" of or reason for our feeling of anxiety and what is no amount of self talk seems to diminish the discomfort of the feeling? We may be diagnosed as having an anxiety or panic disorder, prescribed medication, self medicate and/or sent to a "head" doctor!
Often the medications such as zanax, klonopin or some other one seems to be a miracle cure. The anxiety or panic may quickly diminish temporarily, but will return. We can then take another pill and, again, the feeling of anxiety or panic will diminish. It is a quick, easy solution. Sadly, however, if I continue to take some medications, I will become dependent on them and, in some cases, will build up a tolerance and have to increase the dose. With the increased dose the possibility of having serious side effects will increase. The physician may then prescribe another medication to deal with the side effects.
Now, if one is only taking the medication for a couple of days or for a week to help one get through a funeral, to deal with one’s fear of flying while going to tend to a seriously ill relative or to take care of another temporary situation, that is not usually an issue unless, of course, one has a history of addiction. In that case there may be other, more effective ways to manage one’s fear/anxiety for that brief period.
If one has a chronic anxiety or chronic panic attacks which are not caused by any identifiable medical condition, then the danger of taking medication - prescribed by a professional or self prescribed – is that every time we label the feeling as a big deal or as something which we cannot tolerate, we train our mind to be anxious about the anxiety or panic. When the mind then signals the body that there is a danger, it becomes tense and sends new messages to the brain. Then the anxiety gets worse, feels more intolerable and seems to “require” a stronger response. Then we may take more medication or restrict our activities to a small area which feels safe. Soon we may find ourselves feeling anxious more and more often. We now feel as if the anxiety/panic has taken us hostage.
What can one do? How might counseling/therapy or other treatment help.
First of all, let me say that the original cause of the changes in the chemistry of our body which produced feels of anxiety or panic may be a chronic condition which cannot be diagnosed and treated. Just because some cause cannot be diagnosed does not mean that there is not some condition which no amount of counseling is going to eliminate. Counseling can help with both what I call secondary anxiety (the anxiety about the anxiety or panic) and the anxiety or panic which is connected to an old message in one’s internal file cabinet, i. e. the current stimulus is triggering an old association with some aspect of a memory. For example, let’s suppose that one got physically thrown by one’s partner against a particular type of coffee table. Now, every time one sees that sort of coffee table one has an anxiety attack because one’s mind to taking one back to that dangerous situation and that part of the mind thinks we are currently in danger. We are not.
In the case with the secondary anxiety if one quits labeling the original feeling as something terrible, unbearable, "big discomfort" then one will not keep increasing the anxiety. The goal would be to just notice the anxiety/panic and, as my teacher tells me, to then practice dropping the story line. The story line is “This is terrible. This is a big deal. I cannot cope with this. I am going to die. I am fragile.” The truth is that this feeling is uncomfortable, but I will not die. I am not fragile. I do not need to tense up my body and prepare for a major battle. If I breathe and do not label the feeling it will pass and I will be fine. If I do feel faint I can sit down. If I am driving, I may need to find a safe place to stop the vehicle for a few minutes.
Basically, I am telling myself that it is safe to relax and to continue on with my life. To be sure the feeling is a nuisance. If, sometimes with help, I can identify the stimulus which is triggering an old memory or association I can learn to dissociate the stimulus from the old memory or association. I can, for example, learn that I am no longer in combat and every noise does not indicate danger. Some noises do indicate danger, but most do not. I am learn that the former abuser and the coffee table do not always occupy the same space. I may have to remind myself that “You are now safe. The coffee table did not hurt you. The abuser threw you against an object. The abuser is no longer present. "One is no longer in a combat zone. It is safe to relax."
Changing a habit takes a lot of work. We will not immediately feel better or comfortable. We may never like certain situations but we may learn to tolerate a great many situations which allow one to function at home and in the community at large.
The more we challenge ourselves to systematically practice new thought patterns in situations which formerly resulted in crippling anxiety or panic, the more we will enlarge the world in which we can function. We can learn to distinguish between the lies of the anxiety and currently dangerous situations.
There is one other cause of anxiety which most often affects we males, but can also affect some females. When we have emotions that we decide we should not express or should not share and keep them to ourselves our body is going to feel overloaded. The way that it signals our body is with feelings we often label as anxiety. For whatever reasons we human are not designed to hold emotions inside without sharing them. Whether we are sharing them directly by talking to another person(s), by painting, dancing, or playing music does not matter as long as we are identifying the feelings. If, on the other hand, I am engaging in any activity to avoid the feelings than we are just going to feel worse long term. If I am running and crying and screaming all those emotions I have been storing then I might feel better, but if I am running to stay busy so that I do not have to feel then my body is going to even more unhappy.
Feelings such as anxiety are the body’s way of saying something is off balance; my body needs something. Many of us are used to treating the symptom without identifying and treating the issues. Sadly, some physicians are much too busy and will only treat the symptoms. It is up to us to make sure that the underlying issue is identified and treated.
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