Therapy for anxiety

Anxiety symptoms
Causes of anxiety
How you can reduce your anxiety
Therapy for anxiety
References

Your mind runs non stop. You worry about your job, your family and many other things. When you try to go to sleep, there are so many thoughts that you just can't slow them down enough to fall asleep. It can be hard to sit still, you need to move or to be doing something. Your muscles ache from being tense and sometimes you can even feel your heart pounding. Often, it is an unexpected life event that can precipitate a bout of anxiety. It is to be expected that certain events will cause worry and anxiety (for example, economic uncertainty, relationship problems and significant losses). It becomes an issue when worry or anxiety causes significant problems in your life and last more than a few weeks.
There are many techniques that can help you manage your anxiety. If these prove insufficent or if your anxiety is difficult to manage, these are signs that you should seek professional help. Since there are physical conditions and medications that can cause or mimic anxiety, a physical exam should be your first priority.
To begin with, you should know what the typical symptoms of an anxiety disorder are, or "what it looks like." Below is a list of the most common symptoms.

I can't stop worrying...
What if
the worst
happens?

Anxiety symptoms


So what causes all these symptoms? Where does anxiety come from? There are two time frames that need to be considered. The first is current life events. If you were just laid off from your job, you have a current life stressor that could cause natural anxiety. In addition to a major life stressor, drug abuse or withdrawal from an addictive drug can cause anxiety. The second time frame is the past. This is more likely to be the source of persistent anxiety. The ability to stay calm and manage stressful situations goes back to very early childhood, even before birth. Animal studies and more recent human studies show that maternal stress during pregnancy can affect the developing brain of the fetus. From the book "Psychological Trauma and the Developing Brain: Neurologically Based Interventions for Troubled Children":

[...] pups of stressed [rat] mothers [...] were more fearful and irritable and produced more stress hormones. [...] prenatally stressed monkeys [...] result[ed] in a wide range of impairments including neuromotor difficulties, diminished cognitive abilities, and attention problems. [...] Researchers hypothesize that a mother's stress hormones can damage the developing brain of the fetus. Very recent research shows that maternal stress hormones released during pregnancy may adversely affect human fetal brain development (Stien, Kendall, 2004, pp. 21-22).

After birth, in your very early childhood, the care that you receive will also have a major impact on how well you are able to manage stress and anxiety. This is documented in the research article "Homeostasis, stress, trauma and adaptation. A neurodevelopmental view of childhood trauma" (emphasis mine):

In humans, studies have demonstrated the key role of the responsive, predictable caregiver in the development of a healthy stress-response neurobiology (37-39). [...] As this infant matures, if she is allowed to explore her 'novel' world and have a "stable base" she can turn to when overwhelmed, this child is developing resilience to future stress and trauma. On the other hand, the child exposed to chaotic or threatening caregiving develops a 'sensitized' stress response system that impacts arousal, emotional regulation, behavioral reactivity, and even cardiovascular regulation (74;76).(1998)

Causes of Anxiety



What you can do to help your anxiety


First, meditate

Meditation and mindfulness have a growing body of research that reflect their benefits. From "How God Changes Your Brain":

An overly active limbic system, which generates our emotional states, is physically and psychologically dangerous but we now have evidence [...] Mindfulness-based Meditation, which includes the act of consciously labeling one's moment-to-moment feelings, also reduces amygdala [the key organ in the limbic system that generates anxiety and fear] activity. (2009)

So just by remaining present and fully aware and by labeling feelings as they come up (e.g., "ah, there is anger") you can begin to quiet the fear center in your brain.


Second, seek out supportive people

Talking about your worries and fears with a supportive person can help you put them in perspective. What looms large in your mind may come down in size when you speak about it. Here is a quote from the magazine "The American Psychologist":

There is substantial evidence that the perceived availability of social support buffers the effect of stress on psychological distress, depression, and anxiety (1994).

While social support is beneficial, relationships that are unsupportive or primarily negative (frequent criticism, discouragement, etc) will likely have the reverse effect and thus increase your anxiety.


Third, be assertive and maintain good interpersonal boundaries

Certain types of upbringing can create adults who have difficulty in setting boundaries. One example is families who bring up their children with the idea that "family comes first" and individuals are expected to sacrifice their needs for the good of the family. Another example is when one or both parents are controlling and saying "no" to them is not an option. Essentially, anytime someone is raised without the ability to set reasonable limits, they will graduate into adulthood still not knowing how to set limits.

To correct this, you need to understand that it is your right to set reasonable limits with others. After that, it is important to learn how to set limits. The optimal way to set limits is in a kind, respectful way. Acknowledge that you may be dissappointing or incoveniencing the other person. In certain instances, you may want to explain why you can't honor their request (e.g., when refusing a request from your partner). For a more comprehensive treatment of assertivenss, I'd recommend the book "The Anxiety & Phobia Workbook", which covers assertiveness in chapter 13.

Fourth, watch what you say (inside your head)

quote marks
The more man meditates upon good thoughts, the better will be his world and the world at large.

-- Confucius

Listen to the thoughts in your mind and watch the feelings that result from those thoughts. If you are thinking "I'm in trouble" chances are you will feel worried and anxious. By changing that thought to "This is a challenge that I will overcome" you can effect a major change in your emotional state.
Not many people know that we can think about 10 times faster than we talk. That translates into about 1500 words per minute (Wiley, 2006) of internal chatter. Learning how to monitor this rapid fire self talk and preventing negative self talk is an enormous skill. I have several suggestions about overcoming negative self talk in the "Changes in the way you think" section of "Overcoming Anxiety and Panic."

Therapy for anxiety


In addition to the self help techniques listed above, therapy for anxiety can be very helpful in the management and reduction of anxiety. There are many techniques that an anxiety therapist can employ. Cognitive behavioral therapy is the most widely studied and has a proven track record for reducing anxiety. Learning new coping skills, especially mindfulness and meditation are also proven techniques for managing stress and anxiety.


References

Bourne, E. (2005). The Anxiety & Phobia Workbook. California: New Harbinger Publications.
Cohen, S (2004). Social Relationship and Health., American Psychologist, 59(8), pp. 676-684.
Huynh M, Vandvik, I, Diseth, T (2008). Hypnotherapy in Child Psychiatry: The State of the Art. Clinical Child Psychology & Psychiatry, 13(3), pp. 378-394.
Newberg, A., Waldman, M. (2009). How God Changes Your Brain: Breakthrough Findings from a Leading Neuroscientist. NewYork: Ballantine Books.
Perry, B. D., & Pollard, R. (1998). Homeostasis, stress, trauma and adaptation. A neurodevelopmental view of childhood trauma. Child and Adolescent Psychiatric Clinics of North America, 7(1), pp. 33-51.
Smith, H (1990). Hypnosis in the treatment of anxiety. Bulletin of the Menninger Clinic, 54(2), pp 209-216.
Stien P, Kendall J (2004). Psychological Trauma and the Developing Brain: Neurologically Based Interventions for Troubled Children. Binghamton, NY: Hawthorne Press.
Wiley N (2006). Inner Speech as a Language: A Saussurean Inquiry. Journal for the Theory of Social Behaviour. 36(3), pp. 319-341.