Chapter 1
Peering into the World of Anxiety
In This Chapter
Anxiety is very common. Everyone experiences some form of anxiety on a day-to-day basis. It can be a helpful emotion, making you focused, alert and productive, but it can also be incredibly upsetting, uncomfortable and hard to live with.
In this chapter, I describe the nature, experience and symptoms of anxiety, show how it can affect your body and mind and help you discern whether your levels of anxiety are severe or normal. I also introduce you to mindfulness – what it involves and how it can help when battling anxiety – including a short mindfulness exercise for you to try.
Comparing Fear, Excitement and Anxiety
Fear, excitement and anxiety are all common emotions. All three can conjure the same feelings, but crucial differences exist between them. Fear and excitement can be helpful emotions, whereas anxiety can sometimes result in a lot of discomfort. In this section, I explain the differences between these three feelings.
Investigating fear
Fear is a natural emotion, as is anxiety. In fact, fear raises the same feelings that anxiety can, such as alarm or apprehension. The difference is that with fear, these feelings have a reason behind them.
Fear is a feeling of terror, distress or alarm caused by a danger or a threat. For example, you may feel fear when you see a car racing toward you at great speed, when you're in a situation where you may slip and fall or when you see a snake.
Clarifying the difference between anxiety and excitement
Feeling emotions such as agitation and distress without a just reason is one of the main factors of anxiety.
Anxiety is similar to fear, but without any obvious danger. It's a thought focused on something going wrong in the future and is often a notion that things are worse than they really are. Sometimes a traumatic event or lots of stress-causing factors trigger anxiety, but other times it doesn't have an identifiable reason. For more on the causes of anxiety, check out Chapter 2.
Anxiety is in the present moment, but the reason for it isn't always clear – unlike with fear.
Everyone on the planet experiences some level of anxiety at some point – it's a natural part of the human experience! But if you're finding your anxiety difficult to deal with, don't worry: Anxiety can be a very treatable condition.
In the physical sense, excitement is very similar to anxiety. If you're excited about something, you may recognise the same physical sensations, such as a fast heartbeat and sweating.
Although excitement can arouse the same physical reactions as anxiety, the difference is internal. Feeling excited creates positive thoughts of future or past experiences, conjuring up positive outcomes, such as feelings of happiness connected to your social life.
If you're anxious, however, you may be waking up every day with the same sense of dread but no real reason for it. Perhaps you're avoiding certain social situations or activities, even though you know that doing so is silly. Check out Table 1-1 for a comparison of fear, anxiety and excitement.
Discovering the Effect of Anxiety on the Mind
The mind expresses anxiety through worry, which often conjures up a collection of images, thoughts and feelings. One of the main anxiety problems that people experience is uncontrollable, excessive worries about anything, from minor to major things, despite no real threat of danger.
Your worries can take the form of several types of disturbing thoughts and feelings, such as the following:
- Thinking that you may lose control (go mad)
- Feeling detached from the world around you
- Thinking that everyone is everyone is watching you and knows that you're anxious
- Wanting to run away to avoid the situation
- Visiting the doctor often with irrational worries about your health (for example, thinking that you have cancer or a brain tumour)
- Feeling hypersensitive and hyper alert to everything around you
As well as the worrying, anxiety can also affect your mind in other ways:
- Feeling irritable
- Feeling fearful
- Lacking the ability to concentrate
- Needing reassurance desperately
- Feeling dependent
- Feeling depressed
- Losing confidence
Anxiety is provoked by thoughts about fear rather than an immediate danger, and so the meaning that the brain gives the thought is all about perception. For example, you may have stumbled in a job interview just once, but the brain remembers this event as an unpleasant experience, which then creates anxiety. Other people may have also stumbled at previous job interviews but did well at the next ones; their brains didn't let the unpleasant experience take over.
Read Chapter 4 for more on how thoughts affect your mind and body.
Finding out the Physical Effects of Anxiety on Bodily Functions
As I describe in the earlier section ‘Clarifying the Difference between anxiety’ and excitement, the physical effects on the body from anxiety are similar to the effects evoked from fear or excitement:
Chapters 3 and 5 describe how mindfulness meditations can ease your physical health.
Understanding the Fight-or-Flight Response
The fight-or-flight response goes back to the days of cave dwellers and is the body's natural reaction to danger. A researcher called Walter B Cannon discovered in 1915 that animals experience physical changes when confronted with danger. He found that the increases in blood pressure, secretion of powerful hormones and other physical and psychological changes prepare the animal to fight or flight.
Humans experience this same response to danger. Fight-or-flight is useful when people need to defend their families against wild animals, save them from burning buildings or run from a danger they can't fight off, such as a natural disaster. But when you're just doing day-to-day things, such as going to the shops, commuting to work or looking after children, this sudden release of hormones and physical changes can be difficult to deal with.
The excess chemicals that your body releases aren't needed. As a result, the decreased carbon dioxide level in your lungs and blood can make you feel dizzy or faint, causing you to hyperventilate, which is when a panic attack can occur.
Exploring Why Thinking Negatively Is a Natural Human Trait
Your brain is more likely to think negatively rather than positively for one simple reason: survival.
If people thought positively all the time, they wouldn't have a natural awareness to danger, and the human race wouldn't have survived! If cave dwellers had just chilled out all the time, enjoying their cave paintings without a care in the world, the chances are that they'd have been killed and eaten by wild animals pretty quickly.
As a result, the brain is naturally wired to think more negatively than positively, and people are more likely to remember negative events than positive ones. The brain is also very quick at trying to create patterns, even if it has little evidence. It's your brain's way of protecting you from danger. The human nervous system is nervous.
Imagine that you stumbled during a work presentation a couple of times in the past – mixing up your notes, spilling your coffee and generally coming across like Mr Bean. The brain remembers these embarrassing events and creates a pattern for you, telling you that every time you have a work presentation, you'll mess up again. Or say that you've had two bad relationship experiences: Your brain can now tell you that all members of the opposite sex are useless.
But you're no longer a cave dweller. You don't need this pattern of negative thinking because danger is no longer as imminent as it was thousands of years ago. With no real threat of present danger, these patterns can result in anxiety.
What used to be a saber tooth tiger is now more likely to be a paper-tiger.
It's noteworthy to learn that humans can turn on the stress response by their thoughts alone, which can have the same measurable effects as any threatening stressor in the environment.
Recognising Whether Your Anxiety Is Normal or Severe
Anxiety of some degree affects everyone at some point. In general, anxiety comes in two levels:
- Mild or everyday: For example, being worried about an upcoming exam, work presentation or a medical test.
- Severe or excessive: For example, chronic worrying with no real reason that severely affects your life and having difficulty remembering the last time you felt relaxed.
I help you discover your personal anxiety levels in Chapter 10.
Suffering from excessive anxiety
High anxiety levels can be very unhelpful, interfering with your daily life and function. Here are some attributes of high or excessive anxiety:
- Doesn't have a known reason or only a very vague one
- Very intense, well beyond everyday anxiety
- Lasts much longer than everyday anxiety, perhaps weeks or months
- Has an unfavourable impact on living, perhaps leading to unhelpful and addictive behaviours, such as consuming drugs or alcohol, avoidance or withdrawal as ways of coping.
Sometimes you can have very high levels of anxiety without having an anxiety disorder that can be long term, such as Generalised Anxiety Disorder (GAD). This is normal and can be caused by stressful and traumatic life events, such as a divorce, moving house, the loss of a loved one and other big life changes, which can create anxiety feelings. Mindfulness can help with this because it teaches you to be an observer of your experience rather than feel attached to it. So when life gets a little difficult, you can better manage any anxious feelings that may arise.
Accepting that mild anxiety can be helpful
Mild anxiety that you don't find debilitating can be useful. Everyone worries, and as long as it isn't excessive, it can be a good thing. Anxiety increases your attention and so can enhance productivity and performance. If I didn't have any anxiety whatsoever, I'd never get this chapter written! But I know that I have a deadline looming, and so my brain is kicking me into action to get writing and working. Otherwise, I'd still be at home lounging about!
Here are some other examples of mild anxiety being helpful: just before you go to speak in public; before you participate in any competitive sport; before you take an exam; and before you hand in an important piece of work for a qualification or a work presentation.
Your anxiety keeps you focused by increasing your attention, allowing you to stay productive and get the job done.
Examining two common experiences of anxiety
Here's an example of how one event can spiral anxiety out of control.
Janet was feeling unwell one day and got on a train at a busy time when everyone was leaving work. On this train, she started feeling really sick and then fainted suddenly. Other people on the train looked after her and a friend met her to take her home, but she kept remembering the unpleasant event on that train home from her work. She started to take a different route to work and leave later so that the train wouldn't be as busy. She then started cutting down her hours at work, leaving the house when it was less busy on her route to work. Eventually, she started to work from home, fearful of other commuters and public transport and refusing to leave the house.
No evidence supported the idea that Janet was going to get sick and faint on a train again, but her anxiety took over and stopped her from doing her daily commute that she was so used to.
In this next common experience of anxiety, a stressful event arises, and the brain goes into overdrive.
Adam was a bright and intelligent student. He enjoyed learning and getting involved in projects. He was creative and contributed a lot to whatever group he worked with. However, when exam time arrived, he suffered terrible anxiety. It took over his brain, and he found himself stressed, under pressure and unable to concentrate on studying. He started to panic about the lack of study that his anxiety was stopping him from doing, thus making the anxiety worse.
The more Adam started to worry about his anxiety causing these issues, the worse it got.
Applying Mindfulness to Your Anxiety
It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.
—Franklin D Roosevelt
Scientific studies show that the development of a regular mindfulness practice can improve the way you experience life. With regular practice, you may feel less stressed, better equipped to deal with difficult situations, feelings or emotions, including your anxiety, and more focused and healthier as a result.
Chapter 7 goes into much more detail about your journey away from anxiety with mindfulness.
Defining mindfulness
In its simplest form, mindfulness means paying attention to whatever's happening now in a nonjudgemental way. It involves being aware of your present-moment experience without judgement while using compassion (see Chapter 6), curiosity (Chapter 4), acceptance and openness for yourself, other people and the world around you. You practise mindfulness with daily meditations and by living mindfully day-to-day (as I discuss in Chapter 8). I also describe ten productive mindful attitudes to remember in Chapter 12.
Set aside a couple of minutes for this exercise, which shows how it is possible to be mindful anywhere and at any time just using your awareness to be in the present moment:
- Take three deep breaths, holding each one for around 5 to 10 seconds.
- Feel the weight of your body on the seat (if you're sitting) or your feet on the floor (if you're standing).
- See whether you can feel any sensations with the part of the body that has contact with the floor or the seat.
If you can't feel anything, that's okay and perfectly normal. Just be aware of the lack of sensation if you can.
- After a few moments, gently open your eyes.
If your mind wanders off to other things during the meditation, don't worry; this is perfectly normal and is the nature of the mind. Just gently bring your attention back to the sensation of your body on the floor or chair.
When you're focusing on the sensation of your body sitting or standing, you're bringing yourself into the present moment. This experience is what's happening right now, such as when you're standing or sitting to read this book. I provide a specific sitting meditation in Chapter 5.
Mindfulness sounds simple in theory, but the tricky bit in practice is trying not to react automatically. You may be self-critical when you first start practising, but that's quite usual. For suggestions on staying motivated, flip to Chapter 9.
Mindfulness isn't a new concept, but it's rapidly gaining popularity in the Western world of psychology. Many people associate mindfulness with Buddhism, but it also has roots in Hinduism and other religions. You don't have to be religious to practise mindfulness. It's accessible to all – religious, agnostic or atheist.
Discovering how mindfulness can help your anxiety
Mindfulness can help reduce your anxiety in a number of ways:
- Moving toward your feelings rather than avoiding them. If you're suffering from anxiety, the likelihood is that you try to avoid your feelings. This response is normal because you're trying to protect yourself from unpleasant feelings. But doing it can further increase your anxiety because avoidance comes from a place of fear that also creates anxious feelings. Mindfulness shows you how to approach and accept your feelings bit by bit, thus creating a healthier relationship with your anxiety.
- Refusing the notion that you're just your anxiety. You may believe that your anxiety has control over and is a part of you. Mindfulness shows you how to observe thoughts, feelings and emotions without identifying with them. Therefore, it shows you that you aren't your anxiety. When you separate from the feelings, you can observe them arising and possibly disappearing, too.
- Being aware of unhelpful automatic thoughts. When you become mindful, you start to become aware of unhelpful thought patterns that do nothing to serve you in a positive way. When you notice these patterns, you can shift your attention to something else, such as focusing on your breathing, the sensations in your feet or the task in hand.
- Withstanding difficult physical sensations or emotions. When you practise mindfulness regularly, you become better at simply being with difficult experiences without reacting to them. When you become able to ‘sit with’ your anxiety in this way, you're less likely to make the feeling worse.
- Giving you back a sense of control. Mindfulness allows you a moment of choice about how you react to a feeling. As a result, you begin to feel in control, which can positively reduce your anxiety.
For ten quick meditations for anxiety, turn to Chapter 11.
Positive mindfulness research
Positive research shows that mindfulness is useful for tackling anxiety. Researchers held an eight-week mindfulness course for a small group of patients with Generalised Anxiety Disorder (GAD). This is a long-term condition that causes excessive anxiety across a wide number of situations and issues rather than being linked to a specific event. Researchers found significant reductions in anxiety and panic immediately after the course, after three months and even after three years. Many of the patients continued to practise mindfulness, finding it helpful.
Another interesting form of therapy that uses mindfulness is called ACT (Acceptance and Commitment Therapy). Developed in the 1980s, research seems to show that ACT is effective for a range of disorders including, but not limited to, social anxiety, depression, obsessive compulsive disorder (OCD), borderline personality disorder, workplace stress, chronic pain, weight control, diabetes management and stopping smoking. ACT helps you accept what's out of your personal control and commit to action that improves your life, as follows:
- Using mindfulness skills to deal with difficult thoughts and emotions
- Helping you determine your values (discovering what's truly important to you) and offering ways to help you move toward living by your values
Mindfulness within ACT comprises four principles:
- Defusion: Using techniques to let go of difficult thoughts, memories and beliefs. Fusion means to be stuck, so defusion is about becoming unstuck, seeing that thoughts are just images and sounds in the mind. Here's one of many ways to defuse: If you find yourself thinking, ‘I'm rubbish at this’, for example, you imagine that sentence in front of you with curiosity. Then you imagine Mickey Mouse repeatedly saying those words in a high-pitched voice. Finally, you imagine the character dancing around and saying, ‘I'm rubbish at everything’.
- Acceptance: Allowing painful sensations, thoughts, feelings and emotions without struggling against them. It doesn't mean giving up or admitting defeat or thinking that the feeling will last forever (a common misconception about acceptance in mindfulness – see Chapter 3 for more on such errors). It just means letting go of the fight with your present-moment experience.
- Present moment: Being in contact with the here and now experience with curiosity and a sense of openness.
- Observing yourself: Stepping back and observing your experience without identifying with it. This approach means watching thoughts and emotions as they arise as an observer or witness instead of them being part of you. The ACT approach is different from the mindfulness approach mainly in that the focus is on action and less on longer mindfulness meditations. The idea is to use mindfulness skills as you move toward your goals, which are based on your values.
Trying out a mindful exercise
You can use this practical exercise, known by the acronym STOP (Bob Stahl Ph.D. and Elisha Goldstein, PhD, A Mindfulness-Based Stress Reduction Workbook), to manage your anxiety when it arises:
- Stop
If you're in the middle of work or something else, take the time to stop. If you really don't think that you can stop, you really do need to stop!
If you're at work or in a social situation, excuse yourself to the bathroom or somewhere where you know you can get some peace for a few minutes. Stopping may not be easy, but it has a positive effect.
- Take some mindful breaths
Take a few slow, deep mindful breaths. Feel the breath as it moves down into your tummy. Make sure that your tummy is expanding as you breathe in and contracting as you breathe out. If it helps, place your hands on your tummy and concentrate on the breath pushing your hands out and then in.
You're moving your attention away from thoughts, emotions and bodily sensations and onto your breathing. If you can't feel your breath in your tummy, just focus on wherever you can feel it.
- Observe
When you're ready, notice your bodily sensations. See whether you can shift your attention toward any physical discomfort that you may have and allow these sensations to be just as they are. Try to feel them together with your breathing. Bring a sense of kindness as you do so, instead of judgement.
Remember that feeling anxiety is quite natural. Use your breathing as a sort of rooted tree to help support your attention on any bodily discomfort. You can even try gently smiling toward your feelings, even if you don't feel like smiling. Then, after observing your body for some time, you can move on to emotions and thoughts. Just watch them and see whether they fade away in their own time, if they want to.
- Proceed
Gently bring your attention back to whatever it was you were doing before you started this exercise. As you move your attention back to the outer world, try to give full attention to your senses instead of getting lost in thought. Continue your work or daily activities with a sense of acceptance and acknowledgement of your feelings as they are, knowing that all feelings are temporary and pass away in time.