The Common Root Problem of Anxiety: A Perspective to Manage

anxiety # worry # fear # brain # solution

You think of an angry man, frustrated girl, irritated boy, jealous sibling, fearful friend and so on! The basis for a lot of misery, insecurity, fear and reactivity can be conceptualized as anxiety. It is a worry about something-  fearful of things going wrong or not being recognized enough or loved enough or worry that things may not work out and misfire or what if someone sees you as a dork or losing what you have or not being competent or…lots of ors and ands!  The more I think of anxiety, the more I understand that irritated screaming fits that arise from fear, presents not always just as shivering misery. So what do we do with all this bundled up anxiety?

I believe that it is first important to understand anxiety’s physiological state operated by brain and its interlinked nervous system called autonomic nervous system. It is not something you did to have that happen. It is not so easy to wiggle out of this physiological state no matter what you tell yourself. You would be surprised to know that amygdala is the same region that becomes overactive when you are too angry or too anxious relative to those who are in neutral mind state. It is the medial prefrontal cortex that is additionally overactive if you are ruminating over and over again with worrisome thoughts. The ventrolateral prefrontal cortex is not all that able to control the overactive amygdala. Also why do you feel aroused and hyper vigilant? The insula – that is closely connected to both the amygdala and the medial prefrontal cortex- that makes us aware of the bodily sensations of being aroused- is also in high gear. Another interesting thing that seems to emerge and documented in the journal- Biological Psychiatry by my friend Dr. Luan Phan’s group who works on anxiety is how attentional circuitry regions are also involved in anxiety (fronto-striatal, parietal and posterior cingulate). While all regions may multi-task and not just do one thing, I begin to wonder if ability to focus can impact ability to pull things together in mind and manage the overwhelming thoughts. You can understand how the areas of the brain dictate how we think, feel and experience when under stress.

For the select group of severely anxious folk, we use 504 plans at school to get extra time for test taking and treat them with medications where relevant. Beyond these special considerations, addressing anxiety is common to all of us, sometime or another. Anxiety is universal. It is the degree of anxiety that differs. I recall once bventro
eing on a stretcher coming out of surgical theater and I started feeling restless and out of sorts. Nurse repeated twice, “calm down, calm down.” That was 20 years ago and it still feels off-putting to think of that incident. Forget about the nurse’s empathy and support; may be it was the unusual situation where nothing could have helped me immediately, but for the time to roll forward. In any case, just never say be calm to someone who is anxious.

Think of what is causing the anxiety and rationally understand the veracity using the double column technique. It might be where you can begin. For example, if you avoid people with social anxiety out of fear of what the big crowd of people think of you, you can begin to ask yourself if indeed people know you to even judge you, or you may even find your good friends in the crowd. Or you can find a person who seems kind and talk to them. Find helpful way to think, towards tangible solutions. “I will always get through,” “I am doing my part,” “I have to take the test, I may as well do all that it takes to get ready” and so on may help to pull yourself together. Also, sometimes our past experiences may trigger anxiety. An angry looking or not so pleasant face may be perceived as threatening if you are sensitized to these emotions. Recognizing that vulnerability and practicing to think they do not have power over you will ultimately offer freedom. You may want to act free and practice the same. That takes us to the next part, to take action- change the behavior.

At times, if rational thinking is hard to generate, or even as you think, you can take action- Act towards change. If you are worried about facing a social situation, just face it! Just do it! This is called ‘exposure therapy.’ Just a fancy word to practicing ‘doing what you fear’ or exposing yourself to what you avoid. ‘Desensitization’ is another fancy term to start small and going slow in practicing to do what you avoid, bit by bit in scope. May be you can put on a game face. Game face is a bit like ‘fake it till you make it’ – practicing being brave. Another action is taking quiet deep breaths. 3-5 of them. Concentrate on your breathing to fill your lungs with fresh air. Taking tangible actions to prepare for a feared test is by far the best way to deal with the anxiety. Just focus on doing your part, minute by minute.

Then what do you do with your feelings? Feelings exist and are a signal to recognize the state of mind. They are fluid and you cannot command how you feel like the nurse who tried with me. The feelings rise and fall with the way you think and do. If you are able to pull yourself through thinking and acting/doing, in all likelihood, feelings quieten into peaceful mode. But if for some reason you cannot get a handle on the feeling part, you can think of mindfulness to watch your thoughts and feelings pass by you. It is like you are looking at yourself as an outside person. Relaxation can help sooth the turbulent feelings. It can be like listening to a soothing self affirming tape with or without relaxation exercises. In my younger days, I recall listening to Louise Hay‘s tapes for months on end before bed time during the exams periods. That simply induced restful sleep! I kept that tape as a memorabilia and I may even need to use again!

At times when you start to recognize the feelings, you can observe and experience and not fight the feelings, but summon the thinking engine to find solutions. Put the dorso lateral prefrontal cortex to work! Circle back to Thinking. It is the TAFT cycle! Think-Act-Feel-Think again and so on! Life goes on, soon you will figure out a way to find that peace, that joy and begin to accomplish your goals. Feeling the ebb and flow of barriers and rowing through life, finding a way, makes it interesting, though hard at times! You can do this!