What is an anxiety and how to control it

Feeling anxious in the face of real threats is norma. Your body lets you know you might be at risk and stirs you up. If you feel anxious when pulled over by the cops or about to give a speech in front of a crowd, there is no reason to worry. Your excitement will naturally pass when you figure out there is no real threat.

Anxiety is a problem when it happens for no apparent reason and takes over your life. Dr. David Baldwin, professor of Psychiatry at the University of Southampton, says anxiety becomes an illness when it occurs on more days than not for at least six months.

Other signs that you may have a disorder:

  • Disruptive fear that is way out of proportion to the actual risk involved
    Dr. Sally Winston, co-director of the Anxiety and Stress Disorder Institute of Maryland, says people with anxiety disorders fall into constant suffering and dysfunction.
  • Sleep problems
    It’s bedtime, but your mind is racing and you can’t calm yourself down. The National Institute of Health says that 20 million Americans find themselves lying awake contemplating their problems almost every night.
  • Headchaches and muscle pains
    Clench your jaw and fists or grind your teeth until your muscles are sore? It might be anxiety. The Anxiety and Depression Association of America reports that anxiety causes migraines or severe headaches in 11% of people suffering from anxiety.
  • Panic attacks
    It’s a sudden wave of fear that starts with trembling hands and a pounding heart, often making people feel they are going crazy or dying. The New York Times In-Depth Anxiety Report says panic attacks occur in almost every anxiety disorder.
  • Painful memories
    Research by the Adult Anxiety Clinic suggests that people with an anxiety disorder have regular flashbacks of experiences that were traumatic: traffic accidents, being publicly ridiculed, etc.

According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental affections in the US.
Just some stats:

  • 40 million American adults suffer from an anxiety disorder (18% of total population)
  • globally, 1 out of 13 people on the planet had anxiety at some point or are currently coping with it
  • 2/3 of adults with anxiety do not ask for help, even though anxiety is treatable

49% of entrepreneurs deal with mental disorders like anxiety. Oprah Winfrey, for example, had a traumatic past that resulted in severe nervousness in adulthood. She admits to having anxiety attacks when she has to make important decisions, and even when she is on air. However, she courageously fought her fears, launched her own production business and inspired people all around the world. “The thing you fear most has no power. Your fear of it is what has the power. Facing the truth really will set you free,” Oprah says. According to a recent study, lifetime prevalence of any anxiety disorder is 28.8%, which means one in four people suffer from anxiety at some point in life.

Illness and anxiety

There are medical conditions that can provoke anxiety disorders, even when you are in a good place mentally.
They include:

  • Dysfunction of brain sectors that produce fear and anxiety. One of these structures is the amygdala, which interprets brain signals. It’s the amygdala that you should thank for your fear of spiders or heights. Another structure is the hippocampus, which encodes dangerous events into memories. If these clusters are distorted, a person may experience ungrounded fears and painful flashbacks.
  • Conditions like heat stroke, heart problems like heart attacks, heart failure, and valvular disease, hypoglycemia (low blood sugar), respiratory conditions like asthma, and others.
  • Medical treatment. Medications that warn anxiety can be a possible side effect, such as asthma medicines albuterol and aminophylline, blood pressure drugs like methyldopaoral contraceptives and other hormones.
  • Intoxication from drugs like cocaine or amphetamines and withdrawal from drugs or antidepressants. Even quitting drinking includes agitation and anxiety, usually between 12 and 48 hours after the last dose of spirits. Dr. Gareth Richard, a researcher at the University of Sheffield, warns that moderate consumption of caffeine may relieve anxiety, but excessive consumption can generate anxiety and sometimes mania.
  • Genetic predisposition. If mental health conditions run in your family, you might develop one of them, including anxiety. Genetic studies have shown that variations in serotonin may influence anxiety phenotypes.

Mental conditions and anxiety

Anxiety can stem from psychological issues, such as moral discomfort, emotional trauma, and even your lifestyle. Long hours, caffeine, and lack of sleep often backfire.

Dr. Luc Staner, sleep clinician from the Rouffach Hospital, notes that anxiety and sleeping disorders appear together in 38.6% of cases, while anxiety disorder is followed by insomnia in 43.5% of cases. He explains that significant sleep loss triggers excessive anticipatory brain activity. It means that emotional brain centers like the amygdala and the insular cortex work more than needed in sleep-deprived people and produce anxiety.

Other factors that provoke anxiety include:

  • Abuse or neglect in childhood.
    As Dr. Matthew Jacofsky, Doctor of Psychology of St. John University, says if an abused child had a feeling of control over the situation (like they were able to escape the punishment by being a “good kid”), chances of developing an anxiety disorder are low. Those children who felt a lack of control are at greater risk of having problems with anxiety later in life.
  • Stress of any kind.
    Troubles at work, marriage problems, kids that are getting on your last nerve, or traffic jams. In the UK, stress accounts for 37% of all work-related health issues.
  • Low self-esteem.
    Accredited member of the National Counselling Society Dr. Mark Evans states that low self-esteem creates a mental gap between a “real self” and a “perfect self” that a person strives to be. Eventually, anxiety fills this gap.
  • Personal sensitivity.
    Highly sensitive people sometimes worry over trivial things because it’s part of their personality. Their Big Five personality test would demonstrate high Agreeableness and Neuroticism: they get anxious empathizing with other people and absorbing their feelings. The Journal of Psychiatric Research reports that writers, artists and people responding acutely to emotional stimuli have higher rates of anxiety. Even Ernest Hemingway suffered from it!
  • Alcohol and caffeine.
    Studies show that people can feel agitated or anxious even 12 and 48 hours after a drink.
  • Smoking.
    Scientists from Bloomberg School of Public Health have found that regular smokers, especially those smoking a large number of cigarettes, suffer from anxiety disorders 2 to 3 times more often than nonsmokers.

It usually takes more than one psychological issue to develop an anxiety disorder.

Is anxiety dangerous?

Yes it is. Anxiety creates a feeling of fear and unease, so the body’s response is to flood you with adrenaline. This reaction is called “fight or flight,” and it triggers your instinct to survive a dangerous situation. Excessive worrying can trigger it for no good reason: there is no lion chasing you, you’re just overreacting to your job interview. When it becomes a regular occurence, your nervous system releases a lot of cortisol – a stress hormone. High cortisol levels can mess with your health in the long-term.

It can result in:

  • Constant fatigue.
    Dr. Peter Roy-Byrne, Professor of the Department of Psychiatry of the Washington Medical School, has found that up to three-quarters of patients with chronic fatigue suffer from anxiety disorders.
  • Nausea, indigestion, heartburn, diarrhea or constipation.
    Anxiety causes an adrenaline rush that redistributes water and blood flows in the body and provokes irritable bowel syndrome. Your gastrointestinal tract can’t filter water correctly, which triggers diarrheaConstipation is caused because your body believes you’re in danger and its first priority is to save you, then proceed with food digestion.
  • Low sex drive.
    Research from the University of Missouri suggests that anxiety affects sex drive in women more than men. 79% of women and 21% of men who took part in the research said anxiety reduces their sexual desire.
  • Tossing and turning all night long.
    36% of people with anxiety disorders suffer from insomnia, according to Dr. Luc Staner of the Institute for Research in Neuroscience and Neuropsychiatry. At the same time, up to 42% of participants suffer from hypersomnia – abnormally long sleep.
  • Catching a cold or an infection every time somebody sneezes your way.
    It’s not anxiety itself that makes you sick, but the immune system weakened by constant worrying that can’t fight off germs and bacteria. Cortisone released with fear suppresses T-cells and white blood cells that your body needs to fight external intruders
  • Cravings for unhealthy food.
    Stress releases endogenous opioids in the brain – neurotransmitters that have addictive properties similar to opiates. They stimulate desire for fatty, salty or excessively sweet food that satiates you in an instant.

Unmanageable anxiety interferes with your appetite, lifestyle, sleep patterns, sexuality and job performance.

Work overload and anxiety

Avoid multitasking and make some time for yourself. It’s great to have career ambitions and long to-do lists, but spreading yourself too thin makes a great contribution to your anxiety. Some lifehacks on anxiety-free time-management:

  • Challenge yourself to monotask – concentrate on one activity instead of switching between duties. Researches from the University of Sussex have found out that people who always multitask have a much smaller grey matter density in the ACC – anterior cingulate cortex. Constant shifts of gears overwhelm their brains and it responds with anxiety.
  • Engage in an activity you like and make some time for it every day even if it’s just 30 minutes. European Journal of Work and organizational psychology has published a study performed at the Universities in Surrey and Konstanz that shows positive effects of hobbies on mental health
  • Avoid staying plugged in after hours, don’t check your work mailbox in your freetime. If there is an emergency, your colleagues will find a way to contact you, otherwise enjoy your time off
  • Break up large projects into smaller subtasks and simple steps. If you have massive tasks that you are scared to screw because of their complicity, concentrate on small steps required to manage them
  • Use planning techniques that help make a good use of your time, like Bullet Journal and Google Calendar.

Anxiety and mind

Researcher Robert Baumeister concludes that people who fret and fuss are quick to drain their mental resources. The result — constant bad mood caused by raised cortisol levels. Other outcomes include:

  • Attempting to avoid situations and places that make you feel anxious, even when they’re not actually dangerous. This can lead to fear of leaving your house or complete withdrawal from society.
  • Compulsive or repetitive behaviors like constant hand-washing, hoarding, persistent sexual thoughts. Some people avoid shaking hands or physical contact in order to avoid germs. Dr. Shana Doronn, clinical psychologist and Doctor of Psychology, classes avoidance as a compulsive behavior as well. Others are not afraid of germs, but bite  their nails – 59% of adolescent Americans with anxiety are nail biters.
  • Critical attitude to yourself, extreme perfectionism. Repeated release of stress hormones produces hyperactivity in the hypothalamic system that makes people feel unsatisfied with themselves and others. Studies report six main dimensions of perfectionism: Personal Standards, Concern over Mistakes, Doubts about Action, Organization, Parental Expectations, and Parental Criticism. Anxiety disorder is mostly associated with doubts over action.
  • Substance abuse. Alcohol has sedative effects that people use to unwind. However, it’s not the best strategy to fight anxiety. According to the National Center for Biotechnology Information, alcohol may give temporary relief but exacerbates anxiety in the long-term because it messes with serotonin levels. The Anxiety and Depression Association of America reports that 20% of people with anxiety disorders develop alcoholism.
  • Feeling gloomy and abandoned. Anxiety causes neurotransmitter levels to drop and makes us feel drained of all joy. 70% of people with suicidal thoughts have a history with anxiety. Alertness and raised cortisol levels tend to emotionally wear people out. That’s why anxiety patients appear disinterested and have reduced productivity.
  • Mood shift and fidgeting. Anxiety disorder can make you go from optimistic to depressed without a particular reason behind it several times a day. People with anxiety issues are sometimes unable to sit still. They move around, tap their feet, and even experience feel bouts of uncontrolled anger. Postdoctoral fellow in Psychiatry at McGill University Sonya Deschênes and her colleagues conducted a study with 380 anxiety patients. They found out that 131 of them had much higher levels of anger. The forms of anger varied from “I strike out at whatever infuriates me” to “I boil inside, but I don’t show it.”

Overall, anxiety disorder messes up with your work performance, social life, self-esteem, and mood.

Physical activity and anxiety

Exercising daily has a very positive effect on your body. It keeps you fit, but it also helps your brain release mood boosters like serotonin and endorphins. The Anxiety and Depression Association of America gives some tips on exercising:

What to do

  • Exercise in groups to enhance connections with other people
  • Jogging, walking, riding a bike, or dancing are considered the best activities for people with anxiety disorders

How often

  • The Anxiety and Depression Association of America suggests you stick with the 5 X 30 schedule: do your activity 3-5 times a week for 30 minutes
  • It’s all about consistency, so keep in mind that a daily walk is better than a 3-hour fitness marathon over a weekend.

How to stay motivated

  • Recruit an exercise buddy to keep yourself motivated
  • Listen to audiobooks, podcasts, or music while exercising

It’s not a remedy that can guarantee you will get your act together overnight. However, studies have shown that regular exercise is associated with lower sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis reactivity. It means that exercising can effectively address anxiety and make you feel better.

Healthy diet and anxiety

A healthy diet is key to fighting anxiety. Psychiatrists from J. S. S. Medical College of Mysore found that people with anxiety disorders have diets that lack essential vitamins, minerals, and omega-3 fatty acids. These, together with proteins, are essential. They are made of amino acids and synthesize neurotransmitters like serotonin, dopamine, noradrenaline, and aminobutyric acid. This may sound like something your mom would say, but stop drinking Coke and put the donut back. Eating patterns that can reduce anxiety:

  • Consume balanced proteins, fats and carbs on a daily basis. As a Dutch research group reports, higher protein intake and lack of other nutriments stimulates cortisol release and induces anxiety. And scientists from Louisiana found a diet rich in fats decreased anxiety in rats.
  • Eat more fruit and vegetables, reduce consumption of sugar and candy.  Low-sugar diets are proven to treat mood disorders.
  • Eat fermented food to help digestion, such as yogurts with lactobacillus and bifidobacterium. Scientists from Harvard link fermented foods and mental health, proving they aid the activation of neural pathways between the gut and brain.
  • Avoid drinking alcohol and caffeine. If you can’t imagine your morning without an espresso, go decaf. Korean doctors performed a study on 234 people and found that higher caffeine intake was associated with depression, anxiety, and insomnia.
  • Ask your doctor if you need B-complex vitamins and food supplements with minerals: calcium (raw milk, kale, yogurt), iodine (baked potatoes, cod, shrimp), chromium (broccoli, grapes), iron (spinach, beef or chicken liver), lithium (milk, eggs, pork), selenium (Brazil nuts, tuna, halibut), zinc (lamb, pumpkin seed, chickpeas). This is what your brain needs to produce positive emotions.
  • To track what you consume, download a calorie counter app like FatSecret or Lifesum. Connect them to Welltory and see how different nutritional values and calorie amounts affect your stress & energy levels. This will help you find a diet that works for you.

To sum up, make sure you eat food rich in key nutrients, avoid anxiety triggers like caffeine and alcohol, and track down the way daily meals influence your well-being in Welltory.

Sleeping patterns and anxiety

Professor of Neuroscience and Psychology at the University of California Matthew Walker says:

“By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry and disabling fearful expectations.”

To get better sleep, stick to these tips:

  • Sleep at the same time
    Choose a sleeping cycle most appropriate to you and stick to it. For instance, go to bed 11.00pm sharp every night and wake up at 7.00am every morning, weekend or not.  To find a period of sleep perfect for you track your stress & energy levels with Welltory.
  • Power down the electronics
    Bedtime is for sleeping, not tweeting. People who pass out with a phone in hand or in front of a TV screen experience disturbance during their sleep. Research performed at the University of Pittsburgh with 1,788 participants involved demonstrated that heavy social media users (25%) have sleeping disorders 3 times more often than moderate users. Leave the world of chats, pop-ups and posts at least 1 hour before going to bed and switch the devices off.
  • Use lavender oil to fall asleep
    An Iranian research group led by Dr. Peir Hossein Kolivard suggests lavender oil reduces anxiety by modulating neurotransmission and enhancing the inhibitory tone of the nervous system. They have also scientifically confirmed what hippes have known all along: lavender is an excellent natural remedy to treat insomnia. Six to eight drops of lavender oil added each night to the cartridge improved the sleep quality of 15 healthy young people, 64 ischemic heart disease patients, and 34 midlife women with insomnia participated in the research.

Sufficient sleep doesn’t guarantee you will get rid of anxiety at the drop of a hat, but it’s a very important move in right direction.

Breathing exercises and anxiety

American scientists have found a group of nerves in the breathing rhythm generator of mice that correlates directly with the arousal center of a brain. In other words, respiration plays a key role in alertness, anxiety and stress. Slow controlled breathing is a powerful anxiety-reducing tool. There are several techniques that will help you calm down immediately and bid anxiety a farewell.

  • Deep diaphragmatic breathing
    As Dr. Marla Deibler, a clinical psychologist of The Center for Emotional Health of Greater Philadelphia explains, deep breathing helps our body go from the fight or flight response of the sympathetic nervous system to the relaxed response of the parasympathetic nervous system. Dr. Deibler suggests this practice: inhale slowly to a count of 4 filling your belly first and your chest next, gently hold your breath to a count of 4, and slowly exhale to a count of 4. Repeat several times.
  • Carbon dioxide rebreathing
    When excited you forget to exhale and too much oxygen in blood makes you even more overwhelmed. Take a small paper bag and place in over your mouth or just cup your hands. Inhale slowly and exhale profoundly. This way you can breathe in more CO2 and feel calmer on your 10th or so breath. Researchers from the Limburg University in Holland noted that the more you expect the paper bag breathing to help, the quicker it is likely to happen. Drop the sceptical attitude and take the paper bag. This method is very helpful in the throes of panic attacks, too.
  • Alternative nostrils breathing
    Gently close your right nostril with your thumb and inhale through your left nostril. Then close it with your ring finger and exhale through your right nostril. Breathe slowly, change nostrils every breath. Repeat 5 times, then go to breathing normally. Indian scientists from Jawaharlal Institute of Postgraduate Medical Education and Research have examined the influence of alternative nostrils breathing on heart rate variability and found out it reduces the level of stress when practiced regularly for 6 weeks.

Meditaion and anxiety

Dr. Lynn E. O’Connor, clinical psychologist, professor at the Wright Institute in Berkeley, says that meditation rewires our brains, makes us focus on what is real and lose ungrounded fears.

Once considered more of an amusement than a remedy, contemplation practices now pave their way in Google and other companies of Silicon Valley. Employees attend corporate meditation classes to cope with stress that comes along with working for a prominent enterprise. A PhD candidate from the University of Waterloo, Mengran Xu conducted an experiment with 82 people who had anxiety problems. 10 minutes of mindfulness daily demonstrated protective effects.
We also found that meditation practice appears to help anxious people to shift their attention from their own internal worries to the present-moment external world, which enables better focus on a task at hand.” — says Mengran Xu.

Here are some meditations that can be your anxiety antidote:

Mindfulness Meditation
The review, published in the internal medicine version of Journal of the American Medical Association, analyzed the results of 47 randomized clinical trials involving a total of 3,515 participants. It considers mindfulness the most effective anti-anxiety nonmedical practice. Mindfulness is based on paying attention: on purpose, in the present moment, and nonjudgmentally. Get into a comfortable position and become aware of your thoughts, feelings and body sensations. Don’t try to modify them, just keep attention on them. Let your brain be agile and embrace all the thoughts it brings, don’t judge yourself regardless of what thoughts pop up whatsoever. Always return your attention back to the present moment and your position in it.

Vipassana Meditation
Also called insight meditation. Take a seat with your back as straight as comfortable and your head aligned. Take three deep slow breaths. Close your eyes. Focus your attention on the muscle in the solar plexus, feel how it falls and rises every time you take a breath or exhale. Let your thoughts come in and out, but don’t move your focus from one spot of your body that moves while you are breathing. If your mind starts to wander off gently bring it back to rising and falling chest. Don’t try to breathe fast or slow, let it go naturally and notice every change. Try to keep focus for 15 minutes. In the course of the day when you feel anxious, bring your attention back to breathing in and out, rising and falling.

There is a handful of applications that can help you practice meditation and mindfulness, like Headspace and Calm.  We prepared a whole lecture on mindfulness that you can read here.

How to stop anxiety attack?

If you already had an anxiety attack, it doesn’t mean another one will necessarily strike you. Realize that for all its crappiness, this condition won’t last forever. National Institute of Mental Health confirms what most doctors say: anxiety attacks last for several minutes and get worse only with growing fear. We’ve already described in detail breathing techniques and meditation practices that can ease your anxiety. This is a brief summary how you can use them during the anxiety attack and what else can help :

Knowledge. Make yourself aware of the processes that anxiety triggers in your body and mind. Try to understand its anatomy with both physical and psychological components. When you’re aware of what is going on when you’re in the throes of an anxiety attack, it’s no longer a terrifying paralyzing mystery. Having got the explicit understanding of anxiety as a feeling, you won’t exacerbate your condition imagining you’re having a heart attack. You are not.

Breathing. First thing you need to do is to catch your breath. If you’re over breathing  try to breathe out more than breathe in. Inhale slowly for a count of four, hold it in for a second, then exhale for a count of four. Grab a paper bag and place it over your mouth while breathing.

Distracting from the hustle. If you’re in a fast-past environment all the stimuli around may become additional triggers to your anxiety attack. Close your eyes to block them out and reduce visual stimulation. If you’re driving, pull over on the side of the road. Don’t try to fight it off and pretend you don’t feel anxious.

Mindfulness. If you have a feeling of being detached from reality, focus on what is happening right now around you. Concentrate on something physical around you: feel the texture of your clothes, dig your fingers into your hair, touch your hand with another hand.

Breathing lavender oil or having a cup of lavender tea. Phytomedicine scientists Dr. Woelk and Dr. Schlaefke have published a study proving that lavender oil has a calming effect compared to the one of Xanax or Valium. Keep a pocket size bottle of lavender oil or lavender sachet bag with you and breathe it when feeling anxious.

Finally, never run away from places or situations where you experienced anxiety. If you had an anxiety attack in a shopping mall, keep going there just the way you would normally do.

Xtymound
24 Jan. 2020
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phdavids
06 Apr. 2019
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