Growing up in the south, people did not have anxiety…they just had nerve problems. Being able to identify what is and what is not anxiety or post traumatic stress might be more difficult that expected. So let’s start with some definitions.
DEFINITIONS
When it comes to anything related to mental health, I think it is really good to make sure we are all talking about the same thing. In the mental health field, there are a lot of words that have a specific clinical definition that gets adopted by popular culture, and it winds up meaning something similar, but totally different. Anxiety is one of those words. (As is bipolar, as in, “this weather is so bipolar”, but that’s another topic for another day;-))
In order to describe anxiety, I need to bring two additional words I to the discussion. These words are concern and worry. The difference between these two has to do with what you have power, control, or responsibility over. If you are giving attention to something that you have power and control over, that can be normal and healthy. If you are expending energy on things that are outside of your control, that is unhealthy and is known as worry. Worry is basically when we try to do somebody else’s job, namely when we try to do God’s job for Him.
With either concern or worry, if we devote so much attention or energy to it, that our body starts to develop physical symptoms, those physical symptoms (elevated heart rate, changes in breathing, tightness of muscles, sweaty palms, dry mouth, decreased peripheral vision, irritability, difficulty sleeping, etc.) in my world, that is what is called anxiety.
EXAMPLES
Let me illustrate this concept with the example of driving a car. There are certain things about driving you can control and should be concerned about, and there are things you cannot control about driving. For example, you can control the maintenance on your car, making sure it has gas in it, that your tires have the right pressure, you headlights and signal lights work, your breaks are functioning. These are all perfectly healthy things to be concerned about. What you cannot control is the other drivers on the road, the condition of the road, when a light turns red or green, etc. You can spend energy around both what you can control and what you cannot control to the extent that you begin to develop physical symptoms (sweating, tense muscles, GI problems, etc.). And, in order to not place yourself in this elevated state, you just choose to not drive or leave the house. This can happen over things that you can control (what if my brakes stop working, even though they have been inspected and are in perfectly good working condition) and it can happen over things you cannot control (what if another driver plows into me). It is this risk analysis that creates the anxiety.
INSIDE THE BRAIN
Our brains are designed to keep us safe. When we have experienced negative events in our past, our brains take a snapshot of that event. And when anything that looks similar to that negative event starts to happen, our brains will naturally start to fire some warning signals. Depending on how severe our perceptions of those events are, and how well we have processed and worked through those past events, will determine how intently our brains will go into self protection mode.
When your body is triggered to respond to a threat, there are a couple of reactions that happen very quickly, too quickly for you to even evaluate whether or not they are warranted. This usually involves who gets to control your autonomic nervous system. That is the system that controls your involuntary responses like breathing, heart rate, tightening and loosening of blood vessels, etc. There are two drivers of the autonomic nervous system, the sympathetic nervous system and the parasympathetic nervous system. Let me give these two a nick name for illustrative purposes. Let’s call the parasympathetic system Captain Calm, and the sympathetic nervous system Captain Safety. When it is determined that you are being threatened or under attack, Captain Safety takes over control of the autonomic nervous system ship. Captain safety shuts down what he deems as non-essential functioning, and preps the overall system for survival mode. What it tends to take away is your prefrontal cortex, which includes your ability to make complex decisions and communicate clearly. Your ability to sequence things (finding the start, middle and end) will also go off line. Captain Safety has one job, and that is to keep you alive. When he is triggered and it is necessary, this is a life saving function. Having a properly functioning Captain Safety is key to survival. But when Captain Safety is over active, and stays in control of the ship more often and longer than is necessary, it is really unhealthy, and you body really can’t handle these sustained reactions. It is Captain Calm that lets you stay in control of your complex thinking and communications, and allows you to stay present in the moment.
Think of it this way. In a building, there is a smoke alarm, and a sprinkler system. The smoke alarm is really sensitive. It can go off falsely all the time, for example, while you are cooking and produce smoke, but there is no threat and no fire. When the sprinkler system goes off, there is a significant amount of heat that could only be present when there is a fire. When anxiety, and possibly post traumatic stress is present, it’s like the smoke detector automatically fires the sprinklers instead of giving you a warning.
HEALTHY RESPONSES
When Captain Safety is on control, you cannot think your way out of it, because he shuts down your thinking. You have to first calm your body. To do that, take control of what parts of your autonomic nervous system you can control. Breathing and muscle tension are the easiest things here. Taking a few deep breaths, breathe in for 3 seconds, hold it for 2 seconds, and take 5 seconds to breathe out. Next, pay attention to what parts of your body are tense. Then, force a relax of those tense muscles. Then, let all 5 senses check in. We call this grounding. In military special forces, they call this your three foot wold. What is right in front of you that you can control. (Your next right step). When you do this, you bring back on line that part of your brain that allows you to sequence things, and you begin to recognize that you are here and now, and not in the past, nor are you in a yet-to-happen catastrophic future. When you are relaxed and in the present, and in control of your body, you teach your body how to shut down anxiety alarms.
SUMMARY ANALOGY
To continue the analogy of a car, you have a rear view mirror, a windshield, and a GPS system. If you are trying to drive while looking only at the rear view mirror, you will eventually crash. When you are so focused on the future that you stare only at the GPS, you will crash. To safely navigate, you need to stay focused in the present, glancing at the past to learn things that might be a threat, and noticing the overall path you are on, but paying attending most to the next set of directions. The vast majority of your attention needs to be on the present for you to safely operate a motor vehicle. The same is true to safely navigate life. Stay in the present, process and work through the past, and take a break from time to time to know where you are headed.
NEXT STEPS
Please, go and talk to somebody. Start with a healthy friend and let somebody know what is going on with you. Check out my post on finding a good counselor. Talking with a qualified professional can be a really good step. Consider what medications you might need to take to get your body stabilized. In the mean time, put some healthy routines in your life. Go to bed and get up at roughly the same time. Engage in good sleep hygiene practices. Have a healthy diet, and get some regular movement in your life. You are not alone. Others have gone through this, and others have gotten help and are living successfully with it and beyond it.