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Anxiety Self-Care Protocol

Anxiety is a normal part of the human condition and, in most ways, is very adaptive. If we think in terms of the evolution of the human species we see that it is adaptive. In fact, our species would not have survived without anxiety. Too much anxiety, of course, can make living uncomfortable at best. The following is a discussion of anxiety, where it comes from and what you can do to manage it. Understanding anxiety is a significant part of the cure. In addition to this document we suggest you order the corresponding TherapyWorks Workbook Mastery of Your Anxiety and Panic-Second Edition. (To order: 800-211-8378 ext.95780)

Part I: Understanding Anxiety

What Is Anxiety?

Anxiety can best be thought of in a multi-stage model made up of the following components: Genetic Factors which predispose the individual to anxiety (Over 30% of persons with anxiety disorders have a blood relative with abnormal anxiety.); Life Experiences which increase susceptibility to anxiety (The threshold for the firing of neurons in the brain is lowered in some individuals due to stress, physical illness, biochemical imbalance, etc. so that it takes less stimulation to cause a "danger" message to be sent in the brain.); Environmental Triggers which cause an alarm reaction (Some of these may be obvious and many may be less obvious (a near-miss while driving), internal (stomach discomfort, allergies), or historical (something in current environment reminds us of an old threat)

Anxiety is understandable and normal. It is much better for the organism to over-rate danger than to miss a danger signal and be harmed. Like a smoke detector in the home, the consequences of being calibrated too high and not going off when there is smoke is worse than giving an occasional "false positive" reading. Nature has provided us with physical pain receptors in our body to tell us when we are in danger of physical damage. Anxiety is nature's psychological mechanism for letting us know we are in danger psychologically. In this sense anxiety can be seen as information, which can be used in a helpful way to keep ourselves safe and well-regulated. This is why most people have a moderate amount of anxiety and it is a normal part of the human condition. The problem arises when the anxiety system is disregulated so that we have either too much anxiety (panic attacks, phobias, etc.) or too little anxiety (antisocial behavior).

 TABLE 1: Common Anxiety Symptoms 
Uncomfortable awareness of heart (palpitations)
Racing heart (tachycardia)
Dizziness and lightheadedness
Poor concentration
Blurred vision
Numbness or tingling in the mouth, hands, feet
Lump in throat
Difficulty swallowing
Stomach pain
"Swallowing air"
Muscle pains
Muscle spasms
Shortness of breath "asthma"
Chest pain
Choking sensation
Tension, anxiety
Fatigue, weakness
Poor sleep, nightmares
Dry mouth
Trouble swallowing
Trouble falling asleep/staying asleep
Exaggerated startle response
Trouble concentrating
Believe going crazy
Racing thoughts
Fear of dying
Fear of going crazy
Out of control
On edge/keyed up
Stressed out
Avoiding what makes you anxious
Using drugs/alcohol to decrease your anxiety
Frequent urination

All of these symptoms can be explained in terms of a response by the body that was at one time adaptive. For example, to escape a dangerous predator most animals will release their bowels and, or bladder before taking flight both to lighten their body and move faster and also as a distracter to the enemy. This explains the bowel loosening that occurs during a strong anxiety, or panic reaction in humans.

 TABLE 2: Physical Disorders That Can Cause Anxiety 
Cardiovascular Disorders
Angina pectoris
Coronary artery disease
Heart attack
Heart failure
Mitral valve prolapse
Myocardial infarction (recovery form)
Postural orthostatic hypotension
Pulmonary edema
Pulmonary embolism
Transient ischemic attack
Respiratory Disorders
Collagen disease Emphysema
Pulmonary fibrosis
Endocrine/Hormonal Disorders
Carcinoid tumor
Premenstrual syndrome
Neurological/Muscular Disorders
Compression neuropathies
Guillian-Barre' syndrome
Myastenia gravis
Temporal lobe epilepsy
Ear Disorders
Benign positional vertigo
Mastoiditis Meniere's disease
Otitis media
Hematic (Kidney) Disorders
B12 anemia
Folic acid anemia Iron-deficiency anemia
Sickle cell anemia
Drug-Related Disorders
Alcohol use or withdrawal
Illicit drug use
Medication withdrawal
Side effects of many medications
Stimulant use
Miscellaneous Disorders
Head injury

Why Anxiety is Adaptive

The central nervous system, which is the main operating system that controls all of our physiological functions is divided into two parts: the parasympathetic nervous system makes the body go into a resting mode; the sympathetic nervous system prepares the body for action, including escaping from danger. This is called the Fight or Flight response. When confronted with danger, the sympathetic system prepares us to run away from danger or stay and fight the danger. This survival mechanism came into existence millions of years ago when the kinds of dangers we were likely to experience were a saber-toothed tiger wanting to eat us for dinner. Therefore, the body tries to prepare us for a physical response to survive. You will notice that many of the results of the activation of the sympathetic nervous system are the same as the symptoms of anxiety. Therefore, anxiety is a normal biological process. In fact, if you consider how your body responds to other activities requiring action like exercise, for example, you will notice that the symptoms are very much like those of anxiety: increase in heart rate, increase in respiration, sweating, etc. The only difference is the interpretation we make of the physical signs and the fact that when we push the "panic button," we are often in a situation in which a physical survival response is not helpful (i.e.: giving a speech. We tell ourselves "this is scary!!!" and our body responds by going into survival mode. Part of sympathetic activation is a slowing/stopping of the digestive system, including salivation. This is because the body doesn't expect us to be grabbing a cheeseburger for dinner at the same time as we are running away from the saber-toothed tiger. Therefore, we end up with dry mouth, which doesn't make speaking any easier.)

Neurophysiology of Anxiety

Although it is the body's most important organ, the brain is totally dependent on circulating blood for it's energy and is unable to store nutrients needed for continuous operation. Any stress on the brain decreases blood flow. Persons with panic disorder tend to show a decrease in brain blood flow when under even minimal stress. This in turn affects the amygdala, the para-hippocampal gyrus and hippocampus, the posterior hypothalamus and the periaquiductal gray area of the brain, all of which have been closely associated with anxiety disorders.

Part II: Skills For Anxiety Self-Management >>


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