If anxiety is interfering with your life, or a loved one’s life, it might be time to ask for help
Anxiety can appear when you least expect it
Iwas sitting in the kitchen, deep into my morning routine — breakfast, coffee, CBC Radio and the Waterloo Region Record. Suddenly, my heart began to pound so powerfully and rapidly that I could barely catch my breath. I tried to grasp the situation — was the beat irregular or just super fast? Before I could decide, a zingy humming surged deep in my brain and a sheet of blackness flashed over me, as if I might faint. My immediate response? Denial, which, in retrospective, was probably a sure sign of heart attack. But the flood of sensations dissipated as suddenly as they came, so I assured myself I was fine. Maybe it was low blood sugar. Or something.
But it struck again that afternoon — quick, random and overwhelming. This time, a dull shadow of discomfort and weakness lingered after the initial rush. And when it hit again the next morning, I asked my husband to drive me to the hospital.
I was glum, fearful and steeled for bad news: yet another baby boomer about to become a heart or stroke statistic. But the doctors could find nothing wrong and wondered if it could be anxiety. Anxiety? Well, that was clearly ridiculous. As a journalist, I was always proud of my ability to soar above the high stress of deadlines. For the past six years, I had been editor of Grand magazine. Sure, the weight of the job had caused sleepless nights and cranky days, but that was just the way work was — and I had always managed.
Besides, that’s why I had taken early retirement four months before my first breakfast “event.” I was supposed to be calmer, thinking about gardening.
After the trip to the emergency room and a
followup discussion with my family doctor, I took a close look at my life and some pieces fell into place. Leaving my career — even though it was on my terms — was a huge life change, and the steps into the freelance world were still tenuous.
Added to that was the ever-present heartbreak of a close friend’s battle with terminal cancer. Two days before my anxiety attack, another friend had died, just three weeks after a shocking cancer diagnosis. There were changes afoot in the lives of our adult sons — once a mother, always a mother.
Running in the background was my lifelong addiction to news. News used to be a source of intellectual stimulation before I raced off to the office. Now the world’s sadness settled deep in my heart — climate change, political and economic uncertainties, and general inhumanity among humans.
When I was working full time, my mental and emotional energy was focused on the endless to-do list at the office. Now, all of that energy can be poured into the rest of my life, where the good and the bad await.
At the office, no matter how stressful the day, I still had a lot of control. In my new life, I have to learn to live with uncertainty.
I also have to live with a curious new reality: since anxiety revealed its physical side in my breakfast flareup, my brain and body have forged some mysterious new pact. I seldom have problems under normal stress – a deadline, for example, when my brain is busy with other things. And weeks will go by with no issues at all.
Equally surprising is that I am seldom aware of any particular worries when physical symptoms do begin. It’s as if my subconscious has normalized a state of readiness, and on certain days it picks up on small annoyances, challenges or even exciting situations, and sends bogus distress signals to my body. Most times, I can recognize the first signs and focus on a distraction – my breathing, for example – before the anxiety switch is flipped.
But that’s just me. For every person, anxiety is a different journey.
The stepping stones to adult anxiety vary from person to person, and so do the symptoms. Sometimes anxiety spills over into other issues, such as depression. But where is the line between everyday stress and a problem?
Christine Purdon, a psychology professor in the Anxiety Studies Division at the University of Waterloo, points out the stress response is a normal part of our body’s fight-or-flight survival system.
“It alerts us to threats in the environment. It motivates us to do something about it and energizes our body to do something about it,” she says in an interview.
It is normal to feel stressed when a challenge seems beyond our ability to cope. Blood pressure and heart rate may rise, breathing may be rapid. Blood flow may be directed from the extremities to the large muscle groups, leaving hands and feet cold or tingly. There may be dizziness or a
feeling of depersonalization.
Purdon says the symptoms can be unpleasant but, after the initial distress, problem-solving sets in. “You start to feel masterly and realize that the demands of the environment are actually being dealt with.”
With anxiety, however, the body and mind run on high alert, even when there is no obvious threat. An excessive stream of what-ifs can overshadow reality.
“There’s a sense that a shoe will drop and I somehow need to know what that shoe could be and what I am going to do if it does drop,” Purdon says.
Once the negative thoughts start to churn, she says, “the brain gets triggered and it gives the anxiety response, and then you are like, ‘OK, what’s wrong?’ And there’s nothing actually happening, but your mind, because we have a wonderful prefrontal cortex, can flash forward to the future and start thinking about what could be going on.”
People may view worry as a solution generator — a way to anticipate a potential problem and keep it at bay. But when anxiety kicks in, worry becomes a problem generator as the brain grapples with vague possibilities, Purdon says.
“Chronic stress is where the challenges are coming so fast, one after the other, in combination with mental challenges, such as reliving painful moments of the past as well as anticipating possible problems in the future, that the mind and the body very rarely come down to the rest state,” says Bob Wilson, a social worker and counsellor at Carizon Family and Community Services in Kitchener, in a separate interview.
With no time to re-energize, the mind lives in the distress, almost as though it were really happening.
Anxious thoughts “circle in the mind and go no place,” says Wilson, who specializes in anxiety and depression. “There’s no solution-focus going on, there’s no problem-solving going on.”
Left unchecked, an anxious individual can lose interest in life, yet they are not sure why, Wilson says.
Irritation may set in. “Small things that I could normally take in stride start to irritate me. Now they seem big. Or I am prone to get easily angered and it’s not really my natural personality.”
A person’s immunity might slip so they are frequently ill or regular bodily systems may be amiss.
Wilson says such physical ramifications are a good reason to seek medical help, in case there is another cause. On the emotional front, a person should seek professional help if their anxious responses are causing significant personal distress on a regular basis: Are these thought patterns negatively impacting the person’s primary relationships, capacity to socialize and ability to function at work or school?
Wilson says people may be susceptible to anxiety when they have had an accumulation of stressful events or major personal losses. At such times, it can be difficult to
process the emotions.
A young person’s adjustment to university life is another time of possible anxiety, Purdon says. After all, this transition can bring loneliness and uncertainty coupled with the big questions surrounding identity.
However, Purdon adds, normal ups and downs are not pathological. Well-intended parenting may give the impression that negative experience is unnatural, but learning to deal with disappointments and stress is part of life.
She says another key stage for possible anxiety is post-partum — for both men and women. Not only is there the parents’ recognition that this tiny new life is 100 per cent dependent on them, but sleep deprivation can play havoc with perception.
Conversely, anxiety can even strike when a person tries to relax. “The brain starts to do mental checks of things and then it can’t find anything, but it also can’t prove that there is no danger,” Purdon says. “So your mind starts generating what could be dangerous.”
Once the threat system gets activated, it is quick to start up and slow to shut down.
Relaxation can also be infused with moral qualities, she says.
“I don’t deserve to relax. Look, there are all these things I didn’t accomplish today. And then (the person) can become overwhelmed by the enormity of what they didn’t do, and it becomes paralyzing.”
She says people with anxiety often place unrealistic demands on themselves. They strive for perfection, including trying to control things not within their control. They often lack confidence in their ability to cope.
“Let’s take ourselves off the hook for trying to anticipate and plan against things that haven’t happened yet,” Purdon says. “And, at the same time, let’s help ourselves recognize that we are competent adults who are able to handle things on the fly.”
What can you do?
If the anxiety symptoms are intermittent and not severe, an individual might start with personal reflection, suggests Bob Wilson, a counsellor at Carizon Family and Community Services in Kitchener.
“When my mind is getting into the what-ifs, when it’s assuming things are probably going to turn out terribly, is there any real evidence for that? Are there other possible outcomes?”
And if an actual challenge is on the horizon, are there things that could be done now that would offer a sense of control?
In general, the person might explore relaxation or meditative techniques, as well as physical exercise, to try to calm the mind and body. Writing can also help sort through issues.
Wilson suggests starting with one small, achievable step because our natural response to anxiety is often avoidance. The person could take time for a hobby, a walk or coffee with a friend. “Anything that allows us to take a short vacation from the serious,” he says.
“When we are going 80 hours a week, that often goes out the window.”
With that comes a challenge: “Can I grant myself permission not to have to be ‘productive’ every single waking moment because if we are getting absolutely no recharging, our productivity is going down anyway.”
Christine Purdon, a psychology professor at the University of Waterloo, agrees that replacing worry with problem-solving might help: What is the actual problem in the here and now?
“Anxiety will present a prediction on a silver platter as if it’s a fact,” she notes. “And then there’s a cascade of thoughts that lead to high anxiety. It’s about catching the gateway thought and saying, ‘Wait a minute, of course something is going to happen, that’s life. Of course there’s going to be a problem. ... But right now, there’s nothing going on.’ ”
Ask yourself: What are the perceived demands of the environment? What are my perceived abilities to cope? Instead of referencing all the reasons you can’t cope, Purdon says, reference your strengths.
As for concrete strategies, Purdon says techniques such as meditation can help build nonjudgmental awareness — separating thoughts from facts. But she says such tools are not a panacea, and they don’t work for everyone. However, neurological research has shown that exercise, particularly in nature, does offer positive physiological effects and it is a straightforward strategy.
When the stress response has kicked in, “it’s like being all revved up and no place to go,” she says. “And that’s where exercise can help because it gives you the opportunity to discharge all of that energy in a healthy and constructive way and channel your understanding of what’s happening.”
Purdon suggests sometimes the best response is just to allow yourself to
“It’s like being all revved up and no place to go. And that’s where exercise can help because it gives you the opportunity to discharge all of that energy in a healthy and constructive way and channel your understanding of what’s happening.” CHRISTINE PURDON
panic, dispassionately acknowledging the symptoms. If you relinquish the need to control it, you also relinquish the stress that comes with that.
“The more you do that, the less panic you are going to have because the less reactive and worried you are going to be to changes and bodily sensations.”
However, Purdon also emphasizes that if everyday life is causing a lot of anxiety, an individual should seek treatment from a psychologist.
What do you say?
If a friend or family member confides that they are dealing with anxiety, our first response may be the wrong one. “We have a natural impulse, which in itself is quite noble, to act as quickly as we can to alleviate someone else’s suffering,” says Bob Wilson, a counsellor at Carizon Family and Community Services in Kitchener.
“I might say, ‘Oh, stop worrying, you have nothing to worry about it,’ and I might be sincerely trying to make them feel better. But I’ve just been making them feel embarrassed or stupid. With all good intentions, it’s backfired.”
Better advice is to stop, listen and ask supportive questions.
“How many times in discussions among loved ones or friends do we misread the signal of the messenger: Do they want me to problem-solve or do they want me to just listen and validate?”
It is important to understand that “whether or not the problem they are worrying about is realistic or not, the internal suffering is real,” he says.
Depending on the person and the level of distress, you may want to ask him or her a few important questions: Do you feel this situation is over your head? Do you feel it’s over my head? Do you feel you can manage right now or should we look for some further help?