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?

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