Anxiety in motion

I walk down the halls of the school, so many people, so crowded. I feel like they’re all staring at me, they think I’m a freak. Someone bumps into me, my heart skips a beat. My breathing quickens, I can’t catch my breath. My heart beat accelerates, feels like it’s going to pound out of my chest. My legs start to weaken, my vision blurs, my mouth feels like I haven’t had a drink in days. Dizziness creeps in. My body feels like it’s on fire. My mind spins in a million different directions. My body starts to shake, I feel like I’m going to faint. Now I’m hyperventilating, I can’t stop it, and down I go, straight to the floor which feels like it’s a thousand miles away. People stare, and then I’m gone. 

Everybody’s experiences with anxiety are different, that was an account of something that would happen to me sometimes on a daily basis. Having anxiety is like having an elephant sitting on your chest. It creeps up from nowhere and before you know it, it’s a full blown attack. Once it’s in full motion you think there’s no stopping it, you can try to take a pill or try to control your breathing but nothing helps. It’s a horrible way to live not knowing if this terrifying occurrence so going to envelope you at any given moment.  

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15 Small Steps You Can Take Today to Improve Anxiety Symptoms

Anxiety is a normal, predictable part of life,” said Tom Corboy, MFT, the founder and executive director of theOCD Center of Los Angeles, and co-author of the upcoming book The Mindfulness Workbook for OCD.

However, “people with an anxiety disorder are essentially phobic about the feeling state of anxiety.” And they’ll go to great lengths to avoid it.

Some people experience generalized anxiety disorder (GAD), excessive anxiety about real-life concerns, such as money, relationships, health and academics, he said.

Others struggle with society anxiety, and worry about being evaluated or embarrassing themselves, he said. People with obsessive-compulsive disorder (OCD) might become preoccupied with symmetry or potential contamination, he said.

“The bottom line is that people can experience anxiety, and anxiety disorders, related to just about anything.”

Some people may not struggle with a clinical disorder, but want to manage sporadic (yet intrusive) bouts of anxiety and stress.

Whether you have occasional anxiety or a diagnosable disorder, the good news is that you can take small, effective and straightforward steps every day to manage and minimize your anxiety.

Most of these steps contribute to a healthy and fulfilling life, overall. For instance, “making some basic lifestyle changes can do wonders for someone coping with elevated anxiety,” Corboy said. Below, you’ll find 15 small steps you can take today.

1. Take a deep breath.

“Deep diaphragmatic breathing triggers our relaxation response, switching from our fight-or-flight response of the sympathetic nervous system, to the relaxed, balanced response of our parasympathetic nervous system,” according to Marla Deibler, PsyD, a clinical psychologist, executive director of The Center for Emotional Health of Greater Philadelphia and Psych Central blogger.

She suggested the following exercise, which you can repeat several times: Inhale slowly to a count of four, starting at your belly and then moving into your chest. Gently hold your breath for four counts. Then slowly exhale to four counts.

2. Get active.

“One of the most important things one can do [to cope with anxiety] is to get regular cardiovascular exercise,” Corboy said. For instance, a brisk 30- to 60-minute walk “releases endorphins that lead to a reduction in anxiety.”

You can start today by taking a walk. Or create a list of physical activities that you enjoy, and put them on your schedule for the week. Other options include: running, rowing, rollerblading, hiking, biking, dancing, swimming, surfing, step aerobics, kickboxing and sports such as soccer, tennis and basketball.

3. Sleep well.

Not getting enough sleep can trigger anxiety. If you’re having trouble sleeping, tonight, engage in a relaxing activity before bedtime, such as taking a warm bath, listening to soothing music or taking several deep breaths. (You’ll find more tips here.)

And, if you’re like many people with anxiety whose brains start buzzing right before bed, jot down your worries earlier in the day for 10 to 15 minutes, or try a mental exercise like thinking of fruits with the same letter. (Find more suggestions here.)

4. Challenge an anxious thought.

“We all have moments wherein we unintentionally increase or maintain our own worry by thinking unhelpful thoughts. These thoughts are often unrealistic, inaccurate, or, to some extent, unreasonable,” Deibler said.

Thankfully, we can change these thoughts. The first step is to identify them. Consider how a specific thought affects your feelings and behaviors, Deibler said. Is it helpful or unhelpful?

Unhelpful thoughts usually come in the form of “what ifs,” “all-or-nothing thinking,” or “catastrophizing,” Deibler said. She gave these examples: “What if I make a fool of myself?” “What if I fail this exam?” or “What if this airplane crashes?”

These are the types of thoughts you want to challenge. Deibler suggested asking yourself:

“Is this worry realistic?” “Is this really likely to happen?” “If the worst possible outcome happens, what would be so bad about that?” “Could I handle that?” “What might I do?” “If something bad happens, what might that mean about me?” “Is this really true or does it just seem that way?” “What might I do to prepare for whatever may happen?”

Then, “reframe or correct that thought to make it more accurate, realistic and more adaptive.” Here’s one example: “I would feel embarrassed if I tripped on the stage, but that’s just a feeling; it wouldn’t last forever, and I would get through it.”

5. Say an encouraging statement.

Positive, accurate statements can help to put things into perspective. Deibler gave these examples: “Anxiety is just a feeling, like any other feeling.” and “This feels bad, but I can use some strategies to [cope with] it.”

6. Stay connected to others.

“Social support is vital to managing stress,” Deibler said. Today, call a loved one, schedule a Skype date or go to lunch with a close friend. “Talking with others can do a world of good.” Another option is to get together and engage in an activity that improves your anxiety, such as taking a walk, sitting on the beach or going to a yoga class.

7. Avoid caffeine.

Managing anxiety is as much about what you do as what you don’tdo. And there are some substances that exacerbate anxiety. Caffeine is one of those substances. As Corboy said, “The last thing people with anxiety need is a substance that makes them feel more amped up, which is exactly what caffeine does.”

8. Avoid mind-altering substances.

“While drugs and alcohol might help to reduce anxiety in the short term, they often do just the opposite in the long term,” Corboy said. Even the short-term effect can be harmful.

Corboy and his team have treated countless clients whose first panicattack occurred while they were taking drugs such as marijuana, ecstasy or LSD. “Panic attacks are bad enough if you are straight and sober, so imagine how bad they are if you are high, and can’t get un-high until the drug wears off.”

9. Do something you enjoy.

Engaging in enjoyable activities helps to soothe your anxiety. For instance, today, you might take a walk, listen to music or read a book, Deibler said.

10. Take a break.

It’s also helpful to build breaks into your day. As Deibler said, this might be a “simple change of pace or scenery, enjoying a hobby, or switching ‘to-do’ tasks.” “Breaking from concerted effort can be refreshing.”

11. Problem-solve.

Deibler suggested considering how you can address the stressors that are causing your anxiety. Today, make a list of these stressors and next to each one, jot down one or two solutions.

12. Pick up a book.

There are many valuable resources on anxiety, which teach you effective coping skills. Corboy recommended Dying of Embarrassment for people with social anxiety; The BDD Workbookfor body dysmorphic disorder; The Imp of the Mind and The OCD Workbook for obsessive-compulsive disorder. Deibler suggestedStop Obsessing for adults with OCD (and Up and Down the Worry Hill for kids with OCD).

For people with panic attacks, she suggested Don’t Panic: Taking Control of Anxiety Attacks. For a general overview of cognitive-behavioral therapy for anxiety, Corboy recommended The Anxiety and Phobia Workbook. He also recommended Get Out of Your Mind and Into Your Life and The Wisdom of No Escape.

(You can find more book recommendations at Corboy’s website.)

13. Engage in calming practices.

According to Corboy, “meditation, yoga, or other calming practices can help minimize anxiety in both the short and long term.” Sign up for a yoga class or watch a yoga video online. (Curvy Yoga is a wonderful resource for yoga for all shapes and sizes.) Meditate right now for just three minutes. (Here’s how.)

14. Contact a therapist.

“Sometimes anxiety can be difficult to manage without professional help,” Deibler said. Many organizations include databases of providers who specialize in anxiety (along with helpful information). She suggested these organizations: www.ocfoundation.org,www.adaa.org and www.abct.org.

15. Accept your anxiety.

“If you really want to effectively manage your anxiety, the key is to accept it,” Corboy said. This might sound counterintuitive. But anxiety, “in and of itself,” isn’t the real problem. Instead, it’s our attempts at controlling and eliminating it, he said. “Not accepting these unwanted inner experiences is the actual source of so much of our self-induced suffering.”

Accepting anxiety doesn’t mean “resign[ing] ourselves to a life of anxious misery. It simply means that we are better off recognizing and fully accepting the existence of anxiety and other uncomfortable emotional states that are inevitable, but transitory,” Corboy said.

So if you experience anxiety today, simply observe it, Deibler said. “Think of it like a wave of the ocean; allow it to come in, experience it, and ride it out.”

Anxiety can feel overwhelming. It can feel like chains around your feet, weighing you down. But by taking small steps – like the ones above – you can minimize your anxiety and cope effectively.

Link Between Anger and Anxiety?

A new study suggests anger is a powerful emotion that intensifiesanxiety and compromises therapyleading to serious health consequences.

Researchers from Concordia University discovered anger can exacerbate symptoms of generalized anxiety disorder (GAD), a condition that affects millions of individuals.

Sonya Deschênes investigated the subject after conducting a literature review for her Ph.D. research. In her review of published studies she realized that anger and anxiety were linked, yet poorly understood.

“This was surprising to me because irritability, which is part of the anger family, is a diagnostic feature of Generalized Anxiety Disorder,” she explains.

GAD is a serious affliction characterized by excessive and uncontrollable worry about everyday things.

It often interferes with a person’s ability to function normally. Individuals suffering from GAD typically anticipate disaster, and are overly concerned about everyday issues, such as health, money, and relationships.

Deschênes and her colleagues reviewed how specific components of anger — hostility, physical and verbal aggression, anger expression and anger control — contribute to GAD.

To do this, the team assessed more than 380 participants for GAD symptoms and their tendency to respond to anger-inducing scenarios.

Researcher’s assessed individual response to statements as, “I strike out at whatever infuriates me” and “I boil inside, but I don’t show it.”

The study, which was recently published in the journal Cognitive Behaviour Therapy, found that in the 131 participants who exhibited GAD symptoms, higher levels of anger and its various dimensions were associated with worry and anxiety.

Furthermore, hostility and internalized anger contributed to the severity of their GAD symptoms.

Experts believe this suggests that anger and anxiety go hand in hand, and that heightened levels of anger are uniquely related to GAD status.

Even more, internalized anger expression — boiling inside without showing it — is a stronger predictor of GAD than other forms of anger.

Deschênes acknowledges that more research is needed to understand why anger and anxiety tend to co-occur.

Researchers believe a possible explanation for the associated between anger and anxiety link is that, “when a situation is ambiguous, such that the outcome could be good or bad, anxious individuals tend to assume the worst.

“That often results in heightened anxiety. There is also evidence of that same thought process in individuals who are easily angered. Therefore, anger and GAD may be two manifestations of the same biased thought process.”

Deschênes also argues that symptoms of anger could get in the way of the treatment for anxiety, which often employs cognitive-behavioral therapy.

“If anger and hostility are contributing to the maintenance of symptoms, and these are not targeted during treatment, these people may not be benefiting as much from that treatment,” Deschênes said.

“It’s my hope that, by furthering our understanding of the role of anger in GAD, we can improve treatment outcomes for individuals with this disorder.”

Weak Brain Connections Found in People with Anxiety Disorder

The brains of people with generalized anxiety disorder (GAD) have weaker connections between a brain region in charge of emotional response and the amygdala. 

This suggests that the brain’s “panic button” may be chronically pushed down due to lack of regulation, according to a new University of Wisconsin-Madison imaging study.

GAD, which is characterized by excessive, uncontrollable worry, affects nearly 6 percent of the population.

The findings support the hypothesis that reduced communications between parts of the brain result in the extreme anxiety felt by people with GAD, said lead author Jack Nitschke, Ph.D., associate professor of psychiatry.

For the study, two types of scans showed that the amygdala, which triggers the “fight-or-flight” response, appears to have weaker “white matter” connections to the prefrontal and anterior cingulate cortex, the center of emotional regulation.

Two types of imaging were used — diffusion tensor imaging (DTI) and functional magnetic resonance (fMRI) — on the brains of 49 GAD patients and 39 healthy volunteers.

Compared with the healthy participants, the scans revealed that the brains of GAD individuals had reduced connections between the prefrontal and anterior cingulate cortex and the amygdala.

These connections went through the uncinate fasciculus — a “white matter” path that connects these brain regions. This lowered connectivity was not found in other white matter tracts in other parts of the brain.

“We know that in the brain, if you use a circuit you build it up, the way you build muscle by exercise,” said Nitschke.

The question arises whether this weak connection results in the extreme defensive anxiety and worry that is the hallmark of GAD, because the anterior cingulate cortex is unable to tell the amygdala to “chill out.”

It also suggests that behavioral therapy, in which patients learn to consciously attempt to regulate this emotion, helps reduce anxiety by strengthening the connection.

“It’s possible that this is exactly what we’re doing when we teach patients to regulate their reactions to the negative events that come up in everyone’s lives,” Nitschke says.

“We can help build people’s tolerance to uncontrollable future events by teaching them to regulate their emotions to the uncertainty that surrounds those events.”

Generalized Anxiety Disorder SYMPTOMS

Generalized anxiety disorder (GAD) is more than the normal anxiety people experience day to day. It’s chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.

People with GAD can’t seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.

Usually the impairment associated with GAD is mild and people with the disorder don’t feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don’t characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.

Specific Symptoms of Generalized Anxiety Disorder:

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children don’t need to meet as many criteria).

Restlessness or feeling keyed up or on edge

Being easily fatigued

Difficulty concentrating or mind going blank

Irritability

Muscle tension

Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

Additionally, the anxiety or worry is not about having a Panic Attack, being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (PTSD).

The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.