When Anxiety Is a Bad Thing, Part I

by Kassandra Lamb

Last month, I posted about how a controllable amount of anxiety can be a good thing when performing. It can keep us on our toes and animate our performance. But what happens when it’s not controllable? Then, anxiety is a bad thing.

Basically, this happens when our survival mechanisms go awry. One of these survival mechanism is our fight or flight response.

When we perceive a threat in our environment, our brains and bodies take over. We automatically experience a long list of reactions intended to prepare us to run away from that threat or stand and fight it off—our hearts race to pump blood to our muscles faster, our breathing becomes more rapid to suck in more oxygen, our muscles tense, our pupils dilate to see better, etc.

But what if something biological, a malfunction in our bodies or brains, triggers our fight or flight response, rather than a true threat from the environment?

Biologically Triggered Panic

You’re going about your business, perfectly calm and safe, and suddenly your heart starts thundering in your chest and you’re breathing fast and furious.

You look around, your eyes wide with fright, desperately trying to find the threat. But there is none. Yet, your mind knows that if the fight or flight response has been triggered there must be some threat out there. Right?

This is what people with certain anxiety disorders suffer through on a regular basis, sometimes several times a day.

And they cannot control it!

During a panic attack, their bodies are freaking out on them, without their mental permission. And the sense of impending doom, that is associated with that physiological freaking out, can be quite overwhelming.

Which brings us to the other survival mechanism that can go awry.

Learned Associations

One of the other ways that our brains keep us alive is by making a myriad of associations between certain situations and our emotions. This thing made us feel good in the past (like eating tasty food), so do more of it. That thing was scary and/or hurt us in the past, so avoid it.

We smell food cooking and our stomachs automatically growl, because we’ve learned to associate that smell with something good to eat. We see a snake on the path in front of us in the woods, and we jump back and our hearts start racing. We were not born with the knowledge that cooking smells mean food or that a snake is potentially harmful, and yet these reactions are automatic.

That’s because these are conditioned associations, a different kind of learning than when we intellectually process something and commit it to memory. At some point in the past, we felt the emotion (fear) while in the presence of something (a snake, or an image of a snake on TV, doing something scary) and our minds linked the two together. So now the snake is a “conditioned stimulus” for the “conditioned response” of fear.

For most of us, the fear response can be controlled, once we have assessed the situation. From a safe distance, we take a harder look at the snake and realize it’s just a harmless black snake. So we get a stick, shoo it out of our path and go on about our business.

But sometimes, these conditioned associations reach phobic levels. As a child, you’re chased and bitten by a dog, and now you are terrified of all dogs.

So why can’t we control that phobic fear?

Because conditioned associations are stored in a different part of our brain (the cerebellum) from where our thinking occurs (the cerebral cortex).

(In the swirling image to the left, the cerebellum is highlighted in red, while the cerebral cortex is the tan part.)

So you see a dog, even a small harmless-looking one, and you are running away, even as your logical brain is saying, “This is stupid, That dog isn’t going to hurt me.”

When These Two Mechanisms Interact

People with biologically-based anxiety disorders (panic disorder, generalized anxiety disorder, etc.) often get a double whammy from these mechanisms. Their fear response is being triggered when nothing scary is happening, but the mind still associates the fear with whatever is going on at the moment.

So the person can develop a phobic-type response to a variety of stimuli. They have a panic attack while at the grocery store, so they can’t grocery shop anymore without freaking out. Then they have one while at the post office and they can’t go there anymore. Then while driving, so they can’t drive anymore. Then while getting their mail at the end of their driveway…

In its worst form, this can become agoraphobia, in which the person is afraid to leave their home.

And none of this is under their conscious control!

What Can Be Done?

For those who suffer from anxiety disorders, the answer to this question is a long one. I’m going to do a separate post on that on May 14th. So please stay tuned.

For those of us who care about someone with an anxiety disorder, we need to be patient and understanding. Chastising the person for letting anxiety control their lives is not helpful.

They are most likely already beating themselves up, on a daily basis.

My mother-in-law had generalized anxiety disorder. The best definition of this disorder is being a worry-wart on steroids. People with GAD worry about everything all the time, and they cannot control this! GAD is partly biologically based, and partly a learned pattern of coping that becomes ingrained early in life.

When my MIL was in her seventies, her eye doctor told her she had cataracts and she needed surgery or she would go blind.

She would not do it. After a while, she wouldn’t even talk about it anymore.

I got it, and tried to explain it to my husband and family members. Any surgery, but especially eye surgery, is scary for all of us. But most of us can manage the fear. Not, however, if you have severe GAD as she did.

When she considered such surgery, the anxiety was overwhelming. And the more the family tried to get her to “see reason,” the more anxious she became, until even thinking or talking about it became overwhelming.

Finally everyone gave up, and she lived out the rest of her years slowly going blind, but with her daily anxiety much more manageable.

I’m not saying that I thought her choice was correct, but I understood where she was coming from, in light of the disorder she had.

When we keep pushing someone with an anxiety disorder to do something they feel they can’t do because of the anxiety, we are only driving a wedge between ourselves and them, and pushing them farther into the unnecessary and unhelpful shame they are probably already feeling about their disorder.

Then, anxiety is a bad thing indeed!

It is more helpful to say something like, “I understand. The anxiety is too much. Let’s see if you and I can figure out a way around it.”

Stay tuned for next time, when we’ll talk some more about those work-arounds and other ways to reduce the anxiety and/or cope with it.

In the meantime, I’m happy to answer questions. Have you or a loved one had to struggle with an anxiety disorder?

Posted by Kassandra Lamb. Kassandra is a retired psychotherapist turned mystery writer. She is the author of the Kate Huntington psychological mysteries, set in her native Maryland, and a new series, the Marcia Banks and Buddy cozy mysteries, set in Central Florida.

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