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.
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.
We blog here at misterio press about twice a month, usually on Tuesdays. Sometimes we talk about serious topics, and sometimes we just have some fun.
Please sign up via email (upper right sidebar) to follow us, so you don’t miss out on any of the interesting stuff, or the fun! (We do not lend, sell nor otherwise bend, spindle or mutilate followers’ e-mail addresses. 🙂 )
Bjørn LarssenApril 23, 2019 at 3:39 am
I live with a generalised anxiety disorder.
It’s not the same as panic attacks. Panic attacks start slowly, then escalate until peak, then go back down. I’ve got coping techniques to deal with panic attacks – the most useful one being remembering that it is a panic attack and not, like my subconscious insists, DEATH. (When I first had a panic attack I went to my GP on the other side of the streets to inform them I was having a heart attack. This is apparently how most people discover what panic attacks are.)
Anxiety is a constant. I’m almost ashamed of thinking, as I was reading, “at least her MIL had a reason”. I sometimes spend entire days feeling that SOMETHING horrible is going to happen. I’m nauseous all the time. Bursting with the need to fight or flight. But there is nothing to fight and nothing to run away from, so the anxiety just goes on for no reason.
A Twitter post became a meme a year or two ago. It explains GAD perfectly:
Anxiety: Something bad is going to happen.
Anxiety: Something bad is going to happen.
Me: Any clue…?
My anxiety about writing a bad book pushed me through 21 drafts and now I’m reaping the rewards (also known as reviews 😉 ) My generalised anxiety doesn’t come with any silver linings. It just is.
Really looking forward to the second instalment.
Kassandra LambMay 5, 2019 at 12:36 am
I am so sorry, Bjorn. I just found the notification about your comment in my email spam folder. I was away on vacation and am just now catching up on things.
I hadn’t really thought to compare the acute intensity of the panic attack with the constant nature of GAD. Two different brands of hell!
Yes, the recognizing of the early signs and talking oneself through it are big parts of controlling panic attacks. But GAD can definitely be harder to control. Part 2 on what to do will be posted on May 14th. I hope you will stop by and be part of that conversation. Your insights would be most appreciated.
Indeed, would you mind if I quoted some of your comment above in that installment? You have described the experience far better than I ever could.
Shannon EspositoApril 23, 2019 at 12:59 pm
Even talking about anxiety makes me anxious. It’s probably been the biggest struggle in my life. I’ve learned a lot about the mind/body connection though and how my propensity to go to worst case scenario in every situation fuels the anxiety. On the bright side, catastrophizing is great for writing muder mysteries. 🙂
Kassandra LambApril 24, 2019 at 12:58 am
😀 Good that you are gleaning something positive from the anxiety!
Seriously, I can only begin to imagine what it must be like to live with chronic anxiety. And yes, the mind and body tend to get caught up in a vicious cycle. Learning how to break that cycle is so important. More on that next time.
What to Do When Anxiety Takes Over Your Life (Plus a New Release) - Misterio PressMay 14, 2019 at 1:21 am
[…] always learned reactions, although they are deeply ingrained in the cerebellum (as I mentioned in my last post on this subject) and do not respond well to conscious efforts to control […]