Anxiety

Anxiety has its origins in the fear with which we respond to real or perceived danger that’s encoded in the autonomic nervous system. Without fear, our instinct for self-preservation would be significantly impaired. What differentiates anxiety from acute fear is the absence of any immediate or current threat to which such an intense reaction would be appropriate and proportionate. It is generally more about possibilities rather than current realities.

Anticipating loss of control and vulnerability to harm
There are two key features to anxiety: the fear of loss of control and therefore feeling vulnerable to harm and the anticipation of this happening. Anxiety faces forward, even when contemplating the consequences of a past action, decision or event, with the anxious person fearing, if not predicting, the worst. For this they prepare by taking self-protective measures to gain, keep or regain control. The imprint of historic trauma may be implicated in such patterns. Take that seemingly irrational fear and apply it to another context and it may immediately make sense and appear proportionate. A child growing up traumatised in a volatile, unstable household, for instance, may pre-emptively come to view the world as invariably unsafe, with disaster imminent, if not inevitable. Accordingly, they approach life in a state of defensive alert.

The physical and mental effects
How do we know we are anxious? The autonomic nervous system provides us with distress signals, some of which are physical and others mental. We may experience an increase in heart rate and a rise in blood pressure. Our breathing may become shorter and shallower. We may suffer from headaches, nausea, have cold but sweaty palms, have a dry mouth, feel a need to urinate more frequently or tremble. We may experience a racing mind where thoughts career about incoherently making it impossible to concentrate or think in a calm, ordered and productive way or sleep soundly. Effective decision-making becomes next to impossible. Or, we may become fretfully preoccupied about a particular issue.

A scale of severity
For many, anxiety is an everyday, although occasional and transitory emotion— usually in anticipation of a specific event, such as sitting an exam, speaking in public, attending a job interview or when contemplating some other mildly stress-inducing challenge. For others, however, anxiety is far more serious. It can become a chronic state of mind with little or no relief for people who have either a faulty or no ‘off’ switch on their alarm system. It is easily triggered by almost any form of stress. Generalised Anxiety Disorder, as it is termed, can become completely debilitating, curbing not only the enjoyment of life but also everyday functioning.

In its mildest form, anxiety may be experienced as worry, for instance when likely to be late for an appointment or nervousness when about to speak to a difficult person. Greater intensity would be experienced in situations giving rise to dread, alarm or panic, as with Post-Traumatic Stress Disorder (PTSD), which may involve flashbacks or nightmares. Panic attacks are particularly distressing given the sudden onset of overwhelming and seemingly inexplicable feelings of loss of control, uncomfortable physical sensations such as hyperventilation and even the fear of being about to die. At the extreme end of the scale sits full-blown paranoia, the irrational belief that you are in real and immediate danger from others who you believe (without evidence) to be deliberately targeting you.

Phobias
Anxiety may have a specific focus as in the case of phobias. Some phobias tend to centre on something quite specific such as a fear of heights, flying, injections or snakes, for instance. Other versions are associated with fear of a circumstance or situation such as confined space (claustrophobia), or being in a crowded public place where escape may seem difficult (agoraphobia). Social Anxiety Disorder may afflict people who become highly anxious in social situations. Phobias can become disabling in their intensity as can disorders such as Obsessive Compulsive Disorder (OCD) where someone is at the mercy of obsessive thoughts and compulsive behaviours. While intended to gain control, the thoughts and behaviours can take over, often directing the person to the point where the disorder disrupts normal life.

Defence and coping mechanisms
A number of psychological defence mechanisms against conscious experience of anxiety have been identified. These include not acknowledging what is felt, disconnecting from feeling, holding an oversimplified view of others as either positive or negative and locating the parts of ourselves we’re uncomfortable with in others whose qualities we then criticise, as well as blocking or excluding feelings, redirecting a feeling such as anger towards a person or situation that is less threatening, redirecting a feeling or impulse into a socially acceptable behaviour that brings relief and retreating into a childlike mindset. Other ways of defending against anxiety include procrastination, passivity, perfectionism, aggression and avoidance.

Unfortunately, some of the active forms of “coping”, such as consuming mood-altering but potentially addictive substances (e.g., alcohol, benzodiazepines, heroin) or engaging compulsively in behaviours with a similar risk (e.g., sex, shopping, work) to ease the discomfort of anxiety, only compound the problem. They tend to exacerbate the very feelings the person is trying to eliminate. A number of people will attract a dual diagnosis given the co-existence of addiction and an anxiety disorder.

Treatment
It helps to increase a person’s understanding of anxiety and how it operates in and affects their lives. It helps also to identify counterproductive defensive and coping patterns. Plans can then be developed to find ways of alleviating the anxiety that are specific to the individual. While medication may be called for where anxiety is particularly debilitating, it is much preferred to apply non-medical therapies wherever possible. The treatment team at a luxury private treatment centre like Clinic Les Alpes that takes a holistic approach, is able to call upon a range of therapeutic models and aids, the most effective of which is Cognitive Behavioural Therapy (CBT), a “talking therapy”, supported by Mindfulness, Guided Relaxation, Art Therapy, education in stress management, sleep hygiene and nutrition while not forgetting the support of fellow sufferers. All this is offered in a reassuring, comfortable and calm environment where 24-hour support is available.