Anxiety

Anxiety is an emotion involving feelings of worry and tension that may also include physical changes.

What is anxiety (APA, 2021)?

Anxiety is an emotion involving feelings of worry and tension along with physical changes such as increased blood pressure, sweating, trembling, dizziness, and rapid heartbeat.
Anxiety often involves recurring intrusive thoughts or concerns.
Occasional anxiety is expected in life. For example, you may feel anxious before taking a test or facing a workplace problem. For a person who suffers from an anxiety disorder, this anxiety does not go away and progresses over time. Symptoms of anxiety disorders often interfere with job performance, schoolwork, and relationships (NIH, n.d.).

What causes anxiety (MedlinePlus, 2021)?

The cause of anxiety is unknown, but researchers do know that several factors play a role in anxiety. These factors include:
- Genetics
- Brain biology and chemistry
- Stress
- Exposure to stressful and negative environment(s)
- Medications
- Substance use

Those at risk for anxiety disorders include:
- Certain personality traits such as shyness or being withdrawn in new situations or meeting new people.
- Experiencing traumatic event(s) in early childhood or adulthood.
  - For more information on this please click the following link: https://www.phoenixaustralia.org/recovery/what-are-traumatic-events/
- Family history of mental illness (i.e. depression, anxiety, etc.).
- Physical conditions such as thyroid problems or arrhythmia.

What is a panic attack (Mayo Clinic, 2021)?

People who experience anxiety may also experience panic attacks. A panic attack is a sudden onset of intense fear that triggers severe physical reactions, even though there is no real danger or cause. These happen without warning and can happen at any time.
- Note: Many people have 1-2 panic attacks in their lifetime, typically in stressful situations, but if these attacks are recurrent, you may have a condition called panic disorder. If you feel you may have a panic disorder, reach out to your mental health provider or primary care provider to be evaluated.
  - For more information on panic disorders, please click the following link: https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

Symptoms of a panic attack include:
- Sense of impending danger
- Fear of loss of control or death
- Rapid heart rate
- Sweating
- Trembling or shaking
- Shortness of breath or tightness in the throat
- Chills
- Hot flashes
- Nausea
- Abdominal cramping
- Chest pain
- Headache
- Dizziness, lightheadedness, or faintness
- Numbness or tingling sensation
- Feeling of unreality or detachment

What causes a panic attack?
- Like anxiety, the cause of panic attacks is unknown, but the following factors play a role:
  - Genetics
  - Major stress
  - Temperament that is sensitive to stress and/or prone to negative emotions
  - Changes in brain function

Can I prevent panic attacks?
- There is no way to ensure that a panic attack will never happen however, the following is recommended for prevention:
  - Seek treatment as soon as possible to decrease frequency and prevent the attacks from getting worse
  - Stick with your treatment plan
  - Get regular physical activity daily
    - For more information on exercise and anxiety, please click the following link: https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096

Coping mechanisms for anxiety and panic attacks (Smith & Klein, 2020)

Anxiety and panic attacks can be scary, but there are different techniques that can help you get through it. It is recommended that you try different approaches to find what works best for you. Some techniques to relieve anxiety/panic are:

Remember that it will pass – as scary as anxiety and panic attacks are, remembering that these feelings will pass can ease the mind. Studies show that symptoms tend to decline after 10 minutes.
Take deep breaths – breathe deeply from the abdomen, filling the lungs slowly and steadily while counting to 4 while both inhaling and exhaling.
1. You can also try 4-7-8 breathing. To do this, breathe in for 4 seconds, hold breath for 7 seconds, and exhale slowly for 8 seconds.
Smell lavender – many studies show that lavender can help relieve anxiety.
Find a peaceful spot – certain sights and sounds can actually make your anxiety/panic attack worse. Finding a quiet place will create mental space and make it easier to focus on breathing and/or coping strategies.
Focus on an object – focusing on one stimulus (the object) reduces other stimuli (anxiety/panic). If anxiety and panic occur often, it is recommended you carry a “grounding” object with you. These objects can be a stone, seashell, toy, hair clip, anything you prefer. When you look at the item think about:
1. How does it feel?
2. Who made it?
3. What shape is it?
5-4-3-2-1 Method – this helps direct the individual’s focus away from the stress source. To use this technique:
1. Look at 5 separate objects – think about each one for a while
2. Listen for 4 different sounds – think about where they came from and how they differ
3. Touch 3 objects – focus on the object’s texture, temperature, and their uses
4. Identify 2 different smells
5. Name 1 thing you can taste
Repeat a mantra – repeat a word, phrase, or sound to help with focus and provide strength
1. Example: repeat “This too shall pass” or any other positive reassuring phrase/word
2. Repeating a mantra slows physical responses down allowing for regulated breathing and relaxation of the muscles
Walk or do light exercise – the rhythm of walking helps with regulated breathing and moving around releases endorphins which are hormones that relax the body and improve mood
Try the progressive muscle relaxation technique – this involves tensing up and relaxing various muscles in turn
1. Hold the tension for 5 seconds
2. Say “relax” as you release the muscle
3. Let the muscle relax for 10 seconds before moving on to the next muscle
Picture your happy place – close your eyes and imagine physically being in this place
1. Think about how calm and peaceful this place is and imagine your feet touching the cool soil, hot sand, soft rug, etc.
Take any prescribed medications – if you have prescribed medications from your doctor for anxiety/panic, take as prescribed to alleviate symptoms
Tell someone – if you notice that your anxiety/panic occur in the same environment (workplace, social setting, etc.) it may be helpful for someone to be informed of this. Others can help by locating a quiet spot for you, give you reassurance, etc.
Learn your triggers – learning your triggers can help you avoid situations that may trigger your anxiety/panic reducing frequency of the anxiety/panic

It is recommended that you plan in advance the coping mechanisms you will utilize as it is difficult to make a decision while you are experiencing anxiety or panic.

Patient Story: “Coming Out” – My Journey with Anxiety

I remember it like it was yesterday. My first panic attack. I was 8 years old, and I felt like I was dying. The worries in my mind had taken over my body and it was as if I had no control over what was happening to me. Growing up, anxiety was not talked about often or understood by most people. The stigma, embarrassment, and shame led me to keep this part of me hidden. On the outside I was a typical child with a bubbly personality. On the inside I was dreading daily life and focusing on the uncomfortable sensations that permeated through my body.

I did not have the tools to either express or cope with my inner struggles. My inner anxiety had so much power and control over my life. It seemed like no one understood, and I felt angry when they didn’t. My journey through my adolescence was similar with the exception of my growing ability to mask my secret better. While I was extremely lucky to have parents who tried everything in their toolbox (psychologists, therapists, etc.) to help me, I realize now that it was not until I accepted my own anxiety that my life was able to take a turn. I say a turn, because that is exactly what living with anxiety feels like (twists and turns, highs and lows). I do give a lot of credit to finding the medication that was best for me. Whether you are a proponent of mitigating measures or not, I strongly suggest being open minded to the possibilities of change that come with anxiety medication.

As I got older, I felt that so much of my life was “ruined” by my anxiety. I couldn’t go back, but I did want to give others what I was missing. I wanted to be a person who DID understand what they are going through. With complete irony, I decided to spend my days in the place that caused me so much anxiety as a child. I am now an elementary school counselor and licensed professional counselor. I promote and educate mental health to all students. I am doing my part to help both struggling students as well as educating compassionate allies for them.

I am still on my “coming out” journey (this post being a huge part of that). The ability to share my story without the shame that was previously attached to it is the biggest step in my ongoing ability to not only help others and reduce the stigma, but to continue to help myself as well. The resources we have today were not as accessible when I was a child. The stories that are told on the ADAA website have encouraged me to do the same. The knowledge I gain through the wonderful resources allow me to educate and empower both children and parents. I hope I can encourage others to do the same for both themselves and those who they may impact.

Retrieved from: https://adaa.org/living-with-anxiety/personal-stories/coming-out-my-journey-anxiety

Crisis Resources: