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Anxiety; what's happening and what can you do

As I suggested in my previous blog (two for the price of one this week!), we are living through a stressful period. Not only have our lives and routines changed, we are also in the midst of a very real, very serious health threat. So, I’m going to talk a bit about an occupational perspective on anxiety; what it is, and ways to manage it. (apologies that this is a bit of a monster of a blog but I’m trying to cram a lot in!)


Although you might not describe yourself as anxious, I’m going to use it as shorthand for lots of things you might be experiencing. This might be one, some or all of the following:

  • excesses of emotion

  • feeling overwhelmed or that things are out of control

  • irritable (more than usual!)

  • sad

  • overthinking or racing thoughts

  • catastrophising – thoughts that go from one relatively small thing to everything being terrible in a matter of moments

  • feeling panicky

  • feeling scared

  • feeling worried

  • poor sleep- either can’t get to sleep or disrupted sleep or poor quality sleep in general


Anxiety is the body and brain’s response to stress or threat. It’s the word we use to describe what it feels like when our survival instinct is switched on and stuck in overdrive.


Anxiety is a survival response to individually perceived threat. This might be internal threat (thoughts, worries, beliefs) or external threats (other people and relationships, physical danger or harm, sensory input that takes us back to a time of fear or trauma).


The perception of threat is very individual- what one person experiences as a threat is not always what the person next to them will experience as a threat. Obviously if a car was coming towards you, most people would have a similar threat response. But, more often than not, the reason our threat systems are triggered is much more subtle than this kind of life and death situation. But whatever the threat is, it can feel like a life and death situation.


What we experience as threat is influenced by a combination of experience, memory, neurological pathways developed over time and individual factors relating to how we respond to threat.


It’s a kind of throw back in evolutionary terms; for our ancestor’s anxiety allowed them to survive the threats around them. Unfortunately, our bodies and brains haven’t evolved as fast as our social world and so the evolutionary response to threat is, frankly, a bit less useful than it once was because the threats are so different now.


Imagine this: your long ago ancestor is out foraging in the forest and along comes a sabre tooth tiger.


Your ancestor’s autonomic nervous system (the automatic part of your nervous system that doesn’t need any conscious thought or processing) readies their body for action whether this be fight, flight or freeze. In a matter of moments, without thinking about it, your ancestor is ready to act to survive; increased heart rate, increased breathing rate, hormones required for fast muscle action released and non-essential systems slowed down or stopped. At this point your ancestor (if their autonomic nervous systems is quick and effective enough!) survives the threat of the sabre tooth tiger.


Fast forwards to now; your brain still functions in the same way but the threats are different. They’re less immediate, less physically life-threatening (in that moment) and as a result are less well managed by the fight, flight or freeze response.


Now, we’re not completely stuck in the stone age, we have evolved systems to manage this response; the frontal lobes and cortical input i.e. ‘the thinking brain’. This is where all the higher level functions of the human brain live; reasoning, logic, communication, decision making. The higher level brain can moderate the response of the autonomic nervous system but how effective that higher level thinking can be is tripped up by a few things:

  • the message that there is a ‘threat’ takes longer to get to the frontal lobes than it does to get to the autonomic nervous system i.e. the bits that kick in without conscious thought get the message first

  • the feedback from the body when the autonomic system has been triggered tells the frontal lobes that there is threat and so reinforces the threat response

  • the cortical (thinking) areas are less accessible and function less well when the autonomic nervous system is in charge- it’s harder to think and reason



So, here we are, the threats inherent in our everyday situation (change, health risks, worries about family and friends, financial worries, worries for the future etc) are fizzing away in the background while we push ourselves to cope and manage and get through the day. The problem is that the anxiety doesn’t go away, our system has been triggered and continues to be triggered each day.


In a lot of ways, anxiety makes sense in the context of our current world; daily routines and everyday life have completely changed plus there’s a life-threatening situation that’s unpredictable, indiscriminate and part of our daily lives. I think it’s fair to say that, at this point, anxiety is a natural response to the Covid-19 pandemic. That said, this doesn’t necessarily help you in moments of stress.


So, what can you do?

Well, in all honesty different health professionals will have different answers to that question. My response is that if it’s hard to think your way out of anxiety, use the feedback system. Because the body’s response to threat reinforces the brains understanding of the situation as being ‘threat’, this prolongs the stress response. So, why don’t we ‘trick’ our brain by using our body and sensory systems to stop reinforcing the threat message.


If we can manage to do that, we’ve then got a better chance of being able to think and reason about how threatening our situation actually is is in that moment. It’s about creating a break in the cycle so that you can change how you feel and how you respond.


And how do you do that?

Well, it’s different for everyone but the underlying theory is that you reduce the physical results of the autonomic nervous system activation i.e. reduce heart rate, breathing rate and sensory overload by focussing on physical, sensory input designed to calm those systems.


The way you do this will be unique to you; everyone has a different preferences because everyone has a different sensory system. However, there are some strategies that are generally thought to more calming than alerting for most people (more info at the end of this blog and on the file share page of the website). These tend to focus on reducing breathing and heart rates (breathing techniques, also at the end and on file share) and using sensory systems, that are older in evolutionary terms, to bypass the need for cortical input- the vestibular and proprioceptive systems in particular.


You will already have instinctive ways of calming your system, the next step is to think about what they are and accentuate them in a focussed way (think back to the sensory ladder and the things you identified as useful to move you down the ladder- they’re the clues).


Use your common sense, think about what you naturally gravitate towards and think about why those activities or sensory inputs work for you. Have confidence that you will find something that’s right for you; if you understand the theory of why things might be working, you can explore different routes and find your ‘perfect fit’.

So, try things out and, as always, reflect on what was and wasn’t helpful so you know what works best for you.


In summary, understanding the process of anxiety and applying this to your own sensory ladder can help. This understanding of your own system can be used in different ways:

  1. You can use your ‘best’ anxiety management techniques in a reactive way when you feel yourself in the grip of anxiety

  2. You can use them when you feel yourself moving up the ladder so you can reduce this level before you move any further up the ladder and it becomes less possible to think clearly enough for you to effectively plan and take action

  3. You can use the strategies that work for you in a regular, pro-active way to maintain a consistent state of calm and alert by habitually reducing your levels of alertness:

  • this can reduce the amount you need to rely on a reactive response isn’t always the most helpful- particularly if you don’t quite catch it at the right time

  • it can bring a sense of control: often worries about unpredictability and a lack of control contribute to increasing anxiety

  • it creates opportunity to embed anxiety management into your routine so that it can become habituated; when this happens, you don’t have to think about it all so often (surely a bonus!)


Next time I’ll be thinking about the all important opposite of anxiety: rest.

How and why rest, respite and sleep are so important to our functioning at times of stress.

For now I’ll say goodbye.


Take care, look after yourselves,

Kate












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