Michael D. Williams
Department of Home & Family
Brigham Young University—Idaho
Chapter One
The Physiology of Anxiety
The Physiology of Anxiety
Anxiety is probably the most basic of all emotions. Not only is it experienced by all humans, but anxiety
responses have been found in all species of animals, right down to the sea slug. Anxiety experiences
vary tremendously in their severity from mild uneasiness to extreme terror and panic. They can also
vary tremendously in their length from a brief, almost fleeting flash, to a constant, all-day affair. While
anxiety, by its nature and definition, is an unpleasant sensation, it is not in the least dangerous. It is this
last point which forms the basis of this article. The aim of the next few pages is to teach about the
components (physical and mental) of anxiety to help students realize (1) that many of the feelings they
are now experiencing are the result of anxiety and (2) that these feelings are not harmful or dangerous.
Definition of Anxiety
While an actual definition of anxiety which covers all aspects is very difficult to provide (indeed whole books have been written on the subject), everyone knows the feeling which we call anxiety. There is not one person who has not experienced some degree of anxiety, whether it is the feeling upon entering a schoolroom just before an exam, or the feeling of waking in the middle of the night, certain that a strange sound was heard outside.
Not everyone, however, is familiar with more extreme sensations and cognitive overload: extreme dizziness, spotty and blurred vision, numbness and tingling, rigid muscles, feelings of breathlessness extending to choking or smothering, or the perception that one is having a heart attack or “going crazy.” Some even experience a profound sense of depersonalization, as if they were somehow outside of their bodies and observing themselves.
Definition of Anxiety
While an actual definition of anxiety which covers all aspects is very difficult to provide (indeed whole books have been written on the subject), everyone knows the feeling which we call anxiety. There is not one person who has not experienced some degree of anxiety, whether it is the feeling upon entering a schoolroom just before an exam, or the feeling of waking in the middle of the night, certain that a strange sound was heard outside.
Not everyone, however, is familiar with more extreme sensations and cognitive overload: extreme dizziness, spotty and blurred vision, numbness and tingling, rigid muscles, feelings of breathlessness extending to choking or smothering, or the perception that one is having a heart attack or “going crazy.” Some even experience a profound sense of depersonalization, as if they were somehow outside of their bodies and observing themselves.
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When people have some combination of these symptoms—something which happens far more
often than most of us suspect—they may believe there is something seriously wrong with them. The
fear that something horrible is happening or will happen creates a feedback loop of anxiety that we call
panic attacks.
Fight, Flight and Freeze Responses
Anxiety is a response to danger or perceived threat. Immediate or short-term anxiety is often referred to as the fight-or-flight response, so named because all of its affects are aimed toward either fighting or fleeing danger. Thus, the number-one purpose for anxiety is to protect the organism.
Consider a scenario in which one is blissfully walking through the mountains, enjoying the sights and sounds of nature, perhaps strolling hand-in-hand with someone he or she adores—and the feeling is reciprocal. Imagine they are engaged, and making plans for their upcoming wedding while walking through the hills outside of town while and enjoying the gentle breeze that is making the leaves flutter. As the two of them begin discussing the details of their reception—the comparative virtues of lime green over sea foam green for the table-cloths—they sense rustling in the bushes just ahead on the trail. Puzzled, they come closer and are intercepted by a snarling bear.
Quickly, note what would happen to
Fight, Flight and Freeze Responses
Anxiety is a response to danger or perceived threat. Immediate or short-term anxiety is often referred to as the fight-or-flight response, so named because all of its affects are aimed toward either fighting or fleeing danger. Thus, the number-one purpose for anxiety is to protect the organism.
Consider a scenario in which one is blissfully walking through the mountains, enjoying the sights and sounds of nature, perhaps strolling hand-in-hand with someone he or she adores—and the feeling is reciprocal. Imagine they are engaged, and making plans for their upcoming wedding while walking through the hills outside of town while and enjoying the gentle breeze that is making the leaves flutter. As the two of them begin discussing the details of their reception—the comparative virtues of lime green over sea foam green for the table-cloths—they sense rustling in the bushes just ahead on the trail. Puzzled, they come closer and are intercepted by a snarling bear.
Quickly, note what would happen to
-
their heart rates,
-
their breathing,
-
the sounds of the leaves in the breeze,
-
their interlocked hands,
-
and their preference of colors.
All of those changes happened in an instant, and there is a very good chance that they lost track of one another’s hands and did not care about which green would festoon the tables. What happened?
Ready for Action
Nature has beautifully designed human beings with the capacity to automatically respond (react) to apparent dangers by sending hormones (chemical messengers) to alter the functioning of several parts of the body. The sympathetic nervous system is set in motion as the limbic system becomes flushed with blood and electrical activity, changing the heart rate, breathing pattern, and blood pressure almost instantaneously. It happens so quickly, in fact, that we do not even notice the important gap between the event (for example, a bear sticking its head out of the bushes) and the physiological changes.
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Fight. It would be very useful to have plenty of oxygen-rich blood surging through one’s veins while
preparing to fight off something big and scary. Increased blood pressure also assures greater reflex
speed and intensity—a doctor using a hammer on one’s knee to test reflexes is a “quick and dirty” test
for high blood pressure. Tense muscles could also prepare one to wrestle a threat to the ground or give
it a good thrashing.
Flight. Once again, tense muscles and well-oxygenated blood surging through the blood stream would be very useful when preparing to flee. It would be preferable to get the system ready rather than waiting until the body begins to tire.
High blood pressure also tightens the tympanic membrane of the inner ear, increasing the ability to hear small sounds that might otherwise have gone unnoticed. At the same time, the pupils dilate, making it easier to pick up visual cues of danger. This increased visual and auditory acuity does not equal accuracy. In fact, the body seems to trade off accuracy in favor of sensitivity to danger cues—when trying to escape danger, one is not so concerned about how nice the bad guy’s spurs tinkle or how well his shirt matches his eyes.
Freeze. We are all familiar with fight-or-flight responses, but it may be less well-known that up to 60% of Americans are more prone to freeze at signs of danger. In these individuals, heart rate increases; breathing tends to be shallow and rapid, but blood pressure drops rather than rises. While this physical state is not very useful for running or wrestling, it is very helpful in preparing one to be overwhelmed by physical danger.
When bodies go into shock, they reduce the likelihood of death by retaining blood in the core of the body and reducing blood flow at the extremities. Many animals respond by freezing to avoid being noticed by predators—the same phenomenon has been observed in classes and in social events on campus. Humans are often confused when they have the freeze response; they feel week in the knees or feel like vomiting or wetting themselves rather than sprinting or practicing Tae Bo moves when they feel scared. “Freezers” are only experiencing a normal anxiety response.
Which of the three responses—fight, flight or freeze—would be wisest or most effective when encountering a grumpy grizzly?
Not Ready for Contemplation or Observation
Notice one other important change that occurred when the engaged couple encountered the bear: they likely lost track of the other things that they were or could have been thinking about. Why would God
Flight. Once again, tense muscles and well-oxygenated blood surging through the blood stream would be very useful when preparing to flee. It would be preferable to get the system ready rather than waiting until the body begins to tire.
High blood pressure also tightens the tympanic membrane of the inner ear, increasing the ability to hear small sounds that might otherwise have gone unnoticed. At the same time, the pupils dilate, making it easier to pick up visual cues of danger. This increased visual and auditory acuity does not equal accuracy. In fact, the body seems to trade off accuracy in favor of sensitivity to danger cues—when trying to escape danger, one is not so concerned about how nice the bad guy’s spurs tinkle or how well his shirt matches his eyes.
Freeze. We are all familiar with fight-or-flight responses, but it may be less well-known that up to 60% of Americans are more prone to freeze at signs of danger. In these individuals, heart rate increases; breathing tends to be shallow and rapid, but blood pressure drops rather than rises. While this physical state is not very useful for running or wrestling, it is very helpful in preparing one to be overwhelmed by physical danger.
When bodies go into shock, they reduce the likelihood of death by retaining blood in the core of the body and reducing blood flow at the extremities. Many animals respond by freezing to avoid being noticed by predators—the same phenomenon has been observed in classes and in social events on campus. Humans are often confused when they have the freeze response; they feel week in the knees or feel like vomiting or wetting themselves rather than sprinting or practicing Tae Bo moves when they feel scared. “Freezers” are only experiencing a normal anxiety response.
Which of the three responses—fight, flight or freeze—would be wisest or most effective when encountering a grumpy grizzly?
Not Ready for Contemplation or Observation
Notice one other important change that occurred when the engaged couple encountered the bear: they likely lost track of the other things that they were or could have been thinking about. Why would God
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create us to do that? Of course it would be of no value to keep comparing table cloth colors or enjoying
the sounds of the leaves in the breeze when life is at stake. When the limbic system takes over brain
function, it quickly makes it difficult to see or perceive anything that is not in keeping with the emotional
state. The bear’s teeth look bigger, its breath smells worse, and its size seems even greater than it likely
would be. This is very useful for helping us to focus on the dangers so that we can avoid them, but it
does not help much in terms of making wise or astute observations. (That is why crime victims often
cannot accurately describe the criminal, but the weapon seemed out of proportion). In fact, some men
would embarrass themselves horribly by running away and leaving the fiancé to be eaten, or by even
pushing her forward and hiding. It would not be a function of not loving her, but a natural response
when the limbic portion of the brain takes over. Reason takes a back seat when the limbic system does
the driving—natural or not, that kind of behavior is likely to put more of a crimp in the wedding plans
than differences in color preferences.
The Gap = Perception
All of the above processes occur so quickly that it is not even evident that something happened between the cue (sight of the bear) and the limbic mutiny that occurred. What we most often take for granted is the observation or assumption that the cue signals real danger. With the grizzly example, physical danger is obvious. But what if the “danger” is actually no danger at all? Imagine that the couple had survived this event with their dignity and relationship intact. Months later, the two of them are walking through a similar setting and perceive rustling in the bushes. They would likely respond just as before, with changes in breathing, blood pressure, tension, etc. But if a cow came out of the bushes, chewing its cud, it would take a moment for them to recognize that they were in no danger at all. Their breathing, heart rate, etc. would return to normal, but it would take a while for their brains to accept that there was no real danger.
The brain does not respond to danger, but to the perception of danger. It relies upon us to accurately access and send the “danger" message by thinking that we are in danger.
It may not be difficult to think of a time in which one’s individual fight/flight/freeze response was activated when there was no actual physical danger present. We perceive far fewer actual physical dangers day-to-day than we do social or psychological dangers. In fact, surveys have consistently demonstrated that more Americans fear public speaking than they do death.
Is it because something worse than death is likely to occur if one’s voice cracks or one’s warm-up joke is not funny? No, but when we imagine that it will be horrible, our brain responds with horror; if we tell
The Gap = Perception
All of the above processes occur so quickly that it is not even evident that something happened between the cue (sight of the bear) and the limbic mutiny that occurred. What we most often take for granted is the observation or assumption that the cue signals real danger. With the grizzly example, physical danger is obvious. But what if the “danger” is actually no danger at all? Imagine that the couple had survived this event with their dignity and relationship intact. Months later, the two of them are walking through a similar setting and perceive rustling in the bushes. They would likely respond just as before, with changes in breathing, blood pressure, tension, etc. But if a cow came out of the bushes, chewing its cud, it would take a moment for them to recognize that they were in no danger at all. Their breathing, heart rate, etc. would return to normal, but it would take a while for their brains to accept that there was no real danger.
The brain does not respond to danger, but to the perception of danger. It relies upon us to accurately access and send the “danger" message by thinking that we are in danger.
It may not be difficult to think of a time in which one’s individual fight/flight/freeze response was activated when there was no actual physical danger present. We perceive far fewer actual physical dangers day-to-day than we do social or psychological dangers. In fact, surveys have consistently demonstrated that more Americans fear public speaking than they do death.
Is it because something worse than death is likely to occur if one’s voice cracks or one’s warm-up joke is not funny? No, but when we imagine that it will be horrible, our brain responds with horror; if we tell
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ourselves something is terrible, we respond in terror. The truth is that the brain believes everything that
it thinks, whether it is true or not. Some famous quotes, such as the ones below, illustrate this reality:
“I’ve suffered a great many catastrophes in my life. Most of them never happened.”
–Mark Twain
“If I had my life to live over, I would perhaps have more actual troubles but I’d have fewer imaginary
ones.”
– Don Herold
“Some of your hurt you have cured, And the sharpest you still have survived, But what torments of grief you endured From the evil which never arrived.” – Ralph Waldo Emerson
Once again, the brain believes everything that it thinks, even if it is not true.
Panic Attacks and Persistent Anxiety
While all of the above probably makes perfect sense given one’s own experiences and perceptions, it may be very confusing when we ourselves or others experience either panic attacks or anxiety that continues well beyond the presence of the perceived danger.
“I’ve suffered a great many catastrophes in my life. Most of them never happened.”
–Mark Twain
“If I had my life to live over, I would perhaps have more actual troubles but I’d have fewer imaginary
ones.”
– Don Herold
“Some of your hurt you have cured, And the sharpest you still have survived, But what torments of grief you endured From the evil which never arrived.” – Ralph Waldo Emerson
Once again, the brain believes everything that it thinks, even if it is not true.
Panic Attacks and Persistent Anxiety
While all of the above probably makes perfect sense given one’s own experiences and perceptions, it may be very confusing when we ourselves or others experience either panic attacks or anxiety that continues well beyond the presence of the perceived danger.
Keep in mind that our bodies—beginning with our brains—do not really respond to dangers but to the
perceptions of danger. We might say that a stressor event does not stress us out but the stress we place
on the events creates or maintains stressor responses. Of course we do not consider ourselves crazy,
incompetent or broken if we have anxiety responses to genuine threats.
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But what if no apparent danger is present when we have these anxious responses? If our hearts are
pounding, it is hard to breathe, or we feel week and dizzy when no apparent threat is present, what
could possibly be wrong?
Now we have a different challenge entirely. Now, instead of the anxious responses (e.g. pounding heart and running) leading to a relief from the danger cue (scary bear), and resulting anxious responses (feeling scared), we can experience ourselves as trapped in a feedback loop. The anxious response is normal but is experienced (perceived) as evidence that something is out of whack or somehow dangerous in itself. The brain then responds with more anxiety.
Now we have a different challenge entirely. Now, instead of the anxious responses (e.g. pounding heart and running) leading to a relief from the danger cue (scary bear), and resulting anxious responses (feeling scared), we can experience ourselves as trapped in a feedback loop. The anxious response is normal but is experienced (perceived) as evidence that something is out of whack or somehow dangerous in itself. The brain then responds with more anxiety.
False alarm
Anyone who has held a microphone close to a speaker has experienced the shrill sound that results as
the vibration is fed back and amplified each time in a never-ending feedback loop that began with only a
whisper or an inaudible vibration. It grows so rapidly that it may not be obvious what is happening. But
the sound is very real nonetheless. This is quite similar to the feedback process experienced with panic
attacks. It does not matter what the cue is; if it is perceived as dangerous, the brain goes into auto pilot,
deciding to panic. Where the response was once very helpful, or at least understandable, it is now very
unhelpful and confusing. Once we have had this experience a few times, we become actually anxious
about being anxious, which, in turn, makes us anxious.
Chronic or persistent anxiety often results from developing a habit of anticipating something dangerous or undesirable. It is common to know people who simply expect bad things to happen. These pessimists might even state that they expect the worst outcomes so they can be pleasantly surprised when something good happens. The problem is that it does not work that way.
When we anticipate negative outcomes, our ability to pick out the evidence for negative outcomes increases considerably. Remember that the limbic system makes it difficult for the rest of the brain to even perceive those things that are inconsistent with the emotional state. Negative thinkers can therefore more easily find and focus on negatives. Those who fearfully anticipate something scary happening sharpen their “scary experience” perceptions and find lots of things to be scared or anxious
Chronic or persistent anxiety often results from developing a habit of anticipating something dangerous or undesirable. It is common to know people who simply expect bad things to happen. These pessimists might even state that they expect the worst outcomes so they can be pleasantly surprised when something good happens. The problem is that it does not work that way.
When we anticipate negative outcomes, our ability to pick out the evidence for negative outcomes increases considerably. Remember that the limbic system makes it difficult for the rest of the brain to even perceive those things that are inconsistent with the emotional state. Negative thinkers can therefore more easily find and focus on negatives. Those who fearfully anticipate something scary happening sharpen their “scary experience” perceptions and find lots of things to be scared or anxious
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about. This reinforces the habit of anxiously anticipating until we are anxious about being anxious about
being anxious.
Why Are Some People More Vulnerable?
This is the most perplexing question for many who suffer from anxiety and for professionals. Some people are much more prone to have anxious responses outside the presence of real danger, or to get caught into the types of feedback loops discussed. Some have observed that relatives of panicky people are more likely to panic themselves, leading some to believe that anxiety is a genetic inevitability. We do not know definitively why some panic more than others but there are several clues that can help us. You may well form some of your own hypotheses as you review the following.
Higher Sensitivity. Some people are just more sensitive than others. Some are more sensitive to their own physical cues and responses. Some are more sensitive to the thoughts and reactions of others. This sensitivity may be biologically influenced, but it may also be learned or practiced just like any other skill or strength.
Higher Intelligence. Research has found strong correlations between intelligence—the capacity to learn—and propensities to panic. It has been hypothesized that very bright people simply learn things accidentally without a concerted effort and therefore learn to panic in response to false alarms.
Environmental Training. Many who suffer from anxiety grew up with parents who similarly catastrophized or worried too much to be helpful. Children learn to think and to interact with the world based upon experiences with parents. Wouldn’t it make sense that one would worry if one heard and observed parents worrying frequently?
Challenging Experiences. Many individuals have had experiences that contribute to their expecting negative outcomes. Living in an abusive or dangerous environment (physically or emotionally) can certainly heighten sensitivities or expectations of negative experiences in the future.
Lack of Awareness. Some people are simply not aware that they are having panic attacks and believe instead that they have some medical or emotional condition that is not responding to treatment. This is a difficult situation because good people are often convinced that they have a disease that is beyond learning or treatment.
Why Are Some People More Vulnerable?
This is the most perplexing question for many who suffer from anxiety and for professionals. Some people are much more prone to have anxious responses outside the presence of real danger, or to get caught into the types of feedback loops discussed. Some have observed that relatives of panicky people are more likely to panic themselves, leading some to believe that anxiety is a genetic inevitability. We do not know definitively why some panic more than others but there are several clues that can help us. You may well form some of your own hypotheses as you review the following.
Higher Sensitivity. Some people are just more sensitive than others. Some are more sensitive to their own physical cues and responses. Some are more sensitive to the thoughts and reactions of others. This sensitivity may be biologically influenced, but it may also be learned or practiced just like any other skill or strength.
Higher Intelligence. Research has found strong correlations between intelligence—the capacity to learn—and propensities to panic. It has been hypothesized that very bright people simply learn things accidentally without a concerted effort and therefore learn to panic in response to false alarms.
Environmental Training. Many who suffer from anxiety grew up with parents who similarly catastrophized or worried too much to be helpful. Children learn to think and to interact with the world based upon experiences with parents. Wouldn’t it make sense that one would worry if one heard and observed parents worrying frequently?
Challenging Experiences. Many individuals have had experiences that contribute to their expecting negative outcomes. Living in an abusive or dangerous environment (physically or emotionally) can certainly heighten sensitivities or expectations of negative experiences in the future.
Lack of Awareness. Some people are simply not aware that they are having panic attacks and believe instead that they have some medical or emotional condition that is not responding to treatment. This is a difficult situation because good people are often convinced that they have a disease that is beyond learning or treatment.
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So What Can We Do?
Those suffering from persistent panic and anxiety—and they really do suffer—can find relief by first understanding what is happening with them. While it is not the cure, it is a prerequisite to stopping the feedback loop. Next, they can find ways of interfering with the feedback, similar to how one quickly puts a hand over the microphone or moves it away from the amplification and feedback mechanisms.
Awareness
It is not enough to know what sometimes happens to others. We need to recognize what is happening within ourselves. Recalling the process above and seeing how we accidently start or perpetuate the process is very valuable. And the sooner we see the process occurring, the easier it will be to stop. It is very difficult to stop a full-blown panic attack but not so difficult to interrupt a little worry that is just beginning.
It is also remarkably helpful to distinguish a sensation as simply a sensation rather than interpreting it as a sure sign of danger. This takes some practice but is well worth it.
Change Your Thinking
We tend to believe that our thoughts are simply accurate representations of the world around us. But we often think thoughts that are exaggerated, inconsistent or simply mistaken. It may not be difficult for us to individually think of the last time we were sure that a certain friend did not care about us, only to find out later that something else was going on. If it is difficult to recall such an incident, we can think of how many times others have misread our actions or intentions. We are very poor mind readers, and yet we tend to persist in this and other behaviors that leave us with thoughts that do not line up with reality.
Cognitive Behavioral Therapy (CBT) is built upon these concepts and observations and many useful tools have been devised for helping us to change our thinking to be more in line with truth and to be more effective in responding to opportunities and challenges. They can be save lives—literally.
Accept Your Experience
Ironically, efforts to stop anxiety often amplify and perpetuate it. Rather than fighting anxiety responses, one can develop the ability to see them for what they are—a set of responses to a false alarm or simply sensations. It has been the personal experience of this author that in allowing the sensations to rise and to fall without trying to extinguish them, they go away, almost always within two minutes. Once again, this takes some real practice. Mindfulness practices are aimed at helping us to accept our sensations as
Those suffering from persistent panic and anxiety—and they really do suffer—can find relief by first understanding what is happening with them. While it is not the cure, it is a prerequisite to stopping the feedback loop. Next, they can find ways of interfering with the feedback, similar to how one quickly puts a hand over the microphone or moves it away from the amplification and feedback mechanisms.
Awareness
It is not enough to know what sometimes happens to others. We need to recognize what is happening within ourselves. Recalling the process above and seeing how we accidently start or perpetuate the process is very valuable. And the sooner we see the process occurring, the easier it will be to stop. It is very difficult to stop a full-blown panic attack but not so difficult to interrupt a little worry that is just beginning.
It is also remarkably helpful to distinguish a sensation as simply a sensation rather than interpreting it as a sure sign of danger. This takes some practice but is well worth it.
Change Your Thinking
We tend to believe that our thoughts are simply accurate representations of the world around us. But we often think thoughts that are exaggerated, inconsistent or simply mistaken. It may not be difficult for us to individually think of the last time we were sure that a certain friend did not care about us, only to find out later that something else was going on. If it is difficult to recall such an incident, we can think of how many times others have misread our actions or intentions. We are very poor mind readers, and yet we tend to persist in this and other behaviors that leave us with thoughts that do not line up with reality.
Cognitive Behavioral Therapy (CBT) is built upon these concepts and observations and many useful tools have been devised for helping us to change our thinking to be more in line with truth and to be more effective in responding to opportunities and challenges. They can be save lives—literally.
Accept Your Experience
Ironically, efforts to stop anxiety often amplify and perpetuate it. Rather than fighting anxiety responses, one can develop the ability to see them for what they are—a set of responses to a false alarm or simply sensations. It has been the personal experience of this author that in allowing the sensations to rise and to fall without trying to extinguish them, they go away, almost always within two minutes. Once again, this takes some real practice. Mindfulness practices are aimed at helping us to accept our sensations as
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sensations, our thoughts as thoughts, and to experience life with more joy and less suffering, even in the
presence of real danger.
Common Misinterpretations
Heart Attack
One of the most common misinterpretations of anxiety is that one is having a heart attack or other dangerous medical heart condition. This is commonly exacerbated by the fact that we are often warned about heart conditions and advised to not overlook signs and symptoms. It makes sense, of course, that one’s heart rate would go up while experiencing perceived heart problems, thereby easily spinning out of control.
Suffocation
Though not quite as common, there are a good number of people who become fearful when they feel as if they cannot breathe “normally,” or enough. This is often accompanied by a perceived need to gasp for air, which keeps it going. It is not easy to fight this urge if one feels as if he or she is suffocating. The good news about this and other anxious symptoms is that if one were to over-breathe (hyperventilate) or under-breathe one would simply pass out—and then breathe normally and effectively.
Going Crazy
Because the sensations grab our attention so effectively and because it is difficult for us to think clearly while the limbic system is fired up, one often feels as if she or he is somehow insane or could become insane. Once again, it makes sense that one would be anxious if it were perceived that he or she were crazy, or soon would be.
Nervous Breakdown
”Nervous breakdowns” simply do not happen. Our nerves do not break or collapse, no matter how many stories we have heard. By believing that they can break, however, one is more likely to be anxious and on-guard—and more likely to misinterpret what is happening when the anxious responses take over. It is sad that so many kind, sensitive people have somehow misunderstood and been misunderstood.
Losing Control
Some people believe that during a panic attack that they will “lose control.” They may imagine that they will do something truly outlandish that will bring criticism from others. Because anxious responses are, by definition, out of control or automatic, it is easy to imagine that they will do something that they or
Common Misinterpretations
Heart Attack
One of the most common misinterpretations of anxiety is that one is having a heart attack or other dangerous medical heart condition. This is commonly exacerbated by the fact that we are often warned about heart conditions and advised to not overlook signs and symptoms. It makes sense, of course, that one’s heart rate would go up while experiencing perceived heart problems, thereby easily spinning out of control.
Suffocation
Though not quite as common, there are a good number of people who become fearful when they feel as if they cannot breathe “normally,” or enough. This is often accompanied by a perceived need to gasp for air, which keeps it going. It is not easy to fight this urge if one feels as if he or she is suffocating. The good news about this and other anxious symptoms is that if one were to over-breathe (hyperventilate) or under-breathe one would simply pass out—and then breathe normally and effectively.
Going Crazy
Because the sensations grab our attention so effectively and because it is difficult for us to think clearly while the limbic system is fired up, one often feels as if she or he is somehow insane or could become insane. Once again, it makes sense that one would be anxious if it were perceived that he or she were crazy, or soon would be.
Nervous Breakdown
”Nervous breakdowns” simply do not happen. Our nerves do not break or collapse, no matter how many stories we have heard. By believing that they can break, however, one is more likely to be anxious and on-guard—and more likely to misinterpret what is happening when the anxious responses take over. It is sad that so many kind, sensitive people have somehow misunderstood and been misunderstood.
Losing Control
Some people believe that during a panic attack that they will “lose control.” They may imagine that they will do something truly outlandish that will bring criticism from others. Because anxious responses are, by definition, out of control or automatic, it is easy to imagine that they will do something that they or
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others will see as outlandish or unreasonable. However, this does not seem to happen. Ironically, those
who suffer from panic attacks are so very controlled that no one around them has any idea that they are
feeling that way. They may have grown so accustomed to regulating themselves that they appear calm
and cool. It is also ironic that some people who appear aloof or uncaring are actually so very careful and
tuned into their response to others that they end up being misunderstood. After treating individuals,
couples and families for more than 25 years it has been amazing to this author to see how often kind,
thoughtful, careful, intelligent, sensitive people are misunderstood by themselves and others.
References
Weber, J. G. (2011). Individual and Family Stress and Crisis. Los Angeles: Sage.
Clinic of Santa Barbara, UCLA-ADBP. (n.d.). Physiology of Anxiety. In Anxiety and Panic Disorders.
References
Weber, J. G. (2011). Individual and Family Stress and Crisis. Los Angeles: Sage.
Clinic of Santa Barbara, UCLA-ADBP. (n.d.). Physiology of Anxiety. In Anxiety and Panic Disorders.
