What is Anxiety and When is it a Problem?
By John Deku, LCPC*
Let’s say that on my way to my car tonight I see a grizzly bear, upright and roaring in my direction. I will certainly start to experience anxiety, which may include the following:
- Activating the fight/flight response – wanting to attack or run away
- In some circumstances we may freeze or appease
- Freeze: locking up in the moment and watching events unfold
- Appease: trying to please or barter with someone to leave us alone
Additionally, I may experience other physical symptoms:
- Increased blood pressure/heart racing
- Quick, heavy breathing
- Muscle tension
- Heightened awareness
While experiencing these symptoms may be quite uncomfortable, they are often useful. It is advantageous to have an automatic response to run away or defend yourself from a bear. Increased blood pressure, changed breathing and muscle tension also contribute to escaping or fighting. When there is danger, the fight or flight response is very helpful.
While often helpful, too much anxiety can be impairing. People who rarely feel anxious may not feel the pressure to succeed, while people with inordinate anxiety may be too stressed to accomplish much (Duffy, 1957). There is a ‘sweet spot’ in which stress can help compel a person to prepare for an event. This is expressed in the Yerkes-Dodson law, which suggests that moderate anxiety can help lead to increased performance. That is, some anxiety is useful. In my case with the grizzly bear, my anxiety would likely help to protect me by compelling me to fight or run.
But what happens when the anxiety is too intense and doesn’t allow the person to complete their tasks? Or the anxiety doesn’t go away when the stressor is gone? How does this kind of anxiety help? You may have already figured this out – it doesn’t. In fact, this kind of anxiety makes things worse. Unfortunately, some of us will struggle with this persistent high anxiety. For some, going to school, the store, or group outings create similar symptoms to seeing a wild grizzly bear. When anxiety starts to interfere with your daily life – such as engaging in work, school or spending time with friends – is when we suggest seeking services. In psychology, we call this an “impairment in functioning.”
Treating anxiety starts with how we perceive it. Anxiety is impossible to overcome if seen as something to avoid at all costs. Rather, anxiety could be seen as a set of reactions that are trying to tell you something; such as there is a threat and you should escape. What you choose to do with this reaction will likely influence your anxiety going forward.
There are well-researched interventions that can help reduce anxiety in a relatively short period of time. These include exposure and response prevention (ERP) amongst others (McGrath, 2016). In ERP the person makes a list of anxious situations, with some easier and some difficult. Starting with the ‘easiest’ task, the person approaches the anxiety-provoking event for however long necessary until the anxiety starts to go away. The anxiety will reduce over time. He or she gradually moves to the next anxiety-provoking event until the anxiety with these events is minimized. When conducted appropriately, many find ERP to be very helpful. Of course, there are many approaches to managing anxiety. Good therapy is customized to the needs of the client, with ERP being just one possible tool.
Being highly anxious is uncomfortable, and working on anxiety can sometimes be just as uncomfortable. No one wants to be in a fight/flight/freeze/appease state any longer than they have to. Managing anxiety requires a strong understanding of what activates and increases the anxiety, developing a plan for how to address the anxiety, and, most importantly, having a place to feel heard.
*John Deku, LCPC sees clients out of the St. Charles office
Duffy, E. (1957). The psychological significance of the concept of “arousal” or “activation.” Psychological Review, 64(5), 265–275.
McGrath, P. (October, 2016). Evidence-Based Practice for Anxiety-Related Disorders: OCD, PTSD, Hoarding, Panic and Phobias. Presented at Aurora Public Library, Aurora, Illinois.