What is Anxiety? – Anxiety facts

Generalised Anxiety Disorder, Social Anxiety, Panic Attacks, Health Anxiety (Hypochondria)

“To be human is to be anxious. Anxiety is an unavoidable part of human life.” (Rollo May, 1950)

Anxiety is something that we all experience in everyday life. It is a normal physical response to our experience of the world around us. Anxiety helps us to protect ourselves from danger. Differing symptoms of anxiety naturally come and go dependant on our activities. However anxiety is not a pleasant feeling and when we experience it too often it can become problematic and frightening.
It is when feelings of anxiety become too intense or frequent that we begin to suffer. Suffering caused by feelings of anxiety is referred to as anxiety disorder.
Anxiety disorder is the primary focus of our work in Southampton where we provide a combination of Cognitive Behavioural approaches (CBT) and Clinical Hypnotherapy* for anxiety.

Anxiety facts

In the UK today it is estimated that 12.6 million people suffer with unwanted symptoms of anxiety on a daily basis and numbers are steadily increasing. In the US as many as 40 million adults suffer anxiety disorders, such as Generalised Anxiety Disorder (GAD), Panic disorder, Social Anxiety or Health Anxiety (Hypochondria). 18% of the total adult population in the US are struggling to cope with anxiety daily.
Anxiety treatment is very affective yet it is estimated only one-third of people suffering with symptoms receive anxiety treatment. The rest it is assumed fight and struggle with anxiety, alone.
In the US 33% of the entire mental health care bills are spent on anxiety. That’s a staggering $42 Billion being spent on anxiety treatment, relief and prevention per year.
So if anxiety causes so many problems for so many people, why do we get anxious?

What is the purpose of anxiety?

Anxiety (or the stress response) is the body’s natural response to danger and threat. When we experience a situation we perceive as a danger or threat, our brain triggers a series of physical and chemical responses. Chemicals such as adrenaline and cortisol are released into our bloodstream as we prepare to take action.

Understanding Fight or Flight (What is a Panic Attack?)

Fight or flight is a naturally occurring coping mechanism that ensures our mind and body react quickly and in the most efficient way possible to any number of harmful or potentially harmful situations or triggers. The trigger could be anything from a physical threat/trauma, a phobia, to emotional stresses and lethargy.
During our work with people with anxiety in Southampton, people often ask “what is the difference between stress and anxiety?” and it is often the trigger that is sited as the defining factor.
Stress is considered to be linked to feelings of frustration caused by factors we can control such as work, while anxiety is thought of as a fear of things outside our control, such as fear of the future, fearing a car accident or unexplained pain, being fearful of physical changes/ailments or conditions (common with health anxiety).
Anxiety leaves us feeling helpless, where as stress leaves us feeling overwhelmed.

Anxiety for no reason?
Some anxiety sufferers state “I have anxiety for no reason”, this is often due to negative thinking or self-critical thinking rather than direct stress/anxiety.
The idea that negative/fearful thinking is the cause of anxiety, is the key to understanding all anxiety disorders. It is ultimately our interpretation of things (how we think about things) that causes us to become anxious.
An example can help us understand this more easily –

Person A loves being centre of attention and performs on stage regularly, while person B is terrified of speaking in-front of even a small group of people. Person A sees no threat, while person B feels very threatened by the scenario. The scenario is no different for person A or B but they interpret it differently (think about it differently).

Here we can clearly see that it is not the scenario but the interpretation of how that scenario will play out that provokes the anxiety.

As mentioned above, the body responds to both stress and anxiety in the same way. The body’s nervous system becomes more active as stress hormone release increases during fight or flight. This increase in hormone release creates physical changes that allow us to literally fight or flight (run away).

In early man these hormonal/physical changes were useful when faced with a threat, such as a lion. Fight or flight ensures that when faced with a threat or danger we act quickly and efficiently (you don’t want to be half asleep when faced with a lion).
Traditionally the hormones would get used up by the body and burned off during battle or activity and the body would normalise after the event (the nervous system would settle back down). When anxiety is useful and correctly used we call it ‘natural anxiety’.

Here is a simple diagram to explain this

Trigger (lion) > Hormone release >Physical change (see below) > fight or flight (attack or run away) using up hormones

However in the modern world these changes are no longer appropriate. Today we fear events and things that do not require a physical response, such as social or financial issues. When the body prepares for action and nothing happens, no physical exertion takes place, we are left in an anxious state.
The physical changes (symptoms of anxiety) seem strange out of context and often frighten the person as much or more than the initial problem. The physical changes that occur due to hormone release will often feel like a wave or rush of fear.
This rush or spike of fear is referred to as a Panic Attack. Panic attacks can be terrifying and once experienced the sufferer can become frightened it will happen again.
Guess what happens when we are frightened of the symptoms of anxiety….more stress hormones are released and more symptoms of anxiety occur, more panic attacks!

The sufferer then gets trapped in the vicious cycle of anxiety. They fear the fear.

When we look at the most common physical symptoms of anxiety it is easier to understand this.

Physical symptoms of anxiety

  • Heart racing & palpitations – when we experience anxiety our heart rate increases, helping provide blood to the areas of the body that need it the most – more blood is delivered to the legs enabling us to run faster (flight); the arms also receive more blood enabling us to strike out (fight); the lungs to increase levels of stamina. While this is happening other areas that are not required in fight or flight receive less blood (the skin, toes and fingers). This can cause feelings such as tingling, coldness and numbness (anxiety numbness, anxiety tingling, anxiety numb legs) – Typical negative interpretation (anxious thought) “why are my fingers tingling? Am I ill? Is this a sign of something serious?”
  • Breathing increases in pace –We breath faster when we are anxious and this helps aid the heart in delivering more oxygen to the arms, legs and lungs. Although the greater level of oxygen increases our physical strength, typical side effects include breathlessness (anxiety breathless, anxiety short of breath) and a choking feeling. Anxiety related chest pain and chest pain in the left side are two of the symptoms of anxiety that confuse most anxiety sufferers. Many conclude that they are suffering a heart attack or are having problems with lungfunction. This anxiety attack symptoms vs heart attack is one of the most terrifying symptoms of anxiety, yet is a natural reaction to stress. As our breathing alters people sometimes report feeling that anxiety causes shortness of breath. As these changes happen they are often accompanied by a dizzy feeling or light headedness (anxiety dizziness) caused by a slight drop in the blood and oxygen being delivered to the brain, some may even experience blurred vision (anxiety blurred vision). It is worth noting that although people ask “will I faint during an anxiety attack” the body is preparing to do the opposite and it is very uncommon to faint in the anxious state – Typical negative interpretation (anxious thought) “ Oh God, I’m having a heart attack! Why am I dizzy? Am I going to faint? Is this a sign of something serious?”
  • Muscular tension & aching muscles – when we become anxious many of our muscles become tense in order to create power. As a side effect of this we may experience pain in areas such as the arms, legs, chest or neck (anxiety neck pain, anxiety throat pain, anxiety bad back/back ache, anxiety chest pain). Some even feel shaky. One common anxiety symptom is waking up with aching or numb limbs this is an after effect of this and is also caused by anxious dreaming – Typical negative interpretation (anxious thought) “ Why does my back hurt? What’s wrong with my legs? Is this a sign of something serious?”
  • Sweating – The body begins to sweat which helps to keep the muscles cool and prevent overheating (anxious sweats). People with anxiety disorder often report getting clammy hands or excessive sweats, including night sweats (anxiety night sweats). Another theory is that the sweat makes us less easy to grab if an enemy decided to get hold of us – Typical negative interpretation (anxious thought) “ Why am I sweating for no reason? Perhaps I have something wrong with me. Maybe I have a thyroid problem?”
  • Sensory alterations – We may notice visual changes when we become anxious such as things becoming brighter. This is due to pupil dilation which helps us to see more easily if required. This can cause spots before our eyes and increased sensitivity to light. There are also changes to our hearing. Noises can seem louder or muffled as we adjust to the threat. Some people report being more sensitive to odours and aromas. These changes can cause headaches and sore eyes (anxiety headache, anxiety sensitivity to light, anxiety sore eyes) – Typical negative interpretation (anxious thought) “Why am I suffering such bad headaches? I read about this on the internet, it’s a brain tumour!”
  • Changes to the Digestive system – Our digestive system slows down when we anticipate danger. The body attempts to store and save energy to leave it available for the areas that need it most. The side effects of this are some of the most commonly reported symptoms of anxiety and include feelings of nausea, butterflies and a dry mouth, as well as diarrhea or constipation (anxiety butterflies, anxiety IBS, anxiety dry mouth) – Typical negative interpretation (anxious thought) “What happens if I can’t get to a toilet? Why am I feeling so sick, is this bowel cancer? Maybe it’s my diet? Can my diet give me anxiety?”
  • Increased alertness, trouble concentrating – As our attention turns to danger, we start looking for threats and often this reduces our ability to concentrate on other tasks. We may feel an anxious sense of doom as our body prepares to cope with the imminent danger (anxiety trouble concentrating, anxiety fear of future). We may also feel like we are dissociated from our bodies or not really there (depersonalisation) – Typical negative interpretation (anxious thought) “I’m not sure what is wrong, I just know something bad is going to happen. I don’t feel part of my body, is this mental illness?”
  • Disturbed or interrupted sleep – As we sleep our body tries to clear out some of the chemicals produced during anxiety, this happens during slow wave sleep. However when we suffer anxiety caused by problems that cannot be easily resolved (with a simple fight or flight) our mind tries to resolve the problems during dream sleep (REM). During dream sleep the body reacts to anxiety in the same way that it does when we are awake (anxious dreams). It enters fight or flight and the body makes the same physical responses as above. For these reasons many people suffer anxiety and panic attacks while asleep, anxiety upon waking up or simply anxiety while a sleep. When these sleep related symptoms occur the sufferer becomes fatigued & may feel tired for large parts of the day – Typical negative interpretation (anxious thought) “I’m exhausted… not going to be able to function tomorrow! Why is this happening? Can my bedding be giving me night sweats or do I have a thyroid issue?”
These are just some of the more common symptoms of anxiety/panic and the negative interpretations often wrongly given.
Our clients often report suffering more than one symptom before starting anxiety treatment in Southampton.

As mentioned above, if the stress response is experienced with a purpose, it is an incredible coping mechanism but when the stress response mechanism is triggered in situations that do not require the physiological changes, problems arise.
When we suffer anxiety for long periods of time (chronic stress response), longer term physical problems can arise.
Typically without anxiety treatment a person may suffer bad back, jaw ache, neck and throat pain, headaches, fatigue, nausea, IBS, skin conditions, feelings of dissociation (feeling like you are not really there) and problems concentrating to name a few.

Some of these symptoms of anxiety can be labelled psychosomatic and are common with health anxiety sufferers and hypochondriacs.

When does anxiety become a problem? (Why am I anxious?)

Chances are that you have experienced some of the symptoms above at some point in your life without it becoming problematic. For example you may have had nervous butterflies before or during a presentation at school or work. You may have had difficulty sleeping or felt sick the night before a job interview. Perhaps you noticed a lump and became frightened before seeing a doctor. These things are all very common and are part of life (natural anxieties).

Anxiety disorders evolve when common and useful feelings of anxiety get distorted and exaggerated. Once this happens we can become trapped in a vicious cycle of anxiety.
Anxiety disorder is a fear of the fear.

For example, when a symptom of anxiety scares us during a panic attack, we often blame the symptom on other things.

Remember the diagram?

Trigger (lion) > Hormone release > Physical change (see below) > fight or flight (attack or run away) using up hormones

When we fear the fear, the vicious cycle looks like this –

Trigger (Stress at work) > Hormone release > Physical change (tension in chest) > Negative interpretation (“Oh God have I got a heart condition”) > Hormone release > Physical change (tension in chest) > Negative interpretation (“Oh God I have a heart condition”)

Let’s look at some common types of anxiety disorder to understand this a little more

Case 1 – Health Anxiety
What is health anxiety? Hypochondria Help

‘Hypochondria (health anxiety) is excessive worrying about your health, to the point where it causes great distress and affects your everyday life. Some people with health anxiety have a medical condition, which they worry about excessively. Others have medically unexplained symptoms, such as chest pain or headaches, which they are concerned may be a sign of a serious illness, despite the doctor’s reassurance’ NHS UK

Important: When dealing with health related anxiety (Hypochondria) and physical issues, it is important that symptoms are discussed with your Doctor. Anxiety is not to be considered the cause of symptoms without a Doctor’s agreement. Many people seek hypnosis or hypnotherapy for anxiety without getting a formalised diagnosis from a Doctor and any good therapist will not begin anxiety treatment without this.
When considering anxiety vs heart attack for example, it is usual to feel muscle pain in the chest when faced with excessive stress. If the feeling is being caused by anxiety and we exercise, recognise this as simply a symptom of anxiety, the symptom eventually passes.

However if we tell ourselves “I am having a heart attack” “I have a problem with my heart” “this is going to kill me” more stress chemicals get released and we enter into the vicious cycle of anxiety. We fear the fear (fear the symptom of anxiety).

In our Southampton hypnotherapy practice we specialise in providing health anxiety help. Many people suffer terribly before health anxiety treatment. As described above when we begin to fear the fear we get trapped in a vicious cycle of anxiety.

This cycle can be explained if we consider a typical health anxiety symptom we see in our Southampton therapy practice.

Here is how the anxious cycle may play out for a health anxiety sufferer:

The suffer notices a symptom such as tightness in their chest (the cause of this could simply be a fight or flight response to stress at work)

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Next they focus their attention on the area and tell/ask themselves negative statements such as “could pain in my chest be a problem with my heart?” or “could pain in my chest be lung cancer?”. More chemicals are released and the area becomes tighter.

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The sufferer may start to touch and inspect the area. This can create more sensitivity in the tissue.

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They see a doctor and the Doctor says “I believe it is stress related. Try to cut back at work, or take some Beta-Blockers/Propranolol for anxiety

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The pain remains for a few days (it can take a while to pass) and the sufferer doubts the Doctor. They continue telling/asking themselves “what if the doctor got it wrong?” “ the doctor didn’t seem to do a proper check up”. More chemicals are released and the area becomes tighter. The sufferer continues to touch and inspect the area, creating more sensitivity in the tissue.

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The sufferer begins to feel hopeless “the Doctors aren’t going to do anything” “I may die and no one is going to help

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The sufferer begins to Google the symptoms, reading all about lung cancer. More hormones are released

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They may see a specialist who agrees with the doctor “I believe it is stress related”. The sufferer feels even more hopeless as the symptoms of anxiety remain no matter what the doctor says. Negative self-talk continues, “It must be cancer” “why aren’t the doctors doing scans?

This is a typical health anxiety cycle.

The problem with anxiety disorders is the symptoms are very real, the sufferer may feel considerable pain, have rashes, notice swelling or feel exhausted due to anxiety. They will often feel very frightened and scared that if no one is helping, they will get continually worse. In the case above, as with most anxiety disorders the uncertainty (not knowing if the symptom is anxiety or something more serious) drives the disorder forward.
This leaves the sufferer continually asking “Do I have anxiety?” “have I got an anxiety disorder?” or “am I really ill?

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