Healthy anxiety is our body’s way of telling us of potential physical or emotional injury. It could stem from potentially failing a test, losing an important relationship, losing a job, getting some bad news, protracting an illness, or stumbling upon an animal in the wild. Anxiety is rooted in fear. Your body shakes. Your heart and thoughts begin to race. Your pupils dilate. Your lungs expand and blood pressure elevates. This process all begins in a part of the brain called the amygdala. The amygdala is like the brain’s sentinel for danger. While awake it is always on the lookout. Do you remember the robot from Lost in Space? “Danger! Danger! Will Robinson!” That’s the function of the amygdala. When the amygdala detects danger it then triggers the hypothalamus to alert the rest of the body. This activates the sympathetic nervous system which coincides with the suppression of other less needed emergent processes like digestion, the immunity response, and sexual arousal. Ask yourself, “If the body is preparing to fight or flight should it be directing its energies towards digestion, the immunity response, and sex?” Heck no. For some people, this process can run awry and lead to panic attacks which then can become conditioned by environmental cues leading to panic disorder and agoraphobia.
In ordinary situations, once the perceived danger is averted the parasympathetic then takes over: the heart slows, breathing becomes shallower, blood pressure decreases, thoughts decrease, and the body resumes the process of digestion, immunity, and interest in sex.
However, some people are so wired either due to a history of trauma or so genetically pre-disposed that their amygdala is in a hyper state of arousal. So, how do you deal with this? There are several ways.
The frontal lobe of the brain governs reason. Thankfully, the amygdala does respond to the reassurances of the frontal lobe that conclude that all is safe and that danger has passed. It might conclude things like “I’m over re-acting!”, “What’s the big deal?”, “Everything’s going to work out” and, “Just chill” to name a few.
Some people are masters of coming up with all kinds of potentially dangerous scenarios so that much of their thinking is preoccupied with thoughts filled with fear and worry. It is simply a way of life for them. They say to themselves, “Well, if so and so says or does this then I should say or do that.” Or, “If this happens then I should respond in this way.” And so it goes; on and on in the mind with little end. So, is it possible to come up with every possible dangerous scenario? And, do you want to spend the rest of your life living like this? Have you ever considered for a moment that you can’t possibly ever think of every potential horrible scenario? In effect, by doing this you’re causing more mental suffering for yourself than you could’ve possibly imagined.
Chances are that when the mind is engaged in anxious thinking its focus is in the future rather than in the here and now. Life only happens in the present moment. It doesn’t happen in the past or future. Focusing on the breath helps reconnect us to the body and the present moment.
Focusing on your senses is another way to connect to the present moment. What do you see? Is there something that you haven’t noticed before? What do you hear? Can you focus on listening to something that you might not’ve heard before? What do you taste? How is your body positioned? How do your clothes feel against your skin? What does the air smell like? It’s much harder to be engaged in anxious thinking when practicing mindfulness.
Exercise seems to be one of the most effective ways to deal with anxiety. It’s as if it helps to channel nervous energy that otherwise gets “stuck” in the body. Intensive cardiovascular activity seems to be one of the best ways to reduce anxiety.
For many, acupuncture can also be effective.
Do you know why you’re anxious? Sometimes people notice anxiety in the body, but can’t quite connect it to a reason. Understanding the reasons why you’re anxious, in and of itself, can lessen anxiety.
So, is anti-anxiety medication right for you? Anti-anxiety agents are called “anxiolytics.” The popular medications are Ativan, Xanax, and Klonopin which are also known as benzodiazepines. These are controlled substances because they can be addictive. Their mechanism of action is unknown but it’s believed they work by increasing the production of a neurotransmitter called GABA. As the sedating effect of these medications wane and the residual metabolites are cleared through the body anxiety can spike. This increased spike can lead to an increased need for more medication thereby creating a pattern of dependence. Ideally, anxiolytics are prescribed for acute episodes and not for long-term ones.
Gabapentin is a medication used to treat epilepsy and nerve pain, and has also been found to be effective in the treatment of anxiety. It can be prescribed for long-term use without the risk of dependence.
Alpha agonists such a Clonidine are used in the treatment of hypertension and also have a calming effect. They are also non-addictive and can be used to treat ongoing anxiety.
SSRIs (or Sustained Serotonin Re-Uptake Inhibitors) help to alleviate both anxiety and depression. They include medications such as Lexapro, Celexa, Paxil, and Prozac to name but a few. They work by keeping more of the neurotransmitter Serotonin between the synapses of the neurons. It is believed that this helps to reduce anxiety and depression.
So, are anti-anxiety agents right for you? The first question to ask yourself is: Are you so immobilized by anxiety that you can’t do the things you need to do in order to get through the day? Secondly, are you so overwhelmed by anxiety that you can’t employ effective coping skills such as those discussed above in order to function. To determine if anti-anxiety medications are right for you, please consult with your doctor.
Remember, you can’t be both relaxed and anxious at the same time!
Jeffrey J Howlett, M.Ed, LMHC, LMFT 