If you do a Google search for anxiety memes, you’ll find a seemingly endless supply of posts and imagery captioned with “internal conversations” like those above. And, if you are a living, breathing person, there is a 100% chance you will relate to at least one of the memes.
Like a song starting slowly, anxiety often begins like that first, soft note — perhaps a single key of the piano — only to become a symphony of complex sounds and feelings. The song keeps getting faster and faster. That single note soon cascades in another and another to where there is almost no pause in sound just like there is no pause in the building anxiety.
Everyone experiences anxiety. Everyone. You, your parents, best friend, your 6th-grade teacher, that A-List actor you love, professional athletes — even your pet — undergo varying degrees of anxiety throughout life. Everyone has a song they “dance” to when they feel uneasy, keyed up, or worrisome — life is stressful. Controlling anxiety is just a matter of learning the right moves for your specific dance.
Anxiety can severely impair a person’s ability to function in day-to-day life and can interfere with a person’s relationships. Whether you’re suffering from panic attacks, obsessive thoughts, or unrelenting worries, it’s important to know that you don’t have to live with anxiety and fear. Once you understand anxiety you can begin to overcome it.
What is Anxiety?
Anxiety is a normal neurological event that happens during daily activities, like approaching a busy intersection or when your toddler is a bit too quiet, as well as during intense situations, like changing employment or a family move.
When our heart rate increases and we become more energized or alert, our brain and body are working together to give us tools to address what is happening. Literally, we are getting more oxygen in our blood system so we can instantly think clearer and have the energy required to respond.
For example, we have been living in a global pandemic since early 2020. Each time a governmental agency supplies a new update, like the recent approval for our youngest children to receive the vaccine, it is normal for us to notice a change inside of ourselves – a sort of alert reaction – because it means we need to pay attention since a decision must be made. When a stressful event has gone on for an extended period and those updates have been persistent, anxiety can look like frustration and disinterest.
This alert reaction is described by the current manual used in the mental health field (Diagnostic Manual of Mental Disorders, Ed. 5, 2013) as “apprehensive anticipation of future danger or misfortune accompanied by a feeling of worry, distress, and/or somatic (i.e., physical) symptoms of tension. The focus of anticipated danger may be internal or external” (p. 818).
The manual further defines anxiousness as “feelings of nervousness or tenseness in reaction to diverse situations; frequent worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful and apprehensive about uncertainty; [and] expecting the worst to happen” (p. 818). People who have experienced anxiety or anxiousness also share feelings of depression, guilt/shame, worry, and anger.
Behavioral and interpersonal actions result naturally when we feel various combinations of these emotions, especially when the anxiousness persists.
Common behaviors include pacing, sleeplessness, trembling, quick speech patterns, crying and/or argumentativeness, as well as being grouchy, feeling dissatisfied, isolating, and having difficulty eating.
Anxiety often includes a persistent pattern of circling thoughts typically worded like ‘what if,” “if only,” “they must think I’m,” and/or some other self-defeating or catastrophizing thoughts. In more serious cases, self-harm and suicidal thoughts/attempts may occur. At these serious times, it is best to go to your nearest emergency room.
Common interpersonal actions are a result of the emotions and behaviors listed above. So, when anxiety is persistent, partners may lose sleep or the ability to concentrate at work because of their worry about or frustration with their partner’s status. An increase in arguments about a lack of in-home care may increase over time, which may lead to added problems of daily needs. Anxiousness in one person is experienced by all those who interact with them at home, too
What behaviors occur when someone has too much anxiety?
As noted above, anxiety and anxiousness are normal and helpful in our daily lives. Even though we may believe that we are distressed, we are able to think and respond more appropriately when just enough anxiety is activated.
Anxiety that is within normal limits presents when we express concern for a loved one (e.g., news of major illness or a car accident) or for an expected event that may have risks involved (e.g., extended travel, moving away, planning a celebration). Both expressions of concern may show as frequent phone calls, requests for daily updates, requests for others to consider respite, or receiving help planning and organizing.
We may lovingly refer to a female sibling or an adult child as “bridezilla” because her reactiveness is a bit more than usual. She is expressing anxiety as excitement or maybe even intensity in her desire to have a beautiful wedding ceremony and celebration.
Happy events are stressful just as sad events may be. It can be expressed as excitement for good news, planned fun, or a new adventure. The “butterflies in my stomach” experience is an excited anxiousness. Anxiety within normal limits can also present as having difficulty sleeping just prior to an expected life event or change, like the first day of college, a new job, or a family move.
Anxiety is of significant distress when it persists longer than six months and starts to affect us externally, that is in our family relationships, in our level of productivity, and/or in our social engagements. Basically, the emotions and behaviors described above do not dissipate when the event has passed. The anxious feelings may transition to nightmares, and repeated sleepless nights, and those circling thoughts discussed earlier become persistent and seem to only intensify the anxiety.
Family members’ concerns increase, requests for seeking medical attention are expressed, and extended family members or close friends are sought out to help distract or comfort. Loved ones may notice in their anxious family member either weight gain or weight loss, a distant look or stare, and/or difficulty concentrating on the other aspects of life. It may seem as though all topics of discussion circle back to their worrying.
Other behaviors that show professional help is needed include restlessness, difficulty concentrating, easily fatigued, irritability, and/or reports of muscle tension, as well as an increase in argumentativeness and resistance.
What types of Care and treatment options are available to address anxiety successfully?
There are three generally used treatments to address anxiety-related symptoms: Complementary Alternative Medicine practices (CAM practices), prescribed medications, and mental health therapy. Each has its own set of advantages and disadvantages, and each is better used at different stages of distress.
For example, CAM practices are most effective early in the experience (i.e., while it is within normal limits) and in conjunction with mental health therapy.
Medication is needed when the anxious experience persists for at least six months and your ability to function at home, at work or school, and/or in your social life begins to show distress as well.
Mental health therapy is a good fit at any point in the distress and has been shown in combination with either CAM practices or medication or both. Consider it akin to a type of CAM practice as it is non-invasive and voluntary. Plus, when you engage in the therapeutic process early your recovery will be easier and quicker.
CAM practices come through different paths. The most common are mind and body therapies as the intent is to consciously connect our mind’s focus on our body’s actions while engaging in the breath. This type of CAM practice includes biofeedback, prayer, meditation, yoga, Tai chi, Qi gong, various relaxation techniques, art and/or music therapy, and guided movement experiences.
Biological-based therapies are common as well because of their accessibility and convenience. Their intention is to return the body to its natural state. For example, high doses of megavitamins are used to address the common cold with Vitamin C, although medical research has shown that it does take an enormous amount to have any impact.
The use of herbal medicine in our intake is a gentle way of addressing concerns, like drinking chamomile tea just before bedtime to support relaxation or using essential lavender oils to either calm anxiety or take the itch out of bug bites. Homeopathy is another biological-based CAM practice. It is one of the oldest practices because it started out in our homes.
A basic example would be cold or warm compresses to address fever or muscle aches. More complex examples include blending spices and nutrients, like menthol rubs to heal congestion or cuprum rubs to relieve muscle and joint cramping. A medically covered homeopathic treatment example is when a midwife is called in to aid with natural birthing.
Nutritional supplement use is the third area of CAM practices that has similarities to the use of vitamins discussed above. The intent is to fuel the body with the unique nutrients it needs for specific purposes. A very well-known example of intentional supplement use is seen in an athlete’s diet as it is high in protein and macro-nutrients during training and performance season than their diet is the rest of the year.
The final three CAM practices require the use of specifically trained and skilled providers. Energy medicine aims to replenish a person’s aura or chakra state. Common techniques include reiki and hypnosis. Manual therapies specifically involve manipulation of the body’s muscular system with a massage or skeletal system with chiropractic treatments. And the intent of acupuncture is to awaken the natural biochemical effects in the body when uniquely manipulated to stimulate the central nervous system, thereby improving physical and emotional wellbeing.
It should be noted that many of these CAM practices cross categories like the use of vitamins or body movement meditations (e.g, Qi gong or Tai Chi).
A variety of medications are available to address the emotional and mental distress associated with anxiety. It is important to meet with the physician that has known you longest so that they can assess the extent of your distress and understand what your baseline is and what recovery will look like for you.
Primary Care Physicians typically consider a low dose of anti-anxiety medications. Currently, medical science has found at least four major categories of medication with each having multiple prescriptions within each category.
Anti-anxiety medications are categorized by what neurohormone it is affecting and how the medication will affect it. People respond differently to each category, so it is important to go to your physician with information about any history you have using medicines to address emotional/mental health and any history you know of about your biological family (i.e., parents, siblings) using these medications.
Medication is a common first choice for most people because of the convenience. A visit to your primary care physician followed by taking the prescribed pill each day holds the belief that all will be well very soon. Even though this may be true for many non-major medical concerns, like an infection, it is not the case for emotional and mental distress.
Our psychological research over the past 20-plus years has repeatedly indicated that the most benefit and the quickest recovery have been reported by people who incorporate medication and psychotherapy simultaneously.
Mental health therapy
Anxiety and/or depression is one of the most researched complaints in psychology. Research has examined this complaint from a biological, behavioral, cognitive, emotional, neurological, and interpersonal perspective because symptoms of anxiety and depression affect all areas of our daily lives. Therefore, this comprehensive research continually supplies us with clear, research-based treatment options that are accessible and achievable for adults to our youngest clients (e.g., elementary-aged children and preschoolers).
Treatment approaches include interventions from Cognitive Behavioral Therapy (CBT), Mindfulness-Based Cognitive Therapy (MBCT), Hypnotherapy, and interpersonal therapies.
CBT and MBCT both address anxiety by challenging what we believe – our thoughts about that which we feel anxious – which adjusts the emotions and behaviors resulting from those thoughts into realistic and accurate thoughts. MBCT adds mindfulness techniques to help with activating relaxation neurohormones and deactivating stress-inducing neurohormones.
Hypnotherapy addresses anxiety through the subconscious, and it is not the stage act commonly shown for entertainment. A trained hypnotherapist (mental health provider certified in hypnosis) collaborates with individuals in naming their intention, like fear or an anxiety-related behavior. Together, the hypnotherapist and the client, decide what the guided meditation will sound like, then the client listens to the hypnotherapist as they calmly talk you into a deeply calm state in which the pre-determined, agreed-upon phrase is introduced. The introduced phrase is used voluntarily by the client in their daily life when the slightest anxiousness is experienced to support the release of the calming neurohormones.
Finally, interpersonal therapies consist of a variety of perspectives and interventions used by mental health professionals trained in system theory. For example, the therapist may report being trained in Emotional Focused Couple Therapy (EFT), Gottman Method Couple Therapy (GMCT), Family Functioning Therapy (FFT), Cognitive Behavioral Family Therapy (CBFT), and many others. Each has a unique perspective on how the anxiety you are experiencing is being affected by and within the family, and then has a set of matching techniques to support addressing the distress.
Let’s say, for example, that your anxiety typically presents itself as more distressful during the holiday season. Even your immediate family behaves notably differently during that time as they either become unusually irritated with you or maybe more protective of you.
If you and your partner sought the help of a therapist trained in the GMCT process, communication between the two of you would be the focus of treatment. Interventions would include tools on how to soothe one another’s emotional reactivity and slowly talk through what is truly fueling the anxiousness and irritability.
Each type of interpersonal therapy would be concerned with supporting the family unit as a unit to solve the distress. No one person is the problem. The problem is the problem.
What is right for you?
The big question is figuring out your “good fit” plan for getting better. There is no one-size-fits-all plan. We suggest you start with a few conversations.
- Talk with someone you believe to have your best interest at heart.
- Talk with the physician that knows you best.
- If the concern is family or relationship related, contact a Licensed Marriage and Family Therapist because they are educated and trained in system theory and the various family therapy models.
Then put all the information from your conversations together and take the next step. Call the mental health providers in your area or on your insurance provider list and share what you’ve discovered. They can help you in finding a ‘good fit” plan with you.
What else should you know about anxiety?
Watch family and marriage therapist Susan Harrington, founder of Maison Vie, discuss The ABCs of Anxiety and how to get on the path to overcoming it. You can also contact Maison Vie to see how Susan can help guide you through counseling sessions.