Anxiety Help: Questions and Answers

Chronic anxiety and anxiety disorders can be confusing, frustrating, and disorienting in life. The basic principles of recovery seem backward, counter-intuitive, and oh so difficult to embrace and apply. Its normal to have questions, so this week lets answer some of the most common questions about anxiety. And while we’re at it, lets answer a few not so common questions too!

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General Principles To Lean On

BEING AFRAID OF BEING AFRAID

This is one of the defining characteristics of a disordered state of anxiety. If you are wondering what to do because the thing you fear is your own body or mind – you are afraid of anxiety symptoms and scary thoughts themselves – this is not a special situation at all. This is good news. Being afraid of anxiety itself – the fear of fear – is the common thread that runs through every episode of this podcast and every word of every book I’ve ever written. Its not just you. Its EVERYBODY listening to this episode with you.

HERE’S HOW THIS WORKS

You feel things or think things. Why you feel or think them doesn’t really matter. But when you feel those things or think those things, you experience a state of distress. You are frightened, disturbed, unsure, and feel threatened by what you feel or think. The fact that you are in a state of distress because of how you feel and what you think is the key. That state of distress is then interpreted as proof that there is some danger or threat that you must deal with. You treat how you feel and what you think as an emergency because of the state of distress they create. Apply this to panic attacks, anxiety symptoms, scary thoughts, intrusive thoughts, negative thoughts, fears about health, fears about not sleeping, or anything else. If you are distressed and treating that distress as evidence of danger or threat, you are in internally generated anxiety land.

AFRAID AND DISTRESSED DOES NOT ALWAYS EQUAL UNSAFE

This is incredibly important! Anxiety in its internally generated forms will trick you into gluing “afraid and uncomfortable” to “in danger”. But it is entirely possible for a human being to be afraid or uncomfortable while also being perfectly safe.

If you are acting like you are under some kind of threat, but the source of the threat is INSIDE you in some way, there’s a good chance you are being fooled and the principle of afraid but still safe applies.

FIRST STEPS

Everyone starts by seeing a doctor. Some people see lots of them. They get EVERYTHING checked out, which is totally fine as a starting point. After the doctors comes the psychoeducation. This podcast is psychoeducation. Its the part where you learn about the nature of disordered anxiety and you hear that thoughts and symptoms are scary and not dangerous. That’s where experienced knowledgeable people can assure you that you are safe and won’t die, go insane, or act on scary thoughts.

After this, things get dicey. You might logically hear the doctors and the mental health helpers and believe them, but the emotional part of your brain – the part tasked with keeping you alive – won’t believe it. You may continue to dig and search and question and re-question and try to figure out what is wrong with your body or mind. You may ask for assurance repetitively and urgently when you are afraid.

Why? Because you feel distress and therefore that MUST mean there is something really wrong, right?

THE LEAP OF FAITH

At some point we reach the point where there is no more checking and asking and researching and talking about what MUST be wrong. The source of the threat is the discomfort itself. Its internally generated, and internally generated anxiety is a trickster. This is where the universal principle of “taking a leap of faith” enters the picture. Even when we don’t believe we are safe, and when all evidence around us shows us that we really are, it’s time to test that assertion by taking a leap of faith. It’s the leap – which requires courage – that teaches us that the danger was never real and that even when we were sure that it was “too much” for us, it wasn’t.

NOW APPLY THIS ….

To your specific challenge. Scary thoughts about scary things? Yes, that too. Thoughts about not sleeping? Those too. Feeling like you can’t breathe (while you’re actually breathing)? That too. Nausea or feelings of dizziness? Those too. The general principles we rely on in recovery get applied across the board. Are there nuances and specifics based on each individual and their exact circumstances? Of course there are. But since we can’t address your specifics in a podcast, we have to back to basic principles and start there.

Specific Questions From The Community

AFTER THE CRISIS HAS PASSED, DO YOU STILL NEED THERAPY? DO YOU STILL HAVE TO WORK ON YOURSELF?

Maybe. There is no correct answer to this. Recovery from chronic/disordered anxiety might mean that you don’t feel that you need professional help any more. Or you might feel that there are other issues you’d like to work on with a professional. Or maybe there are other issues in your life you’d like to work on by yourself. All the options are valid. Humans change, grow, learn, and change course throughout our lives. If you spend an entire lifetime working on yourself in some way, that’s completely OK. If you don’t feel the need to do that, its also OK.

WHAT’S THE DIFFERENCE BETWEEN OCD AND GAD OR PANIC DISORDER AND HEALTH ANXIETY?

In a practical sense, there is often very little operational difference between once form of chronic/disordered anxiety and another. In fact, in most instances where a clinician is attempting to reach a diagnosis, the differential considerations for all of these anxiety types almost always include a bunch of the other types. There are no clear cut boundaries between any of these issues so the answer to the difference between OCD and GAD is … it almost doesn’t matter because the approach is the same regardless.

HOW CAN YOU BE SURE THIS IS JUST ANXIETY?

The difficult answer is that nothing is every 100 percent certain in life ever. A non-anxious person understands this and lives with that small degree of risk. An anxious person will not tolerate even a tiny chance that something might be really wrong. They confuse possible with probable. Recovery is the process of returning to being “sure enough” based on what reality is showing you rather than acting only on what you think and feel.

WHEN AM I ALLOWED TO REST?

Its OK to rest when tired. Rest is something all humans need. Resting is not avoidance. However, in the early stages of recovery you may find yourself resting when afraid rather than when tired. This is OK. Experiment and learn from the experiences. Its perfectly OK to learn this through experience which means you will get it “wrong” sometimes as expected.

HOW DOES MINDFULNESS FIT INTO RECOVERY?

In our context, I think it best to conceptualize mindfulness as the act of paying attention with intention and without judgment. When anxiety is demanding to be the center of your attention and it demands that you focus on it completely and exclusively, we can learn and practice mindfully bringing our attention elsewhere as best we can. That’s all mindfulness is. Paying attention. What do you want to pay attention to rather than the fear and the feelings?

ARE POSITIVE AFFIRMATIONS OK?

Sure. If you like positive affirmations because they give you firmer ground to stand on, then use them. However, positive affirmations by themselves are not a recovery strategy. We do not recover by talking to ourselves. We recover by learning to behave in different ways. The words we say to ourselves can be a way to inform and support those behavioral changes, but by themselves they will fall short if we rely on them to fix this problem.

HOW DO I ACCEPT …?

Acceptance is really non-resistance. You do not have to like your anxiety, your symptoms, or your thoughts. You can hate them. You can want them gone. But hating them, fighting them, arguing with them and trying to fix or banish them isn’t a helpful strategy. So … don’t worry about accepting. Instead, try dropping the fight and the resistance. Sounds difficult and scary, right? Well, this is a simpler concept than trying to feel or think differently about your thoughts and symptoms, but it is a difficult thing to put into practice because it requires that courageous leap of faith.

WHAT ARE THE MOST EFFECTIVE WAYS OF SELF-REGULATING WHEN ANXIOUS?

This is where my message is sometimes hard to hear. I always start by challenging the narrative that says that your anxious sensations and thoughts MUST be regulated or turned down in order for you to be OK. In many instances the frantic attempt to “self regulate” the physiology of anxiety backfires and keeps that fire burning when it “doesn’t work”. Consider the possibility that your body might know how to regulate itself if you learn and practice getting out of the way and letting anxiety play itself out. I know, that sounds really risky, dangerous, or impossible, right? Take comfort in knowing that everyone that ever got better this way once had the same view and as it turns out … we were wrong.

WHAT ABOUT THIS KIND OF ANXIETY?

Anxious people often listen to the principles of recovery and get all the information but sill carve out exceptions for the “kind of anxiety” they fear and dislike the most. It can be really helpful to consider that if you are afraid of how you feel and what you think, then the situation around those triggers (anxious at work, anxious while driving, anxious if alone, anxious without an obvious trigger) is largely irrelevant. The content I produce is all based on allowing, accepting, navigating, and tolerating, even in the context that you suspect might be different or special.