Anxiety is the word most of us use to describe general feelings of apprehension, nervousness, or fear.  It's not necessarily a bad thing in itself—a little unease can go a long way toward motivating us to make needed changes in our lives!--but for many people the intensity and pervasiveness of anxiety go beyond mere inconvenience or discomfort.  The National Institute of Mental Health (NIMH) notes that roughly 40 million American adults (aged 18 years and older) are affected by an anxiety disorder in a given year—for these people, anxiety causes severe distress, and generally lasts for six months or more.  It's not a lot of fun.

Symptoms of anxiety are surprisingly varied.  Sure, you have your worry and fear, but anxiety can also cause racing heartbeat, feelings of dizziness, nausea, numbness or tingling—even chills or hot flashes!  Anxiety can also touch down in a kind of tornado of sensation known as a panic attack.  It's not at all uncommon for folks to head for the Emergency Room, fearing they've had a heart attack only to discover that they have in fact experienced a panic attack.  Some folks have a hard time deciding which condition is worse!

 Regardless of how frequently or intensely one experiences anxiety, there are a couple of general strategies most people find useful:

 Mind the Body (It Ain't All In Your Head!)

 Anxiety is not merely a feeling—not if by feeling one means something like opinion, or dream—some purely subjective mental experience.  Like other emotions, anxiety is bound up with very real bodily processes, involving detectible chemicals and observable events both inside and outside (or upon) one's skin.  It's no surprise, then, that there are a number of medical conditions that can cause people to feel anxious!   It's a good idea to check with a physician to rule out any serious medical conditions that might be causing your anxiety system to “run hot.”

 While the doctor is peering into your ears, checking your fluids, etc., you probably should talk with him about two other things:  diet and exercise.  Sometimes merely replacing the daily fast-food lunch with something a bit more nutritionally useful will turn things right around in a couple of weeks.  And sometimes just adding a brisk (or even not-so-brisk) half-hour walk a couple of times each week will soothe jangling nerves.  The addition of a few relaxation exercises or a regular meditation practice can do wonders in retraining an anxious body (and mind)!  The point is that it's all connected in there:  Like it or not, you are (at least partially) a physical creature, and as such your well-being is (at least partially) a matter of physiology!  You gotta take care of yourself!

 2. Question Assumptions (Some Of It IS In Your Head!)

Even though anxiety is bound up with bodily processes, it is also closely tied to psychological processes and events.  Those merely subjective mental experiences do have a very real part to play, both in creating and perpetuating anxiety.  This isn’t really that much of a surprise:  each new advance in cognitive neuroscience underscores just how artificial the distinction between mind and body can be!

Consider for a moment the scenario of a man opening his front door one Saturday afternoon to find a large snake coiled upon his doorstep.  It’s probably easy to imagine this unfortunate gentleman feeling anxious—a sick feeling in his gut (probably caused by his stomach leaping up on top of his lungs in an effort to put as much distance between itself and the snake as possible!), a cold sweat on his brow, his heart rate accelerating. 

We can easily imagine all those physiological components of anxiety rising to the fore.  But stop and think for a moment.  Why should the man feel anxious upon finding this reptilian visitor at his doorstep? 

The Greek stoic Epictetus probably put it most eloquently:  “Man is not disturbed by events, but by the view he takes of them.”  In short:  Our fellow is not anxious because he has found a snake on his doorstep; he is anxious because of what he believes finding a snake on his doorstep means!

At the risk of oversimplifying the situation (hey—this is the Internet, after all!) we might imagine the process like this:




In this case, we find that:





Change the fellow’s beliefs or assumptions, and see his reaction change.  For example:




Or Perhaps:






Now, the upshot of all this is that most people coping with chronic, intense anxiety have likely come to the conclusion (usually based on experience) that the world is a very dangerous and unpredictable place—or at least that many commonplace situations contain hidden threats.  Not all of these threats are of the immediate life-or-death variety; many, perhaps most, have to do with danger to social status, wealth, or the general well-being of loved ones.

 What to do? 

 Well, clearly we want to get in there and reassess our beliefs and assumptions!  We need to weed out the faulty ones and replace them with sound, rational, non-anxiety-escalating beliefs.  As you might guess, this is often easier said than done.  This is why many folks seek out the help of a counselor or psychotherapist – it can really help to have a relatively unbiased partner watching your back!

 One clue to the presence of anxiety-escalating thinking is the presence of “What if” at the beginning of virtually any sentence spoken to oneself or to others, aloud or silently.  Another is the liberal use of “shoulds” and “oughts.”  Such language often points to a preoccupation with imagined worst-case scenarios (“What if…?”) or with idealized situations that do not currently exist (“shoulds” and “oughts”).  Either way, the focus of attention has often shifted from the real present to the imaginary future.

The trick is to remember that while imagination can be great for predicting possible problems and brainstorming solutions, it’s not always correct in its predictions.  By the same token, some of our assumptions and beliefs may not be entirely correct, or may not apply in every situation.  Here again, there are some clues you can watch for that may signal faulty assumptions:  When the words “always” and “never” crop up, for example, it may be a good idea to re-examine your assumptions about a given situation.  Similarly, be careful of any kind of “all or nothing” thinking, where you see situations or outcomes as entirely good or bad. 

This doesn’t mean that you can safely discount every “What if,” “should,” “ought,” “always,” “never,” etc.  The point is that the world is a lot messier than most of us like to think:  Yes, there are quite a few bleak and dangerous places, difficult situations, and bad people to be encountered out there.  But there are also a goodly number of safe places, pleasant situations, and good people around!  Often enough, the same place, situation, or person can be safe or dangerous, pleasant or difficult, depending on the circumstances and one’s expectations.  So stay healthy and keep an eye on those thoughts and assumptions!