How Anxiety Works – Generalized Anxiety Disorder

If you are reading this post, you most likely have experienced feelings of anxiety at some point in your life. This is true because anxiety serves as a protective function by telling our body that something is wrong which then informs how we make decisions that keep us safe. For example, if you are walking through the woods and come across a bear, your autonomic nervous system quickly alerts your body to the potentially dangerous situation. Within your autonomic nervous system is the sympathetic and parasympathetic nervous system. The sympathetic nervous system gets your brain and body ready to decide how you will face stressful situations, which is the bear in this case. Your body will begin to show symptoms of your current emotional state which often times involve increased adrenaline that commonly leads to increased heart rate and blood pressure, pupil dilation, sweat production, and the shutting down of non-critical survival systems, such as the digestion system. Your brain may also begin to produce unhelpful thoughts that further contributes to the hyper-aroused state that your body is entering. With your sympathetic nervous system now activated, your body is now ready to fight the bear, run away from the bear, or freeze. After your body picks a response and you get away from the bear safely, this is when your parasympathetic nervous systems kicks in to calm you down. The parasympathetic nervous system is responsible for keeping your body at rest rather than aroused in situations that are not a threat to safety. Your brain and body recognize that their is no potential threat or imminent danger anymore and your body once again reflects your emotional state. Your heart rate decreases, your blood pressure returns to base level, and your body restores all proper functioning. This is an example of how anxiety would be helpful in a stressful situation and proper bodily responses.

Now, lets say you are walking through the woods and come across a bunny. Unless you have a phobia of bunnies, your parasympathetic nervous system should respond to keep your body at rest because you recognize that the bunny will not be a threat to your safety.

However, if you suffer from anxiety, that bunny may seem like a bear. Before you know it, your sympathetic nervous system is responding to the bunny as a threat before your brain has the chance to tell your body that everything is fine. This is what it can feel like in many everyday situations for people struggling with anxiety. Rather than dealing with bears and bunnies, people may have daily anxiety over things that affect their lives in ways that may not affect people without anxiety. Examples of things that can bring all of us anxiety include being around a lot of people, taking tests, giving a speech, driving in traffic, and many other things. However, when someone is suffering from severe anxiety or an anxiety disorder, the ability to engage in those tasks can become extremely difficult. As a result of attempting these tasks, the brain may inaccurately perceive something as a threat and the body immediately responds in ways to reflect how we are feeling. People can view threats in may different ways – something unpleasant/bad happening, impending doom, and imminent danger, harm, and/or pain. Sometimes dangerous/scary situations that we find ourselves in signal to us that there is a threat and anxiety helps us get out of that situation safely. However, problems occurs when we are in situations and our anxiety inaccurately perceives something as a threat and hinders our behavioral, emotional and mood states.

For example, taking a test may not seem like a threat to some people, but for those with anxiety, the test can represent a threat to one’s self-esteem or self-worth if they fail. Anxiety has a way of making us feel like we are going to fail at something before attempting and/or makes us anticipate the worst case scenario possible. In this case, failing may represent not being good enough or smart enough. This potential threat to one’s self-esteem or self-worth can cause the brain/body to respond in ways that may not be helpful to the situation – not taking the test, rushing through the test, leaving in the middle of the test, etc. This is the sympathetic nervous system at work. In those without anxiety, the test may cause us to feel anxious but the brain and parasympathetic nervous system help us recognize that we are indeed fine and that even if there is the threat of failing that everything will be okay. Anxiety can prevent this perspective from being present and we may get stuck in the feeling that everything is not okay or that everything will not be okay. When we get stuck in these types of patterns of functioning, this can cause distress in many areas of our lives. This only makes it harder to get out of this pattern. Even though it can be difficult to overcome, i hope you can find faith in the fact that because anxiety serves a necessary and vital function, that it can be possible to live with it in a way that helps you rather than controls you.

The first step on the path to coping with anxiety is to recognize if this process is happening to you and break it down in a way that allows you to understand what is causing your anxiousness. Become aware of how your brain and body are responding to stimuli in your environment. Anxiety looks different for everyone and may have developed as a result of many different factors. Anxiety commonly runs in families or develops after one or more stressful life events.

Questions to ask yourself to reflect about a situation that involved feelings of anxiousness:

  • In what ways did my brain/body respond in the situation where i became anxious?
  • What were the specific anxious thoughts that came up for me?
  • What was i feeling when i noticed that something could be a potential threat to me?
  • How did my thoughts contribute to the feelings that came up for me?

Being aware of what is going on for you during/after an anxiety-provoking situation gives you better control in future situations to change the outcome into one that you desire.

The second step is to understand what is contributing to your perception of a threat when there is not a threat or when a perceived threat is making you think that the worst possible outcome is going to happen.

Questions to ask yourself to reflect upon a situation where anxiety played a role:

  • Which thoughts contributed to my perception the most?
  • Are feelings that i hold from a past trauma or experience linked to how i perceive situations that result in anxiousness?
  • Was a real threat present or was it a perceived threat?
  • How did i respond to my perception?
  • What was the worst, best, and most likely outcome in the situation?

Steps one and two focus on recognition of what process you are going through when anxiety arises for you. This recognition is helpful when finding the right coping skills/techniques to combat anxiety. Future posts will focus on specific coping skills for anxiety that can help you challenge your perceptions of threats.

Some of the diagnostic criteria for Generalized Anxiety Disorder are described below (American Psychiatric Association, 2013):

  • Excessive anxiety and worry that occurs more days that not for at least 6 months.
  • The anxiety, worry, and/or symptoms cause distress/impairment in multiple important areas of functioning (social, educational, occupational).
  • Difficultly in controlling the worry.
  • Anxiety and worry must be associated with 3 or more of the following common symptoms of Generalized Anxiety Disorder. The symptoms having been present for most days that not for at least 6 months.
    • Restlessness or feeling on edge
    • Easily fatigued
    • Concentration difficulties or mind going blank
    • Irritability
    • Muscle tension
    • Sleep difficulties – hard time falling asleep or staying asleep, or restless/unsatisfying sleep

The more you understand how you are functioning as a result of a mental health issue or diagnosis can be highly beneficial when finding methods that will help or when seeking treatment/medication.