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Breaking the Anxiety Cycle

15/4/2015

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Now let us examine the places in the anxiety cycle where we may be able to interrupt or change it.
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Firstly, and most obviously, removing the trigger will help to remove some of the stimulation to the nervous system.   Some kinds of triggers may be relatively easy to remove, while others may not.  For example, traumatic events that have already occurred cannot be undone, but anxiety-producing thinking patterns may be able to be altered with some effort and practice.

Secondly, the nervous system may be able to be calmed using the opposite of the fear response, the relaxation response.  While the fear response involves the sympathetic nervous system, the relaxation response involves the parasympathetic nervous system.  Invoking the relaxation response can alter the balance of the nervous system away from sympathetic dominance towards a more normal balanced state. 

Thirdly, the link between anxiety symptoms and fear can be removed, or at least reduced.  This link is what Dr. Claire Weekes refers to as “second fear”, the fear of the anxiety itself.  It is this “second fear” that can perpetuate an anxiety disorder long after the trigger has gone.  If we can learn to break this link, we need never fear an anxiety attack again.

Interrupting the cycle at any of these three places will be helpful in reducing anxiety; however addressing all three together will be the most effective approach.  Now that we know where to break the anxiety cycle, we can introduce specific techniques to do this.
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The sensitised nervous system

1/2/2015

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There can be various causes of the nervous system getting into a ‘sensitised’ state of sympathetic dominance.  Some are mainly physical, others may be more psychological in nature.  Some examples are:

  • An extremely stressful or traumatic event (for example: loss of a loved one, job loss, major injury)
  • Severe chronic stress, from an ongoing situation, for example:
    o   ongoing health problems of self or other family member
    o   threat of losing job or home
    o   stressful work situation
    o   career ‘burnout’
    o   relationship problems
    o   separation/divorce
    o   financial problems
  • Some medical conditions, particularly those that affect the nervous and endocrine systems  (e.g. overactive thyroid)
  • Extreme hormonal changes, for example after childbirth (an extreme form of ‘baby blues’) or around menopause
  • Major surgery, particularly abdominal surgery (interrupts normal breathing patterns making hyperventilation more likely), or when there is a lot of blood loss
  • Chronic unhealthy thinking patterns (habitual worry, catastrophizing, resistance, avoidance, negative self-talk)

    Sometimes it can be a case of the ‘perfect storm’ of factors coinciding at a certain time of your life.

    When the nervous system becomes ‘sensitised’, it is more sensitive than normal.  It is hypersensitive, and overreacts to stimuli.  The sympathetic and parasympathetic sides of the nervous system are out of balance – the sympathetic system is too dominant.  The nervous system becomes stuck in ‘fight-or-flight’ mode.  The brain becomes hyper-alert, so even small stimuli can set off a disproportionate reaction, including big surges of adrenaline.  The mind can race or become stuck in obsessive thought patterns.  Sleeping may be difficult and appetite may be reduced or it may be difficult to eat at all.  It can be difficult or impossible to ever feel relaxed or comfortable when in this state.

    Unfortunately this sensitised state can be easily maintained by a vicious cycle of anxiety and fear.  The good news is that this state does not have to be permanent - the cycle can be broken.  More about the anxiety cycle next time.





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What is an anxiety disorder?

14/12/2014

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There are many variations of these patterns, and these are generally diagnosed as some kind of ‘anxiety disorder’.  Doctors use definitions for different kinds of anxiety disorders, such as generalised anxiety disorder, obsessive-compulsive disorder, and so on.  Personally I do not like the term ‘anxiety disorder’ since it implies the person has worried themselves sick, and that the disorder is entirely mental in origin, ignoring physical factors.  While this may be the case for some, there are other causes and for those people the diagnosis of ‘anxiety disorder’ is confusing and makes no sense to them.  I prefer Claire Weekes’s term ‘sensitised nervous system’, or even ‘sympathetic dominance’, a term that is sometimes used to describe the imbalance of the autonomic nervous system.  I believe that so-called ‘anxiety disorders’ are nervous system disorders rather than psychological or psychiatric disorders.  Of course, there is usually a psychological component, which can work to lock us into a self-perpetuating anxiety cycle.  I believe that when addressing these disorders, it is important to include both mental and physical approaches.  We need to find ways to break the anxiety cycle, and to restore the right autonomic balance.



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Causes of anxiety attacks

30/10/2014

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Anxiety attacks can be “one-off” or very occasional events, or may be part of an ongoing pattern.  For example, a friend of mine told me of an experience she had, when she was travelling on a long international flight and had become ill, probably with some kind of ‘flu virus.  By the time she reached her destination, she was feeling exhausted, run-down, sick from the virus, and probably running a fever as well, and psychologically she was probably anxious about becoming sick while travelling to a foreign country.  All of these factors combined together resulted in her having a panic attack at the destination airport.  This kind of event is something could happen to anyone and not necessarily part of an ongoing anxiety disorder.  The situation becomes too much for the person to cope with and the extreme stress triggers the extreme fight-or-flight response.  It usually blows over within about thirty minutes.  This kind of panic attack can occur as a one-off or very occasional event and does not mean the person has an anxiety disorder.

Anxiety attacks can also be part of an ongoing pattern.  Often the nervous system is in a much more sensitive state than ‘normal’ and so panic attacks can be triggered more easily.  Dr. Claire Weekes refers to this state as the ‘sensitised nervous system’.  In this state the nervous system is hypersensitive and overreacts to stimuli.  An extreme fight-or-flight response is triggered when the situation does not warrant it.  There is no angry bear chasing us in reality, but our nervous system reacts as if there is.  For some people, these attacks are triggered by something specific, such as a flight, drive, meeting, speech, test, etc.  For some people, when the nervous system is extremely sensitised, an ongoing anxiety state can exist, like an anxiety attack that continues instead of blowing over within a few minutes like a more ‘typical’ panic attack. 
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