Retrain Your Anxious Brain: Practical and Effective Tools to Conquer Anxiety - Softcover

John Tsilimparis, MFT, is a leading authority on the dynamics of anxiety. He was featured as a regular on the A&E Television documentary series Obsessed. A former staff therapist at Cedars-Sinai Hospital in Los Angeles and the addiction medicine department at Kaiser Permanente Medical Center, John is also an adjunct professor at Pepperdine University and Antioch University. Visit him at www.johntsilimparis.com.

UNDERSTANDING ANXIETY

"Anxiety is the hand maiden of creativity."

—T.S. Eliot

Anxiety is one of the most misunderstood conditions of the human mind. Yet anxiety disorders are the most common of mental illnesses in the United States. It's estimated that about 18% of the population suffers from some form of anxiety. Anxiety disorders are real, not something that fragile people bring on themselves. In this chapter I will help you to understand the myths and truths about anxiety so that you can do more to take charge of yours, or so you can help someone you care about who suffers from it.

WHY ANXIETY IS OFTEN KEPT QUIET

Even though anxiety is so prevalent, studies show that many people who suffer from it often remain in what I refer to as the "angst" closet for years before reaching out for professional help. Many anxiety sufferers feel different levels of shame or they are scared people will ridicule them if their secret is discovered. I used to feel that way when my mother refused to acknowledge my problem as real. After all, how could I share it with others if my own mother acted like I had no problem and it was all in my head? It's a common response from people who don't understand anxiety. We've come a long way in terms of lowering the stigma of having anxiety and other mental health conditions as a whole in more recent years, but a lot of work still needs to be done.

It's still painfully apparent, and at times shocking, that in this day and age, anxiety, which is often an unbearable condition involving the mind, continues to be viewed by many as an affliction that only affects inferior people. Perhaps there is sanity in numbers. For example, when was the last time you heard someone being judged or ridiculed for having some kind of physiological condition? Apparently, over time, there is a rational and collective acceptance about any human condition that has evidence showing that multitudes of ordinary people are stricken with it every year. But it's very different for illnesses of the mind, including anxiety.

How can this be changed? The more anxiety is discussed as a legitimate condition that people don't bring on themselves, the more people will have empathy, not negative reactions, to someone struggling with it. If people from all walks of life—from college students to seasoned professionals, from blue-collar workers to white-collar executives—admit to suffering from anxiety and getting help for it, the more the average person will accept it like they do other conditions.

My hope is that this chapter and the entire book itself will help shed a more positive light on anxiety and help to validate the seriousness of this condition. If having anxiety becomes accepted like other conditions are, future generations will finally receive the long-awaited recognition that anxiety affects many average people and that it's merely a genetic and environmentally influenced variant of being human. And, there's help available to allow you to manage it.

THE BENEFITS OF ANXIETY

To understand the many aspects of anxiety, you must first recognize some of its benefits. Anxiety is an adaptive function of the human body that exists for the purpose of protecting us from harm.

Anxiety is part of an evolutionary response mechanism developed slowly over many millennia. If primitive humans had no internal alarm system when the dangers of ferocious animals lurked outside their cave looking for their next meal, they wouldn't have survived.

Their life-preserving arousal mechanism, better known as the fightor-flight response system (also called the fightor-flightor-freeze response system), is a biochemical reaction that was developed to help the body sense and respond quickly to danger. We could have become extinct had this system not been part of our makeup. But thanks to our hairy, cave-dwelling ancestors, generations have inherited this fundamental impulse. It's not needed today the way it used to be, but it's wired into us. Some people's systems are more sensitive than those of others.

In essence, anxiety is a response or a reaction to something that the brain perceives as dangerous or threatening. Without anxiety, you might walk through life and go about your business naively, in a blissful state, and be oblivious to simple dangers. A car may strike you because you're not paying attention while crossing the street. Or you may become a negligent parent by not safeguarding your home properly if you have young children. Or you may underperform at work because you are not worried about losing your job. A tendency to feel anxious in speciic situations does help keep you on your toes when it comes to protecting yourself and your loved ones.

Many artistic people, such as writers, actors, dancers and other artists, have credited the feeling of being anxious about their work and the pressure to perform well as triggers that spark their creative ires. Even great intellectuals and inventors throughout history have professed to having been indirectly inspired by the fear of failure or, most commonly, the fear of humiliation or ruin. Being anxious at times means you care about your life and the meaningful people in your life. It means you're a responsible person who wants to succeed and provide for yourself and your family.

Without anxiety, reaching goals and conquering risks wouldn't be so valuable to you. In a sense, anxiety gives you purpose and drive.

It keeps you on the right path and helps you appreciate the good you have. But for the 18% of us who suffer from excessive amounts of it, this organic boost of angst can be very incapacitating. Too much anxiety can cause so much distress that you can't function properly. That can lead you to fail at fulfilling major role obligations in your life that most people take for granted, such as taking care of your children properly, going to work every day and attending school. Anxiety can be so distressing that sufferers would give anything to be rid of all anxious feelings for good. But when you can understand and appreciate its positive efects better over time and learn how to harness its returns, it can seem less like something that only works against you.

UNDERSTANDING THE FIGHT-

OR-FLIGHT-OR-FREEZE RESPONSE

The fightor-flight response is an automatic inner alarm system that physically prepares the body to attack and defend itself (fight), or to run away and protect itself (flight). The freeze aspect describes the paralyzing efect that some people experience when they're so scared that they feel frozen in terror. It also refers to the body's instinct of staying still or "playing dead" in order to ward off a predator. When you experience something that feels dangerous or threatening, a warning bell is triggered. Neurotransmitters are released in the brain and send messages to the adrenal glands, which produce powerful hormones such as cortisol, which is called the "stress hormone" because it's found abundantly in the bloodstream of anxious individuals. What follows as a result of these hormones surging through the body are highly disquieting physical responses that don't feel good. They can also be very scary, which adds to the anxiety that's already working overtime. The typical symptoms that you might experience from this looding of hormones can be very troubling if you don't understand them. You may suddenly experience a rapid heart rate, shallow and labored breathing, sweating, and your mind can start to race uncontrollably, scanning the horizon for seen or other unforeseen dangers.

The rapid heart rate caused by the fightor-flight response produces an increase in the strength of the heartbeat for good reason. It's critical in your body's preparation for ightor-light. Its purpose is to pump blood quickly to the areas of the body that might be needed to face a ight or run away fast, including the large muscle groups, especially your arm and thigh muscles. Blood is then diverted from peripheral areas like your fingers and toes because if the body is badly injured, it's less likely to bleed to death. This is why people who suffer from anxiety oten report having clammy hands and tingling sensations in the feet and toes.

The shallow, labored breathing that's often experienced also has a pertinent function. The pronounced and enhanced breathing helps to prepare you for the fight or to take flight by bringing more oxygen to your body. While this response is supposed to be for your own good, some of the side effects can get intense. The shallow breathing can escalate to hyperventilation, which can scare you. This can also give you choking sensations and chest pain. And because the blood to the head is decreased by excessive panting and gasping for air, you can also feel dizzy or light-headed.

The fightor-flight response mechanism produces an increase in perspiration to keep the body from overheating while it's in action. And an increase in sweat helps make the skin slippery and more dificult to latch onto if a predator catches you.

But the chief function of the fightor-flight response is to reliably alert the mind to a threat or danger in the area. The mind immediately shits its focus and redirects its attention to the immediate surroundings to check for danger. Because of this, some individuals have difficulty with their memory and trouble concentrating and keeping their attention on the present. Or the mind can shift into freeze mode where it goes completely blank, leaving you feeling helpless about what course of action to take. All of this is wired into your system to protect you as it did our cave-dwelling ancestors. While the extent of the fightor-flight response isn't necessary today, it's there whether you need it or not, and it is the trigger for your anxiety.

WHO IS AFFECTED BY ANXIETY?

One of the many problems with suffering from this condition is that the anxious mind struggles to differentiate between a warranted panic situation, like being chased by a hungry grizzly bear in the woods, and the typically mild stress of something basic, like being late for an appointment. The anxious, primitive brain does not distinguish between stress triggers that easily, and every stressor can become a catastrophe in the making.

Most people who suffer only mildly from worry and the daily stresses of life—people who make it through a regular day relatively unscathed emotionally—understand anxiety in a way much like how they experience fear when they're watching a horror film. When watching one, they know it's just a movie and that they're watching fiction. Yet they still get scared as if it were really happening when they see it on the screen. They jump out of their seats or cover their eyes. Once the movie is over, they restabilize to a calmer disposition, and their fear-arousal symptoms subside. They return to their normal activities of living without the anxiety they felt while watching the ilm.

But if you worry excessively, you don't experience anxiety as a brief and occasional phase. It takes more of a hold on you, making it harder to restabilize. One seemingly innocuous event can trigger your anxiety and become debilitating. Despite having suffered for many years with the same recurring fears, the brain doesn't always learn that there's nothing terrible to be afraid of. It's been found that the ightor-light response system that's wired to protect you actually sidesteps the critical part of the brain where you store thoughts—the area that controls how you interpret and rationalize stress triggers.

Another reason for why some people are more at risk than others for being crippled by anxiety is because of their environment. A traumatic childhood, accident, injury, chronic illness, death or other incidents that may have scarred you has the potential to leave indelible psychological consequences, which influence your reactions in the future. A person who grows up in an unstable, chaotic family where he or she is exposed to physical or verbal abuse is likely to become more susceptible to anxiety symptoms—or even more likely to have an anxiety disorder—than someone who came from a stable home. And past experiences can manifest in current situations that are similar. For example, people who had a humiliating public speaking experience are likely to get more nervous in the future when they're communicating in a group or social setting than other people do.

Genetics also plays a role in the neurobiological makeup of your brain. Studies show that the psychological susceptibility discussed earlier can be transmitted multi-generationally or passed down to ofspring. Mom and Dad's experiences in life can begin a genetic legacy of angst—that angst could be passed down from grandparents or their parents. It can be difficult to try to pinpoint exactly where your anxiety came from, but trying to identify the cause can give you more understanding and enable you to take control of it.

My father was, by definition, an anxious and worrisome man who never sought treatment or help of any kind. Instead, he displaced his fears onto his wife and children. He was often punitive and unfeeling in the way he disciplined my brother and me, and he treated my mother very disrespectfully. Because he was also prone to its of rage, his mood swings led to verbal and sometimes physically abusive behavior. As I mentioned in the Introduction, I've suffered from anxiety with a history of severe panic attacks throughout my life, beginning when I was about eight years old. While in therapy in my twenties, I discovered that I, quite possibly, not only inherited my father's anxious psychological makeup, but I was also a victim of his abuse. I didn't connect the dots until later on in life.

To this day I continue to unravel and piece together how and why I often react to things the way I do. It's either genetic, or it's the prolonged exposure to my father's behavior over many years that wired me for a life of oversensitivity, or it's both. My younger brother, who was exposed to the same trauma and instability in our home, has never experienced the types of psychological challenges I have. He was somehow spared the genetic legacy, which, as a result, may have rendered him immune to the potentially damaging trauma. Two boys growing up with the same abusive father and the same chaotic environment, but only one ended up being an anxious person. The dynamics of the brain can be very interesting and puzzling as well.

My brother and I have a great deal in common but when it comes to how we process and react to stimuli in our lives, we couldn't be more different. I tend to be a sponge, often absorbing the stresses of the day and feeling weighed down by them. My brother is the exact opposite. He's one of the most temperate people I've ever met despite having been raised in the same crazy household. In short, genetics and environment can be key factors that contribute to why someone is more likely to be affected by serious anxiety. But those factors don't necessarily wire everyone for a life of having to deal with it.