Why Do I Have Anxiety?
Dr Joseph Barker
Having recently been invited to collaborate with the wonderful mental health charity MQ as a guest editor on their anxiety blog, it felt like to good time to share some more detailed thoughts on anxiety. When MQ asked me to appear on their podcast and my own anxiety went though the roof, this felt even more relevant. When it’s released, you’ll be able to find the episode here and see exactly what I mean!
In this particular time, when we are coming out of a pandemic world, a lot of us feel a lot of anxiety. The experiences we’ve all had of our worlds shrinking has heightened our sensitivity to all sorts of stimulus, naturally meaning we are feeling more nervousness. The boundaries between what is proportionate and what is not are also shifting and perhaps harder to see clearly. Anxiety is a human experience that is common to all of us. However, like most things there are good parts to our anxiety and times where it can cause us problems. In the following article we’ll look at what anxiety is, what causes it, when we might want to seek support.
What is anxiety?
Anxiety is an evolved emotional response that is designed to keep us safe. If our brain picks up signs of danger it prepares up for action by triggering our “fight, flight, freeze” response to get us ready for action. It cues our endocrine system to release adrenaline, diverts blood away from our digestive system and towards our big muscle groups (lags and arms), increases our heart rate, ups our blood pressure and breathing rate, and unconsciously makes us tense all our muscles, ready for action. The feeling of anxiety is deliberately unpleasant to make it really hard to ignore and to cue us to pay attention to any possible dangers. This is why we might feel nervous, jumpy, on edge, and find ourselves constantly worrying about the future or catastrophising. The anxiety is designed to make us hyper-alert to signs of danger and plan ahead, so we can respond quickly and keep ourselves safe.
The physical symptoms of anxiety we notice are side effects of being in this state of “readiness”. For example, having a higher heart rate and raised body temperature would be great if we were about to fight a bear but what we tend to notice is the sweaty palms, feeling sick, out of breath, hot, sweaty, shaky, have blurred vision or feel pain and stiffness. These “symptoms” are all side effects of us being in a state of readiness to for action.
What causes anxiety?
We’ve had the part of our brain that causes us to feel anxious for millions of years. It’s really powerful and our “fight, flight, freeze” response is one of the reasons we have been able to survive and evolve. However, the world around us has also changed. Originally our brain would have been trying to keep us safe from predators. Lions, tigers, bears and rival tribes. These days we have different threats that can trigger our fight or flight response. Traffic, climate change, difficult relationships, or a presentation at work. On top of this, we’ve evolved entirely new parts of our brain which let us store memories, plan, imagine, remember, and worry. Our anxiety is no longer only triggered by real world threats like lions, it can now be triggered by own worries, fears, plans, and to do lists. Our anxiety can trigger more anxiety so it’s no wonder it can feel like our worries are endless and we can’t switch off.
Like everything we have evolved, there are costs and benefits to anxiety. Birds have evolved to have wings which are fantastic for being able to fly but make them terrible pianists! We’ve evolved fingers which are fantastic for playing the piano but nowhere near as good as some flippers would be for swimming. These adaptations evolve over millions of years and the ones that help us survive and thrive in our current environment are passed on to future generations. Our emotions have evolved in exactly the same way. They have benefits and unintended consequences.
Unintended consequences are much more likely to occur when our environment changes much faster than evolution can keep up. In the last few hundred years we’ve gone from the industrial revolution to the internet, self-driving cars and artificial intelligence and our brain and body haven’t changed at all! This is part of the reason our modern world can be so stressful; our anxiety can be triggered by day-to-day stresses, but our brain can still react as if we’re facing predators on a daily basis. This mismatch is why our anxiety can sometimes feel out of step with the threat we are presented with. Our brain may perceive asking someone out on a date as threatening (being rejected isn’t a lot of fun!) so it tiggers our fight or flight mode and we can feel as if we are about to tackle a bear. Sometimes our evolved “new brain” can soothe our anxiety but because our “old brain” fight or flight response is much older and much more powerful, there are times when our anxiety can overwhelm us.
We are all really complex people and the amount of anxiety we feel is determined by an equally complex interaction of our biology (genetics), social (our environment and life experiences), and psychological (how we think and feel about our experiences) factors. This means while we’re likely to all start life with a certain genetic “anxiety set point” of how much anxiety we feel. However, the complex interaction between our genetics, environment and psychology makes it almost meaningless. It can be helpful to think about this as a “stress vulnerability model” (I promise this isn’t as complicated as it sounds).
If you’ve had a really bad day at work, haven’t slept well and an unexpected bill falls though your letterbox you’re likely to be far more worried and anxious than you would have been if you’d be having a great week. Similarly, our anxiety is much less likely to spike when doing a presentation if you’ve had years of consistently good feedback about your presenting skills. Vulnerability factors might include challenging life experiences, trauma, genetics, illness, or lack of sleep. When lots of these factors combine to increase our vulnerability, even really small stressors can cause us overwhelming anxiety. On the other hand, if we’re currently dealing with very few vulnerability factors, we can sometimes cope with huge stressors relatively well. This explains why different people feel different amounts of anxiety in the same situations and why our own anxiety can be so different at different times.
To make things more complicated whether an experience is a vulnerability factor completely depends on how we individually experience it. As an example, we might remember performing in our school play as the moment the world recognised our extraordinary acting talent, or the single most humiliating moment of our childhood. The good news is that we can use this knowledge to help us manage our anxiety. We can make changes to our lives to reduce our current vulnerability factors, remove or reduce stressors, and learn psychological skills to handle our difficult experiences.
When does anxiety become a problem?
Remember anxiety and stress are evolved responses which exist because they help us survive. Anxiety can motivate us, get us out of bed, protect us from danger and even boost our immune system in the short term. Anxiety is a powerful emotion and the reason we have survived and evolved as human beings for millions of years. It keeps us on the lookout for danger and we wouldn’t be able to function without it.
However, we can experience anxiety on a spectrum of feeling a bit nervous to constantly worrying, to having a panic attack where we experience such intense physical symptoms that we may feel like we’re going to pass out. When we feel particularly anxious, we may dissociate where we feel disconnected from the present moment. All of these experiences can interfere with our day to day lives and we may find our ways of coping the anxiety are causing us more anxiety or other difficulties later down the line.
The key difference between helpful anxiety and an anxiety “disorder” is the severity and persistence of the symptoms, whether the anxiety is a proportionate response to a situation or stimulus, and if the anxiety is having a meaningful impact on our day-to-day life. I’m always a little hesitant to use the term “anxiety disorder” or “diagnosis” as this framing isn’t helpful for everyone and you can read more why here.
If you’re concerned about your levels of anxiety there are some questions you can ask yourself to see whether this is helpful anxiety or an anxiety difficulty that you might want some support with.
· Does your anxiety affect your day-to-day routine?
· Does it prevent you from doing things that are important to you?
· Does it stop you being present in activities that you enjoy?
· Does it affect your choices in an adverse way?
· Are you making big adjustments to your everyday life to cope with the anxiety?
· How would your life be different if you weren’t constrained by anxiety?
Anxiety is an incredibly important part of being human and in fact we wouldn’t be alive today without it. We tend to notice anxiety as physical symptoms alongside a sense of unease. But interestingly we experience the exact same range of physical symptoms when we’re excited. Think back to the last time you were about to get on a rollercoaster, meet a friend you haven’t seen in ages, or that delivery you’ve been waiting for finally drops through your door (or leaves a “sorry we’ve missed you” card despite having absolutely been in all day!). If you were really concentrating you might have noticed an elevated heartrate, trembling hands or being out of breath. We even use phrases like “flushed with excitement” or “it took my breath away”.
Amazingly our brain can interpret exactly the same physical response in two completely different ways. This is one of the tools we can use to help us relate to our anxiety in different ways. We can slowly work out what’s maintaining our anxiety and find alternative coping strategies that allow us to build up to doing the things that previously felt too difficult.
While I’ve written this article to help us understand what anxiety is and where it comes from it’s also really important to acknowledge that anxiety can have a debilitating impact on our lives. It can rob us of the things that bring us meaning and make the things we enjoy or want to achieve completely overwhelming. If you’d like to know more about the different kinds of anxiety disorders and what maintains them, this article might be helpful.
A small call to action
I have composed this article because anxiety is something that we all experience as human beings. As a Clinical Psychologist I work with people who are struggling with their anxiety and it’s significantly limiting their lives. This year’s mental health awareness week’s theme is anxiety. So, I’d really value your time if you felt able to share some of what you’ve learned (or already knew) with your friends, family, and social circle where it feels comfortable to do so. Please share this article if it’s helpful and let me know if there is anything else you’d like us to cover.
About the author…
Dr Joseph Barker is a Chartered Clinical Psychologist with over 10 years training and experience in range of mental health services. Joe currently works in the NHS as a Senior Clinical Psychologist supporting people living with HIV, trauma, and long-term health conditions. Joe additionally trains Clinical Psychologists at the University of East Anglia with specialties in trauma, anxiety, and adult mental health difficulties. Joe’s award-winning research has been published internationally and he delivers training and supervision to a variety of qualified professionals. In addition to his doctoral level training, Joe has completed postgraduate qualifications in Health Psychology and Evidence Based Psychological Treatments and completed further training from world leading experts in Trauma Focussed Acceptance and Commitment Therapy, Compassion Focussed Therapy, CBT, and Psychodynamic Therapies. Joe is recognised as a Chartered Clinical Psychologist by the British Psychological Society and is registered with the Health and Care Professions Council (HCPC).