“Anxiety refers to multiple mental and physiological phenomena, including a person’s conscious state of worry over a future unwanted event, or fear of an actual situation. Anxiety and fear are closely related. Some scholars view anxiety as a uniquely human emotion and fear as common to nonhuman species. Another distinction often made between fear and anxiety is that fear is an adaptive response to realistic threats, whereas anxiety is a diffuse emotion, sometimes an unreasonable or excessive reaction to current or future perceived threat.” So goes the opening paragraph of a chapter titled ‘Defining Anxiety Disorders’ from a book published by the Oxford University Press, title Treating and Preventing Mental Health Disorders.

Beyond merely attempting to define anxiety, the chapter seeks, as suggested by the title, to draw a line between occasional anxiety that is a regular part of life, and psychopathological conditions that might require professional treatment. To be clear, the article below is focused on occasional anxiety and its potential to become long-term anxiety and negatively affect our health, as well as preventative lifestyle practices; it is not focused on anxiety disorders that would be best suited to medication or professional treatment.

The body on anxiety

“Anxiety can make one feel completely out of depth, overwhelmed, out of control, like you can’t survive; you feel emotionally dysregulated,” explains trauma therapist and clinical sexologist, Dr Marlene Wasserman. “When we feel in our bodies that we’re anxious, when we can feel that either we’re kind of stuck, or that we’re completely fragmented, your body begins to respond to protect you, because the brain is there to protect you. So what the brain does is that it starts secreting hormones, neurotransmitters to be able to get you to survive. You begin to release adrenaline, noradrenaline, cortisol, norepinephrine, epinephrine, dopamine, serotonin; all of those hormones, you begin to secrete through your body because the brain said to you: there’s a danger.”

Wasserman explains that this influx of hormones, as well as blood flowing into your limbs, is what leads to the flight, fight, or freeze responses, as well as the lesser-known fawn response, which refers to the habit of trying to please in order to avoid conflict. Depending on the context, these responses can be life-saving, either helping one run from danger, fight danger, or as Wasserman puts it, “keeping you absolutely frozen until the danger goes away.”

However, a constant stream of these hormones due to regular exposure to stressors can have quite the opposite effect. Explains Wasserman: “The brain’s purpose is to keep you alive through eating and digesting and peeing and pooping and sleeping; that’s the purpose of the brain, to keep you going. So when you’ve got [constant] anxiety, the brain stays activated, it’s on the lookout all the time. The brain thinks that you’re in a war and it keeps flooding your body with those hormones in order for you to protect yourself through fight, flight, freeze or fawn. Then the body gets inflamed because it’s got all the stress hormones in it all the time.”

That inflammation as a result of feelings of anxiety can lead to very real physical symptoms. As part of her practice, when she does her initial assessment of patients who might be experiencing anxiety, she asks about a number of physical symptoms they might be experiencing, including insomnia, jaw clenching, indigestion problems, irritable bowel syndrome, thyroid issues, sexual pain problems, or fibromyalgia, a “long-term condition that causes pain all over the body,” according to research published by the UK’s National Health Service.

Another condition that Wasserman says often accompanies anxiety is depression. She describes the conditions as being on opposite ends of the trauma response, on the high end there is a state of anxiety, and on the low end, depression: “When you have trauma, you’re living up there a lot of the time, or down here, where you just frozen and you’re depressed. So you’re either anxious, or you’re depressed. And the therapist’s role is to bring the client into the middle into the window, where the brain can be still, and then you’re able to think and be more present in your body, more present with yourself.”

How each individual responds to trauma can also be affected by factors that are specific to that individual. “While we know that when triggered by a stressful event, what usually happens you go into fight, flight or freeze mode; it depends on you as an individual in different circumstances how you’re going to respond to whatever stressor is imposed on you. But we can’t just attribute our response to the stressor only, we also need to attribute it to our own biological as well as psychological factors. For instance, if you’re a person who has previously gone through difficult things, and those difficult things remain unresolved, and there are some loose ends that you still haven’t tied up; then it’s very possible that you’re going to go through one event that will trigger emotions and feelings from other events as well,” says clinical psychologist Esona-sethu Ndwandwa.

Dealing with and preventing anxiety

If one can afford it, whether or not they are currently experiencing anxiety, Ndwandwa recommends seeing a therapist, be it once or twice a month, in order to maintain a reflective space. However, should one not be in a position to see a therapist, she recommends the importance of having someone to talk to, be it “a friend, a mother, a father, a family member, a pastor, a teacher, or a mental health nurse… if I talk to a friend, then I’m no longer keeping all this material in my mind in some kind of loop… the other person becomes a reflective space, and that helps to break the loop. And if there are points of breakage in the loop, then there’s space for other thoughts to come in,” says Ndwandwa.

Should talking to another person not be an option, she emphasises the importance of keeping a journal. Says Ndwandwa: “Don’t only journal when things are difficult, but make it a habit. Make it a lifestyle, to give yourself ten or twenty minutes of this reflective space as often as you can, preferably daily.”

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In addition to journaling, both Wasserman and Ndwandwa recommend lifestyle changes as ways to deal with occasional anxiety and as preventative measures to strengthen our ability to deal with future stressors that might result in anxiety.

“It’s about mindfulness practice, yoga, pilates, being in nature, friendships and connecting with other people; all those things that we know from great research get the brain to be more regulated. It’s about self-care, every day you should start by regulating yourself,” says Wasserman.

Ndwandwa also highlights the importance of a healthy approach to social media: “Social media and the internet can be an amazing source of engagement and information, but it can also be a very dark and detrimental place for people. It’s important to make sure you’re not putting yourself at risk to be in situations where you are susceptible to psychological harm.”

While she is clear that there is no one-size-fits-all solution as to what a healthy relationship with social media and the internet looks like, she recommends being honest with one’s self and paying attention to posts and information that might be triggering or that might encourage unhealthy practices.

That understanding of what is right for you and understanding situations that are healthy is also something that Wasserman recommends as a preventative measure, especially when it comes to dietary choices, which, as per Maverick Life’s interview with nutritional psychiatrist Dr Uma Naidoo, also play a large role when it comes to anxiety.  Says Wasserman: “It’s about living more intentionally. [It’s about asking] what is it that my body requires right now? What would feel good for my body right now? Keep going back to the wisdom of your body. If you are anxious, you’re impulsive and out of control, you just kind of grab anything to try and take away that anxiety, to try to give you some sweetness.”

Those choices are not limited to diet either.

“If you’re functioning at a level of extreme workaholism, for example, your brain isn’t able to manage that because you’re going to keep being stressed, so you get a great adrenaline rush. But the actual thing is, if you slow it down, you come more into your executive brain, and you’re able to think more critically because you’re still in your body, you’ll get more done that way. That workaholism and the extreme sports [can be] a way of escaping anxiety and pain and suffering. It’s a way of escaping being in your body with your feelings of regret, guilt, remorse, pain, loneliness, abandonment, neglect, or even abuse. So we create all of these adaptive mechanisms to be able to manage these feelings which are just too terrible if we sit with them. So the work is how to manage feelings without having to have excessive behaviour, which doesn’t serve us well,” says Wasserman. DM/ ML