Read PDF here : Anxiety (1)

What is anxiety ?

Anxiety is a pervasive emotion that generates distress. This distress manifest differently in everyone. Some people may have:

Intrusive thoughts: thoughts that uncontrolably appear and are uncanny or outright upsetting
A phobia of commiting impulsive acts ( like insulting, hurting or harming others or one self…) however strong this phobia is, it isn’t acted out.
Panic attack : a state of acute distress that often results in chest pains and shortness of breath.
Mental breakdown : a state in which the individual is overwhelmed and feels as if every aspect of their life is hopeless.
Obsessive-compulsive disorder: a state in which a individual acts out a compulsive action in a repetitive manner in order to diminish the feeling of anguish ( ex: check x number of times if the apartment door is propely shut).

And there are many more…

Because of this massive spectrum of symptoms, I find it easier to think of anxiety as the root of most mental health issues. However, this core isn’t alway accessible to consciousness. Meaning we don’t always know why we have anxiety because it remains uncounscious. So please never feel bad for not knowing, it completely normal.

It is worthwhile noting that anxiety is felt and experienced by everyone at some point in their lives. Nobody is totally free of anxiety no matters how much they seem to be.

Lastly, anxiety is to some degree normal and useful as it ‘helps’ us think a head of difficult situations and prepare for them. Like in the case of a job interview, a exam…etc.

It can also be used as a signal as I will expand on later in the essay.

How does anxiety affect us ?

Anxiety affects us on so many levels but for purposes of brevity I will only list 5 of them. Those I find the most important :

Altered sense of self:

When we experience anxiety we are no longer fully ourselves. Our thoughts, emotions, cognition, etc gravitate towards anxiety, a bit like a blackhole swallowing everything in reach. We become fixated on the dread, unable to enjoying fully the moment (however good they might be). And unable to move forward easily.

Strained bonding :

As anxiety take over it can be harder to form emotional connections to others. We might feel that they can’t understand our anxiety, can’t be there to help us or listen to us. This can lead to trying to mask or hide the anxiety or avoid interactions. This can lead to a feeling of isolation that can in turn amplify the anguish.

Social impact

Anxiety because of it’s prevasiveness can prevent us from preforming as we usually would. Be it by procrastination or being unable to focus on the tasks that must be done. As such the social life or work life can become more complicated and require more mental effort to get it done.

Psychosomatic effects

Anxiety can also manifest through physical symptoms like nausea, headaches, insomnia, fatigue, loss of libido, loss of appetite… ( I will explain in detail later )

Of course if these symptoms appear without anxiety or are worsening please consult your medical doctor.

Vanishing future

When we are experiencing anxiety we might feel our future slipping away or be out right unable to think about a future beyond our anxiousness. During those moments the future seems to be replaced by a highly stressful present. Making “decision making” more complicated.

Before we move on, please remember that these levels aren’t dogmatic truths and your undergoing of anxiety might be different and thus your experience would also be perfectly valid !

What are the triggers, how to recognize them ?

Because anxiety is triggered differently in every individual, based on there subjective history and experiences, I will not be able to address every specific situation. So I will give you a broad (too broad perhaps) guideline :

1° Identifying your limits

First and foremost, it is essential to question yourself about your inner limits in any given situation ( what you are confortable with, what do you find too taxing, complicated, scary, distressing, etc.) I will give some questions to help you with this process:

What do you find unconfortable but are ready to do and why?
Why are you doing it? Is it for yourself ? A loved one? Or is it because you feel pressured or forced?
What are you unwilling to do and why?
What do you feel must be done and is it really a necessity?
How are you feeling both in your body and your mind? Are feeling tired ? Angery ? Shocked?
What are the actions you would never do ? And do you feel that the situation is going to lead to you jeopardizing your values, selfesteem, or sense of self?

Once you have a clearer idea of the answers, you can start drawing the line on what is acceptable for you and what is not. And it is important to keep it in mind. Because if you are experiencing a difficult situation it can help you navigate it.

What ever happens, try to avoid going beyond your inner limits. As doing so would increase the likelihood of intense anxiety.

If I were to use a metaphor, I would use the idea of the skin : it protects you and your body but stretched too much and it might tear and become painful.

2° Deconstructing the anxiety

Now that you have a better understanding of your limits. We are now going to deconstruct the feeling of anxiety:

When did it start? During a event ? After a nightmare ? After talking to someone ? …
How did it start? Was it intense ( like a panic attack) or did it slowly creep in (like a growing feeling of unease that turns to dread)?
Has it already happened? If so does it fit a Or is it the first time in this type of situation?
Was it perceived by others or not?
How did you managed it?
Where do you feel the anguish came from? A fear of death, isolation, meaninglessness, powerlessness ? …

Of course there are no right and wrong answers to these questions. The aim here is to unfold the feeling of anxiety, to see step by step and try to understand it, rather than pushing it away. If this can be a scary process to attempt and if you feel that thinking about it might go beyond your limits then it may be best to work on it with a therapist.

After breaking down the steps, try to imagine how things could have gone differently (what could have helped you at any given step.) and see if you can implement them in case the anxiety arises again. Because everyone is different, the solutions and strategies might be very diverse and creative. This is a good thing, as creativity goes a long way in helping us cope with anguish.

3°Trying to understand the “why ?” behind the triggers

Contrary to what people may think anxiety isn’t meaningless. If something has triggered anguish within you then there is a reason for it. As obscure as it might seem our state of anguish and the triggers are deeply rooted in our minds and bodies. As such it is important to reflect on the triggers and think about them. Do the triggers bring back painful childhood memories, a traumatic event, a memory of rejection…?

In these moments of self reflexion it is important to let your mind wander and associate until you have hit a meaningful link between the triggers and the anxiety. These links can be insightful and essential to the healing of the feelings of anxiety.

In this ‘deep dive’ into your mind please remember to be kind to yourself. It isn’t a test nor a race. Your mind might set up defences and make it hard to use introspection.

But take your time and it can grow better.

How does it manifest in our bodies (physical/mental?)

Anxiety manifests in our bodies through physically ailments. These ailments are named psychosomatic disorders (ie mental states that affect the body without a clear biological cause). As stated previously it is one of the most important ways anxiety affects us. Body and mind being closely connect each one has an affect on the other.

The main physical aliments anxiety can cause are the following:

Nausea and/or indigestion
Insomnia and/or fatigue
Headaches and/or migraines
Back or muscle pain
Sexual issues such as erectile dysfunction, vaginal discomfort (cramping and pain, ..)
Skin issues such as eczema, increased acne, ..

Those biological effects do in turn worsen anxiety. As we might feel even more pain and powerlessness. It can become a vicious circle if the anxiety isn’t addressed and propely treated.

In order to help with this process the next chapters will focus on how to cope and what are the options and stategies you can use.

Advice to cope with anxiety

Because of it’s prevasiveness anxiety can quickly overwhelm us. And make us lose our sense of agency as such. I am going to give some counsel and advice on how to manage 3 common types of anxiety. (As previously stated there are infinitly more types and subtypes).

1° Event causing anxiety

These types of anxiety are common and tend to fade when the event in question is over. The event can be a exam, a important meeting, a job interview…

This form of anxiety can allow you to prepare for the moment to the best of your ability. However sometimes is can cease to be useful and become paralysing and dreadful.

In these moments I have a couple of pieces of advice to give:

Try writing down how you feel. And don’t hesitate to go into details about your anguish, but also your hopes, dreams, past, present and future ! Alternatively you can sing, run, excercice, go out for a .. What ever works for you is best ! This is done in order to ease an emotional stress and help you to attain a better state of mind.
Try and remember your past challenges. This can help you put into perspective your present And how you have already managed and sometimes strived in difficult situation. Some people realize that the current anxiety isn’t as bad as things they have already overcome.
Reward yourself after the event (regardless of perceived success or failure) ! Indeed you have experienced something mental and emotionally taxing and you have the right to enjoy your respite. This ‘reward’ can be anything (seeing friends, eating something you love, watching a movie, playing a video game, reading a book…) This gratification serves two purposes : first it allows you to imagine a grounded and positive future after the anxiety and it also gives you a short term

2° Existential Anxiety

This anxiety is also very common but it is less easily identifiable ( ie it isn’t linked to one specific thing). This anxiety might be more diffuse or more sharp depending on many factors ( the death of a loved one, a serious illness, a breakup, been fired…) It is closely tied to our human condition and it’s four ultimate concerns ¹: Death, Freedom, Isolation and Meaninglessness.

This anxiety isn’t something to be repress or avoided. It forces us to confront who we are, what we want, who we love and were we are going. Even if it aren’t easy, this anxiety is at the core of our development as people.

As such I will try to give you advice on how to handle the four ultimate concerns¹ and understand them.

Death is the final point of our lives. And no matter who we are we will have to undergo it. As such it is important not to deny it. The fear of death is part of us and defines who we are. The ending of our “being” is terrifying. But it is also gives perspective to our lives. The finite aspect of our “being” can make it all the more precious and valuable. And for those we have lost, part of them remains in our memories and their kindness, love and gratitude can be passed on to others through us in the most deep and meaningful ways !
Freedom is a vast and complicated concept but the short version is that our lives are guided by our These choices are at the core of anxiety. As freedom can be a scary thing because it implies we must take responsibility for who we are and what we do. It explains why we are anxious about our choices and their impacts. But at the deeper level, no one can choose for you nor for me. And “choice” isn’t a curse it’s a blessing, as it gives us agency. As such taking our responsibility in our choices is paramount. In addition most people will appreciate it, even if you made mistake and as such it can strenghten bonds.
Isolation is a deep and profound feeling of loneliness. Because our lives and choices are unique, we might feel that others can’t and will never understand us, never see us as who we truly are. This feeling can lead to self isolation and pain. It might be true that others may not fully understand us and we them. However it doesn’t mean that you shouldn’t Because even if they fail they might have been a good travel partner in life. As well they might help you accept that even in loneliness others can still be worthy of your time and effort !
Meaninglessness is the confrontation and fear of the absurdity of life. Does what we are doing, what we are experiencing have point ? Is it all towards something greater or is it just hopeless/worthless. Meaninglessness is a terryfing perspective that most of us avoid by staying focused on a task, a goal or by entertaining ourselves. But confronting this fear head on can help you find were you want to do in life and thus help you carve your unique path. It can also greatly help you with your creative process.

Whatever may be the ultimate concern, whatever you are facing, please take your time. Even if it is hard to bear. Please know that you do not have face this alone. This anxiety is complicated, be it also an opportunity for growth and better self understanding.

3° Intense overwhelming anxiety

These formes of anxiety are often experienced in short (5 to 20 minutes on average) but vivid and intense episodes such as in a panic attack and or a highly intrusive phobia etc.

For these intense moment are often very hard to cope with. Therefore I will give you very pratical advice to try and handle them.

Firstly, even if these are incredibly distressing episodes, please remember this, as bad as it is you will not die from the anxiety (even if you have chest pain or difficulty breathing). It is a painful moment but as all moments in life it will pass and you will survive this.
Secondly during the episode try and focus fully on one ( or more) of your sense :

Looking at something intensly, focus on it if it is solid it won’t break and nor will If it’s liquid it will flow just as you will flow out of this state.
Holding an object, focus on the touch, the shape, the action, you have in your Remember you have agency over it. Alternatively you can touch the ground and feel it’s solidity below you feet. It won’t cave in, it’s holding you were you are.
Focus on the sounds, the rythm, how the many noise come together and how they are seperate.
If you have perfum or if there is good smell, focus on it, try and decompose it in your mind ( what does it smell like and how it is comforting)

If you have a piece of food, taste it, and focus on the sensation and the reassurance it brings to you.

By focusing on your senses you will be able to ground yourself. Return back to a lesser state of anxiety. This will also help you realize that the world hasn’t been “swallowed” by your anxiety and that is will remain there unaltered and continuous.

If you are able try to do something, anything but fully focus onto it, then this can also ground you for a time until the anxiety lessens.
Focusing on your breathing, breathing slowly and with control, can help you diminish the anxiety.

Because of it’s intense nature this anxiety feels like a direct threat to one’s life, be it direct (fear of dying) or indirect ( fear of losing something like a loved one, a job…). But please remember that you will survive this and that you aren’t alone.

Coping tools and exercises that help to manage anxiety

In your daily life there several thing you can do to cope and manage your anxiety. Firstly, a healthy life style helps anxiety management :

Having a good amount of quality of sleep. Indeed sleep deprivation plays a substantial role in mood regulation (also avoiding screen exposure up to two hours before sleep helps improve the quality of slumber)
Cutting down on alcohol, caffine, and
Having a healthy diet

Secondly, let us talk about what you can do in your daily life to manage your anxiety :

Enjoy the moments of respite. Anxiety is in essence discontinuous, therefore when it isn’t present it is essential to enjoy your Do something for youreself and only for you. Try avoid putting pressure on yourself during these times. These moments are like a welcomed break from the dread, it is a little like sitting down after a long hike. It might not last, so relax before going back on the journey !
Take time out of your day to think about yourself and your life. Often we are so caught up in our stormy lives to think about ourselves in a deep and meaningful During this time you can go for a walk, listen to music… you can take 5 minute or 2 hours it up to you.
Try and practice breathing excercice The NHS has provide a good guideline on their web site :

https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing- exercises-for-stress/

From time to time do something new or something you always wanted to It might not work but it can open up new percpectives insights and sometimes relationships.

Thridly, let us talk about when the anxiety becomes to much to handle :

If you are feel none of the solutions above have help you and your anxiety is becoming untenable : a source of continuous pain and suffering, hurting your life and prospects. Then it is important to seek help from a mental health professionnal.

So what are the options :

There are two (psychotherapy and medication) they are not mutually exculsive (meaning you can do both at the same time).

Let us start with medication :

The type of medication that helps with anxiety is called an “Anxiolytic”. These can prevent anxiety from However they can have side effects (such as memory loss, slower breathing, also there is a habit-forming risk …). Importantly they must be used exactly how your doctor tells you to. As such, there are not ‘magic pills’. They are a useful tool to manage extreme cases of anxiety and only for short period of time.

This isn’t medical advice therefore please talk to your doctor, if you feel anxiolytics might help.

The psychotherapy:

Psychotherapy or talk therapy, is a process which can help you manage your anxiety, sadness, anger, suffering…

There are many types of psychotherapy. And most of them have proven to be effective. The most important element of therapy is finding a therapist you are comfortable and secure with. And make the commitement to go forward as change happens, in a gradual but continues way. The therapist will help you find a way to reduce your anxiety and make your life liveable again.

Also I would like to point out that seeking professionnal help is quite complicated because people might think that if they go to therapy that they are “weak” In my experience this couldn’t be further from the truth. People seeking therapy and committing to it are amongst the bravest people I have ever met. Confronting one’s problems isn’t weakness it’s a deep sense of courage !

Anything important to remember with anxiety ?

Well yes, something important is that anxiety isn’t useless. It can even be a important/vital signal in ones life. It might seem strange or downright foolish. However our anxiety can also help us realise things in a much deeper way.

To illustrate my point,I will give the exemple of Charles: a patient of mine, who was kind enough to allow me to share his tale with you².

Charles is a clever and witty young french man in his late twenties. He began therapy because he was consistently anxious about his teeth. He feared tooth decay, gingivitis… He was always worrying that his teeth would fall out. To avoid such a fate he would brush them 5 to 7 times a day. He went and saw many dentists and did many exams but they were unanimous : Charles teeth and gums were in perfect condition. This should have been the end to it. But the anxiety of Charles didn’t lessen quite the opposite it worsened (he could no longer sleep, hold a social life…). At this point he felt only professionnal help could help him overcome his anxiety.

So we started therapy. During the therapy he had many dreams about losing his teeth and the anxiety it caused him. After some investigation it seemed to me that the teeth were a standing for an other and deeper anxiety. I asked him what scared him most beside losing his teeth. At first he didn’t quite understand why I was asking but he obliged. It soon became apparent to me that he was very avoidant about his work and career the only thing he could share was that his work was ‘demanding’. After a couple of therapy sessions he became more and more conscious of his work place and the unrealistic and competitive nature of those expectations. And after our sessions he had an ephipany of his own he was afraid of losing his teeth, perdre ses dents (in french) because he had repressed the fear of being a perdant (ie a loser). He realised he was deeply afraid of losing his job, apartment, social status, and the love and admiration of others. A fear he could now express consciously. Because it was the polar opposite of what was demanded of him.

This moment of insight made him consciously aware that his job and it’s environment were profoundly toxic for him. The anxiety was a signal for Charles that what he was experiencing wasn’t ‘ok’ and that part of his life needed to change. As such he left his job and pursued a other career.

Of course the change wasn’t overnight and required a lot of effort and it wasn’t absolute but after understanding the meaning of his anxiety Charle’s life improved and his teeth anxiety vanished.

As such you should never underestimate the meaning of anxiety and the healing factor of understanding it.

In closing I would like to leave you with this quote of the psychologist Rollo May that is very enlightening in regard this essay’s topic : The positive aspects of selfhood develop as the individual confronts, moves through, and overcome anxiety-creating experiences³.

¹ As developped by the psychiatrist Irvin Yalom in his book Existential psychotherapy

² Of course names and details have been changed to garanti full anonimity.

³ Rollo May, The meaning of anxiety, W.W. Notron,1977, page 372

References

Rooted mind :

https://pixabay.com/fr/illustrations/sant%c3%a9-mentale-cerveau-en-pensant- 2313430/

Websites used as references : https://my.clevelandclinic.org/health/diseases/21521-psychosomatic-disorder

https://www.mentalhealth.org.uk/a-to-z/p/panic-attacks

https://takingcharge.csh.umn.edu/what-lifestyle-changes-are-recommended-anxiety- and-depression

https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing- exercises-for-stress/

https://www.healthline.com/health/anxiolytics

Bibliography:

Rollo May, The meaning of anxiety, 1977 Rollo May, The art of counselling, 1939

Jean-Paul Sartre, Existentialsm is a humanism, 1946 Irvin Yalom, Existential Psychotherapy, 1980

Irvin Yalom, The gift of Therapy: An open letter to a New Generation of Therapists and their Patients, 2001

In closing I would like to kindly thank the team of MindMatters for providing me with the drive to tackle such an interesting topic.