Anxiety Part 2 – Managing the Physical Symptoms of Anxiety

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Today I wanted to follow up on a post that I did recently looking at anxiety. Anxiety Part 1 – What is it?. In that post I discussed what anxiety is and introduced the fight or flight reaction, which is a very normal and natural response that the brain uses to kick the body into action when we are facing a threat. So when you’re in danger, your body gets ready to go fight or flee from that dangerous or scary situation.

There is a third option and we can be a little bit animal-like in our third response which is to freeze; so for some people who have experienced extremely traumatic events, they might report later that they felt incapacitated by the fear response, that they were not able to do anything. So if you think from an evolutionary perspective, it’s a little bit like a mouse playing dead when they’re being attacked by a cat. The cat eventually loses interest and the mouse hops up and scurries off. So if you go back to that first anxiety video or written blog you’ll see a bit more information about the fight or flight reaction there.

In a dangerous situation, fight or flight is very helpful. It prepares us to escape, helps us survive; it’s one of our survival instincts in fact. But in the absence of actual danger, that fight or flight response in its full-blown capacity is what we call a panic attack. And at an even lower scale of intensity we’re talking about that gnawing anxious feeling that we can get.

So you imagine you’ve just gone to check your mail and then all of a sudden out of the blue there’s an enormous phone bill that you weren’t expecting. It sets your heart aflutter and you catch your breath and all sorts of thoughts race through your mind.

So when we as psychologists and mental health workers are treating anxiety and remember, this is one of the most common things that we work with by the way, we will take a two or three pronged approach.

  1. We look at letting the clients know what anxiety is (this is called “psychoeducation”)
  2. We give them some strategies to work with those physical symptoms that they’re experiencing and then typically once the client has those skills under their belt,
  3. We will often incorporate some sort of cognitive work (looking at the thinking patterns that might be exacerbating or perpetuating those anxious experiences).

I talk about the cognitive stuff in another video. Today I wanted to talk to you about the physical symptoms and what we do to manage those.

One of the very simplest things we can do is recruit our breathing as a strategy to overcome the fight or flight response.

Now it seems like a really obvious thing. People will say just take a deep breath. There’s a bit more to it than just takimg a deep breath; when you’re anxious and you just take a deep breath, your shoulders come up to your ears, you’re gasping. Your brain interprets that as “my goodness this danger is enormous!”; so that can exacerbate the fight or flight reaction and can tip you over into hyperventilating which in turn gets you right into the guts of a panic attack.

When we talk about breathing as a management strategy, we’re asking you to recruit the body’s breath as a physiological tool to wind back that anxiety reaction.

So when we’re really anxious our breathing and our heart rate become quite fast in order to get freshly oxygenated blood into your big muscles so you can fight off or run from whatever it is that’s causing that sense of threat. When we do the opposite, so when we slow our breathing down and get it away from our upper chest, get it back down lower to our diaphragm (just under your upper ribs), we “unwind” that anxiety response. We calm down.

The diaphragm’s job is to expand and retract your chest wall when you’re breathing but women are anxious. Our breath scoops up to our upper chest and we notice that our shoulders are doing a lot more work when we’re puffing and panting and hyperventilating. So if we can get that breath back down to our diaphragm slowing it down being really consciously aware that we’re engaging the diaphragm in the breath, what then happens is that sends a signal back to the brain, it tells the brain the danger has passed, she’s calming down, we can call off the troops and what we find then is the cortisol (the stress hormone) levels will reduce, your heart rate will follow your breathing, so your heart rate will slow down and all the other symptoms of anxiety will start to follow what the breath is doing.

Now we can actually induce a panic attack; if I train you I’m not going to do it but if I train you to breathe, fast and shallow up in your chest and I said keep going, keep going keep going, we can bring on a panic attack. So by slowing the breaths we’re doing the exact opposite, we’re tricking the brain. We’re assuming that the brain has made a mistake, has labeled the situation we’re in as dangerous, we’re playing along with saying okay brain in this dangerous situation we’re going to now tell you that that danger has gone and the only way we can communicate that information to that amygdala, (the little bit in the middle of the brain that I was talking in the previous post) is physiologically.

So we use the breath as a messenger to tell the brain to settle down. Just using our words and our thoughts to tell the amygdala to calm down doesn’t work and if you experience anxiety you probably know that already, just telling yourself to calm down doesn’t work, so we use the breath, the breath is a really powerful messenger to tell the amygdala that everything’s okay, we can calm down now.

It’s really hard in the middle of a panic attack to remember to do that, so what you want to do is, you want to practice and practice and practice that calm diaphragm breathing as often as you can remember it throughout the day, now you don’t need to set aside time to do this. I know for a fact if I tell you to practice your breathing for half an hour every day you won’t do it. I can’t find half an hour to just breathe; so I don’t tell clients to do that.

What I tell clients to do is peg it to something that you’re going to do every day. It might be doing something as simple as going to the toilet or it might be every time you check Facebook or it might be while you’re standing waiting for the kettle to boil. During those moments in the day let those be a reminder to you to just touch base with your breathing. What I mean is, just poke yourself in the middle of the diaphragm and just feel and notice how that muscle moves. You can feel it when you’re breathing. If you’re breathing from your diaphragm you’ll feel that muscle moving in and out and just pay attention to that for a minute.

That’s all it takes and if you do that once or twice a day every day, you’ll start to notice when your breathing changes. So when anxiety is creeping up on you, you’ll start to be able to tell that it’s coming. You might think that anxiety comes out of the blue without any warning, but usually if we know what to look for we can see some warning signs.

So by focusing our attention on our breathing once or twice a day, sometimes called mindful breathing, really engaging your mind fully focused on that breathing. If you do that a couple of times every day you’ll get better at it and you’ll get more aware of what’s going on in your body. You’ll start to notice when anxiety is going to escalate and then take the time to really focus on that breath and you’ll start to find the more you practice that the more you’ll get really good at unwinding that anxiety. Then the likelihood of it flipping into a really big panic attack is greatly reduced.

So typically with a client that I’m working with, has anxiety experiences, I will talk them through what I did in the first video, educate them about what anxiety is, let them know what’s going on in their body and when I talk about those physical symptoms most people can relate to that quite closely.

Then I teach them that breathing strategy. So what I want you to do now is go home, play around with that, try it in all sorts of different settings, try it when you’re doing the dishes, try it when you’re lying down in bed, try it when you’re on the loo, try it when you’re at work and so on. Get used to the idea of touching base with your breathing, finding out what’s going on in your own body, play around with calming yourself down and don’t just play around with that when you feel anxious. If you notice you’re getting angry remember fight or flight, when something’s bothering us it can flip us into an anger mode, just as much as it could flip us into an anxiety mode.

Play around with the different negative emotions and see what you can do with unwinding that physiological response. See if you can calm yourself down, it’s a really good one for parents. See if you can calm yourself down using your breathing before reacting to what your kids might be up to.

So that’s your homework, I want you to all play around with that breathing, give it a go, see what you discover about yourself. I’d love to hear your comments. I’d really love to know what you find when you try that for yourself. A lot of people have tried all sorts of different relaxation strategies and the number one complaint I hear from people is that they don’t have time to sit with those strategies because they’re too long. So this is a really short sharp thing that you do a bunch of times throughout the day. Just whenever you think of it, there’s no rules, no number of times you should or shouldn’t do it. It’s up to you, play around with it, explore it. Let me know how you go.

Now, if you know some people in your life, some friends or family who you think might benefit from this little exercise, feel free to share the video amongst your friends on Facebook or Twitter or wherever else and let them know this is something they can play around with too and I will be back in a few more days to talk again about anxiety and I’ll talk to you then about how we work with the thoughts that come and go in our minds, that play around with us and mess us around just when we think we’re getting on top of something. There might be those sneaky little thoughts that slot in there and pull us back.

So I’m going to help you work around those as well. That’s it for me today so what I’d really love to know is how much you may or may not be liking these videos. Please let me know… if you give the video a like or a love, that will let me know how many of you are appreciating the information and if it’s helpful for you. Do let me know your comments and your thoughts and certainly your questions if you’ve got questions I’m happy to answer those.

Best wishes … and don’t forget to breathe,

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Tess has a passion for mentoring new psychologists. She also has a strong interest in supporting executives as they juggle the balance between leadership and new parenthood. You’ll see Tess regularly speaking on our Facebook pages and our YouTube channel. Her mission is to provide as many free resources to the community as she can, so her videos offer tips and strategies that might be helpful to you. Read Tess’s full Bio here.

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