What’s anxiety?

“Worry is like a rocking chair: it gives you something to do but never gets you anywhere.”

– Erma Bombeck

Anxiety is a common and normal emotion. Mild anxiety may heighten mental sharpness, enabling a person to cope more effectively with a difficult situation. However, when it is excessive, it may become debilitating and be classified as an anxiety disorder. Generalized anxiety disorder (GAD) is one of the most common anxiety disorders. It is characterised by uncontrolled worrying about everyday things for at least 6 months.

Worry has been described as “the thinking part of anxiety.” However, in extreme forms, worry can become “toxic”. It can poison our pleasures and sabotage our achievements. It can also seriously threaten physical and mental health. Worrying can sometimes feel like putting energy into preventing an anticipated catastrophe. However, in reality, worrying can make the catastrophe more likely to happen. For example, if you are worrying excessively about a presentation you have to give, your worry is causing you to visualise failure. Visualising failure can make it become a self-fulfilling prophecy.

Anxiety typically manifests itself with emotional symptoms (e.g. fear, nervousness), cognitive symptoms (e.g. worry, a sense of doom, or derealisation), and physical symptoms (e.g. muscular tension, tachycardia, dizziness, and insomnia). Concentration is reduced and fatigue is prominent, so that that the ability to perform normal daily tasks deteriorates.

Note: Derealisation is the feeling that things in one’s surroundings are strange, unreal, or somehow altered. Tachycardia is a fast heart rate.

Anxiety symptoms may develop as a consequence of a medical condition. Examples include patients who experience anxiety symptoms following a myocardial infarction (heart attack), a pulmonary embolism, or an asthma attack.

Note: A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually caused by a blood clot that travels to the lung from a vein in the leg.

Ongoing stress or difficulty managing everyday stressors (daily hassles) can result in a variety of problems for asthma sufferers. These include:

  • Irritability from lack of sleep or asthma drug side effects
  • Poor concentration, leading to poor performance
  • Feelings of depression
  • Insomnia or nocturnal asthma, resulting in fatigue
  • Withdrawal from friends and social activities due to a lack of energy
  • Lack of exercise and consequent poor physical fitness
  • Comfort eating

When stress levels increase, so do asthma symptoms, such as wheezing and coughing. As asthma symptoms increase, so can anxiety, creating a downward spiral in health. If stress is severe, anxiety can escalate into panic attacks, which are characterized by: symptoms such as:

  • shortness of breath
  • feelings of smothering or choking
  • heart palpitations
  • shaking and trembling
  • dizziness
  • sweating
  • hot flashes (flushes) or cold chills
  • chest pains
  • a feeling of unreality (such as being in a fog, in a cloud, or detached from one’s surroundings)
  • fear of dying, going crazy, or losing control

 

Breathing in Anxiety

According to Fried (1999), anxiety states tend to be accompanied by the following breathing changes:

  • Breathing becomes irregular (inspiration/expiration ratio shifts)
  • Breathing becomes shallow (tidal volume decreases)
  • Breathing rate increases (tachypnea)
  • The amount of air flowing in and out of the lungs per minute (minute-volume) increases
  • End-tidal carbon dioxide decreases (hypocapnia)

In short, the above changes constitute hyperventilation.

 

References

Bradley D (2011) Hyperventilation Syndrome: Breathing Pattern Disorders and How to Overcome Them, London: Kyle Books

Fried R (1999) Breath Well, Be Well, New York: John Wiley & Sons, Inc

Fried R (1993) The Psychology and Physiology of Breathing, New York: Plenum Press

Karren K et al (2013) Mind/Body Health: The Effects of Attitudes, Emotions, and Relationships (5th Edition), San Francisco: Benjamin Cummings

Timmons B H and Ley R (eds) Behavioural and Psychological Approaches to Breathing Disorders, New York: Kluwer Academic/Plenum Publishers

 

Buteyko Breathing Clinics (Dublin and County Wicklow)