Explaining anxiety... without "anxiety".

These are the physiological and emotional dynamics behind that state of alertness we sometimes feel.

When we get a tremendous fright, or we are victims of a very intense threat, we all understand that the body experiences, "corporealizes" a series of sensations, not less unpleasant for being known: hyperventilation, palpitations, sweating, trembling, etc.

In these cases the fear is instantaneous, but not "irrational". The mind connects all these unpleasant sensations with something "real" that has happened and we know that, with a little time, the body will eventually regulate itself, that is, the sensations will pass.

Then psychologists will explain more technically that when faced with the threat of danger, the limbic system, responsible for the management of emotions (and fear is one of the basic emotions in humans) will temporarily cut communication with the cortex and activate the cortisol pathway, a hormone that regulates the reaction to stress, which will generate adrenaline and noradrenaline production, the heart will suddenly increase the rhythm of its beats to have more Blood and the respiratory system will increase its rhythm, hyperventilating to increase the production of oxygen, both necessary for the "fly or fight" response, fight or flight, typical of a moment of threat or danger.

In addition, other responses will also be triggered in this fight or flight process.The blood will concentrate in specific areas, leaving others less irrigated, with the consequent sensation of numbness, shivering, sweating, etc... The pupils will dilate to have a peripheral vision... in short, a wide variety of physiological responses essential for the act of "fight or flight" always present in a scenario of fear.

The dynamics of anxiety

Up to this point, we all understand and no one calls "anxiety" the activation of unpleasant sensations that in another context we do call "anxiety", becoming overwhelming and terrifying. Why does the activation of our nervous system, necessary as we have seen in a moment of danger/fear, turn out to be apparently "pathological" in other contexts?

What happens when these sensations: palpitations, choking, shivering, sweating, trembling, dizziness... appear when we least expect them? At home sitting on the sofa, in class, at work, when crossing a bridge...

Sometimes, the trigger of the activation is the connection of the place, the person or the event, with previous traumatic experiences in our lives.. That is to say, if I have suffered mobbing or bullying and this has generated anxiety, the mere fact of returning one day to the place where I experienced it or to a place that reminds me of it, can cause the limbic system to trigger cortisol, thus initiating the response to dangerous situations, as if the traumatic event were really happening again. This, although with more difficulty, is also in a way susceptible to be understood with some normality by our rational mind.

But there are very many occasions in which the above-mentioned sensations appear without an apparent trigger, neither current nor remote in time.neither current nor remote in time. They simply appear unexpectedly, and on these occasions, without knowing why, we feel that our heart is racing, that we are short of breath, that we are sweating copiously or trembling uncontrollably.

In these very, very common cases, the mind panics. Panic in the face of sensations that we cannot control and to which we are unable to attribute and to which we cannot attribute neither an origin nor a determined duration, and when the mind loses the capacity of control and comprehension of what lives in the body, it panics.

And of course, panic in this case is not the response to something that happens outside of us, but paradoxically, what is generating panic and fear are the body's own reactions of panic and fear, as we have described at the beginning.

They are the same sensations, only now we do not know the cause or why and we cannot control them, and instead of letting them happen and pass, (as we do in cases where something external to us generates fear in a timely manner), they overwhelm us, terrifying us, and we start an endless chain in which the fear itself to the reactions of fear, only increases the intensity of these sensations, trapping us in a vicious circle of fear, more sensations, more fear, more sensations ... until we reach the crisis, the panic attack, which in its paroxysm, in the extreme of its intensity, will end up exhausting the energy of the system and we will fall into surrender. ... until reaching the crisis, the panic attack, which in its paroxysm, in the extreme of its intensity, will end up exhausting the energy of the system and we will fall exhausted.

This paroxysm normally does not last more than a few minutes, but it is terrifying and sometimes ends in a hospital emergency.

Why does this happen?

Let us imagine that we are in a moment of intense personal, work or emotional stress.And let us also imagine that our quality of sleep breaks down. This will cause our system to remain on alert/alarm for much longer than usual and will also result in inadequate rest. It is as if our brain engine is over-revved and we never have time to take it to the workshop (rest).

Eventually, the system will be exhausted, the battery will wear out and that is when the body (our own nervous system) activates the survival response that will trigger sensations very similar to those we feel in a moment of alert/fear.

That is to say, it is as if our system has a safety relay, a threshold, from which it it "warns" us by means of unpleasant physiological sensations that we have entered in a risk zone, that the energies of our system are not in danger.that the energies of our system are being exhausted and that, therefore, we need a long and well-deserved rest. In this case the feelings of anxiety or fear are not the product of a concrete and easily identifiable fact, but of the breakdown of the system due to exhaustion.

If we understand this, the response should be the same as when we get a tremendous fright, we should let the system settle down and calm down again. For that reason in Vitaliza we give much importance to this psycho-educationto this understanding that what is happening, although surprising, overwhelming and frightening, is still "normal", that is to say, that it has an origin and an explanation.

Once the cause is understood, we try to regulate the physiological state of anxiety as quickly and pragmatically as possible, generally through biofeedback work, especially cardiac coherence and neurofeedback, while developing anxiety management tools such as group therapeutic Mindfulness. This, of course, without forgetting the necessary psychotherapeutic accompaniment that deepens and tries to solve the psychological root causes that led to the breakdown of the system and the appearance of the anxiogenic symptomatology.

Author: Javier Elcarte, expert psychologist in trauma, director of Vitaliza.