When people are anxious, they enter “threat mode” that is meant to alert them and keep them safe. The body enters fight-or-flight, and prepares us to either run away or to fight whatever threat has been identified. When entering the threat mode of functioning, a host of changes occur physiologically, cognitively, and behaviorally, and these changes will sound familiar to anybody with anxiety.
Physiology in Anxiety
Often the changes in the body are easiest to identify as symptoms of anxiety. The body biologically responds to danger by providing what is needed to fight or flee to safety. Thus, people get lots of energy from an increase in adrenaline: heart-rate goes up, breathing becomes shallow and fast to get more oxygen into the system, and blood pressure spikes. In fact, blood even moves away from the periphery to center around organs in case of injury during a fight. The digestive system slows down. These changes explain people’s subjective experiences in anxiety. Some examples include– –
- churning stomach
- shortness of breath
- rapid heartbeat
- tense muscles
- difficulty sleeping.
Cognition in Anxiety
People’s thoughts change when they are anxious, and the focus becomes centered on the identified threat. Because of this, when people are anxious it can be hard to think about anything else. Although they might get distracted, they often end up coming back to their fears. People may start to identify any possible current or future threats. Possible problems are considered, and they may start to ask themselves, “what if…?”
Some examples of these what if thoughts are: –
- “What if I do badly and they reject me?”
- “What if I panic in there and I can’t get out?”
- “What if I feel like this forever or I go crazy?”
- “What if Amy isn’t answering her phone because she’s been in an accident?”
People sometimes imagine things that could go wrong, along with all the negative consequences that could result if it came true. Often, this focus on threats and danger leads to searching for solutions or ways of preventing fears from coming true, and anxiety spikes if acceptable solutions aren’t identified.
Behavior in Anxiety
Anxiety leads to changes in behaviors, often in an attempt to cope with perceived danger. The most common, yet detrimental, way people with anxiety cope with their symptoms is to attempt to avoid danger – the flight part of fight-or-flight response. This may lead people who experience social anxiety, for example, to try avoiding situations in which they might be negatively evaluated (like parties), meeting new people, or speaking in public. Or, if they find themselves in one of these situations, they may try avoiding eye contact, speaking, or moving. Similarly, people who experience panic may avoid situations that have triggered anxiety for them in the past, or settings in which it would be inconvenient to have a panic attack, like public transportation. Those with specific phobias tend to avoid places where they might come into contact with their fear stimulus, avoiding basements if afraid of spiders, or the doctor if afraid of needles.
Many people identify anxiety itself as dangerous, and try to do what they can to avoid the sensations of anxiety. It is common for people with anxiety to avoid exercise or other scenarios that raise their heartbeat because of the similar feeling of experiencing anxiety. People with OCD will engage in rituals to make anxiety go away and avoid feared repercussions. Others sometimes use substances (like drugs and alcohol), oversleep, or try to excessively control their breathing to avoid the internal, physical experience of anxiety.
One of the unfortunate aspects of anxiety disorders, and a central reason why anxiety disorders are chronic and impairing, is that avoidance makes anxiety worse. Although it provides temporary relief, it is short-lived and avoidance of the things we fear strengthens anxiety over time. The person with social anxiety who avoids social gatherings to avoid an uncomfortable interaction will find they feel more anxious in their next social situation. This creates a cycle here, because this prolonged anxiety makes it more likely that the person will avoid these events, leading to increased anxiety without actually having any associated negative experiences.