Battling the Mean Reds
The vicious cycle of anxiety
Yesterday, I had a terrible case of the mean reds. Audrey Hepburn’s character in Breakfast at Tiffany’s, Holly Golightly, explains them as a horrible feeling where “suddenly you’re afraid and you don’t know what you’re afraid of.” I suspect I’m not alone. This past week was difficult for many of us, especially those of us in the D.C. metro area.
I’m not going to get political in this place of wellness, except to say my anxiety levels have been high. Anxiety is a normal part of the human experience. We experience anxiety in response to perceived danger. Anxiety is distinguishable from depression because anxiety is forward looking. Our brains are looking for prospective danger, while depression is focused on events in the past. Physiologically, anxiety is designed to help us identify and respond to danger by fighting or fleeing. This is what is commonly referred to as the fight or flight response.
The fight or flight response triggers changes in our bodies, brain function, and behavior. Anxiety can occur occasionally in response to external stimuli such as school, work, family, friends, money, or our health. Some of us experience anxiety regularly. It may not ever go away or it may appear in response to a particular situation. When anxiety occurs more frequently and is difficult to tame, it may be a good idea to have a healthcare provider conduct an evaluation for an anxiety disorder.
Common anxiety disorders can include:
Generalized Anxiety Disorder (GAD) (my personal favorite)
Phobia-Related Disorders
I am going to limit this blog to the disorder I know well, GAD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the following are diagnostic criteria for GAD:
Excessive anxiety and worry about a number of activities or events (e.g., work and school performance), occurring more days than not for 6+ months.
The worries must be difficult to control and must be associated with 3+ of the following symptoms:
Restlessness or a keyed-up or on-edge feeling
Easy to fatigue
Difficulty concentrating
Irritability
Muscle tension
Disturbed sleep
The above symptoms must cause
Significant distress or
Significantly impair social or occupational functioning
Symptoms are not attributed to substance use or a general medical disorder (e.g., hyperthyroidism)
Treatment for GAD can include medication and psychotherapy. Cognitive behavioral therapy (CBT) can be especially supportive in helping patients with GAD to recognize thought patterns and behaviors that contribute to anxiety symptoms.
So, now that you know what anxiety is, the next step is to recognize it when you find yourself feeling anxious. The most common way to observe feelings of anxiety is in your body. Your brain sends signals to our body so that it can prepare to fight against or flee from danger. You may first feel that adrenaline rush that floods your body in response to the perceived danger. This can result in:
Rapid heartbeat
Increased blood flow to areas that may be necessary for escape (think your muscles)
Fast and shallow breathing (this is your body’s way of preparing for battle by increasing oxygen)
Increase in sweat (to cool your body)
Decreased digestive activity (diverts energy to parts of your body involved in fight/flight)
Muscle tension (aches, pains)
Rapid tapping of your extremities (hands and feet)
Pacing
You may also begin to see changes in brain function. Anxiety often causes people to become irritable or express anger towards others. Because our brains are horizon scanning for perceived threats, our ability to think or analyze is reduced. Someone in fight or flight may find they are unable to focus on tasks in front of them. When no external threat is present, that horizon scanning may turn inwards, resulting in insecurity or its pesky companion, imposter syndrome.
While I am quite familiar with the effects of anxiety and know how it presents in my body, I was blown away in last week’s group therapy when we learned about “The Vicious Cycle of Anxiety”. While the name likely rings true to anyone who suffers from regular anxiety and have come to recognize it as a way of life, it was life changing to learn that we can actually reverse the cycle.
The cycle begins with that initial feeling of anxiety, followed by an increase in your brain’s attempts to scan for danger. This then triggers your body to respond with the physical symptoms outlined above. Once these symptoms intensify and your brain is unable to identify the threat, your brain turns its attention inward. You then respond with behaviors such as escape or avoidance behaviors in response to the discomfort. This can look like numbing by scrolling on your phone, procrastinating on the task that you are scared to do, drinking alcohol, consuming drugs, or eating comfort food.
These avoidant techniques bring short-term relief from anxiety. We become use to them due to the relief that they provide. Yesterday, when I noticed my anxiety symptoms ramping up, rather than going for a walk outside or journaling, I doom scrolled Reddit and binge watched tv. While these activities provided relief in the moment, over time I just felt gross. My anxiety symptoms increased. I worried more and spiraled further by comfort eating. The cycle continued.
Many of us with GAD fall victim to this vicious cycle of anxiety. While doom scrolling and binge watching Netflix provides relief in the moment, it also can rewire our brains to continue to avoid. Avoiding only increases the worry, which can intensify with the next trigger because it reinforces our brain’s belief that the danger is real and must be avoided.
There’s another way out. We can actually face our fears without our unhealthy short term coping strategies like electronics, food, and addictive substances. The first step is mindfulness. It is important to pause and notice what you may be feeling so that you can identify feelings of anxiety. Over time, this can help you understand how your body reacts to anxiety so you can recognize it when it first appears.
I’ve previously shared that I use a CBT app to track my mood and implement tools to reduce my anxiety. Unfortunately, exhaustion and my inner child led me to revert to old habits that were once comforting and familiar. I’m a work in progress. Today, I am going to remind my brain of healthy mindfulness techniques to calm it against perceived threats. This can look like meditation, exercise (e.g., running, walking, swimming), journaling, yoga, progressive muscle relaxation, and tapping. If you follow experts on behavioral changes (I highly recommend James Clear’s Atomic Habits), then you know that change occurs best when attempted incrementally.
Confronting our fears head on can help break the vicious cycle. It gives us confidence that we can overcome perceived danger. One approach is to eat the frog! This approach calls for you to identify your hardest, most important task and just do it, first thing in the morning so that you don’t give yourself the chance to push it for another time. Depending on your fear, you may want to work with a licensed therapist to develop a plan for tackling your fears.
Whatever you do, take a step, any step. Seek assistance if you need it. Make a plan. Do whatever will make it easier for you to put one foot in front of the other. Remember, gradually confronting your fears will lead to an exit ramp off that vicious cycle because it will allows you to see that you can rescue yourself from perceived danger by confronting it directly.
In case if you missed them, here are helpful links I’ve shared in this week’s blog:
The Mean Reds (clip from Breakfast at Tiffany’s)
National Institute of Mental Health topical pages
Generalized Anxiety Disorder (GAD) (my personal favorite)
Full Bloom Therapy and Wellness Blog on the vicious cycle of anxiety
I love “Eat the Frog”!!