What is Anxiety?

What Is Anxiety and What Does It Look Like?

Anxiety can range from a feeling of a small amount of uneasiness to a full-blown panic attack.   Anxiety is often more internal than external and anxious people often cannot specify what they are anxious about. Distress due to anxiety can often be a response to something distant or it can be an unrecognized danger or the perception of loss of control. An anxious response involves a physiological response, a behavioral component, and a state of apprehension. 

The response to anxiety can manifest in different forms and with a wide range of intensity.  Anxiety can be “out of the blue”. This is what psychologists call free-floating anxiety. Current research data suggests that approximately 25% of adult Americans suffer from anxiety in a given year. Other data suggest that anxiety disorders are frequently comorbid or occur with other disorders. People with panic and generalized anxiety disorder (GAD) also tend to suffer from some form of depression. Finally, the symptoms of anxiety originate in neurobiological functions.

The hypothalamus-pituitary-adrenal (HPA) axis of the brain’s stress response system. This illustrates that anxiety is not just in one’s imagination but involves a neurobiological system.

1. The hypothalamus is a deep structure in each hemisphere of the brain.  The hypothalamus (chemically) signals the pituitary gland.

2. The pituitary gland is a deep brain structure that is known as the “master gland” The pituitary gland signals the adrenal glands.

3. The adrenal glands release cortisol (steroids) and adrenaline. Adrenaline helps stimulate the organs of the body to handle the demand for action to fight or run (flight).  Cortisol stimulates the release of fat and glucose to fuel the stress response.  The HPA response is intended to be a temporary mechanism and not designed to be in a state of longer-term activation.

The body’s stress response is activated by the sympathetic nervous system (the gas pedal).

The interventions to calm a stressed individual is achieved by activating the parasympathetic nervous system (the brake).

Peer support or other helpers are activating the parasympathetic nervous system to counter the body’s stress response. Repeated and chronic activation of the stress response will make the (HPA) system hyperactive. 

Examples of Anxiety in the Workplace:

1. Perception of a loss of control in one’s job. (e.g., a new boss or new procedure or protocol)

2. Sudden changes in workplace venue or environment (e.g, new workplace or new crew)

3. Beginning a new position with added responsibilities

4. Fear of embarrassment or scrutiny by coworkers or supervisors

Examples of Anxiety at Home or off Duty:

1. Financial worries

2. Relationship turbulence 

3. Parenting or caring for a family member who is aged or ill

4. Limited support systems

Anxiety versus Fear:

Fear is usually directed toward some concrete object or situation, usually within the bounds of possibilities.

Examples of (a few) Anxiety Disorders:

ATTENTION: FIRST RECALL THE RANGE OF ANXIETY RESPONSES.

SLIGHT DISCOMFORT <------------------------------------------------->FULL BLOWN PANIC ATTACK

Generalized Anxiety Disorder:  Chronic persistent worry for six months or more that involves two or more life-stress circumstances

Social Anxiety: Fear of perceived or actual embarrassment or humiliation in situations where you are under the scrutiny of others.

Specific Phobias:  Strong fear or avoidance of a specific object or situation.  These can include fear of heights, enclosed spaces, blood, or some animals to name a few.

Panic Disorder: Sudden episodes of acute apprehension or fear from a few minutes to hours.  Symptoms include; shortness of breath, heart palpitations, chest pain, dizziness, trembling, sweating, nausea, numbness, or a feeling of impending doom.

How Can Peer Specialists or Others Help Anxious Individuals?

Remember that peer specialists and helpers are trying to use interventions that activate the parasympathetic nervous system or the brain’s inhibitory (or brake) system. The individual is typically in distress because the sympathetic and parasympathetic nervous systems are not in balance. Extreme sympathetic responses are indicative of activation (or hyperactivation) of the fight or flight system. Extreme parasympathetic responses are indicative of the inhibition (or braking) system of the freeze response in humans or other animals.

As a result, certain interventions activate the braking (parasympathetic) response to assist an anxious individual. Peer support specialists or other helpers can use one or a combination of these interventions.

1. Reframing of negative thought processes. Toxic or negative thought processes (“stinking thinkin”) are often supporting the anxious state of the individual. The theme of the helper’s intervention could be to redirect the anxious person. EXAMPLE: “I wonder if there is another way that you could look at this?”

2. Coaching the anxious person to avoid toxic people and situations. EXAMPLE: “How can you limit your dosage of this person/situation?”

3. Coaching the anxious person to distract attention away from the anxious stimuli. EXAMPLE: “take care of yourself or put this (anxiety) aside for a while?” e.g., self-care or unplugging or enjoyment = resilience

4. Assist the anxious person in seeking support people when they become anxious.  EXAMPLE: “Is there a close friend or relative who you can call when you start to worry or become anxious?” “Is there a peer support specialist that you trust? I can connect you with that person.

5. Share (teach) deep belly breathing, sit comfortably and place your hand on your belly.  Breathe in till you feel your belly move, exhale, and repeat for a minimum of ten minutes (preferably 15 minutes). Slow belly breathing activates the parasympathetic (brake) system.  Practice is very important and to gain mastery, practicing twice a day will assist the individual in becoming able to use deep breathing as a tool to turn off the brain’s anxious response.

6. Learn meditation, tai chi, or yoga. All of these activities emphasize a breathing technique and activate the parasympathetic (brake) nervous system.

7. Evaluate and coach in areas of flexibility, setting boundaries, and resilience behaviors and attitudes (refer to the resilience outreach material).

8. Evaluate the need for professional assistance. EXAMPLE: Sell the FREE EAP program provided by your agency or department.

PLEASE CONTACT A PEER SUPPORT TEAM SPECIALIST FOR MORE INFORMATION

Adapted from; 1. Wehrenberg, M. & Prinz, S. (2007)  and 2. Bourne, E. (2015).