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Anxiety is always about fear and vulnerability. Anxious individuals typically overestimate the danger of the situation and underestimate their ability to control it.

Anxiety, when experienced intensely consumes us, and by its very nature anxiety is intense and quick to escalate. The emotional components are feelings of fear, apprehension, dread and panic. The physical symptoms of anxiety include increased heart rate, rapid breathing, shaking, even dizziness.

Anyone who has experienced intense anxiety is aware of the deficits in thinking, attention and concentration that can occur.  Anxious individuals typically feel they just can't think. In actuality they are intensely focused on what is causing their anxiety.  We have a limited capacity in terms of how much information we can attend to at once. When strong emotions are present, they monopolize cognitive capacity. Like depression, cognitive distortions are part of chronic anxiety.

The more anxiety you feel about something, the more you obsess about it, and the worse it gets.  These distortions perpetuate, and even exacerbate anxiety. Anxiety becomes a powerful self-fueling cycle. Anxiety increases physical symptoms which increase distorted thinking which increase anxiety and so on. These intense symptoms drive the person to some sort of escape response. When escape is initiated, it is negatively reinforced by a decrease of anxiety symptoms. Therefore, whenever anxiety symptoms reoccur, so does the urge to engage in escape that has proven effective in the past. Avoidant behaviors vary from abusing drugs or alcohol to reading or isolating.  The behaviors people use to escape anxiety often cripple their lifestyles. And people become caged by the cycle of anxiety and avoidant behavior.

Anxiety is a very common precipitant of addictive habits. Some habits in particular are well suited to anxiety problems, as they have measurable effects on one or many of anxiety's symptoms. A reduction of any of the symptoms of anxiety (physiological, emotional or cognitive) will reduce the strength of the cycle and ultimately reduce the other symptoms as well.

Anxiety is not, in and of itself, maladaptive. Anxiety can be 'debilitating' (when it makes one non-functional) or 'facilitating' (when it makes one work harder at succeeding).  In fact, people who are able to experience anxiety and the associated physiological and cognitive features have an advantage. In fact, anxiety may be one of the most adaptive emotions we are equipped with. Consider the advantages of facilitating anxiety:

• Prepares and motivates you for action.
• Hypervigilance protects you from dangerous situations.
• Increases awareness about what to avoid in the future.

Though anxiety by design is adaptive, there are many people who are crippled by its frequent occurrence.  Consider the three types of symptoms; emotional, physical and cognitive.

Physical
Some treatments focus on the physical symptoms. Medications that sedate are in effect reducing the physiological component of anxiety and thus turning down the cycle. Relaxation techniques do the same thing. Cognitive behavioral treatment for anxiety always includes training in relaxation.  Learning how to relax is an integral part of managing anxiety, because without alternative means of decreasing anxiety, the anxious person will be plagued with urges to engage in maladaptive escape behaviors.

Emotional
Other treatments focus exclusively on the emotion of anxiety. Some medications, for example, directly influence chemicals in the brain that are related to anxiety. 

Cognitive
A particularly effective way to control anxiety is to modify distorted thinking. Cognitive techniques are very useful, making you less vulnerable to anxiety in the future.

The most common anxiety provoking cognitive distortion is "awfulizing” This is when the negatives of an event are exaggerated.  Black and white thinking almost always accompanies strong anxiety states.  (for more info check Distorted Styles of Thinking)

Identifying a catastrophic thought and modifying it so that it is more balanced and realistic can have a profound effect on anxiety.

Behavior Modification
The final symptom of anxiety addressed in cognitive therapy is avoidant behavior. As long as maladaptive escape responses are utilized, the anxiety cycle will continue. Exposure is never comfortable, and in cognitive therapy attempts are made to create stepwise exposure schedules for people so that they are not overwhelmed and abandon change efforts. However, it is important that the steps not be too "easy" as managing anxiety involves helping the patient tolerate mild to moderate levels of anxiety and recognize that these states ebb, and do not necessarily lead to intense panic. Systematic desensitization is a gradual exposure technique for the treatment of phobia, in which the individual is taught relaxation skills that are applied to gradually increasing levels of exposure to the anxiety-producing event. Further steps are not encouraged until the patient has mastered previous steps. The cognitive therapist helps, via a collaborative effort, to create a balance with regard to exposure.

Visualization techniques are also effective for the treatment of anxiety.

Depending on the severity of anxiety one experiences, treatment may involve all of the modalities ie: medication, cognitive therapy and behavior modification.

© Uzma Mazhar 2001 UzmaMazhar@hotmail.com

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