Written by Wonny Kim
Clinical Psychologist
Anxiety
Anxiety is a normal human emotion that occurs in response to a threat or a perceived threat. When we interpret danger in our environment, this can trigger the fight/flight response which is aimed at helping us manage the threat. The fight/flight response involves the activation of three main bodily systems: physical, behavioural and cognitive systems.
- Physical changes: When danger is perceived, the brain sends a message to the sympathetic branch of the autonomic nervous system which turns on a range of physical changes that prepares the body for fighting or running away from the threat, including:
- Increased heart rate (to enable blood to be pumped around the body faster)
- Increased breathing rate (to provide the tissues with extra oxygen)
- Increase sweating (to cool the body down)
- Tightening of the muscles (to help the body get ready to fight or run away)
- Changes in vision (e.g. widening the pupils, tunnel vision – to help increase the ability to see the danger)
- Decrease activity of the digestive system (e.g. dry month – to save energy for the fight/flight response)
- Behavioural system: When the physical changes in our body have been prepared for survival, the two main behaviours associated with danger are to either fight or flee from the situation. When individuals choose to fight, they may show physical or verbal aggression towards the danger, or simply become frustrated, and when individuals decide to flee, they may leave or avoid the situation.
- Cognitive system: Cognitively, the fight/flight responses help individuals to shift their attention to the surroundings to search for potential threats. This is important in survival as it will help individuals in shifting attention from ongoing chores to scanning for possible danger. Thoughts tend to race during the fight/flight response to ensure quick problem-solving.
When the immediate danger has dissipated, the brain sends a message to the parasympathetic branch of the autonomic nervous system to turn the fight/flight response off. By doing this, it helps the body to restore back to a relaxed state by slowing the heart and breathing rate and letting the muscles relax. However, this process may take some time.
In modern society when predators are no longer a common threat, experiencing anxiety can be a helpful motivator such as preparing for an upcoming exam or a job interview or leaving unhelpful relationships. But it can also become unhelpful.
Clinical Anxiety
Anxiety becomes a disorder when it impacts an individual’s ability to adequately function in their daily life such as being able to work, study, or socialise. For example, some individuals worry to the point that their worried thoughts interfere with their daily life. Key symptoms of clinical anxiety can include a constant feeling of restlessness and physical tension, recurrent worrying thoughts/ruminations, sleep disturbance, problems with concentration, irritability, tiredness, panic attacks, and avoidance of situations.
Anxiety disorders are the most common types of mental health disorders diagnosed in Australia, affecting around 14% of Australians per year.
When individuals experience significant distress from anxiety, psychological therapy can help.
Common Evidence-Based Psychological Treatment Options
Common Psychological Therapies:
- Cognitive Behavioural Therapy (CBT): CBT is currently known as the ‘gold standard’ approach for anxiety-related disorders consisting of a combination of cognitive interventions and behaviour therapy. The main theme of CBT is to challenge and reshape unhelpful thoughts and behavioural patterns that maintain anxiety. The cognitive component of CBT involves identifying unhelpful thoughts and challenging these thoughts to develop more helpful and balanced thoughts. Cognitive restructuring and problem-solving are examples of common and effective techniques used in the cognitive component of CBT. The behavioural component of CBT involves identifying individuals’ fear response to anxiety (e.g., fight/flight response) that is maintaining the anxiety, and changing the aspects of these behaviours to break the cycle of anxiety. Challenging and reshaping avoidance and safety behaviours that maintain the cycle of anxiety is a commonly used strategy in CBT. Relaxation strategies are also used, such as slowed breathing and progressive muscular relaxation.
- Acceptance and Commitment Therapy (ACT): ACT aims to increase individuals’ psychological flexibility and drop the struggle of anxiety through their six core processes: acceptance, cognitive defusion, mindfulness, self as context, values, and committed action. The acceptance component helps individuals to accept the uncomfortable thoughts and feelings as they come and go without trying to change or judge them; cognitive defusion helps individuals to gain distance between themselves and their thoughts; the mindfulness component helps individuals to stay in the present moment to not be hooked by their unhelpful thoughts; self as context helps individuals to recognise that they are not the sum of their experiences, thoughts, or emotions, but rather, they are a self outside of the current experience; values work helps individuals to recognise the qualities in life they choose to work towards in any given moment, despite their anxiety; finally, committed action helps individuals to take charge by engaging in actions and behaviours that are more aligned with their life values. Thus through ACT, individuals learn to drop the struggle with their anxiety and take charge by engaging in actions and behaviours that are more aligned and related to their chosen life values.
For more information about accessing support for anxiety, please contact Hardwick Psychological Services.
References
https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Anxiety/Anxiety—Information-Sheets/Anxiety-Information-Sheet—01—What-is-Anxiety.pdf
https://psychology.org.au/for-the-public/psychology-topics/anxiety
https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Generalised-Anxiety/Generalised-Anxiety—Information-Sheets/Generalised-Anxiety-Information-Sheet—01—What-is-Generalised-Anxiety.pdf
https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Anxiety/Anxiety—Information-Sheets/Anxiety-Information-Sheet—15—CBT-for-Anxiety.pdf
Hasheminasab, M., Kheiroddin, J. B., Aliloo, M.M., & Kakhari, A. Acceptance and commitment therapy (ACT) for generalized anxiety disorder. Iran J Public Health, 44(5), 718-719.
https://positivepsychology.com/act-acceptance-and-commitment-therapy/