COPING WITH ANXIETY: JUST KEEP BREATHIN(G)
what types of anxiety are there?
Are you struggling with feeling overwhelmed, worried, tense, and jittery? These symptoms could be an indicator that you are experiencing anxiety. Anxiety is a broad category to capture nervousness, worry, and fear. Under the umbrella of anxiety are several types including specific phobias, panic attacks or panic disorder, social anxiety, generalized anxiety, and obsessive compulsive disorder. Below each one will be discussed in some more detail.
panic attacks or panic disorder
Panic attacks can occur with all types of anxiety. Panic attacks are a physiological manifestation of anxiety. They are intense, brief, and come on suddenly. Panic attacks can include up to 20 different physiological reactions such as shortness of breath, dizziness, sweating, and tightness in the chest. Panic disorder is a condition unto itself whereby someone begins to fear recurring panic attacks and generally cannot identify a trigger for the attacks.
social anxiety
Social anxiety is a type of anxiety where a person fears performing in front of others or interacting with others lest there is negative evaluation. Sometimes it will be referred to as social phobia although the current official diagnostic term is social anxiety disorder. With this disorder, an individual tries to avoid situations that they believe will bring about embarrassment or negative scrutiny. People fear saying the wrong thing or making a mistake in a scenario like public speaking or a type of performance (e.g., music, acting, dance). Anxiety builds before the situation, during, and can continue after as a person replays the event in their mind, assuming the experience went very poorly whether it actually did or not.
generalized anxiety
Generalized anxiety disorder is when a person experiences an overall constant worry and tension about a range of topics with little reprieve. Symptoms can include constant worry, rumination, tension, and negative thinking. The symptoms can be so intense that sleep is impacted. As the name implies, the worry is about any topic such as money, relationships, work, friendships, and so on. There’s not a particular anxiety as in a phobia but just a constant worry about many topics.
obsessive compulsive disorder
Obsessive compulsive disorder, commonly known as OCD, is a disorder where a person experiences repetitive thoughts or engages in behaviors repeatedly. A person feels compelled to think about certain ideas and /or compelled to carry out a certain behavior. The thoughts and / or behaviors are usually based on unrealistic fears or concerns, such as concerns about germs, doubts about safety (e.g., being concerned the stove was left on), or worry about things being perfect. Compulsions can include repetitive cleaning, taking actions to control a situation (e.g., feeling like you have to turn a lock repeatedly), counting (e.g., counting floor or ceiling tiles), and arrangements (e.g., with books or objects or papers). For more information on this disorder, The International OCD Foundation has more details available.
specific phobia
This includes extreme and intense fears of a specific trigger. These fears are generally irrational. The anxiety is in response to a specific object or situation. The categories include: situations (e.g., being in an MRI machine); nature (e.g., heights, lightening); animals or insects (e.g., spiders, snakes); blood, injuries, and medical procedures; or miscellaneous (clowns, bodily functions). A person can have more than one phobia from multiple categories like snakes on a plane!
general information about anxiety disorders
Sometimes life transitions can spike anxiety, and this can result in symptoms like short shallow breathing or hyperventilating, difficulty sleeping soundly, sweating, dizziness, and obsessively fixating on a troublesome thought. Anxiety can have different presentations for various people. Panic attacks, for instance, include 20 possible symptoms but only four symptoms are needed to diagnose an attack; so, five people can have completely different experiences of panic. There can also be symptom overlap between different psychological conditions. For instance, some people believe they have ADHD when in fact they are struggling with anxiety. There are also times where medical conditions can cause symptoms of anxiety, so it is always good to start with a visit to your primary care doctor to be sure you are in good health. Thus, a professional assessment is highly recommended over asking Dr. Google!
Let’s say you identified that you have some symptoms that could be anxiety. In addition to the symptoms mentioned above, you may have some of the symptoms Ms. Ariana Grande sings about in her song, Breathin:
Some days, things just take way too much of my energy
I look up and the whole room's spinning…
I can so overcomplicate, people tell me to medicate
Feel my blood runnin', swear the sky's fallin'
Time goes by and I can't control my mind
Can you relate with Ariana? It is true that people struggling with anxiety can feel tired. Anxiety is draining. Think of a parked car that is running; eventually it will run out of gas. Anxiety can feel this way. With anxiety we may be paralyzed from taking productive actions yet there is excess energy coursing in our bodies and draining our mental energy stores. This can lead people to feel the physiological symptoms of anxiety like shaking, tremors, jitteriness or as Ariana describes it, “blood runnin’.”
what happens in the body with anxiety?
Why is that? Why does anxiety lead us to feel spun up and jittery? Essentially what is happening is our sympathetic nervous system is being activated. This is the nervous system that is supposed to be activated when we are truly facing a life-or-death situation. It is a beautiful design when it is running properly. When faced with a life-threatening situation it is the activation of this nervous system that can save us by preparing the body to fight or flee. Our muscles tense for action, blood flow is constricted to the core, pupils dilate, adrenaline is released, we stop digestion to conserve energy, and breathing and heart rate increase to create energy. The problem comes in when we are in non-life-threatening situations where the sympathetic nervous system is activated anyway. The system is not broken. What is happening is that we are manually triggering the system with our thoughts and perceptions. Our thoughts could be memories of something life-threatening from the past, worries about the future, or false beliefs about something being a threat when it is not.
Have you tried diaphragmatic breathing or belly breathing?
It is a simple and accessible solution for decreasing anxiety and restoring calm.
how does deep breathing help anxiety?
What is the solution? There are several but let us focus for this blog post on the one offered by Ms. Grande: breathe.
Don't know what else to try, but you tell me every time
Just keep breathin' and breathin' and breathin' and breathin’
Sure, she stated earlier that those around told her to medicate herself, but there are drug-free solutions and breathing is at the top of the list. Kudos to Ariana for dedicating this song to one of the best (medication-free) solutions we have. I have had patients tell me in frustration they had been advised by other counselors they saw to “just breathe” when feeling anxious; they felt as if the extent of the anxiety was not taken seriously and that the advice was too basic to be effective. I understand why they feel that way. When anxiety is so intense, and someone is told “just breathe” it can feel like almost insulting advice. It seems too simple. It seems like putting a band-aid on a gaping wound. It can at times cheapen the value of our counseling professions because without explanation, it can seem like some “whoo whoo” solution. I’d like to offer that explanation now to show how it is effective and based on science.
Again, with anxious responses, the sympathetic nervous system is being activated because we had an anxiety producing thought or perception. Recall from your school days that the sympathetic nervous system is one-half of the autonomic nervous system. These nervous systems are involuntary, meaning we have no control over them for the most part. We cannot command our bodies to slow our heart rates, stop pooling blood to the core and once again send it to the extremities, or command how and when we digest food. Yet there are two functions of the autonomic nervous system we can manually override—blinking and breathing. Taking control of blinking can help us when some bit of dirt gets in our eyes, but it will not help us manage anxiety. The good news is slowing our breathing will.
Autonomic Nervous System
Sympathetic Nervous System Parasympathetic Nervous System
Fight or Flight Slow and Steady
The goal of telling someone to “breathe” when anxious is to slow the breath. The idea is to move away from short, shallow, rapid breathing and move to slow, controlled, and relaxed breathing. Slowing the breath is crucial in reducing anxiety because this is the way we activate the parasympathetic nervous system, or the system responsible for returning our bodies to a state of homeostasis or relaxation after the sympathetic system has been activated. The parasympathetic nervous system slows our heart rates, slows breathing, restores blood flow to extremities, constricts pupils, and resumes digestion. Think of the breath as the captain of the autonomic ship: whatever the breath is doing, the other functions will follow. If breathing is short and fast, the other features of the sympathetic nervous system will also accelerate and activate. If breathing is slowed and long, the features of the parasympathetic nervous system will relax and calm. You will then start to feel relaxed and calm, all from just slowing your breathing.
Slowed breathing is only one of many strategies for managing anxiety, but it is simple to engage, always something you have access to, and effective. There are no side-effects. It is an essential tool for anxiety management. I hope this flashback to talk of nervous systems from your school days will help you understand why this strategy is recommended. It’s not just a “whoo whoo” strategy; it is grounded in science. Now that you know how to manually override your autonomic nervous system to reduce your anxiety, give it a try. Along with Ms. Grande, I recommend you keep breathin!
BENEFITS OF ONLINE COUNSELINg
Online counseling saves you time and energy as you access mental health care from your home or office without having to take time out to commute to and from the appointment. Relax in the comfort of your own space as you devote one hour to self-care. Secure platforms are used to protect your privacy. Research shows online therapy and in-person sessions are equally effective. So why not choose the more convenient option? Save time, gas, and minimize stress so that a one-hour appointment takes only one hour and not 3 with traffic.
BEGIN COUNSELING WITH AN ONLINE THERAPIST IN COLORADO, FLORIDA, MARYLAND, AND PENNSYLVANIA
If you’re tired of feeling tense and anxious, stop wishing and take an action towards change today! AROSE eTherapy® offers a Free 15-minute consult. If you would like to proceed to services after your consult, we’ll book you our next available initial appointment, and you’ll be on your way to healing!
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ABOUT the author
Alicia Rozycki, PhD
Dr. Rozycki is a licensed psychologist and the founder of AROSE eTherapy®, an online therapy practice serving high achieving professional women and military affiliates including active duty, veterans, spouses, and government employees. Virtual sessions are available in Colorado, Florida, Maryland, and Pennsylvania. Learn more about Dr. Rozycki.
Grande, A., Kotecha, S., Salmanzadeh, I, and Svensson, P. (2018). Breathin. [Recorded by Stevie Wonder.] On Sweetener. Los Angeles: United States: Republic.
