Know yourself: How to control one’s anxiety?

My friend suffers from anxiety issues, he refused to go to a psychologist/psychiatrist, what is anxiety? What is the best thing to do when someone is having an anxiety attack? -Rajender, Bangalore.

Dear Rajender, good morning, good to get your mail; I got the opportunity to explain anxiety to the people. With your mail, I could understand that your friend never went to any therapist or mental health professional, it is not diagnosed by any professional, you have used a lot of jargon - anxiety, mental breakdown, panic attack, social anxiety etc., your concern to help your friend is highly appreciated, but better first you and your friend need to understand the meanings of above issues like anxiety, panic attack and mental breakdown. Let us understand the anxiety.

Anxiety is defined as: the physiological response to a perceived danger. Austrian neurologist Sigmund Freud viewed anxiety as the symptomatic expression of the inner emotional conflict caused when a person suppresses (from conscious awareness) experiences, feelings, or impulses that are too threatening or disturbing to live with.

Reasons for anxiety: As per Freud, anxiety comes due to

• Moral anxiety: A fear of violating our moral principles.

• Neurotic anxiety: The unconscious worry that we will lose control of the id’s urges, resulting in punishment for inappropriate behaviour.

• Reality anxiety: Fear of real-world events.

As per DSM-5. Anxiety is classified into three categories:

1. Anxiety disorders (separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalised anxiety disorder).

2. Obsessive-compulsive disorders (obsessive-comp ulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder).

3. Trauma and stressor-related disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder).

Anxiety can be understood as an evolution of fear, while the emotion of fear protects us from immediate danger, anxiety serves as an adaptive function. Anxiety prepares us to prevent or avoid, those dangerous situations in the first place. This adaptive function is best illustrated when considering the relationship between anxiety and performance. If we an encounter a challenge that we estimate higher than our skills (or coping resources), we will experience some anxiety. When the skills are less than the challenge, it will interfere with the performance, which will influence our skill. Then in the control process, the expected outcome can add more anxiety.

So, the more significant the gap between our estimated abilities and our perception of the task’s difficulty, the more likely anxiety will negatively affect our performance. However, this does not mean that all anxiety is bad. It turns out we perform better when we experience a little anxiety. This will become an issue once it is making your life dysfunctional, like being unable to move on to day-to-day life properly.

Symptoms: The anticipation of danger, sleeplessness, apprehension, confusion, being on edge, a sense of helplessness, repeated negative thoughts, muscle tension, palpitations and difficulty breathing. I need help to sit at one place. Sweaty palms, butterflies in the stomach, shivering in the legs and hands.

Neuroscience of anxiety: Another exciting relationship between anxiety and the brain is that long term anxiety may damage the brain in a way that could cause further anxiety. A change in brain chemistry may increase the production of hormones (adrenaline, thyroid hormone) that lead to further anxiety symptoms. A weaker connection exists between the brain’s white matter area and the prefrontal and anterior cortex. Those with anxious thoughts showed more left-Brain activity when nervous. Those with physical symptoms experienced more right brain activity.

How to overcome: We use defense mechanisms to protect ourselves from feelings of anxiety or guilt, this process is automatic. The best method is try to understand your inner state of affairs, later, you can deal with external issues start exploring your inner mind. What is the reason for having conflicts at the basic level of your issue? What exactly bothers you? What are the things you keep under denial? What are things you wanted to get but you fail to get it but you pretend and pose to the external world as if you are good at it?

What is the benefit of being in the present state of mind? How serious are you to come out of this issue? For what I am projecting this symptom to the external world? Why I want to show this to the people around me? Get proper and honest answers, then do following activities to engage yourself.

a). Pickup regular physical game, b)do regular breathing exercises, c)be honest with your thoughts, d)learn and understand feelings and thoughts are not facts try to give auto suggestions and have regular self-talk.

You can do following things to help someone having a mental breakdown or panic attack:

1. Stay calm and reassuring. Speak in a soft, soothing voice. Be with them without any judgement.

Ask to take deep breathing exercises or Mindful exercises.

2. Avoid trying to “fix” the problem. Just listen and validate their feelings without judgment. Say things like “You’re not alone. I’m here for you.” Take your time solving their problems. Reassure them.

3. Physical touch and comfort can slow their heart rate and calm their nervous system. Sit or stand close by. Be with them instead of leave them alone.

4. Always inform their family members, take to a psychologist for help, and don’t take responsibility of treating themselves.

5. Suggest professional help or online counsellor to talk to “younger. co” if anxiety attacks persist.

(The writer is a counselling psychologist, www.younme.co)