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Anxiety - addressing causes, not just symptoms


An ever-growing problem

Recent statistics show that very large numbers of us experience significant levels of anxiety at some point in our lives. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults aged 18 and older, which is equivalent to 18% of the population (National Institute of Mental Health).

Statistics from the Mental Health Foundation show that in 2013 in England there were over 8 million cases of anxiety. These are just two examples illustrating the incidence of anxiety... but why is this the case and what can we do about it?

Given that it is so prevalent, it seems critical that we both gain a better understanding of anxiety as well as educate ourselves on how to manage it.

However, managing the symptoms alone is not enough... even more importantly we need to resolve the underlying issues which generate those symptoms, so that they are no longer fed by the deeper ‘drivers’ which exist as a consequence of our life experiences, our history and our individual biological profiles.

Causes of anxiety disorders

There is a range of causes of anxiety and for most there will be a combination of reasons that anxiety develops and is sustained. Anxiety is essentially rooted in fear – fear that we are unable to cope, fear that we are inadequate in some way, fear that everything will go wrong, fear that others will laugh at us, will reject us, will disapprove of us. Do any of these fears sound familiar?

We all live increasingly stressful lives – pressured by time, by financial concerns, by living up to the expectations of others, the need to be all things to all people... these are challenging existences and while a degree of stress can be beneficial and motivate us to achieve our goals, when this pressure reaches a critical pitch and the demands on us outweigh our capacity to meet them, then anxiety can be the consequence.

In addition to the modern-day stresses, we are all the sum total of our life experiences and so it is important to understand that any historical/familial issues that remain unresolved will certainly ‘play out’ in some way in the present. If an individual grows up in an environment of conflict or where love and support were absent or not demonstrated, this leads to them feeling that the world is not a safe place, it leads to insecurity, the perceived need to defend oneself, to be ready to fight or run away from threats, the sense of not being good enough... all of these are precursors to anxiety. See: The Three As and Mixed Messages.

Related to this point is the fact that we all develop various traits and tendencies during the course of our socialization as children - leanings towards certain types of responses to life’s challenges and these create our personality, which is really our response to the world, rather than the truth about ourselves. We refer to this as the ‘acquired self’, which is very different from the ‘authentic self’ (the real you).

If, for example, we have not been helped as children to manage our emotional responses to challenging circumstances, then fear can be a consequence, because fear is actually a mechanism that is trying to protect the individual. So although someone who may be suffering with agoraphobia (the fear of going outside/of open spaces) will likely find this gripping and irrational fear their enemy, actually fear is trying to protect them from the ‘dangers’ of the world by keeping them from it until a better solution is found. See: Dearest Fear.

Alternatively, it may be a particular event or trauma that an individual has experienced which leads them to being hyper-vigilant, worried and concerned, even when there is no need for this response. Such is the power of this pattern.

Just as important to understand is the fact that when we are depleted in a range of nutrients (vitamins, minerals, essential fats and amino acids) this nutritional status lends itself to a ‘biological stress’, which goes on to cause anxiety in the mind. See: The Story of Health.

For example, if you are deficient in the B vitamins, which are associated with emotional balance and mental health, then all the talking therapy in the world, including the popular approaches of CBT and Solution Focused Therapies, won’t fix this aspect of imbalance. Addressing an inadequate diet is therefore essential as well as considering supplementation – a ‘necessary evil’ for most, because our soils are not capable any longer of delivering sufficient nutrients to our food because of the over-farming of land, polluting of the soil with pesticides, insecticides etc. and the loss of topsoil due to deforestation around the planet. See: The Truth About Supplements.

Similarly if the body is dehydrated, this is a state that ‘supports’ anxiety. The state of dehydration is a stressor to the body because it knows that nothing can work properly without it. At every level the human organism is compromised when dehydrated and so simply hydrating properly (a minimum of 2 litres per day for most with an average size and build) will help the body find a place of calm and this in turn will be reflected in the mind.

Common symptoms of anxiety

So, we’ve established that anxiety does not exist only ‘in the mind’. Certainly our fears and concerns exist there but there is a series of physiological responses that are all part of the anxiety response too. Anyone who has had anxiety will know these biological responses well – common symptoms include:

A sense of impending doom, a sustained feeling of dread
A lack of perspective (catastrophizing)
Lack of clarity in mental processing
Increased heart rate
Tense body
Unsettled digestive system
High blood pressure
Negative self-talk

The impact of anxiety on a person’s life can be far-reaching and profound. Anxiety can be completely disabling, terrifying and paralyzing - and it can completely disrupt every aspect of one’s life – work, relationships, health, leisure, day-to-day functioning...

So what is anxiety really – what is happening ?

As stated earlier, a degree of stress or anxiety can be a normal response to challenging situations. Fear is certainly a normal response to a real threat or danger. This degree of anxiety will help us to respond appropriately – to remove ourselves from danger, to stand up to a threat, to find within ourselves that little bit extra to meet the challenge.

However, what most people are experiencing when they are suffering with an anxiety disorder is an on-going dread, a sense of not being able to cope, a constant background ‘noise’ of worry, of ‘what ifs’, of expecting the worst, of bodily tension and discomfort.

Fight or flight

What is meant by the ‘fight or flight’ response that we hear about so often? Below is a summary...

First of all, a threat is perceived. It may be real or imagined. It may originate outside of the self or come from our own inner processes (thoughts and feelings). This perceived threat sparks a chain reaction in the body – a series of responses - as the body is programmed for survival.

The sympathetic nervous system, which is part of the autonomic nervous system (ANS), initiates these responses, which include:

i) The heart beats faster in order to deliver more blood and therefore oxygen to the muscles so that we can run away from the threat, or fight it.

ii) Digestive processes are arrested in order to divert energy to our muscles for this to happen.

iii) Our breathing rate increases to provide extra oxygen to the muscles.

These examples make it easy to see how these quite natural processes are aligned to the symptoms (listed above) most often experienced with anxiety disorders.

For example, if we breathe more quickly, we may suffer from hyperventilation. Healthy breathing occurs when there’s a balance between breathing in oxygen and breathing out carbon dioxide. This delicate balance is upset when you are exhaling more than you inhale. This is hyperventilation, which causes a rapid reduction in carbon dioxide in the body

Low carbon dioxide levels eventually lead to narrowing of the blood vessels that supply blood to the brain. This reduction in blood supply to the brain leads to symptoms like light-headedness and tingling in the fingers. Severe hyperventilation can even lead to loss of consciousness.

It is this kind of biological event that makes the sufferer feel as though they can’t relax, they are uncomfortable, always on high alert – because in fact this is what they are – hyper-vigilant. The stressor in modern day anxiety disorders is rarely a physical threat or danger and so the overstimulation of the ANS in this way not only causes discomfort, it commonly leads to a vicious cycle of stress and exhaustion.

Interestingly, the other side of the coin is the ‘rest and digest’ response, activated by the parasympathetic nervous system (also part of the autonomic nervous system). The parasympathetic system conserves energy as it slows the heart rate, increases intestinal and glandular activity, and relaxes sphincter muscles in the gastrointestinal tract. These functions allow us to relax, be calm, to feel in control. This is the response we need to reinstate if we are to fully overcome anxiety and what the evidence is clearly showing us is that learning to meditate, practising mindfulness, laughing more, living a life with greater meaning and purpose and exercising regularly (moderately) are all ways of engaging the parasympathetic nervous system – therefore reducing anxiety.



The HPA axis

The HPA axis refers to messages sent from the hypothalamus to the pituitary and then to the adrenals and the subsequent feedback loop between these three important glands (which are a part of the endocrine system).

The hypothalamic-pituitary-adrenal axis is our central stress response system. So when a threat is perceived, the hypothalamus (a small gland in the brain) releases corticotropin-releasing hormone (CRF). When CRF binds to CRF receptors on the pituitary gland, adrenocorticotropic hormone (ACTH) is released. ACTH binds to receptors on the adrenal cortex and the release of cortisol results. In response to stress, cortisol will be released for several hours after encountering the stressor.

When a certain blood concentration of cortisol is reached, when the system is working efficiently, the process is reversed... which causes a decrease in the secretion of CRF from the hypothalamus, a decrease in the pituitary release of ACTH and subsequently decreased levels of cortisol released by the adrenals. At this point, systemic homeostasis returns, that is, a state of balance.

However, with on-going or repeated exposure to one or many stressors, (real or perceived) there follows repeated and sustained HPA axis activation. It is this mechanism, which then remains ‘switched on’ for too long sustaining the uncomfortable and unhelpful symptoms of anxiety. It now is a mechanism without an ‘off switch’ and the neurological, biochemical and psychological damage this does to the human body is significant.

To understand what else is happening when we find ourselves in the grip of anxiety and its consequences, see: Overcoming Panic Attacks.

What can we do about anxiety? Is there a lasting solution?

Sadly, too often the response of the mental health services is inadequate – it often relies on medication to dampen the worst feelings of anxiety and panic, or it offers ‘quick fix’ interventions, short-term therapeutic strategies to soothe our discomfort.

These interventions can certainly be helpful in the short term because anxiety feels at times so unbearable. Commonly the mental health services offer such approaches as CBT or mindfulness – both of which can be beneficial and helpful, but our experience tells us that alone they are not sufficient and these interventions often support the ‘revolving door of therapy’, as sufferers find short-term relief but within a few weeks or months need another solution.

Our clinical experience over the last 35 years, having worked with many thousands of clients, has shown us that as we are multidimensional beings, then to resolve any issues, including anxiety, we need a multidimensional approach – we need to work in a truly holistic way if we are to move beyond the often paralyzing grip of an issue like anxiety.

An effective, holistic response

In order to resolve anxiety we need to recognize that all the other things going on in our lives matter. So don’t fall into the trap of just considering the presenting symptoms of anxiety and focusing on them, because otherwise you will be at best engaged in first aid.

Hopefully this article has helped to explain that there are many ‘causes’ and so we need to address all areas of our lives in order to see beyond the symptoms.

Our suggestion is to ask yourself the following questions. Dig deep and really consider your answers because within these answers lie the solutions you’re looking for....

• Do you have sufficient meaning and purpose in your life?

• Are your thoughts kind and compassionate towards yourself and others?

• Do you have enough time for rest and relaxation?

• Do you do enough things that make your heart sing?

• Do you have dreams?

• Do you eat well? Is your diet diverse enough?

• Have you really understood the role and the importance of water in your physical and mental health?

• Do you invest enough time and energy into your most important relationships?

• Do you have a place where you can relax and let go?

• Do you spend enough time each day thinking positively - and changing your self-talk where that’s not the case?

• Are you honest with yourself about what’s really going on inside?

• Are you being true to you?

The answers to these questions will give you some insight into the ‘drivers’ of your anxiety. They will also point you to the things that you need to do differently or change.

You may need help either from a trusted friend, being part of a support group or community or even professional help. Work our what is best for you and have the courage to pursue that.

If we are to be free from anxiety in all its forms, we need to understand that our drivers (our beliefs) sustain our patterns. Our patterns are sustained by our habits and our habits continue to be supported by our thoughts, feelings and actions. See: The Pyramid of Shame.


Some other useful links:

The Inventory of Incongruence

Anxiety States

Who Are You When No One is Looking?

The Power of Introspective Practices

The Facts About Breathing

Dealing with Anxiety and Panic


Click the links below...