By Dr Pablo Jeczmien
The very tone of the word ‘anxiety’ itself lends a certain aura of fear. It’s doubtless to say that the word used to describe this common phenomenon – one that many of us today suffer and have suffered from – creates a certain uneasiness.Just the very mention of the word usually has a scaring effect on most of us. We feel uncomfortable, anxious.
We recognise the word, we remember the feeling, we associate the events and we experience it in our body. From lack of breath to pressure on our tummy, and from the weakness on our legs to feeling our heartbeats, we all remember very vividly the bodily experiences associated with anxiety, each sensation exclusive to every one of us.
This is one of the unique things of anxiety: it is usually linked with some physical experiences, or to put in in a different perspective, we do not experience anxiety in our heads only but in our bodies too. In fact, we only experience anxiety in our bodies and we then reflect on them, which in turn alarms our mind to become aware of them.
Whether it is about sitting an exam, concerns about our own health or the health of someone close to us, issues at work or at home, the vast majority of us have experienced various degrees of anxiety at some point in our lives.
We are used to say that anxiety is the result of our modern stressed life. This is true only to a certain extent since anxiety is the normal outcome of worries and concerns and closely linked to the well-known concept of “fight or flight”.
Fever is to infections what anxiety is to worries and as such, we must agree that it is a normal response to life events. So, when is it that we think of anxiety as something bad?
The straightforward answer is that again, as in the case of fever, if we have it for a considerable period of time, without any external event triggering it and we feel unable to get rid of it, then we should think of it as something abnormal. Using the example of the fever, if it is still there after a few days, then what we thought was a simple flu caused by a virus might be something else, which could warrant antibiotics or further investigations. Similarly, in the case of anxiety, if it is there after having passed the exam or solved health, work or family issues, then, it is worth looking at it more thoroughly.
Very commonly we confuse anxiety with fear, and although they are linked, it is important we distinguish one from the other; else we end up asking for help or worse, end up thinking of ourselves in a very critical way, without compassion, calling ourselves names.
In the professional language, fear is defined as something whose origin we clearly know: whether it is fear of flying or fear of a tiger in the jungle, the object of our fear is clearly defined. In certain cases we call it phobia.
Anxiety is fear of something we cannot identify. And this is why anxiety, as a disorder, is so pervasive and crippling: since we do not know what it is that we are afraid of, we do not have the possibility of developing coping mechanisms. Whilst in phobias we can develop avoidance (not flying, not going into a lift, avoiding spiders, etc), and in the case of fears we can address them with a rational approach, in anxiety we do not have this “luxury” and we feel “stuck” in it.
It can be a tremendous challenge to reduce anxiety and whether we are the patient or the family/friends, we should not be mistaken. It is not our fault that anxiety hangs on and on and on. This is not because we are “making it up”, or because it is in our head or because we are “weak”. We do not “blow things out of proportion” or make “mountains out of mole hills”. Certainly, anxiety does magnify problems and worries and fears, but this is the effect of the anxiety and not something we are choosing to do.
As has been said so many times: WE ARE NOT THE ANXIETY and most important anxiety can be treated.
Just as in the case of fever, the origins of anxiety can be many and therefore it is important to clarify this in as much as possible.
In the coming blogs I shall address this subject in more detail. However, at this point I find it important to comment on the conventional understanding of anxiety from a biological (physical) perspective: “anxiety is the result of a dis-balance in the chemistry of our brains”.
And this becomes also the language patients use; I cannot recall the number of times patients have come to me asking for a treatment that should correct this: “Doctor, I need a pill to sort out the chemistry of my brain.”
Don’t get me wrong, certainly there is a “disbalance in the chemistry” but this is not the point; the point is WHY that disbalance occurs; WHAT are the reasons; HOW we end up having such a disbalance; in short, what happens to our body and not less important, to our mind, that somehow we end up suffering from anxiety.
Although we live in a period where we do not have time and where we want immediate gratifications and solutions, more and more of us feel the need for a deeper understanding of the world and for a sense of ownership of our decisions, to take control of our lives and our health.
The integrative or holistic approach in medicine and in mental health is a fast developing approach, which addresses the oneness of the human being: we are not only the physical but also the soul and the spirit. Only when we address an illness not as a disorder of an organ, but as the outcome of a disbalance of the physical and the psychological and the spiritual, not as a “disbalance of the brain chemistry” but a lack of equilibrium in the fine tuning of the different components of what make us human, only then we can truly feel we are finally making correct attempts to “cure” and not simply “put out” a fire, to get rid of the symptom.
What kind of comprehensive approaches are used and how they address the curative process will be the subject of the next blogs.
In the meantime let us summarise:
•Anxiety, like fever, is a normal response to life events.
•Anxiety becomes abnormal when it is present without a stressful event or after the event has resolved.
•Anxiety, like fever, is only a symptom; it is the body telling us that something is not “functioning” properly.
•By only treating the symptom, we do not address the underlying causes and in fact, we perpetuate them.
•Anxiety is the result of a disbalance between the physical, the psychological and also the spiritual and therefore should be treated in a comprehensive, holistic way.
•Anxiety is treatable.