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  • Help Me Understand Your Anxiety Disorder: What It’s Like

    This is the fourth post in a series that I am writing to help people in the church better understand mental health, and particularly anxiety disorders. Click to read the first, second, and third posts.

    If you don’t have an anxiety disorder, it can be hard to imagine what it’s like. Hopefully the discussion in the last post helped you to start imagining what it might be like, since we all have experienced a fight-or-flight response at one time or another. I’m going to attempt to describe some of what my own experience of having an anxiety disorder has been like.

    For me, my anxiety disorder generally manifests as physical feelings, including a sick feeling in my stomach and my heart skipping a beat (or a lot of beats, if it’s a full-blown panic attack). I am in most cases feeling mentally and emotionally calm and unworried, and not thinking about or experiencing anything that is anxiety-provoking. But, I “feel” anxious because my body is experiencing all of the physical feelings that I experience when I am actually afraid or worrying (because they literally are the same physical feelings I would have if I was actually worrying about something or in a situation that would trigger fear).

    My husband often explains my anxiety disorder to people this way: Imagine you are sitting in a cozy room, sipping tea by a roaring fireplace, and suddenly, out of nowhere, your body is reacting as though someone just threw a brick through the nearby plate glass window. Everything is calm—both your environment and your emotions—but your body’s fight-or-flight reaction has been triggered.

    This is why telling someone who has an anxiety disorder to “not worry” is so unhelpful—in many, if not most cases, they are not actually worrying in any meaningful sense. Their thoughts and emotions are not what is causing them to feel anxious—instead, it is their nervous system run amok. Their body has been hijacked by physical sensations that are unaccompanied by any mental or emotional trigger. This is what is meant when someone says that there is a chemical or physical component to anxiety.

    This is not to say, however, that someone who has an anxiety disorder does not experience the emotions of worry or fear. As I said above, we all experience mental and emotional worry and fear, and having an anxiety disorder does not make you immune to this. In fact, if you have an anxiety disorder, and particularly if it is undiagnosed, the fact that you are experiencing physical sensations of fear or worry will cause your brain to look for an explanation for why your body is having the physical response it is having. Your brain does not think it makes sense for you to be physically feeling worried or afraid if there is no mental or emotional reason for it—and your brain is right. This is why your experience is properly described as “disordered”—your body’s fear response is not the result of an orderly chain of events with an actual emotional or mental trigger of fear or worry.

    Nevertheless, if your brain goes looking for the reason that you are physically feeling worried or afraid, it will continue looking until it finds something–and we certainly all have things that we COULD be worrying about or afraid of. So, if you have an anxiety disorder, and you are experiencing physical symptoms, your brain is constantly trying to find the reason for those symptoms. It may, for example, latch onto a problem at work to make sense of why the body is so anxious. However, if you have an anxiety disorder, it is likely that the anxiety that you are experiencing about the work problem (which your brain has seized on to make sense of the nervous system response that you are having) feels (physically, mentally, and emotionally) way out of proportion to the problem at hand. Because the origin of this worry is a physiological response, even if you can pray for peace, rationally speak truth to yourself, and calm yourself mentally and emotionally, it is likely the physical feelings will not lessen and will remain for some time. Because the embodied feeling of worry or fear has a physiological cause, in many cases, resolving any emotional, mental, or spiritual distress may not alleviate those feelings. In the most simplistic terms, that is what it means to live with an anxiety disorder.

    *Please note: I am not a medical or counseling professional and this series is not intended to be any sort of substitute for any counseling, medical treatment, or other care you or anyone else has received for mental health issues. I am simply sharing my own experience for general educational purposes.*

  • Help Me Understand Your Anxiety Disorder: Fear or Worry vs. Clinical Anxiety

    This is the third post in a series that I am writing to help people in the church better understand mental health, and particularly anxiety disorders. Click here to read the first post, and here to read the second post.

    At the outset, I want to make clear that as I go through the differences between fear or worry versus clinical anxiety below, these are based primarily on my own personal experiences. Therefore, please don’t understand me to be speaking for every person who has an anxiety disorder, because these disorders can manifest in a variety of ways, and it is not my intent here to discount or negate someone else’s experience. I simply want to offer my experiences as one means to provide understanding and education about anxiety disorders.

    People who have anxiety disorders, like every other human being, experience worry and fear. If you are a Christian, you believe that a person also experiences sinful worry and fear. However, speaking from my own experience, the primary indicator that you have an anxiety disorder is NOT simply that you worry a lot.

    I’m going to say that again.

    The primary indicator that you have an anxiety disorder is NOT simply that you worry a lot.

    Let me explain.

    Think about a time that you were worried–say, about a big test, or a review at work, or because you were about to see someone with whom you have a strained relationship. Now, think about how your body felt in that moment. If you have to, close your eyes and recall it. How did you know that you were worried? Did your stomach feel slightly sick? Was your heart beating a little faster than normal? Did you feel lightheaded? Did you feel slightly shaky? Were you sweating? Did your brain feel a bit fuzzy or easily distracted? You may not have felt all or any of these specific things, but if you pay close attention, there were physiological changes that caused physical sensations in your body that you associate with being worried.

    Okay, similar exercise. Think about a time that you felt afraid, say, when your home alarm went off in the middle of the night, or you almost got into a car wreck, or you were walking alone on a street at night and thought you heard someone following you. How did your body feel in that moment? Again, if you have to, close your eyes and recall it. Did you feel your heart beating in your chest? Did you feel blood rushing in your ears? Did you feel your face flush and get warm? Did your heartbeat quicken? Did you suddenly feel colder or warmer? Again, you may not have felt any or all of these specific things, but because you are an embodied being, your experience of feeling fear included some number of physiological changes caused either by having an emotional experience of fear or an instinctual response to a threatening situation. These changes, in turn, caused physical symptoms that you associate with being afraid.

    Still with me? Okay. If you have an anxiety disorder, one of the things that happens is that your body experiences the physical sensations that you associate with worry or fear when there is no external stimulus that is causing you worry or fear and you are not actually emotionally experiencing worry or fear. One more time, just to emphasize: if you have an anxiety disorder, one of the things that happens is that your body experiences the physical sensations that you associate with worry or fear when there is no external stimulus that is causing you worry or fear and you are not actually emotionally experiencing worry or fear.

    I find that many people don’t even realize that the body plays a role in their experience of emotions until you point it out to them. In fact, at first, many people will say that they don’t experience any physical symptoms or sensations when they are experiencing an emotion. We tend to have this idea that emotions are something that is purely a matter of the mind, or maybe the mind and the heart. We often are so tuned out from our bodies that we don’t even realize the role that they are playing in our experience of the world. Unfortunately, there is a particularly significant lack of understanding in the church about the ways in which the brain and body play a role in causing and experiencing emotions like fear and worry.

    In extremely simplistic terms, your autonomic nervous system has two divisions: the sympathetic nervous system (fight-or-flight) and the parasympathetic nervous system (rest and digest). Typically, the two balance each other out. When your sympathetic nervous system is activated and your body pumps out adrenaline and other chemicals which have corresponding physical symptoms, your parasympathetic nervous system then kicks in to calm the body back down when this function is no longer needed.

    However, if you have an anxiety disorder, your parasympathetic nervous system does not function properly and does not kick in to regulate your sympathetic nervous system as it should. Therefore, your body is unable to properly regulate your sympathetic nervous system response, and it can spiral out of control, because there is no counterbalancing system kicking into effect. In this sense, the term “mental illness” doesn’t really capture the reality of suffering from an anxiety disorder, because what in actuality is occurring is a physiological malfunction that can then have emotional and mental consequences.

    Next time, I’ll talk more about what it’s like to have an anxiety disorder and some helpful and unhelpful ways to respond.

    *Please note: I am not a medical or counseling professional and this series is not intended to be any sort of substitute for any counseling, medical treatment, or other care that you or anyone else has received for mental health issues. I am simply sharing my own experience for general educational purposes.*