The Three Parts of Anxiety

When we feel anxious, we automatically generate a three-part response that includes thoughts (what we say to ourselves); physical symptoms (the sensations we experience in our bodies); and behaviours (what we do or our actions). All three parts have an interactive and reciprocal relationship. This simply means that each part interacts and influences the other parts. None will occur in isolation. For example, if you’re anxious about giving a presentation at work you would likely have some worrisome thoughts (e.g., “What if I mess up”?), experience some physical sensations (increased heart rate, upset stomach), and take some sort of action (e.g. rehearse your presentation).  If your rehearsal isn’t going well you may start having more worrisome thoughts (e.g., “What if I freeze and forget what I want to say”?) that might lead to more physical sensations (e.g., sweating and lightheadedness) which might lead to a new action (e.g., calling in sick to work and missing the presentation).

The following diagram exemplifies this process:

What Happens to Our Body When We Are Anxious?

Anxiety can cause many sensations in our bodies as it prepares for danger. These sensations are called the “alarm reaction”. They occur when the body’s natural alarm system (“fight-flight-freeze”) is activated.  These sensations occur because our bodies are getting ready to help us defend ourselves.

  • Rapid heart beat and rapid breathing:  When your body is preparing itself for action, it makes sure enough blood and oxygen are circulated to your major muscle groups and essential organs. This enables you to run away or fight off danger.
  • Sweating:  Sweating cools the body. It also makes the skin more slippery and difficult for an attacking animal or person to grab hold of you.
  • Nausea and stomach upset:  When faced with danger, the body shuts down systems/processes that are not needed for survival; that way it can direct energy to functions that are critical for survival. Digestion is one of the processes that is not needed at times of danger. Because of this, anxiety might lead to feelings of stomach upset, nausea or diarrhea.
  • Feeling dizzy or lightheaded:  Because our blood and oxygen goes to major muscle groups when we are in danger, we breathe much faster to move oxygen toward those muscles. However, this can cause hyperventilation (too much oxygen from breathing very rapidly to prepare the body for action), which can make you feel dizzy or lightheaded. Also, since most of your blood and oxygen are going to your arms and legs (for “fight or flight”), there is a slight decrease of blood to the brain, which can also make you dizzy. Don’t worry– the slight decrease in blood flow to the brain is not dangerous.
  • Tight or painful chest:  Because your muscles tense up as your body prepares for danger, your chest may feel tight or painful when you take in large breaths.
  • Numbness and tingling sensations:  Hyperventilation (taking in too much oxygen) can also cause numbness and tingling sensations. The tingling sensations may also relate to the fact that the hairs on our bodies often stand up when faced with danger to increase our sensitivity to touch or movement. Finally, fingers and toes may also feel numb/tingly as blood flows away from places where it is not needed (like our fingers) and towards major muscle groups that are needed (like our biceps).
  • Unreality or bright vision:  When responding to danger, our pupils dilate to let in more light and to make sure that we can see clearly enough. This reaction makes our environment look brighter or fuzzier, and sometimes less real.
  • Heavy legs:  As our legs prepare for action (fight or flight), increased muscle tension as well as increased blood flow to those muscles, can cause the sensation of heavy legs.
Recognizing Physical Symptoms of Anxiety

You can learn to identify the physical signs of anxiety by asking yourself: “What happens when I’m anxious? Where do I feel the anxiety in my body?” For example, when you feel anxious, you may get butterflies in your stomach, sweat a lot, breathe heavily, and feel dizzy or lightheaded.

REMEMBER:  If you often experience many uncomfortable physical symptoms, but doctors cannot find anything wrong with you physically, you may have problems with anxiety. You are definitely not ”going crazy”. Although these symptoms may be uncomfortable, they are not harmful.

What Happens in Our Mind When We Are Anxious?

Anxiety causes our brain to send messages to alert us to potential danger or prepare us for important events. However, when our brain is overly sensitive it can send messages, or worry thoughts, that are unnecessary and therefore unhelpful.

Examples include:

  • What if I make a mistake at work and my boss thinks I’m incompetent?
  • What if I get really sick and end up in hospital?
  • What if my date thinks I’m a loser and never asks me out again?
  • What if I fail the exam?
  • If there is bad traffic, I’ll be late and get fired
  • I won’t be able to cope with these feelings
  • What if we get in an accident?
  • What if I say something stupid?
  • If I don’t get at least 8 hours of sleep I’ll be a wreck.
  • What if I forgot to turn off the stove and there is a fire?
  • What if my friend is mad at me?
Recognizing Anxious Thoughts

Anxiety also affects how we think. Anxious thoughts typically involve a fear of something bad happening. When we are anxious, we tend to see the world as a  threatening  and  dangerous place. The problem with thinking and acting as if there is danger when there is  no real  danger is that you feel unnecessarily anxious. Therefore, one effective strategy to manage your anxiety is to replace anxious, negative thinking with  helpful thinkingHelpful thinking means looking at all aspects of a situation (the positive, the negative and the neutral) before drawing conclusions. In other words, taking a more realistic view of what is happening. Helpful thinking means looking at yourself, others and the world in a balanced and fair way.

See  Helpful Thinking  for helpful tips on how to identify and challenge your anxious thoughts.

What We Do When We Are Anxious?

When we are experiencing a range of physical symptoms and our mind is flooded with anxious thoughts, it becomes very tempting to engage in either avoidant or escape behaviours. Avoidant behaviours occur when we plan ahead of time not to participate in a specific activity, whereas escape behaviours have us leave the situation once it has started. We also engage in safety behaviours, or things we do to try and feel safer in an anxiety-provoking situation.

Examples include:

Avoidant Behaviours: 

  • Cancelling a date
  • Calling in sick to work
  • Taking public transportation rather than driving in heavy traffic
  • Declining a social or professional invitation
  • Not seeking routine medical care
  • Eating at home instead of in a restaurant

Escape Behaviours: 

  • Leaving the movie, game, party, etc., early
  • Asking a co-worker to complete a task for you
  • Getting blood work but not returning for the results
  • Not returning for a second job interview or declining a promotion

Safety Behaviours:

  • Only going places with a trusted companion
  • Not leaving the house without your cell phone
  • Carrying medication with you at all times
  • Seeking lots of reassurance from others
Recognizing Anxious Behaviours

Anxiety can make us feel very uncomfortable and make us believe we are in danger. No wonder you may feel a strong urge to escape or avoid situations/activities/people that make you anxious. For example, if you are scared of dogs, you would probably avoid going to places where you may encounter a dog (e.g. dog park).

To help you identify situations that you avoid, try to come up with as many answers as possible to the following:

  • If you wake up tomorrow morning and all your anxiety had magically disappeared, what would you do?
  • Where would you go?
  • How would you act?
  • How would someone close to you know you weren’t anxious?

Finish the following sentences: 

  • My anxiety stops me from…
  • When I am not anxious, I will be able to….

Once you are able to understand and recognize anxiety, you will be better prepared to move on to the next stage – learning skills in the  My Anxiety Plan  (MAP) section.