“Suck it up Butter cup.” “Just think positively.” “Just do it and quit being scared.” If it were this easy, don’t you think people with anxiety would’ve done it by now? When referring to these types of “words of advice” from family members and friends, a client once said to me, “I just want to look at them and say, ‘Okay great, thanks, I’ve never thought of that. I’m just deciding it’s easier to feel complete paralyzing fear, unable to control my body’s physical or emotional state, and lose my rational thinking all together instead of just doing it; I guess I’m just lazy’ but instead I shake and turn red and feel pathetic and pressured”. These words really resonated with me. I hear this type of expressed frustration from almost every client I see who is experiencing anxiety. It is so clear to me that even with the information and public service announcements regarding mental health, the lack of understanding around this subject remains an issue.
I’m not judging those who don’t understand, if you don’t have an anxiety problem how would you understand? How would you know that if it were as easy as just pushing yourself to do it, those suffering from this would? How would you understand what happens to your brain and your body, when you experience anxiety in your life (we all do) and always work through it? You see, anxiety is a normal part of being human, we all get ‘butterflies’ before the big game, the exam, or the performance, but the difference is we don’t all experience symptoms and level of anxious response that meets the criteria for generalized anxiety disorder, or social anxiety disorder; also known as social phobia, or other anxiety disorders in the DSM5 (Diagnostic and Statistical Manual of Mental Disorders). It is real, and it is scary and I’m about to tell you why.
First, let’s look at what happens to our brains and bodies when we are faced with danger; a bit of a medical or physiology lesson to help you understand. When we sense fear or perceive danger, the response to threat triggers many parts of the brain. The most important part is the amygdala, which is an almond shaped bundle of neurons found deep in the brain above the brain stem. When we sense something dangerous the amygdala sends signals to other parts of the brain to create hyper arousal, make us alert; the flight or fight response. This happens before our cerebral cortex, (responsible for sensation, voluntary muscle movement, thought, reasoning, and memory) can make sense of the situation. When the amygdala sends the signal, it prepares the body for action. Our heart rate increases, our breathing becomes shallow and rapid, adrenaline is released, the increased blood to our muscles causes them to tense up or feel like jelly, our sight and hearing become more acute. Our brain may feel hijacked with steps for safety or as in the situation with anxiety disorders other ways that the situation can cause more danger, which then escalates the physical reactions. We are ready to fight, to run or in some situations, to freeze. The fact is, our brain senses danger and our body responds.
The problem is, our brain can’t always distinguish between types of danger so I’m going to try to demonstrate it in a way to help people understand. To a person without an anxiety disorder, talking to people, doubting our abilities, ordering food, talking on the phone, presenting in front of people, basically many ‘normal’ day to day activities may elicit some symptoms of anxious response but it’s nothing; however, if we came across someone with a knife pointed at us, a snake, a bird, high buildings, a car accident, something in which we are afraid of, something in which we sense as dangerous, our amygdala is triggered and the responses I listed above happen. Makes sense, right? This is scary stuff, someone has a knife pointed at us or we hear an intruder in our house, of course we are going to respond to this fear with fight, flight or freeze, of course we are going to be on heightened alert. Here’s the thing, people with anxiety disorders see ordering food, meeting new people, talking on the phone, performance based activities, not being at a level physically or intellectually where they think they should be, presenting to a group, etc. in the same way that others see intruders, snakes, or physical attacks. Of course, these types of things can also cause danger response to a person with anxiety as well, but my point is, the brain doesn’t distinguish between what it senses to be danger or fear when it is an anxiety disorder.
If you had a phobia of snakes or there was an intruder in your house; think about the level of fear you feel. So, let me ask you this. How would you feel if I said, “suck it up, just go and pick up the snake, think positively and you’ll be able to do it”, or “just do it, go after that intruder, you must face your fears, you won’t jump him if you’re not pushed to do it”? Yes, these examples may seem extreme, and yes, you can be seriously hurt if you did rush after an intruder and grab certain snakes. The point is, people with anxiety disorders believe they will be hurt in the same way. Their fear is real, because in the moment they truly believe that the situation triggering their anxiety is going to hurt them. It doesn’t matter if it seems minor to us, to them it is not. To add to this fear, it may start with one situation or event, but like previously mentioned, it’s like the brain becomes hijacked and the initial situation or event triggers the “what ifs” and now six more fearful situations are going to occur.
The good news is, anxiety disorders can be treated. Cognitive Behaviour Therapy (CBT) is an evidence based approach which is very effective in treating anxiety disorders and many other mental health problems. I’ve used an integrative approach with a basis of CBT to help many people. The best aspect of my job is when I see clients have light bulb moments; the look on their face when they realize the why’s and the how’s and start using the strategies independently. That smile when they tell me that they challenged the thoughts, they looked for facts and literally felt their anxiety decreasing, and it worked, is so fulfilling.
I now ask a favour of you, next time a family member, friend, co-worker, student, boss, any individual who crosses your path, is showing signs of significant anxiety, has a history of anxiety disorders or anxiety disorder symptoms, please do not push them. Please do not tell them to suck it up and do it, be a man/woman, think positively, or they’ll be stronger for doing it. Should they be pushed? Yes, in a gentle way with strategies to change the fear perception, and in steps. If you are faced with this, I ask you to reflect on the fear and panic you would feel if you came across your phobia and have empathy for those with anxiety. The fear is real, no it’s not always rational, but it’s very real.
Registered Psychotherapist (Q) and owner of,
Dalgity Counselling & Psychotherapy