“Worry is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.”
— Arthur Somers Roche
It’s early Friday afternoon and you’ve just about made it through another work week, intact. Just a few more hours and that worry free-weekend will become a reality. You take a stroll down the workplace hallway and you spot your boss walking in the opposite direction. You wish him a nice weekend and he responds by shooting you a sideways glance and utters a seemingly obligatory thanks. You wonder to yourself, that was a cold response. Hours later with your week over, you’re driving home alone and you can’t shake the unease that was the “look” on your boss’s face. And that’s when the thin stream of anxious rumination becomes a rushing river that dominates the entire weekend. Catastrophe awaits on Monday for sure you think to yourself. The muted response from the boss means that you said something wrong during the week and as a result, you’ll be jobless, the bills won’t get paid and your standing in society will take a precipitous dive. This vision of the future has taken up residence in your mind countlessly in the past for sure but this time you believe, with the strongest of conviction, that it will crystalize. The thoughts of this stick to your mind all weekend like velcro while the present moments slip off like butter on hot teflon.
According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the U.S., affecting about 18.1% of the population. Only one-third of those affected receive treatment. Anxiety comes in many different flavors and there are more often than not, overlapping features between the various anxiety disorders as well as depression. As I often tell my patients, anxiety, and depression can be inseparable cousins. And while the medical literature neatly characterizes and separates the various anxiety disorders ie. generalized anxiety disorder, social phobia, panic disorder etc., more often various overlapping symptoms are found in one individual. The brain is a complex organ that doesn’t follow the textbooks.
I’m often asked by patients, Can you make me 100% anxiety free! My response is that anxiety, in appropriate contexts, is extremely beneficial. Before we were insulated from our natural surroundings in the comfort of our apartment or house, that rustling in the bush might have meant a lion was about to attack. This triggered hypervigilance and we expected the worst. When this rustling intensified, within milliseconds, our heart rate increased, breathing became faster and more shallow, our muscles tensed up and we were ready to run or fight. As we continued to focus on the bush, we noticed a squirrel come out and with that, the above physiologic response slowed down. Ninety-nine times out of one hundred, it was a squirrel but on the hundredth time, a lion jumped out and as a result of the fight or flight response, we were ready and by extension, we survived. Anxiety as a trait survived because it has benefits. In modern times, that “Lion in the bush” might present as financial stress, work-related stress, fear of social settings, fear of ill health, the sideways look from the boss, among countless other threats. It’s as if the fight or flight response and the thoughts that accompany it can become a perennial river that cuts into every moment of existence.
The good news is that with proper treatment, the river of anxiety can be slowed down to a trickle such that you can function optimally in all aspects of life. Studies show that medication, therapy and the combination of the two can result in drastic improvement. Other approaches such as journaling, exercising, meditating and certain breathing exercises are also part of a comprehensive treatment plan that can move you toward a calmer existence. While challenging at times, the journey to understanding, alleviating and making use of anxiety can be an extremely rewarding one.
The team at Scottsdale Mental Health and Wellness Institute hopes to be a part of your unique journey toward relief of anxiety.
Author – Mike Higbee, PA-C
Mike Higbee is a nationally certified physician assistant specializing in psychiatry. Mike graduated from St. John’s University in New York City in 2003 with honors. His guiding philosophy in practice is not only to alleviate the burden of psychiatric illness but also to guide his patients on where certain aspects of the disorder may be useful. Mike has experience in outpatient psychiatry, substance use treatment as well as crisis psychiatry. He is an active member of the Association of Physician Assistants in Psychiatry. He is also in the process of writing the chapters on psychotic disorders and anxiety disorders for a medical textbook in collaboration with Yale Medical.