Overthinking Anxiety?

Mark Manson calls it the feedback loop from hell. It goes something like this: "I feel anxious - what's going to happen? I've been anxious for a while now. Oh crap, I feel anxious about being anxious. And now I'm worrying about being anxious about anxiety .. somebody .. HELP!".

As a coach, I sometimes bump into this, and I've experienced it myself firsthand (no, coaches are not immune to this shit!) It took eight years to settle our insurance claim and finally sell our house after the Christchurch Earthquake in 2011. During that time the financial uncertainty of what can only be called a war of attrition with our insurers was a constant strain. I'm good in a crisis (even apparently an eight-year-long one), but afterward everything goes to shit, and so it was early this year when I found myself at the doctor's office with a PTSD diagnosis and clutching a script for cetirizine (which the pharmacist promptly scared me off using). I was able to hold down my job, but that was about all. I'd return home at the end of the day and just zombie out, I ignored the kids and I stopped coaching outside of work. Although it started with anger, grief, and regret, the anxiety (and the feedback loop from hell) was close behind and quickly became dominant. It became difficult to concentrate at work and I felt constantly overwhelmed. Prioritisation was almost impossible and I remember thinking one day, "Everything on this list is easy, so why am I struggling so much, and why is it so hard to break out of?"

The answer lies in biochemistry. But before I get to that a few disclaimers: I'm not a neuroscientist, nor am I a psychologist, counsellor, psychotherapist, mystic, psychic or otherwise. There are some excellent resources and a self-evaluation tool for anxiety on https://depression.org.nz/ and I recommend seeking the help of a trained professional. This is a personal story about what worked for me and I'm offering it here because it might help someone and I think the online literature overlooks some important points.

Thoughts → Feelings → Behaviour → Results

When I did my initial coach training we were taught a "causal chain", in that thoughts (conscious and unconscious) cause feelings which in turn drive behaviour which determines our results. In other less linear models, it's a circle and there's feedback paths. In my case my thoughts, "My performance is shit; everyone will notice ..." drove my anxiety, which caused me to stare at my task list, prioritise poorly and ultimately drop my performance. Well, that sucked.

Much of the online literature is based on this relationship between thoughts and feelings and advocates changing our thinking or shifting our focus to generate different results with techniques like:

Cognitive Behavioural Therapy (CBT)
Breathing and relaxation exercises
Meditation
Reframing (thinking about the situation from a more useful perspective)
Journalling

Now, I use most of these techniques and I find them useful in the right context, but for me, they just didn't alleviate my anxiety. Meditation and breathing exercises just created a space to worry more, and any attempt to analyse my thinking just drew more attention to it. Not helpful.

Rethinking Feelings

The problem lies in how we interpret the causal chain and the nature of feelings themselves. We see each arrow as meaning "causes", but what happens if we take away or substitute the original thinking? Do the feelings just stop? The answer is no. Taking away a thought doesn't immediately "un-cause" the feeling. Feelings are hormones - chemicals in the blood. In the case of anxiety predominantly adrenalin and cortisol. Take away the feedback loop from hell and what are you left with? Adrenalin and cortisol. They take time to return to normal levels. Adrenalin is not so bad - it clears from the blood in about 20 minutes. But cortisol is a persistent little bugger - it hangs around for hours and accumulates with repeated doses. Both have the biological upsides in normal doses, so it's sustained overproduction that's an issue and leads to the classic feelings of chronic anxiety.

What is needed is a way to clear out the chemicals (no, put the gin away). And rather than spend more time thinking about (or harder: trying not to think about) what's bothering us we need to change the way we think about anxiety itself.

My Anxiety

Yep, it feels like crap. Yep, it's frustrating, self-reinforcing, at times debilitating, and quite literally a head-job! But it's there for a reason. Anxiety is an emotion, and all emotions are just messages from our brains. Emotions call us to do certain things, for example, sadness calls us to remember, guilt to make amends, lust .. well, you get the point. Anxiety calls us to do two things:

Look for threats - usually in the future (this is where the perpetual worrying comes in)
Take action - fight, flight or freeze.

Inaction is a big problem. When we freeze (which often involves withdrawing into a safe routine) nothing changes and hyper-vigilance remains. We feel out of control and the same thoughts go round and round. We can get stuck, and if we're not careful the next stop is depression. So try something! One of the most useful pieces of advice I received was from a friend who told me to study my anxiety and treat it like an experiment. More on this later.

At the time, I found it helpful to own and even welcome my anxious feelings. They're happening, after all, whether I want them to or not, so fighting them and worrying about them just makes things worse. It sounds silly, but I quite literally thanked them for preparing me for whatever was coming. I would feel my heartbeat hard in my chest and welcome the energy it brought. A friend once told me, "Anxiety is excitement without breath," and while breathing exercises didn't help I found it useful to view anxiety and excitement as two sides of the same coin. This is how I broke the feedback loop from hell - every time I noticed I was feeling anxious I consciously acknowledged, experienced and welcomed the physical feelings, rather than rejecting them.

Finally, if you haven't watched this TED talk by Kelly McGonigal you should. It reframes stress, a precursor to chronic anxiety in a similar way.

Do Something With The Energy

Adrenalin prepares you for action, not thinking. Cortisol is, among other things, an anti-inflammatory - it also prepares for action by enabling muscles to work harder. Together they made me feel jittery, agitated, foggy-headed, and tense like a coiled spring. In this state it was no use trying to think my way out of it - I had to burn off the excess energy.

I've long known that exercise helps me relax. My wife, bless her, has known it longer: "You need to get out for a run - now!" The problem was I couldn't squeeze a half-hour run (plus shower and change) between meetings. The day would go by meeting to meeting and I'd have no chance to blow off steam, and by 3 pm my head would be foggy again. My breakthrough came when I started experimenting with the type and quantity of exercise. What I discovered is that short bursts of strenuous exercise, like push-ups when you're 45 and haven't done any for a decade, or pressing one fist hard into the other palm, produced almost the same effect as a half-hour run. Voila! Three minutes and not enough activity to break a sweat or need a shower. The trick was to push hard enough to prevent thinking - all my focus and effort was directed into the activity. This had the benefits of distracting me, burning off adrenalin and producing feel-good endorphins. (Please check with your GP before trying this).

Study Yourself

Try this:

Build a list of all the things people say you should try.
Put the things you think are most likely to work at the top.
Try out the top one or two - give them a fair shot, not just a half-hearted attempt.
Track how anxious you feel before and after (a 1-10 scale works - but any metric will do so long as you know what it means).
Repeat, adjust the list and learn. Be scientific and systematic.