Here is a copy of the handout I provided my students before I retired:
Comprehending and Managing Anxiety, Anxiety Attack and Agoraphobia
Stress and anxiety has frequently been called the “common cold” of emotional conditions. Most people experience stress and anxiety in one demanding circumstance or another, while many of us have actually experienced or will experience anxiety at some time in our lives that is intense enough that it interferes with our everyday activities.
Among the biggest problems in dealing with stress and anxiety for the majority of people is that admitting that you experience stress and anxiety is not socially acceptable in many circles. Males particularly have trouble admitting to signs of stress and anxiety since much of them anxiety as contravening their of being “strong” and manly. Not owning up to signs of stress and anxiety, however, does not make those symptoms disappear. One just becomes “anxious about being distressed” and resolving the problem ends up being more complex.
Fear versus anxiety
If you are walking across United States-41 from Heaps over to Fisher, you slip on some ice in the middle of the roadway and see a logging truck barreling towards you, what you will experience is fear. Worry is a feeling that is linked to real-life, here and now risks. The feeling of fear is very good and adaptive, because if you are afraid enough, ideally you will obtain off of the roadway very quickly and that logging truck will miss you by a country mile. We are come down from people who had the ability to become really scared and were then able to avoid threats out there in the real life that would have eliminated them had they not escape as fast as they could. We are not descended from those individuals who, in the face of serious dangers that couldn’t be combated, acted very nonchalantly about it or who put on a macho attitude that then got them eliminated by the huge hairy animal with sharp teeth. Worry then, has two main characteristics: 1) it is based on a practical assessment of actual, here and now risks; and 2) it serves to stimulate us to take efficient action to successfully prevent those risks that are best handled by avoidance.
Fear is a healthy and a natural feeling. In its appropriate location, worry is excellent.
Anxiety, on the other hand, is by meaning a psychological disruption. A psychological disruption is any emotional experience that 1) is not mostly based on an actual, here and now scenario; 2) tends to be based on catastrophic fantasies of what might take place rather than on a practical assessment of the real risks (the possibilities and reversing possibilities of what may go wrong) within any given situation; 3) tends to energize habits that moves one far from one’s main goals in life instead of towards those objectives; 4) tends to lead to highly inadequate and self-defeating habits rather than effective and self-actualizing habits.
If you avoid crossing United States-41 unless it is completely devoid of all traffic simply since five years ago you practically got struck by a cars and truck as you tried crossing the street in your home town, then your emotions are not based on actual here and now experience, nor are they based on a realistic assessment of the actual danger of crossing United States-41 You are experiencing the emotional disruption of stress and anxiety rather than fear. If your anxiety is strong enough, you will stand at the curb for 15 minutes and be late to class rather than cross the roadway when you can see a single cars and truck one hundred yards away. In this example (drawn from reality), the emotion of stress and anxiety is serving to interfere with your objectives of crossing the street and getting to class on time, and is therefore self-defeating and disturbed.
If you avoid talking with attractive members of the opposite sex due to the fact that you imagine them potentially declining you and you imagine how horrible and intolerable that would be to experience, you are experiencing crippling stress and anxiety, not fear. Some individuals experience such intense anxiety that even if an appealing member of the opposite sex gives clear signals that she or he wishes to strike up a discussion, these individuals isolate and avoid such encounters, preoccupied by the fantasy of how shameful and awkward it would be to make a verbal mistake and how extremely they would be rejected by this appealing person if they made such a spoken or social slip.
Fear then, is not stress and anxiety. Anxiety is not fear. One is healthy, one is a psychological disturbance.
Reactive anxiety and fears
Some people are nervous just in certain scenarios. Lots of Michigan Tech males, for instance, show no particular worry or anxiety when they engage in sports that bring a practical threat of injury, such as hockey, rock climbing or skydiving. These same males, on the other hand, can become extraordinarily distressed and avoidant when talking with an appealing lady or talking with a professor about a question they may have on some subject products.
Reactive stress and anxiety is comprehended as that sort of anxiety that is localized to a couple of particular situations and which may have been initiated by painful experiences in the person’s past. Many males, for example, report having actually been significantly teased or teased when they remained in grade school after they experienced their very first infatuation with a woman. Now, ten or more years later on, these very same males envision the exact same feelings of shame and embarrassment might strike them now as they felt at age 10 if they talk with an attractive Tech female and end up being turned down by her. Many students report sensations of test stress and anxiety based on poor performances during a test weeks, months or even years previously. The test anxiety is not based upon a realistic evaluation of how one might do on this particular test and how one might deal with a poor grade, rather it is based upon disastrous dreams of how doing poorly will be awful, terrible, something one can never truly recover from, and how socially humiliating such a poor grade will be and how helpless one would be do deal with the social response of others in such a scenario.
Phobias tend to be far more particular than reactive stress and anxieties. Some individuals are phobic of bugs, mice, spiders, crossing bridges, riding in elevators or flying in airplanes. In other areas of their life, they are great. Fears tend to be a bit harder to fix than a reactive anxiety reaction. We at Counseling Providers have a pretty good success rate dealing with trainees who have apparent fears.
Generalized or “complimentary floating” stress and anxiety
Some individuals feel nervous all the time and can not determine the source of their anxieties to any one particular circumstance, person or thing. This kind of stress and anxiety is called generalized or “complimentary drifting” stress and anxiety.
At the mental root of all stress and anxieties is a psychological phenomenon called catastrophizing or negative possibility thinking In everyday life, all of us sometimes think of what “might” happen that might be undesirable or unfortunate. We might slip on the ice today and break our arm. We could get struck by a bus or a logging truck. The Russians might be initiating a nuclear attack on us this extremely moment. The sun might go supernova today. We may have a heart attack and pass away after lunch.
While thinking about these possibilities, most of us also perform a quick probability look at the things we think about and conclude that, while yes, I could slip on the ice today, probably I will not. While the Russians may have just launched their rockets, most likely they haven’t. While I may die of a cardiac arrest today after consuming lunch, in all probability I’ll be just great. Opportunities are, I won’t be struck by a logging truck today. After we likelihood check the things we think about that are definitely possible today, we calm down, unwind and then set about our business, material in the likelihood that today will hold no major surprises for us besides the ones we planned for.
The catastrophizer does not do this.
The individual caught up in catastrophizing gets “stuck,” believing that the possibility of something occurring is nearly the exact same thing as the certainty of that thing taking place. “If it’s possible that I might screw up this test, it’s specific I’m going to mess up this test. If it’s possible this attractive complete stranger will refuse me if I try and strike up a conversation, then it’s specific that he or she will. If I’m thinking I might have a heart attack this afternoon, then the fact that I’m believing it must be a clear and precise premonition that the cardiovascular disease is on its method– otherwise I would not be considering it.”
In addition to thinking that the existence of a possibility produces a certainty, the individual caught up in devastating thinking likewise tends to overemphasize the pain that a negative outcome will include. The catastrophizer likewise tends to him or herself as completely powerless to deal with the unfavorable result, imagining it to be catastrophic and not just regrettable or a disappointment that can be dealt with.
Instead of seeing a bad grade on an exam as disappointing and unpleasant but something that can be managed by studying more difficult and attempting again the next time, the catastrophizer a poor grade as “horrible,” “horrible” and something that “I can’t stand!!”. The catastrophizer tends to make international conclusions based upon only a few experiences: if she or he gets a bad grade on a calculus test, the catastrophizer too easily presumes “I’ll never get it, I’m simply silly in mathematics” and quits trying. If rejected by an appealing stranger for a date, the catastrophizer too easily concludes “I’m just a loser with females” or with guys and stops approaching prospective dating partners and mopes inside his/her residence hall room wondering. In this style, generalized or free-floating stress and anxiety often precedes or is accompanied by some type of anxiety.
Generalized stress and anxiety rarely fixes itself by itself, yet is among the conditions most effectively treated in a therapy or counseling setting.
Few events in the world of human experience are as frightening as a full-blown anxiety attack. Fight veterans who have experienced an anxiety attack for the very first time have said that they would have chosen battle all over again to another anxiety attack.
One of the worst functions of panic attacks is that the private experiencing them generally becomes sensitized after the very first attack. To put it simply, after experiencing an anxiety attack once, you become a lot more vulnerable to experiencing them again and again. After about ten panic attacks, you are extremely vulnerable to experiencing anxiety attack on a daily and even on a numerous times daily basis.
Anxiety attack rapidly become debilitating, in that they dramatically disrupt the average person’s efficiency of daily life activities. Individuals experiencing several panic attacks in the course of a week are at extreme threat of establishing an even more severe anxiety disorder called agoraphobia. The person becomes so afraid of experiencing yet another panic attack that she or he refuses to leave his/her apartment or condo, dormitory or home.
The symptoms of an anxiety attack
The signs of anxiety attack are frequently felt as odd and are normally analyzed as catastrophic:
- A sense of impending death or insanity
The private experiencing the beginning of a panic attack typically feels as though he or she is on the edge of dying or of losing his/her sanity. The ability to focus is significantly impaired, and the range of other signs that start to occur are so unusual that the private experiencing them generally concludes they are catastrophic. This sense of impending doom generally makes the panic attack much worse and more extreme.
- Pronounced shakiness in the hands and legs (rubber legs)
As a panic attack advances, the person may discover extreme problem writing, dealing with little items or perhaps holding a cup of coffee without spilling it. There is often a feeling of severe weakness and instability in the legs and a fear that they may not hold you up. Trying to unwind utilizing the standard relaxation strategies generally doesn’t work at all, and simply serves to heighten the feeling that something truly terrible and probably deadly is going on.
- Rapid heart beat (tachycardia)
As the individual experiences the panic attack magnifying, he or she may all of a sudden observe his or her heart beginning to beat at a really rapid speed. Heart rates of 140, 160 or perhaps 180 beats per minute are common throughout the course of some person’s panic attacks. Noticing this, this person may realistically however improperly conclude that he or she is having a cardiovascular disease. This conclusion typically makes the panic attack even more intense.
- Skipped or extra-strong heart beats (extrasystoles)
As the panic attack gets underway, lots of individuals experience what they refer to as their heart “beating so difficult it seems like it might explode” or “beating irregularly, like it’s about to stop.” Experiencing extrasystoles typically persuades some individuals that they are having a cardiovascular disease, especially when extrasystoles are accompanied– as they regularly are– with tightness in the chest and often even discomfort shooting down the left arm. Once again, thinking one is on the brink of a cardiovascular disease intensifies all the symptoms of an anxiety attack. Many individuals experiencing both tachycardia and extrasystoles go to an emergency clinic fearing they have actually had a cardiac arrest. In some cases, emergency room doctors who were not well-informed about panic attacks belittled their patients after an electrocardiogram (EKG) showed no signs of cardiac illness. More regularly nowadays, however, emergency situation department personnel are better informed about the symptoms of anxiety attack and can make some useful interventions to the people reporting there.
- Intense pressure in the chest, or an abrupt intense sensation of “my heart leaping out of my throat” (antiperistalsis)
When these signs are accompanied by the fast heartbeat, particularly if it skips beats a number of times, the specific quickly reaches the frightful conclusion that she or he is experiencing a cardiac arrest. Not comprehending the real nature of the symptoms, the specific attempts to understand them as best she or he can.
- Unexpectedly extremely cold or sweaty hands or feet
The person who notifications cold hands or feet may try to “warm them up” and become significantly nervous when they don’t warm up. The individual experiencing sweaty palms might try repeatedly to wipe his/her hands off, only to fail to dry them. This experience typically leads the distressed individual to mistakenly conclude something devastating is occurring clinically.
- An intense “pins and needles” feeling in the hands, feet or face (paresthesias)
Individuals who end up being acutely knowledgeable about the “pins and needles” or “face dropping off to sleep” feeling quickly reach the incorrect conclusion that they are having a stroke or other neurological disaster. Some fear they are on the brink of ending up being paralyzed. Often the pins and needles feeling starts in the hands or cheeks, and starts to intensify and advance to the feet, earlobes, up the arms and up the legs. As the feelings progress, the individual panics much more.
- Loss of focal vision and focal hearing; a “darkening” of the field of view
Individuals experiencing panic attack regularly explain losing the ability to check out. They regularly describe a loss of three-dimensional vision, explaining their visual field as “flat” or “as though everything is being forecasted on the inside of a ball where I’m floating in the middle of it”. The individual’s sense of vision is in some cases reported as merely “weird” or “unbelievable”, yet unusually vivid and intense. Sounds are frequently reported “as though they are coming from inside a barrel or from inside a conch shell”. Periodically noises are described as incredibly clear and distinct, while total, everything seems peculiarly and extremely quiet. In intense situations, the private might have the experience that “whatever is going dark”, and may have the worry that he or she is about to pass out. Individuals who have actually passed out in the past understand the feeling of “the lights going out” that preceded their fainting episode. Individuals experiencing anxiety attack have exactly that very same experience, except they typically do not understand what is going on.
Panic attacks are generally misinterpreted according to the person’s previous experiences
Typically, people who are particularly aware of their loss of focal vision and hearing, or who have experienced a “darkening” during their anxiety attack start to conclude that they are having either a stroke or the starts of a “anxious breakdown.” Those individuals who have try out hallucinogenic drugs in the past such as LSD, mescaline
(” shrooms”), psilocybin or cannabis often conclude they are having a drug “flashback” that is a sign of long-term mental retardation.
In the past, regrettably, there were many psychiatrists and psychological health employees who agreed with both those people who hesitated they were having a “anxious breakdown” or psychotic decompensation, in addition to those individuals who feared they were brain damaged and suffering from flashbacks.
Panic attack is better comprehended expertly nowadays
Nowadays, nevertheless, as the symptoms of panic attack are far better comprehended than they utilized to be– even in the psychological health occupation– incorrect and inappropriate medical diagnoses are much less frequent, and assistance for the underlying panic disorder is quicker made available.
Panic attacks are very treatable! Martin Seligman, one of the primary researchers in the field of psychotherapeutic effectiveness, writes that anxiety attack is among those conditions that best responds to therapy. It is extremely essential, if you have experience panic attacks, for you to come into Therapy Providers and begin talking with a therapist. This is one of those conditions that usually just becomes worse if you attempt and ignore it or try and handle all of it by yourself. At the same time, it is likewise among those conditions that begins to clean up rather quickly when help is sought right away and the underlying physiology of panic attacks are better understood and experienced for what they are. Relaxation techniques, performed in the understanding of what a panic attack is, are then really efficient.
Individuals who have experienced repeated anxiety attack frequently risk establishing agoraphobia. While the literal significance of agoraphobia is “worry of the market,” a better working meaning is “a morbid fear of heading out in public.”
The specific with agoraphobia classically has the intense worry that if he or she has a panic attack in front of other individuals, that those other individuals will mock, judge or embarrass that person to the point where that individual’s social image and track record will be destroyed permanently. In some cases agoraphobia takes another tack: some individuals who have experienced anxiety attack fear that they will “have a heart attack” or some other disastrous medical event while out in public and fear the public loss of control associated with such an occasion. This is especially real if the individual is called upon to make some kind of public discussion, such as a speech, or is needed to voice his or her in an open forum. Frequently agoraphobia is likewise connected with public claustrophobia. The individual is afraid to go on elevators (for worry the elevator will get stuck which they’ll have a panic attack and be “trapped” inside unable to get relief) or fly on a plane (because they may have an anxiety attack in flight and once again be “trapped” up until landing).
As an outcome of their fears of having a public panic attack, the agoraphobic individual quickly limits his/her movements till they generally refuse to leave their home or home. They often count on parents, partners or buddies to do their looking for them, and limit their movements progressively up until they are entirely separated.
Plainly, agoraphobia is a devastating condition, one that can quickly subvert a Tech student’s studies and academic career.
Luckily, the early stages of agoraphobia are correctable if the person receives therapy. If the agoraphobia progresses to the point of near or total seclusion, however, the student is probably best recommended to withdraw from school at today time, go house and, in his/her home environment, receive extensive expert assistance.
Trainees who remain in the early phases of agoraphobia can easily be assisted by coming into Therapy Services and dealing with their condition. Frequently this condition can be dealt with without any substantial interruption of the provided trainee’s studies. Students who are already experiencing full-blown agoraphobia, on the other hand, most likely need to require time off from college and deal with an expert near house to resolve the condition to the point where they can return to Michigan Tech and have a reasonably optimistic chance of success. Trainees recuperating from agoraphobia can benefit profoundly from entering Therapy Services for follow up, confident that by teaming up with one of the CS therapists there is very little opportunity of a regression.
- A sense of impending death or insanity