The Anxiety Solution

CHAPTER 2 Why are we all so worried?

I am an old man and have known a great many troubles, but most of them have never happened.

MARK TWAIN

If you suffer from anxiety, then a typical day can feel like one long struggle not to slip into panic. There’s a sort of buzz going on in your brain, and its not the good kind. You shower, inhale your breakfast and get the train to work. Your mind is busy in its own internal nightmare. As your tensed-up, crunchy-shouldered body goes through the motions of your day, your brain is set to overthinking autopilot. Your heart races in your chest – a thumping, erratic reminder that you can’t cope. Before you even get to the office you’ve mentally played out today’s stressful meeting, felt defensive as you had an argument with your boss about a deadline and sensed a wave of dread wash over you as you imagine tackling that ever-growing mound of emails. Not to mention worrying about everything from sorting out the boiler to creating your own online media empire by the end of the month!

Truth is, all of this happened in your mind as you stood in line at Starbucks.

In our modern world, scenarios such as this have become commonplace. I can guarantee that at least some of those people in the queue with you will be going through the same repetitive thinking. It’s becoming the norm for us to feel anxious. We’re chronically worried: about cash, our relationship or lack thereof, the housing market, not being good enough, the people we love, whether we’ll have babies, what to eat, what not to eat, wars, natural disasters, politics and the economy, the shape and proportions of our bodies and the lines on our faces.

Young women and anxiety

According to the Mental Health Foundation’s 2014 report ‘Living with Anxiety’, 22 per cent of women in the UK feel anxious ‘most of the time’.1 A 2016 review by researchers at Cambridge University found that women are twice as likely to experience anxiety as men, with those under thirty-five most affected.² Research has demonstrated that at the age of eleven, boys and girls are equally likely to be anxious but by the time they’re fifteen, girls are in the lead.³

So what’s the explanation for this massive difference in the way women and men experience anxiety? Part of it seems to be down to biology. Women’s brains (in particular the amygdala, which governs emotion and responds to stress) are more likely than men’s to fire up at a stressful event.4 But there are also a host of social, cultural and political factors that make women particularly prone to anxiety. Women are more likely to experience physical and sexual abuse than men.⁵ There is also pressure on women, both from ourselves and society, to ‘have it all’ – the fantastic career, a great body, a rewarding relationship – and then balance babies, boardrooms, buying property and often taking on the brunt of caring for parents as we, and they, get older. Not to mention the fact that women are paid less than men in 90 per cent of all sectors, according to the UK government’s 2015 report.⁶ Then there’s the fact that our hormones fluctuate monthly, which can cause more stress and anxiety.

We are also, annoyingly, more likely to ruminate over our problems while men are more likely to take action to solve them.⁷ It looks as if this is down to the way we’re raised. Dr Lynn Buska of the American Psychological Association told the Guardian in 2013, ‘As girls, we’re taught to think more about relationships and subvert our needs towards the group’s needs or towards others. Whereas boys are socialized earlier on to be more assertive and expressive about their needs.’⁸ In other words, in order to help lower our stress levels we need to take care of ourselves, express our needs and be a bit more ‘selfish’. Taking a more active role in how we cope with things rather than putting up with stress or fretting about it will certainly help. (And if all this sounds daunting, don’t worry; this book is stuffed with tips on how to do it!)

A key factor is a sort of ‘learnt helplessness’ that can result from differences in the way boys and girls are treated by parents, teachers and others. Boys are more often told to ‘toughen up’ if they slip and fall or make a mistake. Girls are typically given more compassionate attention.

I vividly remember Mum scooping me on to her knee and cooing ‘poor baby’ – when I was eighteen years old! All because I’d been struggling with something at college. I’m pretty sure she’d respond in the same way now if I scraped my knee. And while this is very loving (thanks, Mum!), it can result in a sense of helplessness. If we’re not allowed to discover that we can cope when life feels difficult or things are going wrong, we end up uncertain of our abilities. We don’t trust ourselves to be able to fix things, or simply get through them. Many young women have not developed the internal coping mechanisms and confidence to handle challenges.

There’s an irony here because we women spend a lot of time trying to hold it all together and, often, we do a very good job of it. At least from the outside. The problem is that even if we’re managing pretty well we often fear that we’re about to fail. Or we’re convinced we’re not doing well enough. Everywhere I go, whether it’s to a party, a work event or a yoga class, when the subject of what I do for a living comes up there will always be at least one woman, often many more, who leans in and, in a hushed voice, confesses her own struggles with anxiety. These women, who appear cool, calm and together, tell me that actually they’re a hot mess of worry and self-doubt. There is an epidemic of anxiety happening out there, a lot of it behind closed doors and inside buzzing brains.

How can you tell whether you have anxiety?

When I talk to people about their anxiety they often tell me that they don’t want to make a fuss, or that they feel bad because they know there are so many others with worse problems. They believe they ought to be able to pull themselves together. All this puts extra strain on them and makes them feel more anxious.

The first thing to say is that, if you are suffering, then there is a problem and you deserve to get help. If anxiety or worry or panic affect your daily life or are causing you distress, please don’t suffer in silence.

If you suspect you may have anxiety it’s essential to have it diagnosed by your GP. They will be able to help you decide if therapy or medication is a good option, and also distinguish anxiety from other issues such as depression.

Secondly, all anxiety is normal – you’re certainly not ‘abnormal’ if you have it. Some people experience persistent anxiety no matter what is going on in their lives. For others it’s triggered by certain situations such as social events. Other people will experience temporary spells of anxiety, for example when going through a big change in their life or before an exam.

You can’t self-diagnose anxiety but, in the interests of being clear about what we’re talking about, it may help you to know that anxiety is basically an umbrella term to describe uncomfortable, nervous thoughts and feelings, often about things in the future. It typically also has physical symptoms, even though it’s primarily thought of as a mental health issue. As well as a sense of dread or irritableness and trouble with concentrating, anxiety can make you feel dizzy, sick and exhausted. It can give you palpitations, tense muscles, stomach problems and trouble sleeping. If you’ve had symptoms such as these for at least six months then your doctor might well diagnose anxiety.

The way that anxiety most typically expresses itself is in worrying. We all worry, of course we do, but if you are thinking about actual or potential problems in a way that regularly creates anxiety, then worry has got out of hand. Worrying is a problem if it feels uncontrollable and stops you from focusing and enjoying life. Maybe you find yourself persistently coming back to the same train of thought again and again. Worry can also be called rumination, over-analysing or overthinking. It’s one of the primary symptoms of generalized anxiety disorder (GAD).

The other definite warning sign that something is wrong is if you have feelings of panic. A panic attack is a sudden and overwhelming feeling of intense anxiety caused by a huge rush of adrenaline. You might experience palpitations, shortness of breath (hyperventilation), dizziness, tingling in the fingers, shaking or sweating. Usually the symptoms pass after 5–20 minutes. Panic attacks feel terrifying but they aren’t actually dangerous and can’t hurt you.

If any of this chimes with you, make an appointment to see your GP right now. The Anxiety Solution gives you a whole lot of powerful techniques to manage anxiety and get your life back, but it needs to be used as part of a programme of medical or therapeutic care.

You don’t have to stay anxious

If you’re one of the millions of people who are suffering, fortunately there is a lot you can do to help yourself. This book is stuffed full of practical suggestions and techniques you can use to manage and diminish your anxiety.

Many of my clients come to me feeling that their anxiety is out of control and that, unless their whole life changes. they will never feel better. I help them to see this is not the case. We can make changes to the way we think that allow us to cope with things we previously felt were overwhelming. And it’s usually much easier to change ourselves than it is to change our external environment. After all, unless you pack it all in and go and live in a cabin in the woods (and sometimes that might be tempting), then your unreasonable boss is going to remain a fact of life. So is social media. There is no getting away from the need to make decisions, and a certain amount of life stress is inevitable.

Having said all that, it’s important and empowering to remember that you have more options than you may realize. If your relationship is making you miserable, for example, you have the option to leave. If you cry in the loos at work every day, maybe you should hand in your notice. These decisions might cause you anxiety but it’s important to remember that, sometimes, changing your external environment is the shortest way out of long-term anxiety.

But whatever our circumstances, if we want to feel better, we have to be the ones that change. Only then will our lives change for the better. We have to clean up our thinking and adjust our perspective so we can approach modern life calmly. We may not be able to control everything that goes on in our life, but the good news is that we do have control over how we respond to events. When you really grasp the truth of this, the power flows back into your hands.

What causes anxiety?

Anxiety is a natural and normal phenomenon. When human beings were evolving we needed the fight-or-flight response to help us escape from dangers or fight for our lives. These short bursts of adrenaline (and the anxiety and panic they bring with them) kept the species alive. These days, in our society, we live in much safer times. There are no wild bears, and no alien tribes attacking ours. The problem is, the amygdala – the part of the brain that triggers the fight-or-flight response and is responsible for our emotions – didn’t get the memo. It misinterprets everyday challenges and irritations – from giving a presentation or flying in an aeroplane to receiving a large bill in the post – as life-or-death situations. Then it fires up our survival response, pouring adrenaline into our bloodstream and making sure we’re on high alert. The feeling of nervousness or butterflies in your stomach is a result of your brain directing blood flow away from your digestive system and towards your limbs so that you are better able to run away or fight, as required. Excessive worrying is another survival mechanism gone wrong. Worry is designed to help us be on high alert for the worst-case scenario but when it becomes a more or less permanent state of mind, it can profoundly damage our mental health.

That’s the general explanation but, of course, some of us are more prone to anxiety than others. The factors that lead to an individual developing anxiety are practically limitless. On its own, knowing the particular events or circumstances that caused you to become anxious probably won’t be enough to change how you feel, but self-knowledge can be a powerful first step to lessening the grip anxiety has on your life. It might be that you can’t pinpoint the cause of your anxiety. That’s also fine. You can still take steps to overcome it.

Here are some possible causes for anxiety:

Genetics plays a role, although genes only ever create a predisposition, they don’t cause anxiety. In an area of science called epigenetics, scientists have discovered that your lifestyle, your behaviours and diet can make genes either turn on or off. So even if you think you might have inherited a predisposition towards anxiety, there is a lot you can do to help yourself.

Childhood and upbringing definitely play a part. As children, we are very impressionable and we learn ways of thinking, feeling and behaving from observing family members and from our experiences. Perhaps you had an anxious parent and you learnt to worry by copying them. Or you might have had a critical parent for whom nothing was ever good enough. From this you learnt to be overly self-critical or a perfectionist. Or maybe being overprotected meant you grew up without learning how to cope with challenges on your own.

Stressful life events and trauma in your past can affect your current situation. Things such as your parents’ acrimonious divorce, the death of someone close to you, experiencing abuse or being involved in an accident can all be highly stressful and traumatic experiences that leave you feeling unsafe, fearful and uncertain. In this context, anxiety is partly a protection mechanism to try to keep you safe in the future. You may have taken on board the belief that you must worry or be on high alert in order to be safe. Even seemingly less significant things such as a humiliating experience at school could contribute to anxiety.

Your lifestyle is a huge and often underestimated factor. Not taking care of yourself, not getting enough sleep, eating poorly and not taking any exercise could lead to or make anxiety worse.

Long-term health problems or chronic pain can contribute to anxiety.

Big life changes such as getting a new job, buying a house, getting married or experiencing a break-up could cause an increase in stress that leads to anxiety.

Alcohol or drug use or abuse or side effects from some prescription drugs can bring on anxiety or make it worse.

Whatever the causes of your anxiety, please remember: it’s not your fault and you’re not stuck with it. Change is always possible. In fact, change is inevitable because nothing stays the same and, as human beings, learning and progress is innate to us. You can do this.

Are we getting more anxious?

The latest research shows that a higher proportion of young people are reporting mental health problems (including anxiety) than ever before. But does this mean that anxiety is more of an issue, or is it simply a more recognized condition?

Being close to our parents is a wonderful thing, but the flip side of that closeness is that we may be unable to function as adults ourselves, preferring to defer responsibility to authority figures when we’re stuck. And our parents’ fear can rub off on us. If you’ve been warned to ‘be careful!’ often enough, it’s easy to grow up thinking the world is a dangerous place. Due to a psychological phenomenon called ‘confirmation bias’, you’re likely to unconsciously seek out evidence for the things you believe are true. If, unconsciously, you are sure that potential tragedy lurks around every corner, your brain scans your environment for evidence to support this. It can mean you’re constantly on high alert, expecting something bad to happen. This plays havoc with your stress response. When your adrenal glands are producing too much cortisol – one of the stress hormones – you end up feeling permanently anxious.

Another big problem with being overprotected is that our failures are prevented before they’ve even happened. We are the first generation to grow up with mobile phones, which means that parental advice and support are never more than a few seconds away. But if you don’t feel able to make decisions alone, if you’ve been protected from making mistakes or experiencing rejection, you won’t have learnt that failure is OK and that you can overcome setbacks. The result is a fear that if something bad does happen, you won’t be able to deal with it. The truth is than you are stronger, wiser and more capable that you think. This book will teach you to trust yourself more, so a lot of that anxiety will fall away. Again, all these things are learnt, not innate, which means you can unlearn them.

The trouble with social media

Being constantly connected to social media can become addictive. Research says we check our phones up to eighty-five times a day.10 That’s a lot of potential for added stress and information overload, not to mention envy and dissatisfaction with our own lives. But why are we so hooked on our screens? The answer is probably that dopamine is involved. This neurochemical causes us to seek out ‘a hit’ of gossip, information or news. And, by the way, it triggers the same neural pathways as cocaine and nicotine: the struggle is real.

For me, there is a direct correlation between the number of times I check my phone and the speed of my thoughts. Every bit of information has the potential to create a cascade of feelings, memories and stress. I’ve been known to be that girl who checks her emails before getting out of bed, and it only takes one urgent email to get the adrenaline pumping before I’ve even brushed my teeth.

A couple of years ago I made a resolution to reduce my use of social media. I’m glad I did, because a 2015 study by the Happiness Research Institute in Denmark proved that social media is making us miserable.¹¹ It found that those who abandoned Facebook for a week were happier, less worried and less stressed than those who continued to log in.

Think of the media you consume as being like food for your brain and soul. If you feed your brain junk, you’re going to feel like crap, end of story. If you want to feel good, a digital detox might be a good idea to cleanse out all the rubbish. Social media isn’t all bad, of course, and it’s pretty much impossible to avoid it completely, but there are ways to limit it, shift your perspective on it and build yourself up so it doesn’t mess with your peace of mind or self-worth.

Are you hooked on worrying?

There’s nothing nice about feeling anxious, right? Worrying is one of the most unpleasant ways to spend your time. That’s absolutely true, but (here’s a biggie that could be keeping you stuck) many people believe, consciously or unconsciously, that their worry serves a purpose. How often have you thought things such as:

‘If I worry about work enough, it will motivate me to work harder.’

‘If I imagine {insert catastrophic disaster} happening, at least I’ll be mentally prepared for the worst.’

‘If I have a freak out about money, it will help me to come up with a solution to get me out of this mess.’

‘If I punish myself by worrying about that mistake I made, it will stop me from making it again.’

If you believe that worrying serves a useful purpose, it’s much harder to stop doing it. I should know. I used to think it helped. I felt compelled to worry, convinced it was useful in some way that I couldn’t quite rationalize. Sometimes it felt like my way of trying to find a ‘perfect’ solution to a problem. Other times, worry was simply my default setting; if my mind started to wander or if I was without distractions, worry would be there, taking the reins and veering off into some horrible places. On some level I felt it wasn’t safe to relax in case something went wrong. I had to be on high alert.

If you’re worrying as a way to try to solve your problems, then you need to know that it’s highly unlikely to give you any valuable insight. This might be hard to swallow if you’re a habitual worrier, but I assure you it’s true. When you’re chronically worried you’re almost always stuck in a state of confusion, panic and fear, caught in a jumble of thoughts and emotions that has you tied up in knots. This frenzied state is light years away from the calm clarity that leads to true insight. When we’re clear-headed, we’re better able to focus, solve problems and tune in to our inner resources and strengths. The truth is, you are more prepared to handle things when you’re relaxed and living in the moment.

Maybe you believe that worrying motivates you to do better. Surely all that worry will make you try harder next time? In fact, the opposite is true. Studies have shown that giving ourselves a hard time is strongly linked with lower levels of motivation and increased procrastination.12 In fact, being kind and supportive to ourselves is what truly motivates us.13 Say you’ve been trying to exercise more. You spend your time worrying about how unfit you’re getting, how useless you are and how you simply must make time to exercise. The more you worry about it, the less appealing it seems. You feel shitty about the whole thing and end up ordering a curry and zoning out in front of Netflix. Worry saps your motivation and your mental energy to do the things you want to do.

But surely worry is helpful sometimes? I hear you ask. True. In the very short term, a little worry can be just the thing to light a fire under your bum and get you to take action. But those chronic, circular worries about uncontrollable future events? They aren’t doing you any good. (And if some part of you secretly believes that worrying about things will stop them from happening, I’m here to tell you to let that one go, once and for all!)

You’re not alone with your anxiety

One of the things that can keep us feeling stuck in anxiety is a sense of deep alienation from those around us. For people who have never experienced anxiety, it can be difficult to understand. Incredulous partners and friends may say things like, ‘Why can’t you just snap out of it?’ They won’t understand why you’re getting so worked up over something that, to them, is trivial, and they’ll not have a clue that you lie awake most nights as a tiny army of ‘what ifs’ march through your brain, becoming more irrational as the hours tick on. After all, it’s tough to understand unless you’ve been there, felt the gut-wrenching dread and been practically paralysed by endless rumination.

But when people don’t understand what we’re going through it leaves us feeling lonely and can make us doubt ourselves. Perhaps they’re right and we should just snap out of it? Then we end up feeling guilty and ashamed for not being able to cope, or for making a fuss about things when other people have it so much worse. We can see how lucky we are to have enough to eat and a roof over our head and to live in a stable country with no wars or natural disasters, so we feel guilty for still finding so many things to worry about.

If this sounds familiar, please give yourself a break. There’s actually an explanation for this phenomenon of there always being a new thing to worry about. It’s called Maslow’s hierarchy of needs. Abraham Maslow was a psychologist and came up with his groundbreaking theory back in 1943. He claimed that we all have needs which we are constantly trying to meet. The most basic and crucial ones are for things like food and shelter because, unless they are met, we will die. Once we’ve dealt with those, we move on to safety, which includes things like good health and personal security. The next tier of needs covers friendship, intimacy and family; then comes esteem and respect. Finally, once we’ve taken care of everything else, comes self-actualization. That’s the fun stuff about finding your purpose, uncovering your passions and living the fullest life you possibly can.

In modern times in our culture, many of us are lucky enough to have our basic needs met, which is clearly great. But that simply opens us up to new levels of things to worry about. Things such as our achievements, what other people think of us, what we think of ourselves, our creative pursuits, what we look like or reaching our full potential. Yes, we’re in an incredibly privileged position to be able to worry about these things, but it’s all relative and your feelings are valid. It’s normal, as more of your needs are met, that the things which concern you will change.

All this shame and guilt mean that it’s no surprise that, according to a 2010 survey by Anxiety UK, 55 per cent of us don’t feel comfortable telling others about our anxiety.14 This sense of isolation and stigma has serious consequences. It is very often one of the reasons people don’t get help. Another study found that only 15–25 per cent of people with some kind of anxiety actually get treatment for it.¹⁵

Please remember that you are not unusual if you suffer from anxiety. The statistics suggest that 22 per cent of us suffer from it. Don’t let your feelings of isolation or guilt around not being able to cope stop you from seeking help. As well as speaking to your GP, try contacting one of the organizations listed in the back of the book. There is a lot of support out there.

Reasons to be cheerful

A seriously reassuring study recently found that 85 per cent of the things we worry about actually end up having positive outcomes and 79 per cent of people coped better than they thought they would when things didn’t go to plan.16 I’m sure you’ve had the experience of dreading something beforehand – a party or a meeting – and imagining all the things that could go wrong, only to find that in reality it goes well and you actually enjoy yourself. Things will probably turn out fine and, even if they don’t, you’ll handle them better than your anxious mind thought you could.

Here’s something else that happens when we’re worried. We get confused about probability and possibility. When we turn on the news, it’s easy to think that the world is a dangerous place. Fear-mongering stories grab people’s attention and drive up ratings. We’re all glued to our phones, so the intricate details of the latest world horror are only ever a few clicks away. Those things are, of course, sadly real. But because it’s only the bad stuff that is reported in the media, our perception about the probability of something terrible happening is skewed. There is always that possibility but the probability is very small.

You might find it reassuring to know that, despite all the doom and gloom, in the media it simply isn’t true that the world is on the decline and suffering is at its peak. The data says differently. The website Our World in Data¹⁷ shows us that the world has never been a safer, richer, healthier place. There is less poverty, fewer homicides, fewer wars and more democracy than ever before. Average life expectancy in the UK has gone from thirty-four years in 1543 to eighty-two in the year 2012. For the majority of us there has never been a better, safer time to be alive.

I want you to consider that people have coped with things for millennia. You and your DNA are the result of 200,000 years of natural selection during which only the toughest, smartest and most resilient humans survived to make babies. You are a refined and brilliant human being. You’re, basically, amazing. Don’t underestimate your abilities and resources. You already have all the abilities and strengths to survive and be happy. It’s built into your human-ness. Believing you are capable is the only thing you need to do to actually be capable.

I remember talking to my mum a few years ago about childbirth. I was pretty anxious about the whole idea of pushing a tiny human out of me (we’ve all heard the ‘pulling a chicken out of your nose’ equivalence stories, haven’t we?!) and all the pain, blood and potential danger involved. What she told me changed the way I thought about it for ever. She explained that there is an intelligence and wisdom in the human body that knows what to do, a part of you that was passed down from mother to daughter through every generation. It’s instinctual. It’s innate. We contain resources we’re not necessarily even conscious of which we can call upon when we need them most. We can absolutely trust ourselves to know what to do when that moment of birth comes because it’s in our DNA. This is true of any situation in life.

If all this sounds too good to be true, don’t worry! This book is full of strategies that will support you in worrying less. It takes practice, but you can do it. For now, I want you to just hold this thought: your anxiety is not your destiny. You are way more powerful than you realize and you will get past it.

Summary

★ Young women are particularly vulnerable to anxiety but there are lots of things you can do to help yourself.

★ If you suspect you are suffering from anxiety, make an appointment with your GP or contact a support group such as MIND. Don’t self-diagnose your anxiety.

★ Anxiety is never your fault. Neither is it an innate part of who you are. Change is possible.

★ Don’t let guilt, shame or fear stop you from getting help for your anxiety. You are not alone and you can get better.

★ You are a brilliant human being and way more capable than you think!