Most of us have some background anxiety. By background anxiety, I mean anxious feelings that seem to hang around, even if there is no apparent cause. This kind of anxiety can either show itself as a general feeling of dread, or it can attach itself to events, and interpret them in a negative way.
Freda (imagined name, imagined situation) wakes up every morning with a lurch to the stomach. Her body seems to be telling her something is wrong. Her heart rate goes up slightly, and she starts to experience the world as a fearful place. This is before she has really thought of anything in particular.
A bit later in the morning, Freda goes downstairs and sees some post on the hall floor. Her background anxiety attaches itself to the letters, and she starts to imagine all sorts of possibilities: are the letters about unpaid bills? Are they some kind of legal letters saying she has done something wrong?
The important thing about this kind of anxiety is that it is there in the body before any particular thoughts or events have arrived. It seems that the body ‘wants’ to be anxious. Symptoms can include:
- sleep disturbances
- difficulty concentrating
- feeling restless
- feeling faint or dizzy
- heartbeat disturbances
It is easy for the mind to try to find reasons for the anxiety. We may start to interpret our normal, everyday lives in the light of the background feeling of threat. We can start to react defensively, hiding from others, or starting little arguments with them. Eventually, the hiding can turn to loneliness, and the little arguments can turn into big relationship problems.
HANDLING BACKGROUND ANXIETY
There are two main ways to approach this kind of anxiety.
APPROACH #1 – THROUGH THE BODY
To an extent, background anxiety exists in the body’s internal messaging system. We can affect our bodies in two main ways:
- By choosing activities which improve sleep, strengthen the heart, and balance restlessness. Exercise is a particularly good remedy in this respect (see this link for an article by John Ratey for Harvard Health).
- By chemical intervention. A series of anti-anxiety and antidepressant medications are available on prescription (see this link for a brief tour of medications for generalised anxiety).
APPROACH #2 – THROUGH THE MIND
Background anxiety inevitably interacts with our thought processes. It’s a two-way system. Felt anxiety informs our thoughts, and our thoughts then re-inform our anxiety. We can either get more anxious in a vicious circle, or get less anxious if we can change the cycle.
Therapies differ in approach. Here are a few examples of mental therapies which can help over time:
- PERSON-CENTRED THERAPY (see this link for a description). Here, the therapist offers a warm, equal relationship where the client can develop their authentic self.
- PSYCHODYNAMIC THERAPY (see this link for a description). Here, the therapist helps the client to develop insights about their patterns of behaviour. In particular, the client may come to see how they are using inefficient defence mechanisms (such as denial or rationalisation) to cope with life.
- COGNITIVE BEHAVIOURAL THERAPY (see this link for a description). Here, the therapist helps the client to eliminate negative thought patterns, often by trying out new activities, or thought patterns, and reporting back any improvements.
If you prefer a warm, friendly approach, then person-centred therapy may be for you. If you like to analyse yourself, and are happy to delve into your past, then a psychodynamic approach may be for you. If you like a good practical project, and prefer to try out techniques rather than dwell too long on analysis or relationships, then CBT may be for you.
A good integrative therapist will be able to borrow the best of each approach, and adapt it to the client.
WHICH IS BEST – EXERCISE, MEDICATION OR THERAPY?
TRY EXERCISE FIRST
Exercise is probably the easiest thing to try first. It’s low risk, and cheap. A walk costs nothing. Running costs the price of a good pair of trainers and some running gear. Cycling costs the price of a bike. Gym memberships are also relatively cheap these days.
We can build some exercise into your daily routine, and see how we go. The health benefits are well-researched and well-evidenced.
TRY THERAPY SECOND
For background anxiety, a course of therapy may be a good option before looking at medication. If it works, then we have avoided the need to use chemical intervention, and the techniques developed in therapy can last a lifetime. A disadvantage can be the cost; but health services often provide a certain number of sessions for free, and some services offer concessions.
TRY MEDICATION THIRD
If neither exercise, nor therapy, seem to be working, then perhaps look at chemical intervention. Medication is very common – around 10% of individuals receive antidepressants in the UK and US. It can take a while to find a medication that suits, and then to find a dosage that suits. It can be a bit hit and miss. And most drugs have some side effects.
Exercise, therapy and drugs are not mutually exclusive, though they do affect each other. A good therapist will take into account what drugs you are on.
Also, although I have talked about three main approaches, there are plenty of others, such as journalling, travelling, changing social environment, investigating religions and philosophies, financial changes, employment changes, enlisting social support services… life is a journey, and there are a huge number of factors which affect us.
Most importantly, it is your life. Take good advice, but at the end of the day there is no shame in self-care. Try not to suffer alone. Whether you talk to friends, your GP, or a good therapist, try to reach out.