Dr. Hanscom's Blog Anxiety is the Pain

Objectives:

• Anxiety is the sensation generated when you feel unsafe, and your body’s chemistry is stimulated into a fight or flight state.
• It is physiological state and not primarily a psychological one. It is not subject to rational control.
• Anxiety indicates danger and is the pain. It is intended to be unpleasant enough to compel you to act – to survive. It is also necessary and there is no use in trying to get rid of it.
• Being in a threat state is critical for survival but prolonged periods of time in this condition damages the tissues of your own body.
• When your stresses overwhelm your coping capacity, you’ll go into threat physiology and develop various mental and physical symptoms.
• You can lower anxiety by learning skills to lower the levels of these stress hormones and inflammatory markers.

Every living creature on this planet survives by your nervous system processing sensory input from your environment that is transmitted vis the body’s sensors and immediately regulating your internal functions and behaviors to keep you safe. All of the sensory inputs are constantly competing. There is nothing inherent in your eyes, ears, skin, stomach, etc. that indicate safety versus threat. It only by the nervous system interpreting the data that we understand, catalogue, and navigate the world around us. It is your brain that allows you to “feel.”

So we must first avoid threats and secondarily, seek safety to allow the body to rest, regenerate and propagate the species. At this basic level humans are no different than any other species of living organisms. Most of the time, we exist in a neutral zone by being unconsciously directed to avoid potential discomfort before feeling more intense avoidance cues. This “navigation” process is called the nociceptive system.

How does your body react to threat?

The three aspects of processing your surroundings are 1) the input (stresses) 2) the state of your nervous system (calm or hyperactive) 3) the physiological response (output). Physiology is the term used to describe your body’s functions as opposed to the structure. Your body exists one of three states, and all are necessary.

• Homeostasis – neutral where your body’s demands are adequately met with enough energy, and you remain in balance. This state can be maintained indefinitely.
• Safety – Your body is in a state of “rest and digest” where your reserves are built up to deal with the inevitable threats.
• Threat – The threats are both mental and physical and are similarly processed in the brain. This state is necessary to remain alive, but the goal is to use it only when required.

Under threat, hormones are secreted that increase your chances of survival. Some of the core ones are adrenaline, noradrenaline, endorphins, histamines, and cortisol. The net result of these hormones is an increased capacity to flee from danger. This is modulated through the autonomic nervous system, which results in an increased heart rate, rapid breathing, increased fuel supply, dilation of certain blood vessels to your muscles, and constriction of blood flow to your brain, bowel, and bladder. Every aspect of it is intended to maximize your chances of survival.

Another aspect of the survival response is stimulation of the immune response, which is largely mediated by small communicating proteins called cytokines. These are inflammatory cytokines in contrast to anti-inflammatory ones produced in the presence of cues of safety. This immune/ inflammatory reaction affects every cell in your body. The problems arise when it is sustained. The results are devastating. Essentially, all chronic mental and physical disease is caused from long-term exposure to inflammation and elevated metabolic activity. Your body is being attacked by your own cells.1,2,3

Humans call it anxiety

The sum total of all of these inflammatory/ elevated stress chemicals is a strong unpleasant feeling that compels us to take action to resolve the threat. All animals experience this heightened state, but humans have language and consciousness. We label it. This feeling of dread is what we call anxiety. It is so deep and uncomfortable that there is no choice but to act. Once the threat is gone/ resolved and the body is back in balance (homeostasis), you can go on with your life.

Anxiety is just a word that describes the cumulative sensations caused by threat. It is not the cause of a threat. It is symptom, not a diagnosis, disease, or disorder. Therefore, it isn’t treatable by addressing it as a primary psychological problem.

So, anxiety is incredibly unpleasant, powerful, and we need it to survive. We’ll do almost anything to avoid or escape it. Essentially, anxiety is the pain. It is not subject to rational control, and we waste a lot of energy trying to solve it or fix it. You’ll learn that developing a “working relationship” with it is much more effective.

Anger = anxiety

The basic intent of anxiety is to cause you to act in a manner to diminish a threat (control) and move on. When you can’t escape a mental or physical threat, your body will secrete more stress hormones and inflammation in order to increase your chances of survival. The sensation generated through this process is anger – anger is anxiety with a chemical kick. They are the same entity. Anger is even less subject to rational interventions.

Anger and anxiety are necessary survival reactions that are out of our conscious control. So, how do you lower anxiety? There are many ways, but the answer is that you lower the levels of stress hormones and inflammatory markers.

What can you do?

When you stresses overwhelm your capacity to cope with them, your body to into a threat physiology that creates physical and mental symptoms. It has been demonstrated the type of stress that is the most damaging is chronic low-grade stress. Besides, the stresses that have the most impact on your health and quality of life are those that you cannot control.

The DOC Journey will teach you skills to better navigate adversity so as to minimize your time being exposed to the threat physiology of stress hormones and inflammation. The tools work on different aspects of your processing your environment – input, nervous system, and output. It is one thing to read and hear about the skills but another to master them. Regular practice is critical in order to make them automatic. You are not going to learn to become an accomplished pianist by reading books.







Minimize your time in threat

You can shorten the amount of time you spend in threat physiology focusing on three different aspects of the development of symptoms.

• You can directly lower this stress reaction with tools that stimulate the vagus nerve (10th cranial nerve of the midbrain), which is powerfully anti-inflammatory. Examples are breathing techniques, humming, certain pitches of music, rubbing your forehead.
• The nervous system can be retrained to be less reactive. ACT (Acceptance and Commitment Therapy) teaches you to be with your pain instead of running from it. Paradoxically, as you pay less attention to these circuits, they’ll atrophy from disuse. Sleep, diet, and exercise also help calm the reactivity of the nervous system.
• Finally, it is only logical that what you upload into your system, will translate into one the three states of safety, neutral, or threat. There are two categories to consider.
  • What are you choosing to upload into your brain? Not discussing your pain or medical care, avoiding violent movies, no gossiping, complaining, or giving un-asked-for advice is important. Also the expressive writing, cognitive behavioral therapy (CBT), mindfulness, and some meditations change the sensory input.
  • What are you holding onto is dealt with by understanding that forgiveness is an ongoing dynamic process, and it is not what you might think.

The DOC Journey will continue to teach you skills to better deal with adversity. You’ll spend less time in threat, your quality life will improve, symptoms will resolve, and with practice, most people learn to thrive.







Recap

Physical and mental symptoms are created when your stresses overwhelm your capacity to cope with them. Your body will go into a defensive threat physiology, which is damaging when it is sustained. Humans call this state anxiety, and it is a physiological issue that is powerful and not subject to rational control. You can lower anxiety by learning skills to lower these stress chemicals. In other words, you’ll develop tools to better deal with adversity.

References:

1. Song, H, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA (2018); 319: 2388-2400.
2. Torrance N, et al. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain (2010);14:380-386.
3. Rahe R, et al. “Social stress and illness onset.” J Psychosomatic Research (1964); 8: 35.

References:

1. Song, H, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA (2018); 319: 2388-2400.
2. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
3. Torrance N, et al. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain (2010);14:380-386.
4. Rahe R, et al. “Social stress and illness onset.” J Psychosomatic Research (1964); 8: 35.

Related posts:

1. Anxiety is the Correct Name for Pain
2. Principles of Solving Chronic Pain
3. Anxiety Basics

 

This is very helpful information.