Breaking the cycle of anxiety
For a long time, I have had difficulties with anxiety. A few months ago, I came across some useful information that has shifted my own view of anxiety, and since then, my anxiety symptoms have been cut at least in half (without medication). Though I still sometimes feel anxious, I no longer consider anxiety a problem in my life. So I would like to share my new way of thinking about anxiety and how to recover from it, with the hope that it's helpful for others.
Here's a summary of the mental model that has helped me overcome anxiety:
Anxiety consists of some stimulus followed by the activation of the body's fear response. The stimulus is often the occurrence of a thought (like "What if I shouldn't have sent that text message?"), but can also be a situation (like seeing someone you feel uncomfortable around). In a person with anxiety, the body's fear response is hypersensitive, causing it to arise in situations where it is not useful or needed. This means that when I feel physical fear, it's not a reliable indication that there's something I need to do. It's like a faulty alarm.
The thing that perpetuates anxiety is the way we react to fear. When fear arises, it's very natural to try to make the fear go away somehow. For example, if I'm afraid I said something dumb in a text message, I might ask a friend for reassurance to make me feel better. This kind of action may bring temporary relief, but it essentially tells your body "Hey, great job alerting me to this threat, I took care of it now! Be sure to alert me again next time in this exact same situation!" This process seems to be at the root of the cycle of anxiety.
Correspondingly, there are two main ways I think about treating anxiety:
Addressing the hypersensitivity of the fear response directly through physical means
Changing how I react to the fear response when it arises
I believe the second point is the most important one, and it's what I'll focus on first (and most), but I will discuss some of the things I've done to directly alleviate physical symptoms of anxiety towards the end of the article.
Changing how we react to the fear response
The key to breaking the cycle of anxiety is to change how we react to the fear response when it arises.
If taking actions to alleviate fear quickly is what perpetuates the anxiety cycle, then the way to avoid perpetuating the anxiety cycle is to avoid engaging in such actions. In other words, to break the cycle of anxiety, you must allow yourself to feel anxious and uncomfortable in the face of uncertainty without feeling compelled to do anything about it. I've done this, and even though it can be quite painful, I've seen that over time, it works.
One way you can think about the fear response is like an annoying kid on the block who keeps coming up and asking you for candy. If you give the kid candy, he'll go away, and you'll feel better for a second, but the kid is DEFINITELY coming back for more candy. And as he gets older he's going to get hungrier too! Until soon, you're going broke feeding this kid candy. But at least giving him candy gets him to go away for a while!
The way to get the kid to stop coming back is to quit giving him candy! You'll have to deal with his pestering for longer at first, which will be annoying, but eventually he'll be like "Okay fine I'm gonna go play video games" and run away. And he'll still come back later, until he realizes he's not getting any more candy from you, and then maybe he'll just wave from time to time or only come back to you if he's literally starving and actually needs food to survive.
What does this actually mean in terms of how you respond to anxiety? I can give an example from my own life. A lot of times if I had a good first date, I would get quite nervous after, feeling like "I can't mess this up". So then afterwards if I sent a text message to the person I went on a date with to ask them out, and they didn't respond quickly, I'd start to feel quite fearful that maybe I did something wrong.
This initial rise of the fear response is the kid coming to ask for candy.
So what would I do in response? I might try to convince myself that what I said is totally reasonable and that if it was the wrong thing to say, too bad, there are other people out there to date. (Here anxiety, have some candy.) And if that didn't work, I might text a screenshot of what I said to a friend, saying "This is reasonable right? I didn't say anything wrong?" and they might give me reassurance that would make me feel better. (Wow, anxiety, you're hungry today, have more candy.) And then if I didn't hear back from the person for a while and I was STILL anxious I might send a follow up text like "No pressure though if you're not free this week!" or something. (Please anxiety kid, skidaddle, here's my wallet.) And this whole time I might be checking my phone frequently to see if the person texted back.
Any of these things might at times make me temporarily feel better by giving me some semblance of control or certainty in what's fundamentally an uncertain situation, but they're effectively telling the fear response that it did its job, and encouraging it to come back again later. So these behaviors actually serve to continue the cycle of anxiety.
So what could I do instead if I feel fear after texting someone? Basically, what I've done is to avoid these behaviors as much as possible. If I notice myself wanting reassurance, I don't ask for it. If I notice that I'm wanting to check my phone, I don't let myself do it. Sometimes if I'm really wanting to ask for reassurance from a friend I'll set a timer for 15 minutes and say, "If I'm still really needing reassurance in 15 minutes, I can ask, but for now I'm not going to worry about it."
If you're like me, this sucks to do. It feels like shit to do nothing while your body is yelling at you that something is very wrong and you need to do something about it. It's so tempting to give in and ask for reassurance or to check your phone or send a follow up text. But if you do any of these things, your body never learns that the fear will go away on its own, without you having to do anything about it. So even though it sucks to do, I've stuck with it, and over the past few months of doing this, my anxiety around texting (and basically everything else) has gone way down. The fear response comes up less frequently and less severely, and when it does come up, it doesn't bother me as much.
Of course, there have been times where I've given in and asked for reassurance or talked with a friend about something. And I don't beat myself up about that. I've found that if I think of this in all or nothing terms like "I CANNOT GIVE IN" then it actually makes it harder and more tempting to give in. So I find that the important thing is really just to have this model in my head - that giving into these behaviors can encourage the anxiety cycle and that I don't have to do anything to make anxiety go away - and that allows me to do what I can to refrain from behaviors that aren't helpful for me, and over time, they become less and less tempting.
As an additional note on the example about texting, people might think that convincing yourself that your text was reasonable is a pretty natural thing to do and a normal way to reassure yourself. It's definitely a natural thing to do, and if it just kind of happens on its own, that's no problem. But what I've come to realize is that just like there's no way you can convince that annoying kid that he doesn't want candy, there's no way to convince yourself not to be anxious. It's fundamentally a physical response that has been learned by your body, and the only way your body will unlearn that response is by actually experiencing anxiety, not engaging in the usual responses to get rid of it or solve the problem it's telling you to solve, and then finding out that you didn't die after all. What this also means is that you really can't get over anxiety by avoiding it, either.
That's not to say that you need to run and expose yourself to all the things you're afraid of at once. Let's say you have some common triggers for your anxiety and some are more extreme than others. If you go straight to trying to do the thing that gives you extreme anxiety, it may be too overwhelming and actually make that thing even more anxiety-inducing in the future. So it's important to start this process of recovery with things that are a bit more manageable. This is how exposure and response prevention works. Though I've never done it formally and have no affiliation with NOCD, reading their articles was the turning point in allowing me to deal with my own anxiety, and I definitely recommend reading about exposure and response prevention even just for general anxiety. In fact, most of what I'm saying here is straight out of the ideas behind exposure and response prevention.
Also, though I'm saying that it's important to be able to allow yourself to feel anxiety without necessarily having to respond to it, I do think there's a few physical techniques that can be useful for taking the edge off in certain cases, especially if your fear response is extreme. I think it's probably important not to apply these techniques obsessively, since then you end up giving anxiety candy again (and reinforcing your fear of anxiety), but if you can do it selectively, I think it can overall reduce the amount of time you're spending with an activated fear response, which can in turn decrease the ease with which the fear response arises in the future. For instance, I came across vagus nerve reset exercises a little while ago and I've found them really helpful to take the edge off anxiety in certain social situations as well as to check in with a feeling of safety/relaxation. There are a million things people recommend for this kind of thing - deep breathing, etc. but doing the exercises in this video was the first thing that really seemed to basically bypass my brain and make my body tap into a state of sleepy relaxation. The first time I did it, my stomach was hurting from stress, and doing the exercises made the pain go away almost entirely. (Obviously, your mileage may vary.) I'm not saying that you need to do these specifically or that they will work for you, but I do think it can be helpful to have some physical tricks up your sleeve if you can find some that work for you.
Addressing the hypersensitivity of the fear response directly through physical means
Though this article is mostly about what to do about the fear response when it actually arises, there are also things you can do to make the fear response less likely to arise in general. There are a lot of articles about this - sleep more, exercise more, eat healthy, etc. It can be easy to dismiss these, and not everything is helpful for everyone, and these kinds of techniques have not been sufficient for me in breaking the cycle of anxiety, but I've found that some physical component of anxiety treatment is useful for lowering the baseline likelihood of the fear response occurring.
Here's a high level overview of things that have been helpful for me:
Gradually decreasing caffeine consumption from 1-2 cups of coffee a day to 1/3 of a cup of coffee in the morning (don't go cold turkey - I did that once and it was very unpleasant)
Not drinking alcohol (I have maybe one drink every few months)
Certain kinds of exercise (ones where I have to really push myself seem the best)
Vagus nerve reset exercises. Every morning I have been doing the exercises from a book called Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg. Most of the book is tedious and I don't know if the science behind it is valid, so I skipped most of the text and went straight to the exercises, and I have no idea if this is really doing anything to help me overall, but it does feel nice and the exercises do pretty reliably trigger a felt sense of relaxation. They seem to activate something that makes my body go "It's cool, you're safe now, time to chill" without me having to make any real effort or try to consciously manipulate my emotional state.
Lower caffeine consumption and not drinking alcohol probably have the biggest impact on me.
If you take nothing else away from this article, I'd like you to take away that though recovery from anxiety may take a lot of time and can be quite painful, it is definitely possible and it's definitely worth it. Hopefully what I've written helps, but if it doesn't, keep trying new stuff! Life is an experiment, not a math problem with one solution.