Anxiety and CBT


Anxiety is a common problem that we all experience from time to time when we feel stressed or have extra worries in life, particularly when anticipating an important occasion such as a test or medical assessment. When you start noticing more excessive levels of anxiety and worry most days and this persists over a period of time, it may be that you are struggling with something called Generalised Anxiety Disorder (GAD). GAD can have both physical and mental symptoms and can present as mild or severe, depending on the individual and their situation. Some common symptoms of anxiety include:

· worrying excessively, thinking bad things might happen

· restlessness, irritability, and/or difficulty concentrating

· a sense of dread, or feeling constantly "on edge"

· dizziness

· strong, fast, or irregular heartbeat

· muscle aches and tension

· trembling or shaking

· dry mouth

· shortness of breath

· feeling sick, stomach or headache

· insomnia and/or tiredness [1]


Excessive anxiety and the related symptoms can be very unpleasant and distressing. However, we have anxiety for good reasons. This is because throughout human history, we have evolved instinctual responses to protect ourselves from danger. One is commonly known as the fight-or-flight response – an automatic reaction to a potential threat in the environment, whether it is physical, emotional, or psychological. Hormones such as adrenaline and cortisol are released during a fight-or-flight response [2], triggering an increase in heart rate, blood pressure, and breathing rate, which provides the body with energy to tackle the threat [3]. The fight-or-flight response has been helpful in human survival throughout history by facilitating a rapid response to danger, however in the modern day it can be counterproductive when triggered by a false threat, causing unnecessary anxiety.


Individuals with GAD are in a state of fight-or-flight frequently or even constantly, and often feel anxious about a wide range of situations and issues rather than just one specific event. This becomes a problem that needs to be addressed when it affects the ability to live life normally, for example if anxiety is ongoing, intense, hard to control, or out of proportion to the situation [4]. This can disrupt day-to-day life and functioning, as individuals with GAD feel anxious most days and often struggle to remember the last time they felt relaxed [1]. Experiencing the symptoms of anxiety every day can lead to social withdrawal as a way of avoiding feelings of worry and dread. This can make it difficult to go to school or work, meaning those with GAD are likely to take more time off work than the average individual [1]. However, avoidant behaviours like this can lead individuals with GAD to become more self-conscious and worried about socialising, creating a cycle of anxiety where anxious thoughts, feelings and behaviours are exacerbated by one another. It can be extremely difficult to break out of this cycle, especially when there is no clear identifiable root or cause. This is why it is important to seek professional help with recognising and understanding the source(s) of anxiety, as well as the symptomatic responses to these sources.


Developing an understanding of the way in which this cycle develops is the first step in a common treatment for anxiety called Cognitive Behavioural Therapy, or CBT. This is a talking therapy based in the knowledge that thoughts, feelings, and behaviours are interconnected and dependent on one another. This relationship is represented visually in the image below:


CBT helps with anxiety as it aids the individual in recognising unhelpful patterns in thoughts, feelings, and behaviours by breaking bigger problems into smaller components. The individual works together with the therapist, focusing on current problems and learning how to deal with them in a more beneficial way. For example, the therapist may encourage the individual to keep a journal in order to assess current life situations that may be contributing to their anxiety. Having a physical record makes it easier to spot negative or unhelpful patterns in thoughts, feelings, and behaviours that may arise in response to a particular situation. From here, the therapist and the individual can break down the patterns in order to understand how they are problematic. The therapist will often tailor their approach to their client’s specific situation and their therapeutic goals by providing them with some new skills and tools that can be used both in and outside of therapy. This might include learning to challenge worries, or to find ways to disengage from negative thoughts or test them out in order to develop more balanced ways to think, which in turn can reduce anxiety.


By learning new ways to manage and cope with anxiety, CBT provides the individual with the ability to independently incorporate positive changes in daily life to tackle and overcome unhelpful patterns that contribute to their anxiety. This makes CBT effective because even once the course of therapy is completed, the client is equipped with more balanced and constructive skills and understanding that can be used to face future challenges. In order for CBT to be effective, the individual must be willing and committed to learn about and confront their emotions while working with the therapist to make positive changes to their thoughts, feelings, and behaviours. Although everyone responds to therapy differently, CBT has been proven to be effective in treating anxiety, as well as improving quality of life in anxiety patients [5].


Here at Surrey Therapy Practice, we have a team of experienced professionals who offer a range of treatments for anxiety, including CBT. Many of our team members use an integrative approach to tailor their treatment plans to specific individual needs. Get in touch and make an enquiry here.


References:

1. https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/

2. https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/

3. https://www.verywellmind.com/what-is-the-fight-or-flight-response-2795194#toc-what-happens-during-the-fight-or-flight-response

4. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/anxiety

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/