Northwest Health | WINTER 2009

Let's say you're worried about finances. Or a family crisis. Or about giving a presentation to a roomful of people. Don't be surprised if you find yourself having a full-blown anxiety attack with symptoms such as shallow breathing, a pounding heart, sweaty palms, and racing thoughts.

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"Everyone experiences anxiety once in a while — it's part of being human," says Jill Birnberg-Perry, MSW, psychotherapist at Group Health Behavioral Health Services. "Anxiety is considered normal if it causes an occasional sleepless night, or some tension in your neck or back. But after taking a few deep breaths, going for a walk, or talking to a friend, you should feel better."

What's not normal, she says, is frequently feeling vulnerable and overwhelmed, and experiencing sleepless nights on a regular basis. Other signs include headaches, fatigue, depression, and patterns of avoidance, such as not paying bills or skipping meetings.

What happens when you're anxious? Your brain assumes you're in physical danger. It prepares you for a "fight or flight" response with a big adrenaline rush. Your breathing becomes shallow, sending less oxygen to your brain. (An oxygen-starved brain is not an effective problem-solving machine.) And your blood goes to your core, preparing you to run away from danger.

Some people can't tell if they're very anxious or actually having a heart attack. "A heart attack causes intense pain, while anxiety is generally uncomfortable and will pass," says Birnberg-Perry. If there's any doubt, call your personal physician or the Consulting Nurse Service, or go to an Urgent Care Center.

Stopping the vicious cycle. The first thing to ask yourself when you start feeling uncomfortable is "Could this be anxiety?" If your answer is yes, try some of these techniques:

• Take some deep breaths. Deep breathing tells your brain it's OK to relax.
• Exercise. Physical activity releases chemicals in the body that improve your mood and give you a "feel good" sensation. "There's a notable difference in our ability to problem solve before and after exercising," says Birnberg-Perry. "When we're feeling empowered and relaxed, we're better able to conquer life's stressors."
• See if getting a massage, acupuncture, or other alternative treatment helps. The Group Health Center for Health Studies is currently studying alternative relaxation treatments for people experiencing stress and worry. These include therapeutic massage, thermotherapy (a gentle heat treatment using heating pads and warm towels), and "tranquility treatment" (which involves music and deep breathing).
• Limit anxiety triggers. Use of alcohol, caffeine, and nicotine may seem like short-term solutions, but can create more problems in the long run. And listening to the news, or reading about what worries you, tends to feed your anxiety. Use discretion.
• Talk to a friend. Anxiety is often reduced when we share our worries, and practical solutions may emerge during the conversation.
• Consider the worst-case scenario. Imagine the thing you fear has actually happened. You'll feel more in control if you go ahead and plan what you'd do afterwards.