025 Anxiety – Part 2, General Anxiety

Anxiety Refresher

Anxiety is a mechanism our brains use to ensure that we are prepared for an upcoming problem where we may need to switch into the fear’s emergency system – Freeze, Flight and Fight. 

When anxiety works correctly, this is a good thing. It helps us be alert, prepared and able to switch modes effectively. 

When anxiety misfires, we are either stuck in the anxiety mode for too long, or have an anxiety attack. We have covered anxiety in a whirlwind tour earlier – link below.

Today we are going to talk in more detail about the General Anxiety feeling – that is, the anxiety you may feel at a general level and the frequent anxiety attacks that may occur.

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General Anxiety

Some specific anxieties can be social – where you are anxious around people; phobia, where you are anxious around a specific thing, or trauma, which is anxiety regarding an experience and events that remind you of that experience.

General Anxiety describes how someone can feel anxious in most places – whether it be the privacy of their own home; or at work/school; or at a peaceful park. The feeling of anxiety is independent of the location.

If you are feeling generally anxious, and it is a recent thing, then you are likely experiencing a reaction to a recent crisis, or responding to a circumstance of stress such as changes at work, disharmony at home and so on. It is important to both do something about the anxiety you are experiencing and the crisis or situational events that are driving this anxiety.

If you have had general anxiety for a long time and it seems independent of a situation that you are in, then you may have a condition called General Anxiety Disorder, often shortened to GAD. 

This is not a diagnostic tool, just a way to help you tell the difference.

General anxiety feels like a pervading expectation of something going wrong and you always feel on the alert. 

  • This can feel like an unspecified premonition or a dark foreboding or just never calming down and relaxing. 
  • Sometimes you are worried about a specific thing, but it has a low probability of occurring, or low probability of it being a big problem
  • or you can’t put your finger on the specific problem, but it is vaguely about *waves* “that”.

Reasons vs Post Justification

It is important to recognise the difference between  a reason to be anxious, and an anxiety feeling we have post justified.

To be blunt, we humans are often terrible at recognising when we have an out of place feeling. We will frequently have an emotional response that we then carefully justify with poor logic and mistake that justification as the trigger or reason.

Consider deciding to purchase milk for breakfast tomorrow. Naturally you go to the store. Upon leaving the store you have both milk and a candy bar. 

Bottle of milk and candy bar
The goal was milk, not candy

The milk was planned, but the candy bar is a spontaneous purchase. We humans will be tempted to explain that we also wanted the candy bar before we went in, or that our blood sugar was a bit low, or some other logical seeming justification for why we purchased the candy – other than it was placed there carefully by the store to inspire impulsive purchases.

We don’t like to admit we got tricked.

We like to think we are rational and logical creatures. We like to be able to trust our brains.

Sometimes our own mind is tricking us.

The Hindbrain and False Alarms

Sometimes our emotions do this. We have a brain fart, feel anxious, then look for a reason to be anxious. We don’t want to admit it was a false alarm. It is far more comfortable than to believe the post justification is real than to accept that we were wrong.

A brain fart is where for some reason your brain does something odd for no good discernible reason.

The false alarm comes from our hindbrain. It’s job is to look at the world and work out our best survival strategy. The hindbrain is a poor communicator and has only two direct ways to tell the rest of the brain what is going on – a feeling and a sense of urgency. The feelings it uses are joy, fear, anger, sadness, disgust, or surprise. The emotion will have a strength component that we will interpret as urgency –  from mild, medium, high and emergency. The hindbrain triggers indirect communication by telling your body to get ready for the freeze / flight and fight reflex, which will release a bunch of chemicals into your bloodstream.

Head with brain, hind brain is highlighted - just above the nape of the  neck
Hind Brain

The stronger the urgency, the less capable we are to think clearly. We become reactive.

Our fear reflex response is tied in with both the fear feeling and the anger feeling, where fear triggers more flight, and anger triggers more fight. The state of alertness and preparation before action is anxiety.

Upon the detection of danger, our brains will give us some default actions, just in case we have no time to consider a better option. The last thing we want to be doing in an urgent emergency is to slowly plod our way through to a solution.

If our hindbrain has actually detected a danger, then this is exactly what we want it to do. 

If it is a false alarm, this can be  uncomfortable, embarrassing or debilitating.

From our hindbrain’s perspective, it is better to give you an embarrassing false alarm than to miss a danger that is actually there, which could risk our lives. Our hindbrain is all about survival, so if you survive, it’s job is successfully done.

Don’t blame your hindbrain for false alarms – it’s doing the best it can, okay? It’s just trying to help, even if it is a bit over enthusiastic!

If you don’t have a history of false alarms, it is fair to assume your hindbrain has warned you of an emergency in good faith. If you have a history of false alarms, then it is time to start getting sceptical about those signals.

As an analogy, consider an over eager smoke detector in the kitchen. You definitely want the smoke detector to let you know when there is a fire. However, if it repeatedly goes off because you are making toast, you are likely to be a little sceptical of it and respond more slowly.

Over eager smoke detector

If it starts to go off because you looked at the bread loaf, it is time to get really jaded.

Ideally you’d replace the smoke detector with a better working one. That is kind of hard to do with our hindbrain. We just don’t have the medical knowledge to do that yet. While we can’t replace it, we can train and tune it.

Training the hindbrain is a three part process

  • Recognise that it is a false alarm
  • Calm the system down
  • Deliberate planning and action

Tuning the hindbrain may require

  • Medication
  • Allowing yourself to sit in discomfort

Training the Hindbrain – Small Loop, Big Loop

The Small Loop aka The Default

A trigger has happened, and you have perceived it. Your hindbrain has analysed this trigger via your memory pool and determined a recommended feeling – in this example’s case, possibly fear or anger. Your hindbrain has also offered a Threat Level Advice in the form of a sense of urgency. Combined this is your Reflex Feeling.

Your Reflex Feeling then prompts your brain to create a Reflex Action. If your Threat Level Advice is Mild or Medium, then your Forebrain, the part of your brain that considers logical options, future desires and makes plans, will consider the Reflex Action, and if all things seems right, it will enact the Reflex Action.

If the Threat Level Advice is High, the consideration of your forebrain will be briefer before doing the Reflex Action, because so far as your forebrain is concerned, a High Threat Level means little time to solve, so quick and easy solutions are prioritised over subtle and considered.

If your Threat Level Advice is Emergency, then often the Forebrain’s response is “just do it’, and bypasses consideration of other options. So far as the Forebrain is concerned, there just isn’t time to consider other options, so this will do! 

Head with brain, fore brain just behind forehead is highlighted
Fore brain

This feels like life and death folks. Don’t think, just survive!

When this works fine, we can live our life reflexively and be quite comfortable. We survived the perceived threat and so we reinforce in our memory pool this solution, speeding up the loop for next time a similar situation occurs.

When this default system is not working fine, then the Reflex Feeling and subsequent Reflex Action can make us look chaotic, over the top and lead to a poor quality of life. We will find ourselves acting poorly and regretting what we did.

Medication

We mentioned medication earlier in regards to PRN medication. While it is nice to be able to retrain our brain without medication, it is also unfair to demonise medication as part of a possible strategy.

Some people will need medication. They may be temporary medications or long term medications.

Medication can be used to override a run away anxiety response where slowing down and calming down without medications is not effective enough. This is generally done via PRN medication, scripted by your health professional.

Medication can also be used to bring a daily calmer state, which can help a person to manage a recent and ongoing situational crisis. When the crisis is over, the medication support is generally no longer needed.

Both of these are examples of temporary medications that may be prescribed to help a temporary or recent situation, and in combination to talking therapies can be very powerful.

There are also situations where it is identified that ongoing medication is required. At this point the general anxiety has the word “disorder” added to it, and is generally not a response to a stressful or temporary situation.

Ongoing medications are most commonly in the SSRI class or SNRI class. 

SSRI means Selective Serotonin Reuptake Inhibitor, SNRI means Serotonin Norepinephrine Reuptake Inhibitor. Generally they are giving you greater access to your own neurotransmitters – the biological chemicals your brain uses to transmit signals – two of the thinking chemicals.

Medication and Stigma

When these medications are prescribed on a lifelong basis, it is easy for people to feel stigma about needing daily medications to be okay.

We do not stigmatise people taking heart medication, or dieabetic medication to be ok. Nor do we stigmatise people for using glasses to read or drive.

Similarly we should not stigmatise people taking brain medications. They are not prescribed because people are weak, or amoral, or lazy. They are prescribed for genuine medical conditions.

Conclusion

This is a very brief look at general anxiety and general anxiety disorder – a type of ongoing or unexpected anxiety you can feel for no specific reason. We have taken a look at something you can do to try to address general anxiety and a brief look at some reasons why medication can help.

This is not medical advice or therapy – but it can be used to help you to get an idea of what might help.

If you are struggling more than this can help, please go and talk to your doctor or therapist.