Anxiety and the fight flight response, a quick guide

Anxiety – it can be tricky.

Below is a quick and basic guide to addressing long term anxiety.

For a deeper dive on Anxiety [Link]

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It starts with some CBT (Cognitive Behavioural Therapy), where we look at a combination of the thoughts and behaviours around the triggering things, in this case emails.

If there are only a few triggering things, then you may have had an adverse event that has led to a heightened response to things that seem similar to that bad event. We can do some de-escalation and mood regulation exercises around those triggers to take the power out of them so that you can overcome that fight / flight response.

If there are a few more triggers than can be explained by a simple adverse event or two, then we need to look at some of your boundaries around people. This is often around when it is fair that someone is angry versus when it isn’t, and what your share of responsibility is towards that person who may or may not be justly angry. These core values may need some tweaking if they are set to “self sabotage” mode. That combined with some of the de-escalation and mood regulation, reinforced with boundary ascertion, possibly getting away from toxic environments, and some timely mantras to remind you that you have rights as much as they do often does the trick.

If this fight or flight response feeling is pervasive, then either we are dealing with a trauma response (PTSD style) or a neurotransmitter imbalance.

PTSD style first.

If you know the traumatic event(s) that created this anxiety, and your anxiety doesn’t pre-date the traumatic event, then we can do some trauma therapy around this. Trauma therapy has a few parts:

– ensuring the neurotransmitters are okay; which might mean some medication, exercise and dietary adjustments to correct

– mood education; so you can understand what your feelings actually are and are actually trying to tell you – and importantly when they are wrong

– mood regulation skills; to get your mood back under control so that your mood informs you and you choose your actions, rather than your actions are chosen by your mood

– understanding toxic behaviours and how they can manipulate you

– and finally, if and when you have a good handle on all of the above, stepping through what you know of the traumatic memories, mapping out timelines, separating facts from story, decompressing events and working out what the event(s) mean to your older you now vs your younger self

* sometimes even then the event(s) are too stressful to process directly, so we can use a distraction method to decrease the feeling of intensity such as eye movements, textured items, building lego objects, drawing and so on

If you can’t remember the trauma, then it isn’t trauma.

If the anxiety predates trauma, or isn’t explained by trauma, then we are looking primarily at neurotransmitter problems. That often starts with SSRI medication. If SSRI’s don’t give an adequate relief, likely switching to SNRI or a Beta Blocker medication depending on certain traits/symptoms. If that doesn’t work, then a more comprehensive assessment needs to occur to figure out what is going on, which exceeds what this quick guide can do.

Importantly, while SSRI is often a good place to start, it isn’t the end of the medical line; just often the end of what the GP is likely to trial. At that point you really want a therapist who is informed about medication and probably a psychiatrist. This will help work out the actual likely diagnosis for mental health and the likely medication that will help that medical problem.

Biological problems require biological responses. You can’t will power your way through diabetes, heart conditions or neurotransmitter irregularities.

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