Health – Anxious moments

All Black coach, Steven Hansen, has a great one-liner: “worry is a wasted emotion”. It’s so true – and yet on a daily basis I see patients whose lives are adversely affected by anxiety and apprehension. Some of these are high achievers and public figures. Certainly a professional rugby coach would have more reason than most to be living on his nerves but somehow Steve has found a way to cope with the stress and pressure of that role.

It’s important to understand anxiety as a normal physiological reaction. If you are being chased by a Sabre-toothed tiger (or even just imagining it) your body triggers an appropriate fight or flight response. The sympathetic nervous system cuts in causing increased heart rate and breathing, diversion of bloodflow and energy to muscles, release of adrenaline and cortisol, all of which is designed to increase survival in threatening situations. And it works. My father always claimed he broke the world high jump record when being chased by a bull!

But if this response doesn’t switch off, the person is left in a state of constant hyper-vigilance with unpleasant physical symptoms, decreased immunity and a pervasive feeling of dread. Sometimes this is due to a series of traumas or troubles. I know when I went through a rough time a few years ago I was waking up with a knotted stomach even before I had time to think anything, and then had to battle this feeling all day.

The relationship between our thinking processes and anxiety is complex. Certainly some people seem to be constitutionally prone. “I’ve always been a worrier,” is a common confession in my consulting room. But also the perception of threat is a very socialised construct. If our great fear is rejection by other people then any situation that might lead to this is anxiogenic. I know for some people public speaking absolutely terrifies them, whereas I’m more afraid of going to the supermarket with a list and getting the wrong things!

One’s personal sense of value, resilience, sense of humour, philosophy on life and religious beliefs all impact on the tendency to worry or not. It’s very sad to see people regretting their past and fearing their future so much that they can no longer enjoy their present.

I’m a big fan of supportive counselling for anxiety. A few insights and psychological techniques can be life changing.