3rd week: regulating severe anxiety

Anxiety and alertness

Fluctuations in alertness are associated with anxiety. When a person is in an optimal state of alertness, they are within their window of tolerance, so to speak. In that state, it is easy to be social, playful and creative. Stress can cause the person’s state of alertness to increase beyond the window of tolerance into hyper-arousal. Stress boosts our activity and can thus be useful in reasonable doses. The increased alertness brought about by stress can manifest itself as physical restlessness, difficulties with keeping still, an elevated heart rate and difficulties with falling asleep. Some people experience increasing anxiety as their level of alertness increases.

Usually, the body and the mind return from hyper-arousal to the window of tolerance spontaneously. Sometimes, long-running stress can cause a persistent state of hyper-arousal, resulting in issues such as sleep difficulties, anxiety and physical symptoms. This can also be caused by an underlying innate or trauma-based sensitivity to neural activation.

When stress continues for a long time without sufficient recovery or when the person perceives a threat as extreme, their level of alertness can drop down into hypo-arousal. In the animal world, prey animals freeze or go into suspended animation in situations in which they are unable to flee their predator. This state can fool the predator, but is also a way to alleviate physical pain. People can also use freezing as an extreme survival mechanism. Events such as traumatic experiences often involve dissociation, whereby the person’s mind “exits” and they may feel like they are outside their own body, for example. Long-running hypo-arousal is often associated with depression.

We have different levels of arousal: hyper arousal, optimal arousal and hypo arousal.

You can influence your state of alertness

We can learn to influence how quick we are to become hyper or hypo-aroused, as well as how well we are able to return to our window of tolerance, through conscious practice. One important step in the regulation of alertness is strengthening our self-knowledge. This involves the ability to identify how easily our alertness fluctuates, what are our own signs of hyper and hypo-arousal, and what things can cause our alertness to increase or decrease. Accordingly, this self-care programme focuses on our own anxiety symptoms and sources right at the beginning. Another way to increase self-knowledge is to increase our body awareness, which we will tackle next week.

Last week, we examined the connection between breathing and anxiety. We can regulate our breathing to affect both hyper and hypo-arousal. When we are feeling hyper-aroused, we can calm both our body and our mind by lengthening our exhalation. Long exhales activate the parasympathetic nervous system by sending a message that there is no threat. We can tackle hypo-arousal the opposite way; by lengthening our inhalation. Long inhales are connected to the operation of the sympathetic nervous system (cf. excessive breathing).

Try this: Do the finger exercise above for a moment. How does it affect your alertness? Next, do the finger exercise in an opposite way: inhale while drawing an S figure upwards, and then bring your finger straight down when exhaling. How does this affect your alertness?

Sometimes, the anxiety brought about by hyper or hypo-arousal is so intense that regulating your breathing is not enough. Below are various physical exercises and eye movement exercises that can help you regulate severe and extreme anxiety. Combining different methods is also often called for when you are experiencing particularly severe anxiety. When you are outside your window of tolerance, it is important that you not only utilise these methods and breathing regulation, but also increase your sense of security through suitable means, learn to ease up and seek to connect with people important to you and your environment.

Exercises for the week

We hope that this week’s section has provided you with tools for regulating severe anxiety. In the coming week, reserve some time for doing this week’s exercises every day and record them in the monitoring form:

  • Finger breathing
  • Intense physical exercises: calf pump, sitting against a wall, pushing the wall, plank, etc.
  • Eye movement exercises: drawing an X and a lying figure eight
  • Combining exercises