“It’s funny because I’m not an anxious person,” I muse to my therapist on the idiosyncrasies of my mental health. In many ways, it’s true; at school I never got nervous before exams, and I don’t break a sweat at the thought of public speaking and I’m painfully laid back about timings. And yet, I have panic disorder and OCD, conditions which are inherently centred around anxiety.
“Everyone is an anxious person, because everyone experiences feelings of anxiety. Anxiety forms part of the fight and flight mechanism that enables us to survive,” my therapist replies. She explains it’s like someone who “isn’t an angry person” but then lashes out at a seemingly mundane moment. If we don’t properly deal with our feelings, they’re probably going to manifest in unhealthy ways.
So, how do we know when anxiety is good, and when it is bad? According to experts, it’s all in how we perceive and react to certain situations. "There is a difference between healthy anxiety and unhealthy anxiety, which is determined by our cognitive and behavioural responses," explains Dr Monica Cain, Chartered Counselling Psychologist at . Healthy anxiety is a physical response to a threatening or demanding situation, like an exam or an approaching attacker, and can in extreme cases keep us alive. Unhealthy anxiety, on the other hand, is disproportionate to the situation.
An example of unhealthy anxiety would be what happened to me when I recently boarded a ten hour flight to LA. I sat down next to a woman who looked unwell, but instead of assessing the situation as posing a very minimal, if non-existent threat, my mind began to race with a series of irrational, spiraling thoughts; “She touched my seat when she sat down. What if she left some virus on the seat that now I’ve picked up, and I just touched my face so the virus has probably already infected me.” Followed by contingency planning; “Well I’ll be ill tomorrow and the next day so I won’t be able to attend that meeting so I’ll have to email my editor and explain.” Followed by fatalism, “I’ll probably get fired because I didn’t attend the meeting and I won’t be able to afford living in London anymore so I would have to move back home.” And so on…
Ultimately, unwarranted anxiety can culminate in a panic attack, which can be utterly debilitating. “Acute anxiety symptoms can include an increased heart rate and shakiness,” explains Bupa Health Clinics’ Medical Director, Dr Arun Thiyagarajan. Luckily, my anxiety is now under (some) control thanks to a combination of therapy and antidepressants, and so never mounts into full panic, but it still consumes an awful lot of my brain power. Whether it’s over-analysing social situations, or catastrophising a bad decision, it means that I’m not actually present in the moment for a huge chunk of the day - instead, I’m lost in thought playing out my worse case scenario future life.
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This understanding of unhealthy anxiety has led many mental health researchers to advocate practices like mindfulness. Before you roll your eyes, mindfulness doesn’t have to mean connecting with how each toe is feeling or appreciating the movement of the air sifting through your nostrils. “Mindfulness encourages you to be more aware of what’s happening without feeling overwhelmed by it. Mindfulness won’t remove the problem, it might not change a situation but it’s a tool that can help you to change your response to it and that’s the key,” says Dr Thiyagarajan.
Plus, it can be even more effective when combined with established therapies like Cognitive Behavioural Therapy, which addresses the way you think and act. “Mindfulness Based Cognitive Therapy (MBCT) is effective as an ongoing relapse prevention tool that helps us remain aware our patterns of thoughts and behaviours as we go about daily life,” says Dr Cain. “This can help us detect earlier the initial signs and signals that may indicate a difficulty emerging. The earlier the detection, the better able we are at responding healthily.” In the case of my cabin freak out, this means recognising my thoughts as anxiety, rather than a reaction to any real threat, and gently bringing my attention back to the facts that surround me - all I know as fact is that I am on a flight to Los Angeles, in a grey and blue seat and there’s a woman in the seat next to me. The state of her health is unconfirmed and totally subjective - any assessment would be a product of my anxiety. She might look ill all the time. She might think she looks great. But it’s certainly none of my concern.