Anxiety – Fight or Flight (or Freeze) Response

Anxiety is an emotion we get when we think about potential future dangers and threats.   So thinking about the possibility of something bad happening.   Fear is an emotion we get when we perceive direct, immediate threats.   Fear and anxiety can be both viewed as survival emotions and emotions we get when threatened and in danger.

The Fight or Flight response is the body’s way of responding to threats and being in danger.    When a threat is detected, the amygdala (reptilian brain)  whose primary function: to keep you alive fires the danger signal and the body releases the hormones cortisol and adrenaline, which trigger the sympathetic nervous system and the fight or flight response.   This is an automatic process and causes lots of bodily changes that are good for survival:

- Freezing, hiding and 'playing dead.

- Running away (taking flight).

- Fighting or acting aggressively.

Helpful Anxiety vs Unhelpful Anxiety

We could not have survived without this response.   When we were more primitive people, we had various physical real threats that we had to fight and runaway from.   Our brain is incredibly well evolved for detecting threats and setting off your fight or flight response to keep us safe.   Anxiety is not bad, it can be productive.   Anxiety is our way of preparing to meet the challenges posed by these threats.   A certain amount of anxiety helps us to be more alert and focused.

However, the fight or flight can be unhelpful in modern times, as it can be triggered by non-threatening situations and by psychological threats.   As modern humans we can think of future & imaginary dangers.   Your brain isn't very good at telling the difference between real threats in the world vs. imagined threats that you are just thinking about.  

Furthermore, your brain operates on the better safe than sorry principle.   It would rather set off ten false alarms than miss one real danger.   This means that we are prone to suddenly feeling afraid, even when there is no real danger.   Additionally, after the threat is gone, it can take between 20 to 60 minutes for the body to return to its pre-arousal levels.

Anxiety & Thoughts – Anxiety Equation

Anxiety problems can develop through the way we think. We  can often interpret things to be more dangerous and threatening than they really are. The anxiety equation can help show how we get anxious. Someone will become anxious if they overestimate the risk of threat and underestimating how they will cope with the threat.

Anxiety Equation

                          How likely the threat will happen and how awful the threat will be?   (We tend to overestimate the risk of threat)   

   Anxiety =                                                                                                                                                                                               

                                       How will I cope with the threat if it happened?   (We tend to underestimate our ability to cope)

Anxiety & Behaviour – Safety Behaviours.

Anxiety problems can develop through our behaviours and the way we act.   Safety behaviours are actions carried out with the intention of preventing a feared catastrophe.   For instance, when we avoid and escape from situations that make us anxious, it helps reduce our anxiety in the short term.   However, avoidance and escape means that we will just get as anxious every time we confront this fear and in the long term reinforces our fear and anxiety can get worse.

Safety Behaviours

Safety behaviours are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, but in the long-term they are unhelpful because they prevent the disconfirmation of the beliefs that are maintaining anxiety.

What is a catastrophe?

Catastrophes can vary enormously, but tend to be about different kinds of threats to the individual, for example:

• Physical threat - “I’ll be killed”, “I’ll be hurt”.
• Psychological threat - “I’ll go mad”, “I can’t cope”.
• Social threat - “I’ll embarrass myself and never be able to show my face again”, “They will think I’m an idiot”.

What types of safety behaviours are there?

There are three types of safety behaviours:

1. Avoidance – e.g. not going to a feared situation.
2. Escape – e.g. leaving a feared situation.
3. Subtle avoidance, which can include things we do in our minds - e.g.

• distraction - counting in my head during a panic to stop myself from going mad.
• calming my breathing - otherwise I’ll be overwhelmed by my fear and lose control.
• averting my eyes - in case someone picks on me and I’m humiliated.

What are the effects of safety behaviours?

• Short term: In the short term safety behaviours lead to a reduction in anxiety. Any form of escape or avoidance
is often accompanied by a powerful feeling of relief. Relief is powerful negative reinforcer, and once an
individual has learned that a safety behaviour leads to relief they are likely to use it again.

• Long term: In the longer term, safety behaviours act to maintain anxiety by preventing the disconfirmation of
unhelpful beliefs. For example, if someone has the belief “dogs will attack me and bite my face” and avoids
dogs, they don’t get the opportunity to learn that most dogs are friendly, or fail to learn the difference
between friendly and unfriendly dogs.

• Unintended consequences: Safety behaviours often have unintended consequences which can reinforce the
original belief, make the anxiety worse, or lead to other problems.

Relaxation Techniques when Feeling Anxious

Relaxation is allowing physical and mental tension to be released.   When we are anxious and stressed, the fight or flight response is triggered and the body speeds up and gets ready for action.

Autonomic nervous system

The fight or flight response causes tension in our body and the build-up of tension can cause unhelpful bodily feelings, such as headache, backache, tight chest etc.   These aches and pains can cause mental worry, making us even more anxious and tense.

When we relax and calm down our parasympathetic nervous system is active.   Its job is to tell your body that it can take some time to cool down and recuperate.   It helps in relaxing your muscles, lowering your heart rate, replenishing your bodily fluids, and performing many other crucial downstate processes.

Relaxation skills help activate our parasympathetic nervous system, which can help slow down the fight or flight response and help release some of this tension.   Mental relaxation is about calming the mind and physical relaxation is about releasing tension from the body.

There are different relaxation techniques.   They do take practise but practising regularly means we’re better prepared to use it when we are stressed.   The ability to relax is not always something which comes naturally; it is a skill that can get better with practice.

As a adult we can practice these things, however, we will need to guide our children through these processes at different stages of their lives - some are more relevant than others.

Relaxation in Everyday Life

• Slow down.   Stop rushing around – you achieve more by doing things calmly.

• Give yourself short breaks – relax, stretch, go for a walk.

• Adopt a relaxed posture – deliberately relax if you notice yourself tensing up.   Drop your shoulders, sit back in your chair, and unclench your fists.

• Inject pleasure and treats into your daily routine.

Anxious Breathing

Research shows that different emotions are associated with different forms of breathing. Consequently, changing how we breathe can change how we feel. 

When we’re anxious, our breathing becomes shallower and quicker due to the fight or flight response.   Breathing faster will activate our sympathetic nervous system (known for being in control of the fight or flight response) and keep the fight or flight response active.  However, slowing down our breathing sends signals to our brain to slow down the fight or flight response (e.g., reduce heart rate, blood pressure, and muscle tone) and activates the parasympathetic nervous system (known for being in control of the rest and digest response).

Anxious over breathing (hyperventilation) can result in more uncomfortable sensations. When we hyperventilate, it causes an imbalance of oxygen and carbon dioxide in our blood.

Slow Deep Breathing

To slow down our breathing, we want to make our out breath, longer than our in breath.  This helps rebalance O2 and CO2 levels in our body. Breathing out longer means we are breathing out more CO2 and breathing in less O2, which helps balance out the levels in our body.

Quick And Easy

Ensure the ‘out breath’ (through the mouth) is longer than the ‘in breath’ (through the nose). Pause between breaths. For example, breathe in through nose (count 4), hold (count 2), breathe out through mouth (count 6), pause (count 2).

Belly Breathing

Deep breathing is far more effective when we are using our diaphragm, sometimes referred to as Diaphragmatic, or Belly Breathing.

1. Put one hand on your belly just below your ribs and the other hand on your chest.
2. Take a deep breath in through your nose, and let your belly push your hand out. Your chest should not move.
3. Breathe out through your mouth. Feel the hand on your belly go in and use it to push all the air out.
4. Do this breathing 3 to 10 times. Take your time with each breath.

Colour Breathing

• For a fast and effective calming technique in a stressful situation, visualise breathing in that blue calm and breathing out red tension.

Links

• Box Breathing relaxation technique: how to calm feelings of stress or anxiety
• The 5-4-3-2-1 Method: A Grounding Exercise to Manage Anxiety
• Mindful Moment #2: Five Finger Breathing

Progressive Muscle Relaxation

Progressive Muscle Relaxation (PMR) is a method that teaches you how to relax your muscles It can help reduce overall tension and stress levels and help you relax when you are feeling anxious.   People with anxiety difficulties are often so tense throughout the day that they are unable to recognise what being relaxed feels like.   Progressive Muscle Relaxation teaches you to distinguish between the feelings of a tensed muscle and a completely relaxed muscle.   You can then begin to “cue” this relaxed state at the first sign of muscle tension that comes with anxiety.

Find a comfortable place to sit or lie down, then close your eyes, and let your body ‘go loose’.

• Take five, slow, deep breaths.
• Apply muscle tension to a specific part of your body, your left hand for example.
• Take a slow deep breath and squeeze the muscles of that body part as hard as you can for about 5 seconds.
• Then let all the tightness flow out of the tensed muscles, exhale as you do this. Feel the muscles in that part become loose and limp as the tension flows out.
• Make sure you deliberately notice the difference between these two states.
• Repeat step one, then step two, with each muscle groups (hands, arms, shoulders, neck, mouth, eyes, forehead, chest, stomach, buttocks, legs, and feet).

Mindfulness

Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgementally.   Mindfulness is about being present in the moment, really paying attention to our senses. So, what am I seeing, hearing, smelling etc?   If we are in more control of what we attend to, then this will have big effects on our wellbeing.

Practising mindfulness helps you:

• to be fully present, here, and now
• to become less judgmental
• to increase self-awareness
• to become less disturbed by and less reactive to unpleasant experiences
• to have more direct contact with the world, rather than living through your thoughts
• to experience more calm and peacefulness

There are a number of useful Mindfulness resources available online:

• http://www.getselfhelp.co.uk/mindfulness.htm
• http://www.freemindfulness.org/download
• Apps: Headspace, CALM

Imagery

Imagery can help us take us away from our thoughts and go to a relaxing place in our mind. All visualisations can be strengthened by ensuring you engage all your senses in building the picture in your mind's eye - it's more than just "seeing"!

• Start by getting comfortable in a quiet place where you won't be disturbed, and take a couple of minutes to focus on your breathing
• Imagine a place where you can feel calm, peaceful and safe. It may be a place you've been to before, somewhere you've dreamed about going to, somewhere you've seen a picture of, or just a peaceful place you can create in your mind’s eye
• Look around you in that place, notice the colours and shapes. What else do you notice?
• Now notice the sounds that are around you, or perhaps the silence. Sounds far away and those nearer to you. Those that are more noticeable, and those that are more subtle.
• Think about any smells you notice there.
• Then focus on any skin sensations - the earth beneath you or whatever is supporting you in that place, the temperature, any movement of air, anything else you can touch.
• Notice the pleasant physical sensations in your body whilst you enjoy this safe place.
• Now whilst you're in your peaceful and safe place, you might choose to give it a name, whether one word or a phrase that you can use to bring that image back, anytime you need to.
• You can choose to linger there a while, just enjoying the peacefulness and serenity. You can leave whenever you want to, just by opening your eyes and being aware of where you are now and bringing yourself back to alertness in the 'here and now'.