distress signals

Survival Strategies Part 5:
Coping with Anxiety.

by Survival Expert James Mandeville ©2020
(First published December 2017; revised January 2021)

This article is primarily for:
The General Public, Medical Personal and Military Personnel.


Coping with Anxiety

According to the Office for National Statistics (UK) the number of people reporting high levels of anxiety has sharply elevated during the coronavirus (COVID-19) pandemic. "There is understandable concern about the impact of the pandemic on people’s well-being... Our figures show that the equivalent of 19 million adults in Great Britain report high levels of anxiety. Especially in the older age groups people are understandably worried about catching Corona Virus and people who are tested positive risk high levels of anxiety and even panic."

A new variant of Covid 19 was first detected in September 2020. This variant has proved to have a substantial increase in transmissibility. In November 2020 around a quarter of cases in London were the new variant. This reached nearly two-thirds of cases by mid-December 2020 and in January 2021 the variant has been detected throughout the UK and daily infection and deaths rates have accordingly soared.

The announcement that an effective vaccine produced by Pfizer and BioNTech on 2 December 2020 had been approved for use in the UK gave everyone hope and this was closely followed by the announcement that a second vaccine developed by Oxford/AstraZeneca will begin its roll out on 4 January 2021. Many breathed a sigh of relief hoping there was now a foreseeable end to the pandemic, however, confusion and mixed messages by Government and medical advisors regarding the country's immunisation programme coupled with grim warnings that the new virus variant is spreading despite Government attempts to halt its spread has, once again, caused an increase in anxiety especially in the vulnerable age groups.

What is Anxiety and how it differs from Panic
There is a fundamental difference between panic and anxiety. Panic comes on suddenly as a result of intense and often overwhelming fear. The symptoms of panic are characterised by frightening physical symptoms, such as, a racing heartbeat, a feeling one cannot breathe, or feeling nauseous. Panic, or a panic attack, may occur without an obvious cause because of external stressors driven by an excessive and irrational fear reaction. People prone to panic attacks fear them, which worsens the situation. People who experience recurring unexpected panic attacks are regarded as having a psychological disorder.

Anxiety is caused by worry, distress, and fear and is a continuum with symptoms ranging from a mild to an extreme state. Not being able to see a solution to an existentially threatening problem can lead to a build up of anxiety and often people troubled this way may live in a state of permanent anxiety. Anxiety is often related to the anticipation of a stressful situation, experience, or event.

Panic and anxiety are both fear–driven and are similar because they share a lot of the same emotional and physical symptoms. It is possible to feel both anxiety and to panic at the same time. Where anxiety and panic differ is in the emotions experienced. Anxiety is driven by apprehension, a feeling of unease and restlessness. Both anxiety and panic are ultimately driven by the fear of dying or losing control. Panic is uniquely characterised by an emotional feeling of detachment from the world or from oneself. The physical symptoms of anxiety and panic are similar but the degree of intensity of the symptoms can differ. Because of the similarity of the physical symptoms it is difficult to know whether a person is experiencing a panic attack or an anxiety attack. In order to try and establish which it is, it's important to know what is going on in a person's life that led to the state they are in. An indicator is that anxiety attacks are the result of stress or a perceived threat and build up; panic attacks mostly occur out of the blue and for no apparent reason. So you have to know the person quite well in order to determine what state of mind they are in when they are suffering this way.

Irrational and Rational Anxiety
Unless you have suffered from anxiety you cannot know just how pervading and debilitating it can be; it can steer one's whole life. We should be tolerant of people who suffer in this way because the factors driving their responses are often beyond their control and it can be a very miserable existence.

I subscribe to the understanding that anxiety has two dimensions: rational (existential, if you like) anxiety and irrational anxiety. A person suffers from rational anxiety when their existence is genuinely threatened and they can see no way out of a particular situation. They have a legitimate right to be worried, nervous, anxious or even downright frightened about their situation because their very existence is under threat. The ultimate fear is they will die, or suffer terribly. When a person suffers from a seemingly irrational state of anxiety (one where there appears to be no apparent cause for the person to be anxious about anything) this is almost always rooted in their past. Often, the cause of their irrational anxiety was an over–anxious parent and lack of real love and confirmation as a child. They learned to be anxious, nervous, worried and frightened by everything and everybody because their childhood role model was anxious about everything. They had no true personal identity as a child, but always had to be what their parents wanted them to be and in many cases ended up as the comforter or pacifier to an anxious parent – a role no child should have to play. As a result of this, these irrational anxiety sufferers often grow up themselves constantly seeing life as a threat, being worried and anxious about almost everything. In reality, they are seeking the security they never received from their parents and they are missing their true identity because they were never allowed to develop one. When any event in their lives brings their life–role into question, their anxiety level rises, sometimes to the level of an anxiety attack.

A constant state of anxiety, rational or irrational, is a dreadful thing to bear. In a survival situation, if you suffer this way, there is no way of knowing if your state of anxiety will be a liability or an asset. It all depends upon whether or not you can manage your normal level of anxiety, a level you are used to tolerating, or it goes off the scale and becomes incapacitating resulting in poor decisions, lack of necessary actions or in an anxiety attack meaning you are unable to do anything to better your situation until you have recovered.

Can Anxiety have Positives?
For some people, in a specific set of circumstances, there is evidence that heightened anxiety can also lead to a heightened sense of general awareness and this boost to the senses can be an advantage in a survival situation as long as a person's perception of the situation remains rational.

If you normally have a low to moderate (i.e. acceptable to the individual) level of anxiety, in a survival situation your fight/flight response is already heightened. Your brain is constantly and efficiently scanning for threats because you are in this heightened state. As long as the anxious person does not perceive threats that do not really exist (again, this depends upon one's personal psychology) and they can focus in on the real existential threat of the situation and attempt to deal with it, an anxiety sufferer may have a slightly better chance of surviving than a person who is overly calm. The overly calm person may not see a potential threat until the threat is a real one and they have a late reaction to it. To recap, in a survival situation, how we react is governed by how well we respond to the initial shock of the event, how balanced are our normal survival mechanisms and how we are individually affected by our personal body chemistry and psychologically. We know that there may be a degree of traumatization after surviving a dire situation which also leads to a heightened state of anxiety escalating into anxiety attacks.

When someone is feeling anxious, they experience physical feelings and worrying thoughts. This can make it hard to do even simple tasks and so they begin to avoid things. Often the person does not understand why they feel the way they do. When they are relaxed they can see that their worries were over the top, but when the anxiety builds up they feel overwhelmed once again.

In a survival situation, anxiety can build up rapidly and become quite demotivating and debilitating. Of all the psychological problems a person can experience when their survival is threatened, anxiety is one of the most insidious and, although it is not an illness and one cannot die from anxiety, the lack of motivation and narrowing of the sufferer's world makes it very dangerous and potentially life–threatening.


The effects of anxiety on how we think, what we do and how our body reacts

How we think
When anxiety is out of control, people describe having thoughts such as:
  • I can't cope;
  • I'm going to die;
  • I'm going mad.
These thoughts flash automatically into their heads when they are anxious. Two things should be remembered about automatic thoughts:
  1. They are irrational and unrealistic — you will not die or go mad.
  2. They end up making you feel more anxious — if you think that you are not going to cope, you will worry even more.
Learning to control such thoughts can help you to handle your anxiety.

What we do
People suffering from anxiety often avoid things, e.g. going out alone or chatting to people. In a group of survivors, the anxiety sufferer will become withdrawn and not take part in any group activity, or appear very nervous about taking part. They usually do this because they think that they will cope badly, e.g. they will panic or make a fool of themselves. By avoiding the situation, they feel better. But in the long–term, avoidance always makes the problem worse. This is because more and more anxiety gets associated with the avoided thing and so it gets harder and harder to face up to it. In a survival situation this may manifest itself in:

Not wanting to get up in the morning, preferring to lie where you are rather than, for example, procuring supplies.

In not maintaining personal hygiene.

Not bothering to eat or maintain an adequate level of hydration.

In fact, any routine activity can become difficult. Being anxious over finding sufficient food for the day can turn into the thought that is not worth trying to find food. In this extreme case, not bothering to source food becomes more comfortable than facing the anxiety brought on by having to make the effort with the associated worry that all attempts may be in vain.

Anxiety in the normal environment can also make people feel that they must do certain things e.g. they might start repeatedly checking to see if doors are locked or electrical plugs are pulled out, or they might clean the house much more then it needs. In a survival situation, this can manifest itself in constantly checking equipment, searching pockets to see that belongings are still there and a few minutes later having to do it all over again. (How many times at the airport have you checked you still have your passport in your pocket?) Anxiety can also lead to other behaviours such as talking too fast or mixing up words. Being aware of these behaviours can also make you feel more anxious. This is known psychologically as having angst for angst. The fear of getting anxious makes the person more anxious, the worry about anxiety brings it on.

How our bodies react
There are many physical symptoms of anxiety (see the picture below). The symptoms are very unpleasant and sometimes seem to appear for no reason. People worry that they have a serious physical problem or that something terrible is going to happen. It is important to know that these symptoms are not dangerous and will not do any damage to you even if they are severe. If you look at the picture below, you may recognise some of these feelings. Most people will feel only some of these, not all of them. A very common and distressing one is experiencing breathing problems. This is because the anxiety sufferer breaths too fast and takes in too much oxygen, leading to mild to severe hyperventilation. In this state the over intake of oxygen actually makes the person feel they can't breathe. This can be overcome by breathing into a paper bag to increase the carbon dioxide in the blood, or by controlling the breathing by breathing in for three seconds, holding the breath for three seconds and then exhaling for three seconds. Repeating this for fifteen to thirty minutes a day can help overcome the problem. If you feel you are losing your breath, try this breathing technique. If you are very visual, imaging you are breathing in red and exhaling blue. It works for many people.


What causes anxiety?
Some people have had difficult experiences earlier in life and this can make them more likely to get anxious. Other people have always been "the worrying type". For many people, anxiety problems begin following a time of stress. The stress of a survival situation can cause physical changes in the body and make it more likely that anxiety begins.

Changes in our body
When you are stressed, adrenalin gets released into the body. This is a chemical messenger which makes the body ready to run away or fight what it thinks is dangerous or threatening – the fight/flight response. When we feel we are in danger, adrenalin is released, the feelings in our body change and can make us feel horrible.

What keeps anxiety going? You may first notice anxiety in either thoughts, behaviour or body. But your anxiety reaction in each area feeds into the others. This keeps the body "on alert" and creates a vicious circle that keeps the anxiety levels up.

Dealing with Anxiety

Understand your anxiety
People who have never suffered from a prolonged period of anxiety have no idea just how all–consuming and debilitating anxiety can be.

It is important to realise that displacing by focusing one's attention on an activity of some sort can bring temporary relief, as can taking anti–anxiety medication, but until you have eliminated the root cause of anxiety you will never be free of it.

Having said that, it is not always possible to eliminate the root cause of anxiety. So anxiety may be a permanent state. Then all a sufferer can do is try to minimize the symptoms. If anxiety is caused by a purely irrational fear then seeking psychological help is the only way out of that situation.

Practical steps you can take
Do not try to fight anxiety on your own, try to find qualified help. It is essential that you identify the root causes of your anxiety and deal with (or learn how to minimize its effect). For the majority of anxiety sufferers the cause is existential and most doctors will tell you that the majority of patients suffering from anxiety or depression (the two often go hand–in–hand) suffer from financial worries or fear of illness — ultimately fear of not being able to survive. Anxiety is brought on by feelings of helplessness, whereas, depression is brought on by feelings of hopelessness.

For the majority of anxiety sufferers the root cause is locked within the mind somewhere, the person has the reason locked within but pinning the root cause down can be painful because it it easier to block it out, rather than face up to it. Worry about money (and not knowing how to survive) is a very common cause of anxiety. Facing up to one's financial situation and beginning to put matter right gives relief, even if the money worries are great and the future is looking black starting to face the problem and seeking a solution helps to reduce the intensity of anxiety. It is quite possible there is no solution and facing up to the fact that the root cause of the situation cannot be solved in the foreseeable future means the person will have to live with anxiety; in this case, all a sufferer can do is take measure to reduce the intensity of anxiety. Such measures include distraction by turning the immediate attention to doing some mental or physical activity.


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