"I'm not anxious, I just don't sleep well"
Part 2: The spectrum of anxiety—jumpy people.
Posted Nov 05, 2020
The Spectrum of Anxiety: Jumpy People
Anxiety comes in many different flavors, and it helps to think of it as a natural spectrum that can range from functional to mild to severe. Let's start with the scariest first.
- Panic attacks are in my opinion the most severe form — these are brief periods of "impending doom," palpitations, and the kind of fear that makes you think to go to the ER.
- Less intense than panic is chronic worry — what most people associate with anxiety. People with high anxiety are always thinking of what will go wrong. Finances, health, or any threat large or small can become what I call in my work, a "daymare." Like nightmares, but freakish, catastrophic fantasies by day — the opposite of a daydream. People think catastrophically, where every small event is the beginning of the end, a collapse, a failure, or some other freakish outcome, and they just cannot stop.
- Reactivity (and irritability): Some people are cool, calm, and composed (when left alone in a silent retreat, on a hilltop monastery), but they react intensely when life throws them curveballs. Or when the waiter asks too many questions, or someone cuts them off on the road. Moods can vary significantly by the hour and according to circumstance. People can have excellent mornings and terrible afternoons depending on events. Moods zig-zag all over the place, and people are left without any understanding or predictability of how they will feel next. It's hard to get help when you feel amazing sometimes and terrible at others. Hypervigilance and "jumpiness" are other features I see in anxious people. They check and respond to emails in minutes. They drive like professional racecar drivers, watchful of everything on the road. They jump easily when startled, physically and emotionally.
- Thinking too much (and sleeping too little): This is perhaps the least obvious form of anxiety. Decisions get confused by too much data, and again, we see the forest getting lost among the trees. I often say these patients live too much in their minds, and not enough in their hearts. In the absence of feeling, and flooded by too much thinking, every meaningful decision becomes challenging. Thinking too much also makes it hard to fall, and stay asleep, so people end up not getting enough sleep as they jump out of bed far earlier in the morning than they need to.
- FOMO (Fear of Missing Out): Sometimes the enemy of good is better. Indeed as anxious people tend to live anywhere but the present, there is always something better going on somewhere else. Ekhart Tolle, author of The Power of Now, does a wonderful job of describing how mental time travel (over-thinking and non-presence) is the enemy of happiness, and happiness can only be truly found in the present. Anxious people are inherently non-present — because their thoughts go on and on about possibilities that are somewhere else, or in the past or future. A little bit of planning and dreaming are good, but not when you cannot experience or be happy with what you have in this moment. Tolle writes that like a good tool, you have to know when and how to put your thinking mind down and give it a rest. Or else it becomes dull from overuse — and you become less present and less happy. This exact moment is the one you truly have control over. How would you like to feel?
Slow Down, Sleep, Run, Zen
If reading this helps you come to the conclusion that you might be anxious, or "wired a little hot," here's some things that definitely help everyone, anxious or not.
- Speed kills. I see this road sign and often think of the implications for anxious people. Nothing creates stress more reliably in a lab than rushing people. Say no more. Try to err on the side of having less scheduled activity — especially on your days off. Don't worry, you will find things to do. Slow down.
- Sleep is another one of those things that gets better with less pressure and more time. Try to allow seven to eight hours to sleep in the night. Reading books helps tremendously (not little internet tidbits, which you don't remember the next day anyway). Being well-rested improves impulse control, which can help you resist anxious urges or recurrent thoughts.
- Exercise. Break a sweat to make it count. Ideally 30 to 40 minutes three to five times per week. Every anxious person I work with agrees, this is one of the best ways to literally "blow off steam." It's also nice to see that you can feel adrenaline when it's appropriate, like 20 minutes into your run, not as you read the email from your boss.
- Meditation helps too. Practice bringing your thoughts back to your breath. You, like everyone, will be terrible at it in the beginning. You were terrible at driving in the beginning too, but you did not quit, and now you can drive without even thinking about it. The goal of meditation is not complete absence of thought, but the practice of bringing the squirrely, monkey mind thoughts back to the silence or the breath. It takes practice, and you will improve if you keep at it.
Peace at Last. "I Didn't Know I Could Feel This Way."
You are not alone, but everyone is keeping quiet. Perhaps because anxious people are sometimes, ahem, "paranoid," they tend to not want to share their weakness with anyone, and perhaps even themselves. Anxiety disorders affect about 40 million Americans each year, or about 18% of the population. That's nearly 1 in 5 people. But only one-third of those people will get help. In my experience, an even lower number will stay the course long enough to get better. But it is always such a delight to see people on the other side, and this is an opportunity no one should miss. Between meds and therapy, I have seen mind-blowing miracles in my work. The racing thoughts subside. Sleep gets deeper and longer. People's inner beauty shines, as they move back into their body from their mind. They find peace and presence. The constant hurry, the feeling of being overwhelmed, the irritability with self and others melt away (and I already expect the anxious reader to be critical of this). I often say that love is the opposite of anxiety, and truly so, when anxiety is reduced, love emerges. Love for work. Love for family. Love for friends. Love for the now. And most importantly, love for self.
For other helpful tips, watch a recent presentation by Dr. Alex Dimitriu here.