By Robert Wright, Jr., Ph.D., COFT
Let’s face it.
By itself, anxiety can be challenging. But, when you add addiction issues to the anxiety equation – if you are not careful – you can set yourself up for potential disasters including repeated relapses. Certainly, simultaneously dealing with anxiety and addiction (dual diagnosis) complicates recovery for both problems; thus, increasing the need for diligence and consistent self care.
Whether you currently are coping with addiction or are in recovery, anxiety – in any of its many forms – can seriously knock you off track if you do not address its potentially debilitating effects. So, it’s important to become more aware of the significant role anxiety plays in your life as you work to deal with, heal and recover from addiction.
We’ll help you do that here. Then, we invite your comments and questions about anxiety at the end. In fact, we try to respond to all legitimate queries personally and promptly.
Why is anxiety so harmful?
Did you know that according to the National Institute of Mental Health anxiety disorders are the most common form of mental illness in America? Did you know that 40 million Americans or 18% of all adults have some form of anxiety disorder? Did you know that more people visit doctors for anxiety disorders than for colds?
The statistics show that Americans are hurting!
Here’s a brief round up of the most recent studies.
1. According to the Anxiety and Depression Association of America, individuals with an anxiety disorder are 3 to 5 times more likely to go to the doctor, and 6 times more likely to be hospitalized for psychiatric disorders than those without anxiety.
2. The National Institute of Mental Health reports that:
- 18.1% of adult Americans experience anxiety during any given 12 month period.
- 22.8% of anxiety sufferers have severe cases of anxiety (4.1% of U.S. population).
- 28.8% of anxiety sufferers wrestle with an anxiety disorder their entire lives.
- The average age of anxiety onset takes place at 11 years old.
- For Specific Phobias the median age of onset is 7 years old.
- Women are 60% more likely to experience anxiety than men during their lifetimes.
3. A 2015 meta anxiety review study published in Bio Med Central Public Health Journal demonstrated a positive association between sedentary behaviors and anxiety risk.
4. In a 2011 animal study, a team of Stanford University neuroscientists were able to reverse the effects of anxiety using optogentics, an experimental procedure that generates brain activity using light. Thus, holding out hope of a future anxiety disorder treatment that may instantly stop anxiety without unwanted side effects.
5. A 2007 study in the American Journal of Psychiatry concluded that half of adults with anxiety disorders had a psychiatric diagnoses by age 15.
In 2007 Dr. Joshua Smith and Dr. Sarah Book conducted a comprehensive review of the research literature on the comorbid relationship between anxiety and addiction. Their review demonstrated that anxiety disorders were significantly related to both alcohol abuse and drug addiction. Additionally, the results showed that generalized anxiety disorder and panic disorder had the greatest associations with substance abuse disorders.
A key finding was that in at least 75% of the cases, anxiety disorders occurred BEFORE substance use disorders. Therefore, getting your anxiety under control may be a pathway for preventing or lessening the chances for a dual diagnosis of anxiety and addiction.
What is anxiety?
According to the American Psychiatric Association (APA),
“anxiety is a normal reaction to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention….Anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior.”
The APA criteria for being diagnosed with an anxiety disorder indicates that the anxiety or fear must:
- be out of proportion to the situation or age inappropriate
- last six months or longer
- hinder your ability to function normally
Further, according to the American Psychological Association, “anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.”
Likewise, Jonathan Davidson, M.D., says that anxiety is a natural emotional component of our “fight-flight” stress response which protects us from real threats to our own or our family’s survival. He says that healthy anxiety causes us to take swift action whenever we are in real danger, while unhealthy anxiety overloads of our nervous system. The resultant stressor overload triggers a cascade of neurochemicals which prolong activation of our sympathetic nervous system even when there is no real danger or threat.
Unhealthy anxiety causes us to have a heightened “hair trigger” stress response to imaginary or remembered threats. Even though they are not real, we react and feel “as if” the threat is real. These repeated events place undue burdens upon our cardiovascular, endocrine, immune, musculoskeletal and nervous systems to our detriment and can make our lives miserable.
What causes anxiety?
There is no general agreement within the academic, medical, psychotherapeutic or scientific communities for what causes anxiety. However, there is evidence that mental conditions, physical conditions, environmental factors, the effects of drugs or alcohol or any combination of the above can trigger anxiety. Examples of circumstances associated with anxiety include:
- change in living arrangements
- chronic conditions such as asthma, diabetes, hypertension, and heart disease
- death or serious injury of a close loved one or pet
- epigenetic factors, e.g. adverse environment
- family history, e.g. genetic pre-disposition
- financial distress, e.g. pending home foreclosure, job loss or car repossession
- sides effects of medication
- stress, e.g. excessive and repetitive stressors at home or work
- substance abuse
What are the major types of anxiety disorders?
According to the National Institute of Mental Health, anxiety disorders are the most common form of mental illness in the United States. This means that over 40 million Americans are suffering from some form of anxiety disorder. Below is a list of the most common anxiety disorders.
- Social Anxiety Disorder: 15 million or 6.8% of Americans suffer from this condition. Usually begins around age 13 and affects men and women equally.
- Generalized Anxiety Disorder: 6.8 million or 3.1% of Americans suffer from this condition. Women are twice as likely to report having this condition compared to men.
- Specific Phobias: 19 million or 8.7% of Americans suffer from this condition. Women are twice as likely to report having this condition compared to men.
- Panic Disorder: 6 million or 2.7% of Americans suffer with this condition. There is a very high comorbidity rate with major depression and women are twice as likely to be affected than men.
- Post Traumatic Stress Disorder: 7.7 million or 3.5% of Americans suffer with this condition. Women are more likely to be affected than men. Childhood sexual abuse is strongly correlated with PTSD.
- Obsessive Compulsive Disorder: 2.2 million or 1% of Americans are afflicted with this disorder. The condition is equally found in men and women and the median age of onset is 19 years old.
What are the symptoms and debilitating aspects of anxiety?
The long list of negative effects of living with severe anxiety include:
- fatigue or exhaustion
- excessive worry or catastrophization
- difficulty concentrating
- sense of “impending doom”
- panic attacks
- muscle tension
- heightened levels of impatience
- excessive or unexplained sweating
- uncontrollable shaking
- heightened levels of irritability
- feelings of being “on edge” or keyed up
- headaches or migraine headaches
- risk adverse
- shortness of breath or hyperventilation
- increased heart rate
- increased risk of relapse.
Solutions for Anxiety
Dr. Deborah Rozman, co-author of Transforming Anxiety: The HeartMath® Solution for Overcoming Fear and Worry and Creating Serenity, offers a novel perspective on the nature and source of anxiety. She says that at the root of anxiety is some type of fear and that the key to transforming anxiety is learning to master your emotional investment in fear feelings and projections.
Dr. Rozman says that most forms of anxiety are due to our emotional investment in the anxiety which turns your anxiety into a habit. She indicates that learning how to relax deeply and enter a state of gratitude using the HeartMath® and other stress relieving approaches provides an effective long term solution for eliminating unhealthy anxiety from your life.
Others such as Jonathan Davidson, M.D., co-author of The Anxiety Book: Developing Strength in the Face of Fear, offer a more traditional view: namely that in certain cases, anxiety disorders are caused by an imbalance in your brain chemistry; therefore medication is necessary to control anxiety. He says that such an imbalance can cause your physiological alarm bells to go off – amygdala, hypothalamus, locus coeruleus, pituitary and adrenal glands – to activate repeatedly.
From Dr. Davidson’s perspective, the neuroendocrine system is at the heart of many anxiety disorders: “Norepinephrine mediates anxiety responses, while serotonin and GABA tend to quiet the stress response….In people with chronic anxiety, these three may not be performing properly–they can be overactive, deficient, or just not making the right neuron to neuron connection.”
Dissolving anxiety with Open Focus™
Most likely you already know that standard approaches to dealing with anxiety involve taking anti-anxiety medications such as Ativan, Diazepam, Paxil, Serax or Xanax. And, you may even be familiar with Complementary and Alternative treatments for anxiety such as Acupuncture, Biofeedback, Cognitive Behavioral Therapy (CBT), Hypnosis, Meditation, MBSR, Neurofeedback or Yoga. But you may not know that for many years, the Open Focus™ technique has helped countless individuals successfully lessen or relieve their anxiety.
Open Focus™ is an incredibly effective anxiety and stress relieving technique which dissolves anxiety and stress by shifting your focus of attention. By paying attention to how you’re paying attention, Open Focus™ is able to increase your awareness of your anxiety in an objective fashion. Doing so allows you to fully immerse yourself into your anxiety—neither resisting nor rejecting your anxiety—such that your anxiety begins to dissolve. Although this approach may seem counter-intuitive, it works!
Created over 40 years ago by Dr. Les Fehmi of the Princeton Biofeedback Centre, Open Focus™ gives you the same type of elevated anxiety and stress relief that the highest levels of biofeedback and neurofeedback provide—without using any equipment! Dr. Fehmi scopes out these anxiety and stress relieving effects in his two best-selling books Open Focus Brain and Dissolving Pain.
When you are in an Open Focus™ state, your attention becomes more flexible, shifting you out of a “normal” narrow focused attentional style into one that’s wider and more global. Although being in a narrow focused attentional style is helpful for goal attainment, remaining and maintaining a narrow focus for too long, often results in unnecessary anxiety and stress. When you are able to focus upon your anxiety in a new way—”resting” in or “bathing” in your anxiety by fully immersing and opening your attention to your anxiety and your surroundings without fear—you can easily begin to diminish your anxiety by learning and using Open Focus™.
The good news is that when you begin using Open Focus to reduce your anxiety, you’ll simultaneously lessen the effects of any stress, chronic pain or grief you may be dealing with. This happens automatically as you begin to attend and pay attention differently. This can be a wonderful opportunity for you especially when you are wrestling with the combination of anxiety and addiction. The really good news is that as Addictionblog.org founder Lee Weber wrote in a previous blog post, when you are looking for relief, doing Open Focus is “10 times easier than meditation.”
Anxiety relieving power of Open Focus™
The best way to grasp the anxiety relieving power of Open Focus™ is to experience it. After all, when you are dealing with severe anxiety, you can sometimes feel that you’ll do almost anything to get relief, especially when your anxiety is INTENSE. If you’ve ever experienced a seemingly uncontrollable bout of anxiety such as a panic attack, then you know what I mean.
Based upon more than 40 years research and clinical experience, Dr. Fehmi explains the good news for anxiety sufferers in his book Open Focus Brain: “The good news is that the nervous system is malleable and the chronic symptoms of increased stress can be reversed. To begin releasing long-held anxiety, we need to de-ephasize narrow objective attention and move into Open Focus….Muscles tense throughout our bodies to keep us from feeling the unpleasant stress that occurs in the emergency mode of attending. Some of those muscles can stay tensed for years or even a lifetime.
It’s as if the energy of fear gets trapped in the muscles. It’s not gone, though; it’s just hidden from consciousness….To finally release underlying anxiety, we need to dwell in Open Focus, which gradually wakes up this tension to be felt again, and then released. When we find the tension it is a gift–for once it is made conscious, it can be completely dissolved.”
Sample Open Focus™ pain exercise
In general, Open Focus™ exercises are made up of guided questions that help you change the way you pay attention so that your anxiety is lessened and begins to dissolve. On page 56 of Open Focus Brain, Dr. Fehmi has more good news for anxiety sufferers: “While anxiety is usually viewed as a mental disorder, it is really a product of our mode of living perpetually in narrow-objective attention, furthering a chronic engagement of fight or flight that has kept fearful, high-intensity memories and feelings repressed in the body and mind.
Faulty attention is not the only cause for the accumulation of anxiety–genetics and environment play a role; but whatever other causes there may be, attention is a fundamental and controllable factor.” Thus, this means that when we change the way we pay attention, doing so, can profoundly modify the way we experience the world; including dissolving anxiety. Of course, this includes whether and how we recognize our anxiety.
Open Focus uses the concept of space to break up habitual rigidity in our attentional processes. This increases brain plasticity while simultaneously reducing our stress and anxiety. The really good news is that you can begin to get a handle on your anxiety right away by trying out the Open Focus exercise below. You may be surprised by the simplicity of the exercise but the proof is in the pudding! When finished, ask yourself the following questions:
- Do you feel better?
- Did your anxiety begin to dissolve?
- Did your stress level go down?
- Do you feel any relief from your anxiety?
Want to know exactly how it works? The following exercise was adapted from Dr. Fehmi’s Open Focus Brain and Dissolving Pain books and CDs. Remember, do not operate a car, truck or any type of machinery or equipment where you need to pay attention while doing Open Focus since the exercise may make you feel drowsy. Please allow approximately 15 seconds between questions as you read them to yourself internally Or, have someone else read out loud and pause for 15 seconds in between questions.
– “Take a moment now to relax your posture.”
– “Can you imagine letting your mind and body naturally and effortlessly respond to the following questions about your ability to imagine certain experiences?”
– “Can you imagine not giving any particular effort to listening to the questions or to achieving any of the associated images or experiences?”
– “Can you imagine that your ideal response is whatever spontaneously happens to your imagery or experience when a particular question is asked?”
– “Can you imagine the that your imagination happens freely and effortlessly?”
– “Can you imagine the distance between your left foot and your right foot?”
– “Can you imagine the distance between your right hand and your left hand?”
– “Can you imagine the distance between your right ankle and your left elbow?”
– “Can you simultaneously imagine the space inside your mouth, throat and ears?”
– “Can you imagine the space inside your throat, mouth and cheeks as you inhale and exhale naturally?”
– “Is it possible for you to imagine the space inside your nose as you inhale and exhale naturally?”
– “Is it possible for you to imagine that as you inhale naturally, your body begins to be filled with space, surrounded by space, permeated by space, and equally and simultaneously, as you exhale naturally, is it possible for you to imagine that your body is left filled with space, surrounded by space, permeated by space, right where you are?”
– “Is it possible for you to imagine your breath flowing up behind and around your eyes and eye sockets as you inhale naturally?”
– “Is it possible for you imagine your breath flowing down behind and around your eyes and eye sockets as you exhale naturally?”
– “Can you imagine the distance between the space inside your nose and your eyes?”
– “Can you imagine the volume of your knees?”
– “Can you imagine the distance between the left side of your face and the right side of your face?”
– “Can you imagine the space between your thumb and fore finger on each hand?”
– “Is it possible for you to imagine the distance and space between the fingers on your left hand and the fingers on your right hand?”
– “Can you imagine becoming aware of the space in your body where your anxiety resides?”
– “Can you imagine feeling into the space where your anxiety exists and focusing your attention right up to the edge of your anxiety, neither resisting nor rejecting your anxiety?”
– “Can you imagine resting your attention right into the heart of your anxiety – that is – resting right in the center of your anxiety?”
– “Can you imagine bathing in the core of your anxiety, neither rejecting or resisting your anxiety, and
simultaneously broadening your attention to become aware of the smells and sounds in your environment?”
– “Is it possible for you to imagine that as your become aware of the center of your anxiety, that as you inhale naturally, your breath flows up right through the center of your anxiety, and equally and simultaneously, is it possible for you to imagine that as you exhale naturally, your breath flows down and out right through the center of your anxiety, dispersing, diffusing and dissolving it?”
– “Can you imagine hearing silence?”
– “Can you imagine becoming aware of your thoughts and the mental silence from which they emerge, the silence in which they exist, and the silence into which they dissolve?”
– “Can you imagine that as you continue to practice your experience will become more vivid and more effortless?”
– “Can you imagine practicing this exercise at least twice daily?”
Want to learn more?
If you’d like to learn more about Open Focus and how you can experience the benefits of having your anxiety reduced, diminished or dissolved, consider contacting me by email at Dr.Bob[at]StressFreeNow[DOT]com. I have been a certified Open Focus Trainer for over 10 years, achieving excellent stress, anxiety and chronic pain reduction results for clients. Feel free to contact me with your questions or to schedule a wellness coaching session. www.StressFreeNow.info