FIVE YEARS AGO, Meredith Arthur, a 45-year-old San Francisco employee of the social media company Pinterest, arrived at a neurologist appointment in a distraught state. She spoke a mile a minute, rattling through her extensive research on the vagus cranial nerve and explaining why she thought it might hold clues to her crippling shoulder and neck pain, frequent dizziness and nausea and chronic migraines. “I was presenting my inexpert case to an expert, and she stopped me and said, ‘I know what’s wrong. You have generalized anxiety disorder.’”
For Arthur, the diagnosis was a shock. She had been so focused on her debilitating physical symptoms that she hadn’t considered that they could be linked to her mental health. But almost immediately, it clicked.
“My brain was always in overdrive, from early childhood,” Arthur recalls. “I always wanted to work really hard all the time and solve everything.”
She would have never described herself as a worrier, however, and certainly didn’t connect her perfectionism to anxiety or its impact on her body. But in fact, physical discomfort (like stomach and chest pain, feeling restless or irritable, sleep problems, fatigue and muscle aches) is most often what drives people with anxiety to seek treatment, not distressing thoughts.
“The diagnosis changed everything,” says Arthur. “It’s like somebody picked me up off the earth, turned me around 180 degrees and put me back down. It was the same world, but everything looked a little different.”
Arthur is one of the 44 million North American adults who experience an anxiety disorder—the most common form of mental illness—every year. But beyond serious cases, anxiety is something that touches everyone to varying degrees. Typically, it’s intermittent and brought on by a stressful or traumatic event. The core features of anxiety are excessive fear and worry—followed by extreme problem solving, in Arthur’s case—and one of the major underlying factors is a feeling of uncertainty about situations that occur in daily life.
Enter big, bad 2021. These are exceedingly anxious times due to the unholy combination of economic precariousness, social unrest, political volatility, environmental catastrophes (pause: deep breath) and the COVID- 19 pandemic. But an individualized, holistic approach to managing anxiety—including lifestyle tweaks, medication, mindfulness exercises and, to begin with, acceptance—will ensure it doesn’t rule your life.
What Anxiety Does to Your Body
Anxiety is part of your body’s stress response system—and it’s uncomfortable, overwhelming and sometimes plain confusing.
“I describe anxiety as a future-oriented emotional response to a perceived threat,” says Dr. Joel Minden, a clinical psychologist and the author of Show Your Anxiety Who’s Boss. “We anticipate that something bad will happen. Maybe we have evidence for thinking that. Maybe we don’t. But we have a belief that something catastrophic might occur.”
Almost immediately after that, Minden says, your sympathetic nervous system, which controls involuntary processes like breathing and heart rate, kicks into high gear. This leads your adrenal glands to release adrenalin and cortisol, two of the crucial hormones driving your body’s fight-freeze-or-flight response, which prompt anxiety’s physical symptoms. Your heart races, your blood pressure rises, your pupils dilate, you get short of breath and you break out into clammy sweats.
Meanwhile, cortisol curbs functions that your brain considers nonessential: it alters immune-system responses and suppresses the digestive system, the reproductive system and growth processes. This was helpful for our ancestors trying to outrun a sabre-toothed tiger, but not so much when you walk past someone in a grocery store and, even though you’re both wearing masks, can’t stop ruminating for days afterward about whether you might have caught COVID-19 when they coughed.
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