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Understanding Anxiety




For years I have struggled with anxiety. There was a point during this journey where it turned into a much more severe symptom. It felt like something bad was going to happen and there was a physical pressure on or in my chest. Understanding more about this emotion has been helpful in focusing on the best ways for me to help deal with this emotion.


Believe it or not anxiety is a good thing that helps keep us alive and comfortable.  If we had no anxiety whatsoever, and were totally unconcerned about events around us, we would never achieve our desires and we would tolerate all kinds of 'obnoxious' and dangerous things.  So, we can define anxiety as basically uncomfortable feelings and the tendency to act when we become aware of unpleasant happenings or warnings that you're in danger.



"Uncomfortable feelings and the tendency to act when we become aware of unpleasant happenings or warnings that you're in danger."

Kelly Orr PhD, Trauma Psychologist


Healthy anxiety helps us preserve our life, but unhealthy anxiety can do more harm than good.  Think about walking across the street.  Healthy anxiety results in walking cautiously, paying attention to traffic lights, watching out for cars, and walking briskly across the street.  On the other hand, unhealthy anxiety may result in your heart beating wildly as you are enormously anxious about getting safely across the street.  You may run wildly across the street in acute panic, stumble, look the wrong direction, create an accident or you may become so frightened you refused to cross the street at all! 


Other words used for anxiety are worry and a feeling of distress.


Anxiety is a feeling that can be helpful or harmful.


Anxiety can take control of situations as a warning of something not being right resulting in healthy coping, OR it can take the form of panic, terror, horror, phobias, trembling, choking, numbness, and all kinds of physical sensations that result in destructive lifestyle patterns.

This can certainly be helpful if you are in the woods and getting too far from the trail, or in a meeting and it's not going the way you thought, feelings need to be paid attention to because sometimes anxiety can result in the loss of control that interferes with our ability to cope adequately in life.  What we need to know is if there is something behind the anxiety that determines if anxiety is helpful or harmful. 


Is there something behind the anxiety that determines if the anxiety is helpful or harmful?


Our response to events or situations have a great deal to do with the way we keep distress at a manageable level.  Our goal then is to learn ways to make healthy thinking choices so that we don't get ourselves more distressed than we want to be.  This refers to how our thoughts impact our physical, emotional and behavioral reactions.  Specific to anxiety, we want to learn to identify patterns of responding to events or situations that are not working for us but against us.  This is very much a skill building process, not an overnight cure, but certainly within our capabilities. What we monitor is our physical, emotional and behavioral reactions or signs of distress.  For instance when we're anxious our physical responses may include increased heart rate, our emotional response may include fear, and our behavioral response may include shaking. 


Physical Responses To Anxiety:

  • Increased Heart Rate
  • Shallow Breathing
  • Sweaty Hands
  • Higher Systolic Blood Pressure
  • Nausea, Stomach Ache


The physical responses to anxiety is our fight or flight or sympathetic nervous system.  Think of your sympathetic nervous system as the up-regulating system or alerting system of our body.

The balancing system is our parasympathetic nervous system.  The system that lowers our blood pressure and heart rate.  Our calming system to balance out the sympathetic nervous system.


"The sympathetic nervous system promotes the fight-or-flight response while the parasympathetic nervous system helps calm the body once the threat is gone."



Sleep issues are linked to our emotional state, and in a lot of cases the cause of our increased distress. The common link is increased sympathetic activity.



The same physical and emotional responses of anxiety are also common with decreased sleep quantity (sleep deprived) and quality of sleep (Sleep Disordered Breathing like Obstructive Sleep Apnea).

Both have higher levels of sympathetic activity.  What does this mean for you?  Not getting enough sleep or having a poor quality of sleep and you are in 'fight or flight'.  Snoring can be a sign of poor sleep quality while getting 7 hours of sleep or less a night for most people is sleep deprivation.





Since we've determined that anxiety is an emotion or a feeling the next question is how do we control it?  The better we become at identifying what triggers our feelings of anxiety, the greater degree of control over our problems.


Not all uncomfortable emotions are bad.


It is important to remember not all uncomfortable emotions are bad.  As we stated before, uncomfortable emotions can benefit us, help us cope with loss, motivate us to get our needs met and help us perform better on tasks and protect us from danger.  What we want then is a way to help us identify triggers, identify our responses, assess how we're doing and ultimately gain control. 


  • Identify triggers
  • Identify our responses
  • Assess how we're doing and gain control


When we become better at identifying our responses to events and situations using the dimensions of physical, emotional and behavioral responses, we can ask the question, how did we get ourselves upset?.  Were our thoughts working for us or against us?  Most of us have different responses to life situations such as “breaking a leg” or “losing a job” or “moving.”


Who or what is responsible for how upset we get ourselves?


Do events all by themselves cause the severity of our reactions?   What if our “self-talk” or beliefs about these situations create the intensity of our reactions?


When we predict the worst possible outcome or label a situation as hopeless, or drive ourself with excessive standards or expectations of what must happen, we tend to rate everything as the 'worst possible'!


Self-talk refers to our thoughts that drive our feelings of anxiety.


Our thoughts drive our feelings


I was at a conference in Atlanta. In an effort to save some money I took the subway to the airport. After running off the subway and halfway into the terminal I discovered that I didn't have my wallet. After several frantic conversations with the subway personnel and airline employees, I learned that there was virtually no hope of retrieving my wallet and that it would be impossible for me to fly without tickets or identification. Here is a train of events around the stress of this situation.


ALARMING THOUGHTS - What are the triggers?


PREDICTIONS (What is going to happen?)

  • "I will never get home!"


LABELS (Others, myself, the situation)

  • Unfeeling or uncaring staff
  • I’m irresponsible, doomed, an idiot!
  • Hopeless, impossible to fix


MY EXPECTATIONS (What am I saying MUST or 'OUGHT TO' happen?)

  • The airline should understand
  • The subway personnel should be more helpful
  • This should not have happened


BEHAVIOR (How did I respond?)

  • Physical - Sweats, shakes, stomachache
  • Emotional - Panicked, anxious, fearful
  • Behavioral - Yelling, pacing, walking aimlessly


You 'feel' anxious, but now we see that it is the thought or belief that is driving it.  By paying attention to the feelings and asking “What was I just thinking?” we can recognize the train of thoughts that came before the feeling.  By reviewing our alarming thinking we can identify the beliefs that result in the alarming predictions, labels and standards or expectations.  Once we do this, we can generate more moderate or helpful thinking leading to moderate and realistic reactions, and the desired lifestyle control.


You cannot ERASE your thoughts but you can CHALLENGE THEM and REPLACE them.






We get fixated on the future, which we cannot control. We can control our actions and ourselves, attitude, and we can take responsibility. We need to accept the results. Did you give your best?


Strive for EXCELLENCE, not perfection


For perfectionists this is a tough one. We are the ones that have our self-esteem wrapped up in our performance. Craig Groeschel, a pastor with Life Church, spoke on this idea and coined the phrase GETMO, Good Enough To Move On. Excellence is getting your project >90% of the way there (perfection by definition or 100% is not attainable) but spending the most effective amount of time to achieve excellence. Sometimes taking more time can actually limit your effectiveness. Say this out loud with me all you perfectionists... GETMO! And then move on.




Feedback from trusted sources as well as colleagues and your boss if you know they have your best interests at heart. They do not have the same emotion that you are feeling and can be much more objective as to the reality of the situation.




“I’ve concluded that the metric by which God will assess my life isn’t dollars but the individual people whose lives I’ve touched.” Clayton M. Christensen, cancer survivor


I have seen and experienced this truth so many times. It is this truism that helping others comes with a sense of purpose. Too many times we isolate and spend too much time focusing on our problems, limiting us in our effectiveness to help others.




Focus on what you can control, not the results or outcomes necessarily, and this will reduce your anxiety. 


Control and anxiety are connected


Sometimes a sense of anxiousness occurs when we have too much on our plate. I have a problem of 'biting off more than I can chew' and this creates stress and worry.

If this is you, creating a plan is one of the best ways to reduce anxiety. Even just collecting your thoughts and writing them down can change your state of mind. The idea of setting up a plan, even if that is all you do, can reduce your anxiety.



  1. Purpose of your project? Does your project or idea align with your purpose and core values and behaviors?
  2. What does success look like? What’s the WIN?
  3. Brainstorming, getting the ideas out.
  4. Organize your ideas. Identify key milestones, ‘mission-critical components’.
  5. Next actions steps, what can you do next? What is the next physical action that you can take with your project?

'Getting Things Done' by David Allen


This last step is very important as it gets you focused on what is the next physical action that you can do next. This is the first domino as it were. Take that next step and it will lead to others.





This is an exercise used by psychologists to address toxic or anxious thoughts. For 20 minutes a day write down as many anxious thoughts that you currently have. Set a timer and work hard to get as many thoughts on paper that you can.

Following the 20 minutes shred, tear up, and throw in the trash what you have written down. YES, get rid of these thoughts! The rest of the day is yours to do with as you please. You have taken the time to validate these thoughts and emotions in this exercise. The rest of the day is now for you.


Now here's the trick. You will still have anxious thoughts or emotions interrupt your thinking. You have two choices in how to respond; one, "I have already recognized that anxious thought", or two, "I will deal with that thought tomorrow".


"In 1 month, patient's are not driven by their anxious thoughts." Kelly Orr PhD, Trauma Psychologist


What can be daunting is taking the 20 minutes out of your day to do this exercise. If you are like me this can create some anxiety thinking about carving out time to focus on this activity. Here's something to think about though. How much time do you spend worrying right now? Each day? Probably a lot more than 20 minutes.


I have already recognized that anxious thought


I will deal with that thought tomorrow


A good length of time to work on any replacement behavior type therapies is 21 days. But even if you can only accomplish a week, there should be noticeable, measurable changes, in how your brain is working. You should notice a difference. That is the reward that can keep us motivated to continue.






If you are having poor or interrupted sleep, or sleep disturbed breathing, this can affect your anxiety. Find out if you have a sleeping problem, get an accurate home sleep study, over multiple nights.




Here is some other content that you may be interested in.




Co-written and reviewed by Kelly Orr PhD, clinical and research psychologist

Dr. Orr has over 35 years experience in injury and trauma psychology including EEG mapping and LENS therapy.

Liberty University Department of Psychology


In collaboration with The Anxiety Project, The Headache Center and Mayfield Counseling Center.


Understanding Anxiety