Five Anxiety Myths

Notes on Dr. Sally Winston’s talk on Common Myths About Anxiety Disorders

Myth 1:

Anxiety disorders are caused by stress, so reducing or eliminating stress will make you better.

You might be more likely to have a panic attack if you have panic disorder and are stressed, but that's not actually the cause.

Similar to diabetes: it gets worse under stress and better with stress-management tools, but still requires specific dietary and behavioral changes and sometimes insulin to address the underlying problem.

Avoiding stress can help, but the treatment might need to focus on anxiety sensitivity. You might be afraid of your anxiety or symptoms of arousal in your body, be perfectionistic, or have a "sticky mind."

Look at the things that you do that maintain your anxiety: Trying not to let yourself get anxious, avoiding situations, and seeking excessive reassurance.

If you back away from anything that makes you anxious, this can develop into phobias.

You'll start feeling fragile or vulnerable. Avoidance snowballs on itself.

A lot of things that are stressful are things that you really enjoy: Your job, relationships, children, traveling, etc.

Myth 2:

Someone who is anxious just needs enough love and reassurance from family members and loved ones.

Have you noticed that the reassurance never seems to "stick" for very long?

People struggling with anxiety disorders have an intolerance of doubt. They have trouble dealing with uncertainty, and they want to be certain.

But certainty is a feeling, not a fact.

Think about someone you really love and care about. Do you know for sure that they're alive right now? If you really think about it, something could have happened that you don't yet know about.

You feel certain, but you can't be certain. Certainty is a myth.

Learning how to tolerate doubt is the ultimate outcome. Those with anxiety have to practice tolerating risk. Live gracefully and joyfully in the present.

Find places where you do tolerate doubt and show yourself that you have that skill. Present yourself with the situation that you normally seek reassurance for and then don't seek reassurance. Remind yourself that certainty is a feeling, not a fact.

Family and friends: Be empathic, but don't do everything for them. They need to go towards what's scaring them and not away. Tell them how brave they are.

Myth 3:

Depression and anxiety always have their origins in childhood, so you must find childhood causes and fix them.

These experiences can be a significant contributor, but altering what keeps anxiety going is the issue... not where it came from. It's more immediately helpful.

Sometimes there is not originating event at all.

Maybe the initial anxiety started during a period of great stress, but what keeps it going is how you react to those symptoms now.

You need therapy that focuses more on the here and now. You need to change your relationship with your anxiety so it doesn't run your life.

It's not your personality, and it's not weakness. It's likely a genetic predisposition.

The symptoms can be very uncomfortable, but they aren't dangerous.

Myth 4:

Fight negative thoughts with positive thoughts, and they will go away.

Actually, fighting thoughts works backwards. That's called "paradoxical effort."

We can forcefully distract ourselves, but only temporarily.

Try not to think about elephants. What happens? Try not to think about your feet. What happens?

Your mind is a monitor for bad feelings. You can't enjoy a party if you are always worried that _____ is going to show up or ruin it by acting out.

The "monitor" can relax if it doesn't care who comes to the party or what they do.

The key is to make the thoughts not matter.

If you don't dignify thoughts by trying to answer them or trying to keep them out, then they'll eventually go away.

Everyone knows that their mind is filled with lots of random associations and junk thoughts. We can swing our attention from one channel to another, but we can't turn them off.

Most thoughts don't have an X in the corner, so you just have to wait until they run out. This takes practice.

Myth 5:

Try everything you can to relax if you are having a panic attack.

Your brain is issuing a false alarm. It's a cardio workout you didn't ask for. You can't relax immediately, and there's no turn off switch. You have to let it run its course.

Imagine you’re driving a car that has a gas pedal but no brake. You're on a wide-open road with no traffic or stop signs or lights. You can swerve and freak out and wreck into the ditch, or you could take your foot off the gas and wait until it coasts to a stop.

You can do this if you know the panic attack won't hurt you, you won't pass out, and it will eventually run out of gas. This attitude shift is what helps it go away - and eventually stay away.

If you treat your anxiety as something that's uncomfortable but doesn't have to be controlled, then it will resolve on its own.

As you weather these storms, you start to get less scared of them coming back, you start to be less sensitive towards your anxiety, and then you eventually stop having such intense reactions to your anxiety.

Unlike some approaches, we are working on our relationship with our thoughts and symptoms more than the actual thoughts and symptoms themselves.