Dr. Todd Benjamin Young is a board certified psychiatrist who specializes in the diagnosis and treatment of anxiety and panic disorders in children, adolescents and adults. He serves the residents of Northern San Diego County at his offices in Encinitas, California.
If you are depressed, you are living in the past. If you are anxious, you are living in the future. If you are at peace, you are living in the present.
Lao Tsu –Chinese Philosopher and Writer, 5th Century BCE
Fundamentally, anxiety represents internal conflict. Though it may seem counterintuitive, we frequently experience conflicting feelings simultaneously. We may feel both love and hatred toward someone. We may be afraid of, and yet drawn to something. We may at once desire a close connection, and yet still long for greater independence. From psychodynamic theory, we understand that the conflicting thoughts and beliefs lying deep in our unconscious mind are defended against through psychological processes without our conscious awareness. We may be aware of the feeling of anxiety or panic, and yet have the equally real sense that it arises out of nowhere, for no apparent reason. We may be acutely aware of nausea or physical pain, and yet remain unaware that these sensations often spring from unconscious thoughts or beliefs that seem to cause too much discomfort when brought to conscious awareness.
In addition to the psychological perspective, our physical bodies are wired to manifest and utilize anxious states in an adaptive process critical to our survival. When we encounter, and survive grave danger, the experience may become emblazoned in our memory. Hopefully, this gives us a future survival advantage, should we encounter the same threat again. In an earlier time, when most of us lived closer to nature, this capacity of the nervous system served to prepare us to respond quickly to the various threats in our environment, whether from predatory animals, or the general uncertainty of the natural environment. Today, when the pace of societal change is accelerating at a dizzying rate, anxiety and stress are quite literally making us sick. Our bodies experience all stress in the same manner, regardless of the cause.
The first step is an accurate diagnosis by a trained clinician, including a review of potential medical, behavioral, and psychological causes. When anxiety is ingrained and persists beyond the time frame during which it serves an adaptive role, it can cause significant difficulty in our lives and relationships. The treatment of anxiety may involve anti-anxiety (“anxiolytic”) medications, but this is not always sufficient to achieve enduring relief through changed mental patterns and brain circuitry. Often, a close exploration of the psychological and behavioral contributors to one’s anxiety challenges can be highly productive. In these accelerated times, we must also deliberately develop ways to calm the body and mind, and to be aware of the potential for alcohol and sedative/hypnotic medications to cause “rebound anxiety” in our attempts to handle the over-stimulation and chaos that seems to surround us. Fortunately, a comprehensive approach to understanding how one’s normal human anxiety becomes a pathological state of disorder, can open the door to meaningful change and relief.