Anxiety Sensitivity

Hello Everyone,

I hope this finds you all doing well and that you’re enjoying the change of seasons from Summer to Fall. I like Summers, but I have to confess that Fall is my favorite season of the year. The cooler weather combined with all the changing Fall colors has always appealed to me.

                                                   What is  Anxiety Sensitivity?

We all experience anxiety in life. And most people have experienced flushes of panic in particularly stressful moments, like right before stepping on stage for a performance or taking a make-or-break test. Some of us have even had particularly frightening "out of the blue'' panic attacks. But only a few people--about 3.5% of the total population--go on to develop panic disorder. So the question is, what is happening for those relatively few people who do develop panic disorder? Years of empirical and observational research in this area has told us that the answer is misunderstanding what anxiety symptoms actually mean. Panic disorder doesn't arise from the panic symptoms themselves (i.e., racing heart, shortness of breath, dizziness, etc.) which can be uncomfortable but actually are harmless, but rather from a person's fear of those symptoms as being something dangerous and life threatening. Once they experience panic symptoms, some people develop an inescapable fear of those symptoms because they are convinced that they lead to terrible things like completely losing control, going insane or death. 

What Causes Anxiety Sensitivity?

Researchers have compiled evidence suggesting that it is a complex combination of both biological and psychological vulnerabilities that makes some people especially prone to developing panic disorder. The term many researchers use for this is "anxiety sensitivity". People who have high anxiety sensitivity are simply far more afraid of panic sensations than others are. A self-generated cycle gets started when an anxiety sensitive person notices a sensation (they just climbed some stairs and their heart is beating faster than usual) and they react to that with intense fear (because they mistakenly believe the rapid heart rate is a sign of a possible impending heart attack). This then creates more anxiety symptoms and which  increases their heart rate even more so they become even more convinced something is wrong with them and now they start feeling light headed and dizzy…and you can see where this is going. They usually then become on “high alert” for future “dangerous” sensations and often start unconsciously scanning/monitoring their body for more of the “dangerous “ symptoms. And since most of us often feel some of these sensations throughout a typical day, they find evidence regularly that they may have another panic attack. 

Since panic attacks are very unpleasant, we, of course, then start avoiding what we think is causing the attacks. So using the example from above, the person who notices their heart rate going up after they climb some stairs might stop taking the stairs or take the elevator instead and avoid the sensation of their heart going fast. Perhaps they might stop exercising and drinking any caffeine in an effort to avoid the “scary” sensations. By avoiding these activities they may believe they are solving the problem, but they are actually making it worse. Since their heart racing isn’t really dangerous they are engaging in what is called “safety behaviors”, which means doing things that we think are protecting us but which are actually making the problem worse over time. Of course, there are times when the sensations we are experiencing can actually be dangerous signs of something wrong and it is always best to get checked out by your physician, but the clients I work with have already been to their doctor numerous times and they have checked out just fine.

What To Do About Anxiety Sensitivity

Recognizing what is happening is the first step to interrupting and eventually stopping this pattern. And as I’ve mentioned many times on this blog, exposure to what you fear is a crucial part of long term recovery. Avoidance generally makes anxiety worse and exposure generally reduces anxiety in the long run. If you’re afraid to cross bridges, the best way to overcome that fear is to start crossing bridges. While there are many books on treating Panic Attacks and/or Panic Disorder, two of my favorite resources are An End to Panic and Panic Attacks Workbook.

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I hope you find these tips useful and let me know if you have any questions. As always, let me know if I can be of any help and I’m happy to answer any questions you might have. This post isn’t meant as a substitute for therapy and so if you’re struggling with anxiety/OCD please consult a qualified therapist.  

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Stay safe,

Dr Bob