If you think of anxiety as an alarm system

I was recently trying to explain to a patient about the panic attacks they were having and to help them understand what the issue was without making them feel like I was saying, “It’s all in your head.” (Which she had already heard too many times.)

So I reached for a metaphor I have found useful in the past, and thought I’d share it more publicly, for whoever else may find it useful.

It begins with seeing anxiety as an alarm system.

Ordinarily, that is actually a good thing: when it works right, an alarm system alerts you to danger, so you can prepare for it. In the case of your body, it even helps prepare you: it makes your heart beat faster so you have more oxygen, which means more energy, diverts blood from your skin (which doesn’t need it right then) to your brain (so you think faster) and lungs (again, more oxygen = more energy), and narrows your focus on the object of alarm so you aren’t distracted by anything else.

Your body’s alarm system is pretty great.

Except when it‘s, you know, not.

An anxiety disorder, therefore, is like having dysfunctional alarms. Picture alarms going off, not for intruders, but for just any bird or small animal landing on the fence—or even for no reason at all (think panic disorders and phobias). Or alarms that go keep going off long after the intrusion has happened (think PTSD). Or alarms that interpret the slightest “touch” as danger signals (think somatisation disorders and hypochondriasis, where people are convinced they are sick when there’s no identifiable illness).

You get the idea.

Still, to switch metaphors, you might also think of anxiety disorders as disorders of information interpretation: you’re not filtering incoming data properly and all kinds of random data are registering as important. Which is a problem, because life is constantly throwing data at you.

Anxiety disorders mean you’re not only filtering that data poorly, you’re also seeing a lot of it as danger signals.

Which is why anxiety disorders are so stressful…

And once you see anxiety disorders this way, a couple things become clear:

You see why testing doesn’t help: people with anxiety disorders sometimes are bent on getting tested for what’s wrong with them—but when you’re already misinterpreting information, more data only means more alarm (pardon the pun!). So while doing more tests may ease it short term, in the long term, it makes things worse.

You see why therapy is challenging: retraining your filters and alarm system has to start with learning to distrust them—which is hard. Basically, recovering from anxiety disorders means learning to ignore alarms (despite their signalling danger!), before you can re-learn when they deserve your attention.

Ignoring what sounds like danger is far from easy. It’s possible, sure, but it takes a good bit of work. And there’s really no other way that works long term. People sometimes kind of want the alarms to just reset or something, but that doesn’t just happen. Even medication really mainly quietens the alarm sounds.

The real long term value is in learning to distrust them.

Therein lies the paradox of anxiety disorders: step one is learning to distrust your own ability to interpret signals that represent danger.

It’s hard, but with the right support—therapy, understanding loved ones—and your own emotional work, it’s totally possible.

Know anyone living with an anxiety disorder? Sharing this with them might help in giving them a helpful way to talk about it—or for you to talk about it with them.

(My thanks to Mark Riechers for making the header photo available freely available on Unsplash.)

Published by Doc Ayomide

I’m a medical doctor with specialty training in psychiatry, and I love thinking and writing about what it means to be human.

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