Anxiety Psychoeducation

What Is Anxiety?

Anxiety is an emotion. It can show up in our mind as worrying thoughts, fear-based thoughts around uncertainty and the unknown, and over-thinking. Some people report that anxious thoughts interrupt their quality of sleep, and can lead to mental rumination, over-thinking and catastrophising. Generally, anxiety is a worry or concern for something that is in the future, versus the emotion of fear that is considered to be more about an immediate and present threat.

Anxiety is also often felt in the body as:

• Tension

• Restlessness

• Fatigue

• Light-headedness

• Soreness/aches

• Trembling

• Tension or ‘butterflies’ in the stomach

• Vomiting

• Increased heart rate and/or a pounding heart

• Increased blood pressure

• Sweating

• Shortness of breath

• Difficulty swallowing

• A dry mouth

• Gastrointestinal issues

• Feeling hot

• Disrupted sleep

We all experience anxiety because it is a normal, natural and sometimes helpful emotion. It serves as an internal alarm system - alerting us to potential threats. Without it, we would be less prepared to deal with those threats.

Anxiety that is excessive, disproportionate, and persistent is considered unhelpful and people who experience this level of anxiety can often be diagnosed with Generalised Anxiety disorder, Social Anxiety disorder, Agoraphobia, Panic disorder and other related conditions. People often manage excessive anxiety with therapy or medication, or a combination of both. We can never “cure” ‘Anxiety’, because anxiety is a normal (and needed) emotion. What we can do is learn new tools to manage anxiety, learn to manage our relationship to anxiety, and reduce those unhelpful cognitive and physical symptoms.

The Neuroscience of Anxiety

First off, let’s explore the parts of the brain that involve anxiety:

• Amygdala

• Hypothalamus

• Prefrontal cortex

• Hippocampus.

The amygdala is a tiny almond-shaped part of the brain and is responsible for detecting threats and activating the body's fight-or-flight response. When it perceives danger (real or imagined) it signals to the hypothalamus (the part of our brain that regulates hunger, thirst and sleep and other bodily functions). This then triggers the release of stress hormones like cortisol and adrenaline throughout our body. This prepares the body to respond quickly to potential threats. In individuals with anxiety disorders, the amygdala tends to be larger and hyperactive, often misinterpreting neutral situations as dangerous, leading to heightened and prolonged states of anxiety. For example our amygdala might become over-active when we are getting ready to attend a party. Rationally we know we are safe and there is no threat, but our brain has decided to set off that alarm bell anyway. 

The prefrontal cortex, responsible for rational thought and decision-making, normally helps regulate the amygdala’s response by assessing whether a perceived threat is real (like the difference between a party versus being confronted by a lion). However, in those with excessive anxiety (a hyperactive amygdala), communication between the prefrontal cortex and the amygdala is often weakened, making it harder to override those irrational fears and thoughts.

The hippocampus, which processes memory and context, also plays a role. A smaller or dysfunctional hippocampus can lead to difficulty distinguishing between past traumatic events and present-day experiences. This can result in persistent anxiety responses even when no actual threat exists. What makes some people’s hippocampus smaller, you ask? Anxiety, depression, post-traumatic-stress, chronic stress, certain medical conditions, ageing, dementia, Cushing’s Syndrome, head injury and early-life adversity are a few common reasons. 

The good news is this: if anxiety and our responses to it are rooted in the brain, we can learn to manage anxiety by re-training our brain.

The Evolutionary Roots of Anxiety

Anxiety is not inherently unhelpful. It has been essential for our survival throughout millennia. Early humans relied on anxiety to stay alert to dangers such as predators, natural disasters, and hostile rival groups. This heightened awareness helped ensure survival by triggering fast decision-making and self-preservation behaviours. Anxiety also served another function: social safety. Humans are social creatures and this social aspect has been a big part of our survival as a species. Our anxiety response has helped us to adapt socially by helping us to understand social norms and enhance our social awareness. Those who were more cautious and alert had a greater chance of avoiding life-threatening situations, passing on their genetic predisposition for anxiety to future generations.

Over time, our environments have changed quite rapidly, but our brains have not evolved at the same fast pace. In modern society, threats are often more abstract and social-based, such as financial concerns, social rejection, or work related stress. Despite the differences in threat types, our brains still react in the same way - activating those same survival mechanisms. However, because many modern stressors are persistent and cannot be resolved with a quick fight-or-flight response, anxiety can become chronic, leading to exhaustion and difficulty functioning. This can feel like us being ‘trapped’ in an anxious state. 

Additionally, anxiety serves an important function beyond immediate survival. It can enhance performance by increasing motivation, particularly in situations that require preparation, such as public speaking, sitting an exam, or meeting a work deadline. It can help us to plan our public transport route in advance so we don’t get lost, and be mindful of our behaviour at an important event. Anxiety can also help us to be more empathetic and socially conscious. However, when anxiety becomes excessive or irrational, it can impair rather than enhance daily functioning, leading to distress and avoidance behaviors like procrastination, self-sabotage, substance use, and disconnection. 

Anxiety: Just Another Emotion

Like happiness, sadness, or anger, anxiety is a natural human emotion. It serves as a signal, alerting us to potential threats or challenges that need our attention. The problem arises when we begin to fear anxiety itself, interpreting it as something dangerous rather than a normal response. The issue becomes the way we respond to the emotion of anxiety, versus the emotion itself. This can lead to avoidance behaviors and an increased sense of distress when anxiety arises, reinforcing the idea that it is something to be controlled or eliminated rather than understood and managed.

Why Anxiety Can Feel Unmanageable

For those with anxiety disorders, navigating anxiety is particularly difficult because their brains and bodies are wired to be on the look out for potential threats, most of the time. Because anxiety can feel all-encompassing, it often leads to avoidance of situations that trigger the emotion (and physical symptoms). Unfortunately these avoidance behaviours strengthen the brain’s association between those situations and danger, creating a cycle that can be difficult to break.

Avoidance, while offering temporary relief, ultimately fuels anxiety. When we avoid an anxiety-provoking situation, our brain receives confirmation that the situation is, in fact, dangerous. This reinforces the amygdala’s overactive response and increases the likelihood that similar situations will trigger even stronger anxiety in the future (this is where that link between the amygdala and hippocampus is important!). Over time, avoidance shrinks our world, limiting our ability to engage in normal activities, maintain relationships, or pursue new opportunities. The paradox is that the more we avoid anxiety, the stronger and more overwhelming it becomes. 

Another reason anxiety feels unmanageable is the struggle to accept and tolerate it. Many people with anxiety disorders engage in a constant internal battle, trying to suppress or eliminate anxious feelings. However, this resistance only amplifies the distress, much like trying to push a beach ball underwater—it takes effort, and eventually, it pops back up with more force. Learning to accept anxiety as a normal emotion, rather than something dangerous, is key to reducing its power. When we allow ourselves to experience anxiety without judgment, it tends to lessen in intensity over time. By gradually building the ability to tolerate discomfort we teach our brains that anxiety is not something to be feared. Instead, it is something we can manage, and even use to our advantage.

Women and Anxiety 

Research shows that women are more likely than men to experience anxiety disorders. This may be due to a combination of biological and social factors. Estrogen and progesterone fluctuations can influence stress responses, making women more susceptible to anxiety at different points in their menstrual cycle. Also, societal expectations often place greater emotional labour on women, leading to increased pressure on girls and women to care for others, perform well in multiple roles, and suppress their own emotional and physical needs, from a young age. We know that this can lead to the formation of chronic stress, anxiety, depression and other mental health issues. 

Women’s experiences of sexual harassment, violence, discrimination, and daily microaggressions also play a significant role in heightened anxiety levels. Experiencing or even fearing gender-based violence can lead to hypervigilance. This is an increased state of alertness that keeps the nervous system on high alert, instead of in a rest and digest mode. For survivors of trauma, the brain’s threat-detection system can become hypersensitive, leading to chronic anxiety and avoidance behaviors. Workplace discrimination and microaggressions, such as being dismissed, interrupted, or undermined, create a persistent sense of insecurity and stress, further fueling anxiety. The cumulative impact of these experiences means that many women carry an additional psychological burden, making it harder to feel safe and relaxed in daily life. Women/girls who have other intersecting identities such as ethnicity, disability, sexuality, religion, socioeconomic level and culture, have a greater likelihood of also experiencing excessive anxiety due to their lived experiences. As you can imagine, addressing systemic issues is therefore an important challenge we face in regard to reducing anxiety at a societal level.

Cultural and social conditioning also influence how women/girls experience and respond to anxiety. From an early age girls are often socialised to be agreeable, accommodating, and emotionally attuned to other people. They receive messages that they must be “nice,” avoid confrontation, and prioritise the needs of others over their own. This can lead to difficulties in asserting boundaries, excessive unhelpful people-pleasing tendencies, and heightened self-doubt—all of which contribute to anxiety (and self-worth). Eldest daughters in particular are at risk of being expected to take on an extra emotional and psychological burden within many families and culture, that can result in unhelpful anxiety. In contrast, boys are often encouraged to be independent and resilient, meaning they may be less likely to internalise stress in the same way as girls. In many cultures boys/men of course are taught to externalise certain emotions (such as anger), and suppress others - and this also leads to mental health issues in boys/men. As a contrast here, girls/women in many societies are taught to suppress anger, as this goes against the “good girl” expectation.

Your Relationship to Anxiety

Rather than trying to eliminate anxiety, the key to managing it is to change how we respond to it. Neuroplasticity - the brain’s ability to rewire itself - plays a crucial role in anxiety recovery. When we repeatedly respond to anxiety with avoidance or fear, we strengthen the neural pathways that associate anxiety with danger. However, through intentional and regular practice, we can create new pathways that help us respond to anxiety in helpful ways. For example, if we fear public speaking, avoiding it will reinforce anxiety and our fear of feeling anxious, while gradually exposing ourselves to public speaking will help strengthen tolerance and acceptance of anxiety, our confidence and resilience. 

Medication can be used to help us manage anxiety. Medication is often used in parallel with therapy. Therapy can be a powerful starting point for anyone looking to improve their relationship with anxiety. Working with a counsellor provides a supportive space to explore anxiety triggers, develop coping useful strategies, and practice new ways of responding to anxious thoughts and feelings. Through therapeutic approaches such as cognitive-behavioral therapy (CBT), mindfulness therapies, somatic therapy, and exposure therapy, we can gradually rewire our brains, reducing anxiety’s power over us.