Anxiety in the East and West
“Perhaps, nothing ever really attacks us except our own confusion. Perhaps there is no solid obstacle except our own need to protect ourselves from being touched. Maybe the only enemy is that we don’t like the way reality is now and therefore wish it would go away fast. But what we find as practitioners is that nothing ever goes away until it has taught us what we need to know.”
Pema Chödrön
Everyone experiences anxiety at some point in their lives. Whether it's the nervous anticipation before a big presentation or the uneasy feeling of walking alone at night, anxiety is a natural and unavoidable part of being human. In fact, it can even be seen as a sign of intelligence and self-preservation, as it has evolved to help us navigate the world and keep ourselves safe. However, there are those whose experience with anxiety goes beyond the typical worries and fears. For these individuals, anxiety can become an absolute living nightmare, consuming their thoughts and actions, making every day an uphill battle against their own minds.
When does anxiety become suffering? Where is the line between normal worry and agonizing anxiety?
Everyday anxiety usually occurs occasionally or when you anticipate specific situations. People with everyday anxiety typically find that their anxiety goes away when those situations end or when they find a solution.
For someone who truly suffers from anxiety, or someone with an anxiety disorder, the feeling is chronic and pervasive. Anxiety happens even when there doesn't seem to be a clear reason to feel anxious. For people with an anxiety disorder, anxiety turns against them, causing tremendous suffering. It significantly affects their quality of life and can worsen if not addressed.
Because anxiety is common, those with higher levels are often dismissed by others who may only experience everyday anxiety. Because of this, individuals with anxiety often feel embarrassed about their difficulties, which can eventually lead to low self-esteem.
Symptoms: What does Anxiety feel like?
Here are some ways that anxiety can manifest in your body:
mild irritation
fast or irregular heart beat
sweating
feeling flushed, dizzy
shallow breathing
nausea
teeth grinding, tensing of muscles
physical aches and pains
irritable bowels, needing to use the restroom more often
lack of appetite or overeating
and more
Anxiety can manifest in your thoughts and emotions in various ways:
racing thoughts
excessive worry
difficulty concentrating, or the mind going “blank”
not being able to slow down or let go of worrying
rumination of “bad” experiences (thinking about them over and over again)
restlessness, unable to relax, feeling on-edge
feeling that something horrible is going to happen, or a sense of dread
feeling self-conscious that other people can tell you are anxious or that other people are mad at you
having anxiety about anxiety
feeling the need for constant reassurance that other people are not upset with you or that you are okay or that a situation is going to be okay
feeling disconnected from yourself, others, and/or the world around you
sleep disturbances
and more
A Western View on Anxiety
According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), someone with generalized anxiety disorder (GAD) experiences some or all of these symptoms for more days than not for at least 6 months, finds it difficult to “stop” or regulate their fears or worries (as long as the disturbance is not caused by substance use or better explained by another mental health condition). For someone with GAD, symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The Western, cognitive-behavioral perspective views anxiety as an excessive stress-response stemming from distorted thinking patterns and maladaptive behavior. The Western approach to anxiety treatment includes challenging these patterns and replacing them with more realistic and adaptive responses to stressors. Research has shown cognitive-behavioral therapy (CBT) to be the leading treatment for anxiety disorders.
The down-side of CBT is that many people find this approach dismissing to their experiences and lacking insight into how or why they have adapted to think and behave in certain ways. For this reason, many therapists are trained in various modalities and incorporate a blend of CBT with insight-oriented talk-therapy, which can (and in my opinion, should) include compassion for the stress one has endured and continues to endure.
The medical model views anxiety as an imbalance of chemicals in the brain, most commonly, one called serotonin. Anxiety and depression are viewed to be caused by imbalances in serotonin levels. To treat these conditions, doctors typically prescribe medication to restore the right balance of serotonin and alleviate symptoms. Combining therapy with medication is often seen as the most effective way to treat anxiety disorders when therapy alone isn't enough.
A Buddhist View on Anxiety
Some Buddhist lineages assert that the crux of anxiety arises from the deep-rooted fear of death. Not only death in the literal sense, but also the profound unease that arises when confronted with the transient nature of all things.
The practice of meditation in Buddhism is not to reach some goal of becoming an expert meditator. The practice of meditation in Buddhism is learning how to be more present in our lives, which includes seeing things-as-they-are. Thoughts are thoughts. Sensations are sensations. Feelings are feelings. The suffering of anxiety comes when we attach to notions that our thoughts, sensations, and feelings are something other than their intrinsic nature. More specifically, we suffer when we cling to them, turn away, or fight them.
The Buddha taught about the Three Marks of Existence, which is just a fancier, more systematic way of categorizing things-as they-are. The first mark of existence is impermanence; meaning that everything, all phenomena is ever-changing, bound to disintegrate, certain to end. In other words, everything dies.
The second mark of existence is pain (many texts say “suffering” instead here, but I find it misleading). Pain is an inevitable part of life, whether it’s extreme distress or even a subtle sense of un-ease. Illness happens, aging happens, accidents happen, death happens, and pain happens with it all.
The third and last mark of existence is egolessness, or no-self, meaning there is no solid, separate sense of self. This means, that there is no core of who we are, no matter how many ideas and stories we have attached to what it means to be “me” as a separate entity. Egolessness asserts that we, in the here-and-now, are simply the result of multiple causes and conditions.
The three marks of existence are important because they provide the foundation for understanding suffering. Suffering arises when we try to ignore or deny these principles, even though they are fundamental aspects of human existence. This view is simple, but not easy to digest.
If you had to boil it down to one mark of existence (and our resistance to it) that causes the suffering of anxiety, which would you pick? I think it could be any, all, or a blend of a few. I believe we all have our different flavors of anxious suffering.
Suffering of impermanence: We suffer when we try to deny the fact that everything and anything changes and eventually will come to an end.
If anxiety, at the crux of it, is the fear of death, then one might say that anxiety is caused by turning away from the first mark of existence, impermanence. We cling to consistency, so when things change, we feel anxious because we believe they should remain constant, predictable, and not unexpected.
Suffering of pain: We suffer when we think that we should not be experiencing pain, or that the pain we are feeling is “wrong” somehow.
We can feel anxious when we try to avoid the unpleasant feelings and physical sensations we experience. Being in an alive, vibrant human body comes with many sensations, many pleasant, many unpleasant. We suffer when we confuse unpleasant for “bad” or “wrong” and therefore resist unpleasant sensations, which may feel painful at times; often, we do not realize that it is the resistance, not the sensations, that cause us the suffering of anxiety.
For example, excitement and anxiety share very much the same physical sensations; shortness of breath, fast heart-rate, sweating, dilated pupils. The difference is in how open or closed we are to experiencing these sensations. Discomfort is not suffering, yet so often we mistake them out to be the same thing. Some people misinterpret sensations so often that they hardly ever feel excitement anymore. We learn to fear the experience of excitement, as the mere sense of it turns straight into anxiety and fear.
Suffering of non-self: We experience distress when we cling to rigid ideas of our identity, especially when confronted with circumstances that challenge these deeply held convictions.
Anxiety has evolved to tell us when something is wrong in our environment, so that we can take rightful actions to stay safe. That is the wisdom of anxiety. That is why we need it. The suffering of anxiety (in the realm of egolessness) comes when we mistake the experience of anxiety as something that is wrong with “me.” Or, that something in the environment is surely wrong— “surly this will happen to me”— despite no direct experiential evidence of threat.
Focusing too much on what anxiety sensations imply about ourselves or our situation and holding onto these beliefs amplifies our suffering with anxiety. Alternatively, we may become preoccupied with thinking that experiencing anxiety means we've made a mistake or that there's something wrong with us, which is another way of clinging to the idea that anxiety defines us.
We also suffer when we believe we are special, which includes being cursed (a macabre twist on one’s special-ness) with anxiety. We turn away from things as they are because they do not match the stories about “me.” If I strongly believe that I am unworthy of love (which is already painful), I will feel even worse when I misinterpret acts of kindness from others as something bad or unwarranted. The things we genuinely desire often become things we reject because they don't align with our convictions about who we are.
Anxiety is fundamentally wise.
Anxiety is that guttural response that tells us when something might be wrong. Anxiety tells us to stay alert to stay alive. It can tell us when we are in a situation that is not working for us and when it’s time to make a change for the better.
Anxiety is meant to be a fleeting experience, a temporary reaction that serves a purpose. It is not meant to be a stagnant state where you find yourself trapped, feeling as though there is no way out. If anxiety has settled in as a persistent companion, it's important to understand that it's not your fault. It's a learned coping mechanism, initially due to a deep-seated wisdom within you. However, just as you have learned to relate to anxiety in the ways you do now, you can unlearn it too.
You have the power to break free from the chains of anxiety and discover a more liberating way to live. Therapy helps! A good therapist for you is a solid ally, offering support, insight, skills, and a caring guide on this path of self-discovery.
