Managing Negative Emotions (like anxiety!)

Believe it or not, anxiety can be good! It can help us tackle difficult situations and get through tough circumstances. On the other hand, too much anxiety gives us the opposite effect. It depletes us and undercuts our effectiveness. We'll talk another time about boosting positive emotions, but this post is meant to help us manage negative emotions, such as anxiety, fear, and unease.

Catastrophizing and the relationship of anxiety to resilience

If you've read the post Challenge Negative Self-Talk, you've heard about the five thinking traps. These are different belief systems that block our ability to see things from different perspectives. One of them is called catastrophizing. Catastrophizing can lead to wasting critical energy by ruminating about irrational, worse-case outcomes of a situation. These emotions can stop us from taking action. As you might imagine, catastrophizing is not a healthy or helpful way of thinking.

When we have intense anxiety, our thoughts can be so vivid that the body responds as if what we’re imagining is actually happening in the moment. The body goes into a fight or flight response.

Effects of anxiety on our bodies

Stress activates different systems in our body. When we’re anxious, our body thinks it is reacting to a threat! Even though our bodies are pretty amazing, they can’t tell the difference between what is really happening and the story our brain is telling us.

Dr. Michael Baime is the Director of the U of Penn Program for Mindfulness and a leader in mindfulness-based stress reduction. During a resiliency course, Dr. Baime describes what happens to the body during the fight or flight response. As a nurse, you’ve already heard about this during school – but here’s a quick refresher!

The nervous system is meant to help us adapt to surroundings. The sympathetic nervous system is activated when we are stressed. It gears us up for action and preps us to fight or run.

During the fight or flight response, hormones are released throughout the whole body. Adrenaline increases heart rate, dilates pupils, shifts blood to muscles that can help us fight or run, and moves blood away from digestive places or other places that might help us renew or regenerate.

Adrenal glands secrete cortisol (what you may often hear called the “stress hormone”). This hormone helps us use stored energy to act in the short run, but in the long run it impairs healing and weakens the immune system. Long term cortisol secretion is even associated with diabetes.

On the other hand, the parasympathetic autonomic nervous system is used for digestion, using food to heal or restore, regenerating the body, or sleeping to repair the body. When our fight or flight system is activated, all of these necessary functions of the body are shut off.

How does anxiety affect you?

I break out in hives at time in stressful situations. I’ve also discovered that I get REALLY COLD when I am very anxious, so much so that I shiver and my teeth chatter. Some people get dry mouth, nausea, or headaches. Researcher Susan Nolen-Hoeksema has produced interesting research that shows the differences in responses between male and females during the beginning stages of uncomfortable emotions (like anxiety).

Her research showed that in general, men distract themselves (leave the situation, play video games, or go outside), while females ruminate about the situation (think about it or call a friend to talk about what they are feeling).

Unfortunately, rumination increases the negative emotion. What does this teach us? It might be helpful to take a break, take a moment to breathe, or even distract yourself until you can circle back to the situation with a clear mind.

Soooo..... we talked about catastrophizing a little bit earlier.

There are three types of catastrophizing.

All three types engage the flight or fight response. They include downward spiral (a story that gets worse and worse the longer you think or talk about it, i.e. “I’ll never get this work done on time. Then I’ll get fired. Then I won’t be able to pay my bills. Then I’ll be homeless!”), scatter shot (different bad scenarios are generated due to the situation, i.e. “I’ll never get this done in time. Plus my car might break down. I probably won’t get that job. I’m never going to get my dream home."), and circling (continues to say/think the same thing over and over which can lead to procrastination, i.e. “I don’t have time to do this. There’s no time! No way I can get this done! It’s not possible!”).

There are specific styles of catastrophic triggers.

1. Ambiguity: something is unclear, and you don’t know how to make sense of it. Because it’s ambiguous, there are many ways to interpret it. The brain can push you into a catastrophic thought process. For example, if your boss texts you and says “drop by my office - I need to talk”, that might trigger catastrophic thinking ("Did I make a mistake and not realize it?").

2. High Value: something you value highly is at stake. For example, I highly value my sister. If I had plans with her and she didn’t show up or answer my phone calls, this might trigger catastrophic thinking ("Is she okay???").

3. Fear: you already fear the situation. For example, if you fear giving presentations in front of people, you might have catastrophic thinking before you deliver a presentation to a group of people ("There are so many ways that I could mess this up.").

4. Burnout: being run down or depleted. If you’re already tired or not feeling well, you’re more likely to catastrophize even if you’re not prone to catastrophizing. Get the text “drop by my office” from your boss after a long day? This can trigger catastrophic thinking.

There’s an activity for that! Write down an example or two of times you have catastrophized.

For example, mine is when a meeting with my boss gets thrown on my work calendar with no explanation. The triggers for this are the ambiguity ("what is the meeting about?") and the high value ("I care about my job and work performance.").

Then, challenge the catastrophic thoughts directly by following these four steps.

Step One: What’s the worse case scenario? Get it all out – what are the worst things that can happen?

Step Two: What is the best case scenario? This should provide some relief to the catastrophic thinking from earlier.

Step Three: What is probably going to happen?

Step Four: Action. Based on what is probably going to happen, what is the purposeful action we can take in preparation of it? What typically helps you? Deep breaths? A sip of water? What helps me the most is taking a few deep breaths and naming three things I am grateful for (I did this today at work!).

You can also prepare yourself with a specific thought that you can use with during a short period of time. For example, if you are nervous about a presentation and know that your focus might wane due to anxiety, choose an action (like taking a sip of water) or a thought (“I am prepared for this, I’ve got this”) that you can have ready to go when you need it.

Creating an action plan also can help make you feel less anxious when you actually go into the stressful event!

Writing down the catastrophic thoughts can help you realize that it’s really all they are – thoughts. They are not reality! Writing them down can also allow you to take a step back and distance yourself from them.

There are other things you can do deliberately to reduce anxiety, like practicing mindfulness or belly breathing. Do you ever catastrophize? Are there specific triggers that affect you more than others?

I hope you found this helpful! Let me know below!