Today I highlight the loss of life engagement that occurs with chronic anxiety. In addition to the distress that arises directly from anxiety’s physical symptoms, such as muscle tension, dyspepsia, impaired concentration, and impaired sleep, and from its mental symptom of worry ruminations, another tragedy ensues. These anxiety symptoms become the main focus of the sufferer’s ongoing consciousness, crowding out and distracting from all the other events and interactions taking place. In a sentence, the tragedy of chronic anxiety is – life is elsewhere.

If living life means engaging with the moments that make up a life, of looking out at and interacting with the world, then the anxious person can’t do so fully since they are continually preoccupied – quite literally. As they arrive at each new moment of the present, their attention is already occupied by thoughts that either harken to the past or focus on an imagined future. In both cases, the past and especially the future, are seen darkly. For example, a parent sending their child off to school cannot enjoy the moment if they are preoccupied with visualizations of their child being splattered on the windshield of a speeding car as they cross the street on the way to school. A person at work cannot fully focus on their task if they are preoccupied with how their boss will react to their work and about how badly it went last time. These thoughts bring on feelings of distress which, because of their chronicity, exhaust the sufferer, make concentration difficult, and lead to a burned-out emotional state. Some of my patients over the years with chronic and severe anxiety have described it to me as feeling “like my head is surrounded by a noxious cloud”, “like I’m muffled and far away”, “I barely feel like I’m there”, and “It’s like I experience the world through a long tube, through which images and voices reach me.”

So, anxiety not only adds noxious thoughts and feelings to the anxious person’s life but, equally importantly, it takes away a great deal – being present for one’s life. Imagine how this affects memories of events that occurred during periods of anxiety. The person who suffers such anxiety often can barely remember anything, for example, of their graduation, wedding day, vacation to some wonderful location, or their child’s graduation. What they often remember best is the tension and distress they felt during that event and little of the event itself. Even worse, that event, because of its association with the experience of anxiety, is now an unpleasant memory. Evoking it presently can cause discomfort and grief.

And grief is one aspect of anxiety important to note: the anxious person is aware that life is passing them by, and that experiences that would bring others joy often bring them little in the present and bad memories in the future.

I believe clinical awareness of this aspect of chronic anxiety can help the clinician better engage the anxious patient, to manage the patient’s anxiety symptoms, of course, but also to help them rehabilitate, to learn to be present, to feel enjoyment, to form experiences that will become cherished memories in the future. And, also, to help them articulate and come to terms with the years lost to the anxiety, years during which they were barely present.

Thanks and take care until next time.

Dr. Jack

Language Brief

“It’s incredibly easy to get caught up in the thick of thin things.” ― Stephen R. Covey

“Distraction leaches the authenticity out of our communications. When we are not emotionally present, we are gliding over the surface of our interactions and we never tangle in the depths where the nuances of our skills are tested and refined.” ― Marian Deegan

“Anxiety is love’s greatest killer. It makes others feel as you might when a drowning man holds on to you. You want to save him, but you know he will strangle you with his panic.” ― Anaïs Nin