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BUILDING SAFETY ANCHORS

Generalized Anxiety Disorder & the Polyvagal Theory / ep45 show notes

Updated: Mar 27



TOPIC - GENERALIZED ANXIETY DISORDER & THE PVT

**Disclaimer: This information is NOT meant to diagnose. If you feel like you may be experiencing symptoms of anxiety, consult with a mental health or medical professional. We are speaking in generalities. Your specific situation, diagnosis, treatment and medication are entirely between you and your provider.


Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

  • Anxiety is general, doesn’t need to be about a specific thing, can be about future, present or the past

  • Worry is about a specific future thing

  • In sympathetic arousal, we have energy to survive

  • “Excessive”: If there’s no direct threat to our safety, the energy lingers and then gets placed onto things that don’t require that energy

  • When in safe/social, we simply don’t have out of control anxiety

  • It’s tolerable, noticeable and signals something needs to change in a relationship or we may have to prepare for something like a test

  • It’s accurate, it’s a message related to something

  • Not an issue of actual bodily danger, but that system still kicks on


The individual finds it difficult to control the worry.

  • Difficult to ground the self

  • Difficult to control the thoughts because it’s a state issue


The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one item required in children.

Restlessness, feeling keyed up or on edge.

  • Energy within you that needs to be discharged

  • Our experiment with not laughing in presentations

  • Being ‘on edge’ or ‘keyed up’ is the experience of being in a flight/fight state


Being easily fatigued.

  • You’re constantly on edge, keyed up, constantly tense and ready for danger

  • Sounds pretty fatiguing to me

  • Exhaustion is a common underlying emotion in therapy


Difficulty concentrating or mind going blank.

  • Ready for danger, scanning

  • Hard to focus on one thing that is not dangerous

  • Easy to focus on something and perceive it as dangerous

  • Everything seems like a potential danger

  • Everyone seems like a potential danger

  • Little things become big problems


Irritability.

  • On edge, keyed up

  • The experience of being ready to run

  • But the inability to discharge the energy may actually result in dropping further down

  • “Irritability” seems like a mild fight state to me

  • Because you direct it outward


Muscle tension.

  • Ready to run

  • On guard

  • Don’t laugh, don’t seek eye contact or escape from a mild distress and see how you feel

  • Or think of something that brings mild irritation like a sound or what someone does: chewing nails


Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).

  • Immobilizing is a cue of danger

  • The neural platform is not for sleeping!


The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Does flight sympathetic energy cause this? Natch.


The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

  • These things are not necessary for flight sympathetic arousal.


The disturbance is not better explained by another medical disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder)

  • These things are not necessary for flight sympathetic arousal.



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