S2-Episode 28 – The Lowdown On High Anxiety

So I want to say a few words about the pandemic yet again. Specifically, since we're talking about anxiety, I want everyone to really understand that this pandemic has taken its toll on our collective mental health. Now, with mask and vaccine mandates being relaxed in many jurisdiction, I want you all to understand that some people may be reluctant to change, and we need to accept this as a good thing. I for one will continue to wear a mask, social distance, and receive vaccine boosters when available. If you choose not to, that's a choice you're making, but please, please, please do not judge or shame those who still feel the need to stay safe and healthy. Remember pillar number 5 – Don't Be A Dick. Just, don't.

Today we're going talk about a phenomenon labelled high functioning anxiety. Although not recognized as a distinct anxiety condition, some people with anxiety symptoms describe themselves as being high functioning and, by this, they typically mean that they manage to function well in their day-to-day lives. Yet people with high functioning anxiety experience many typical symptoms of anxiety, such as excessive worry and fear, overthinking, and poor sleep. So with a distinct lack of research in this area, and no formal DSM-5 diagnoses, this will have to suffice as the definition. It's complete enough, just deal with it. 

Our first quotation comes from Jodi Picoult, an American writer who has published 27 novels, accompanying short stories, and has also written several issues of Wonder Woman. Picoult has covered a wide range of controversial or moral issues, including abortion, assisted suicide, race relations, eugenics, LGBT rights, and school shootings and has been described by the Encyclopedia of Contemporary Writers as, "a paradox, a hugely popular, at times controversial writer, ignored by academia, who questions notions of what constitutes literature simply by doing what she does best." She says, “Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” Hmm... that sounds familiar.

Our next quotation comes from Henry David Thoreau who was an American naturalist, essayist, poet, and philosopher. He is best known for his book Walden, a reflection upon simple living in natural surroundings, and his essay "Civil Disobedience" (originally published as "Resistance to Civil Government"), is an argument for disobedience to an unjust state. He said, "There are moments when all anxiety and stated toil are becalmed in the infinite leisure and repose of nature." Although I, too, believe in the healing power of nature, not all anxiety can be healed by it, but I think you should take a hike anyway, literally not metaphorically.

Our final quotation comes from Rose Kennedy who was an American philanthropist, socialite, and a member of the duh, Kennedy family dynasty. Her husband John F. Fitzgerald held numerous political titles over his gold-plated and privileged career, and they were the parents to many children including John Kennedy, Robert Kennedy and Ted Kennedy, all of whom also got a silver-spoon free ride in politics, although some at considerable cost. She said, "Neither comprehension nor learning can take place in an atmosphere of anxiety." So, she was right about that at least.

So what is high functioning anxiety and why are we talking about it now. The truth is, some version of this has been around forever, especially since post world war two where industry and business ramped up considerably, but the echoes of war were still very close. The middle class was exemplified by the ideal worker who never took a sick day, worked extra hours, never missed a deadline, and wore the tortuous work schedule like some shiny, glow-in-the-dark, a badge of honour. This became known as Type A Behaviour and, according a research paper in the American Journal of Public Health titled, "Type A Behaviour Pattern and Coronary Heart Disease: Philip Morris’s “Crown Jewel”, it was first named and described as far back as the 1950s. And here's the thing, it was called Type A Behaviour then, but it's the same thing as high functioning anxiety and, guess what, it's really, really bad for you. Let's talk about that, strap in.

To start, according to the article, "cardiologists Meyer Friedman and Ray Rosenman argued that TABP was an important risk factor for coronary heart disease." Further on, they state that those findings were supported by positive findings from several other research projects. At the time, the findings were not publicly supported because, in part, funding for these studies came from the tobacco industry who clearly did not like these findings. Years later, we would find out that tobacco had an even larger role to play than was stated in the original projects. That's not a surprise. What is a surprise is that nothing, and I mean nothing, changed for those workaholics who were suffering everyday under this weight, and there were even fewer mental health resources available in the 50s, 60s and 70 s then there are today. So a failure on multiple levels. 

But it's not just your heart you need to worry about. In a paper titled "Comorbidity of mood and anxiety disorders" by Kaufman and Charney, states, "estimates show that 60 percent of those with anxiety will also have symptoms of depression, and the numbers are similar for those with depression also experiencing anxiety." According to the National Alliance on Mental Illness, "there are many well-researched treatments available for mental illnesses, but not for co-morbid mental illnesses." So they can treat one, or the other, but treating both requires some creativity, and there's very little evidence for the efficacy of such treatment. And, really, having anxiety AND depression is no picnic: it is not like having chocolate AND peanut butter, or biscuits AND gravy. You get the point.

One last thing to consider: anxiety and depression can lead to sleep disorders, which may further trigger gastrointestinal disorders. In a paper from the journal Sleep titled "A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression", it states that "best available evidence suggests insomnia is bidirectionally related to anxiety and depression." It further states that "Sleep disturbances, anxiety and depression are common problems that lead to neuropsychological impairment, alcohol and drug abuse, and suicidal ideation." So it's not just your heart, or the emergence of clinical depression, but a further consequence of sleep disorders establishes a trifecta of terrible outcomes. So you may look like a super-hero at work, you may even feel energized, at times, because of your performance. But in the end, the anxiety you know you have will come back and bite you unless you do something first. So what can you do? Well I'm really friggin' glad you asked!

High functioning anxiety, although not listed as a specific diagnosable condition, can be said to be part of the anxiety-related conditions. As such, it is really, really important that you realize that a pretend life coach can NEVER help you out of this if it's serious enough. If you think you have a psychological issue, please seek actual help from a real professional before self-diagnosing or listening to a kook like me, or, you know, Dr. Phil, or worse, Dr. Oz. Having said all that, I will tell you that the best thing you can do is understand what's going, and why, and arm yourself with the information you need to get on track. Look at the problems in your life, truly try to isolate what is anxiety-related, and be honest with the level of anxiety you have, this is where you must start.

Once you've taken stock, start to think about what you're doing and how you're filling your time. Here's where I'm going to repeat something I've said in at least two other podcasts - eliminate some of the extra shit in your life. That's right, it's just say no speech. But seriously, the world will not come to an end if you say no to a few things, and you spend that time recharging and focusing on where you are and what you need to do to be less anxious. You will not lose friends, and the world will still continue to operate, you'll just be out of the machine for a while. Taking a step back to get the bigger picture is a great way to put things into perspective and show you what's really important.

And, as a final thought, if you don't need to, or want to, see a doctor, the very least you can do is develop a support team around you. They don't have to be psychology or psychiatry professionals, just people that you know who wont judge you and will help you put those thoughts and chaos into containers for you and allow you space to breathe and relax. They may tell you to seek help and if they do, you should consider that advice. They may tell you to buy more musical instruments, and you should listen to that too, but be realistic about how far material things will get you. This is a psychologically neural atypical situation you're in, so you need to not find a quick fix. Ask questions, get answers and opinions, and talk to knowledgeable people, and a plan will become obvious to you. But at some point, trust someone else to tell you the truth if you don't know it yourself.

Okay, so that’s it for this episode. As always, I’ll leave you with a Disgruntled nugget in a second, but first I want to thank you for listening. Remember to subscribe to this podcast, I’m on all the major platforms, and please visit www.disgruntledlifecoach.ca for all my podcasts – if you're following along, you'll know why that w-w-w pisses me off. Please also follow me on twitter @lifedisgruntled, there’s a link on my website – DM me if you want some stickers, really, free stickers. Free. Also, if you like what you’ve heard today, tell your friends. If you think this is ridiculous, still, tell your friends, I mean how hard is that?

Disgruntled Nugget
Hillary Clinton once wisely said, “Don’t confuse having a career with having a life.” Then Dolly Parton who is not confused, clarified by saying, “Never get so busy making a living that you forget to make a life.” And then, in the immortal words of Mr. Miyagi, balance comes to forefront when he said “Better learn balance. Balance is key.” So we should all be less confused if we learn balance because life is not the career we forgot to wax on, was off, or something, I don't know, whatever...

Again, thanks for listening, and thanks also to Audionautix and Partners in Rhyme for music and sound FX, thanks again to Neatnik for visuals, and thanks for your patience - see you in two weeks, or not, whatever...