Anxiety and ‘Fight or Flight’

“Anxiety is a word we use to describe feelings of unease, worry and fear. It incorporates both the emotions and the physical sensations we might experience when we are worried or nervous about something. Although we usually find it unpleasant, anxiety is related to the ‘fight or flight’ response – our normal biological reaction to feeling threatened.”

Mind, “Anxiety and Panic Attacks”

Anxiety is how many people describe the physical and mental sensations that are experienced when someone is frightened, scared or senses danger.  In that sense, anxiety is a perfectly natural state that everyone will experience from time to time.  These physical and psychological sensations are what is known as the ‘fight or flight response‘.

The fight or flight response is present in all animals and it’s the process that keeps them alive; the ability to sense and react to danger in order to remain safe is what perpetuates existence.  Sometimes, our perception of threat or danger can become over-sensitive and this might lead to problems with the normal anxiety response.  These difficulties might result in an anxiety disorder.  You can read more about anxiety disorders in this useful booklet from the mental health charity Mind.

This video explains more about anxiety, why we have it and how it can become a problem for people.

As with most difficulties, CBT looks at anxiety in terms of the way we think and behave, and how that can impact our feelings.  There is often a vicious cycle of anxiety that becomes self-maintaining and it can seem difficult to break out of that cycle.  One way to understand the cycle of anxiety is by using thought diaries to see how our thoughts, feelings and behaviours are maintaining the problem.


Panic attacks (also known as anxiety attacks) result from your body going into ‘fight or flight’ mode.  Much like other issues discussed on the course, panic attacks can be seen as the end result of a vicious cycle of anxiety.  The unpleasant physical and psychological symptoms of anxiety are often misunderstood which leads to further anxiety about the symptoms.  The anxiety increases, as do the symptoms.

Common anxiety/panic symptoms include a racing heartbeat (also known as palpitations), sweating, shaking, feeling unable to catch your breath, breathing quickly or hyperventilation, feeling unable to swallow or that you might choke, nausea, dizziness, tingling sensations and ringing in the ears.  Some people also experience feeling disconnected from themselves (depersonalisation), or the world around them (derealisation).

Understanding the symptoms of anxiety and their evolutionary function can help people to normalise their experience.  In doing so, it can prevent the catastrophic misinterpretation of their symptoms that often maintains anxiety and panic attacks.  There are some common misinterpretations of panic symptoms; some people fear that they are having a heart attack, or that they will collapse or pass out.

Avoidance is one of the unhelpful methods that people employ to deal with panic attacks.  Avoidance however, serves to reinforce the idea that anxiety symptoms are dangerous and cannot be coped with.  By escaping from the situation, the panic attack sufferer doesn’t learn that anxiety symptoms will naturally go away on their own, and that they can (and do) cope in anxiety-provoking situations.

Panic attacks can sometimes be sudden, out-of-the-blue experiences, with no discernible trigger.  This can lead to a persistent fear that a panic attack might happen at any moment.  This might be indicative of panic disorder, but a mental health professional would be able to help determine this.

The NHS Choices website has a useful podcast on Panic Attacks which you can listen to here.

There are some medical conditions which have symptoms similar to anxiety which may need to be ruled out by your GP.  There is more information on this on the NHS Choices website.

Graded Exposure

One of the techniques for learning that you can cope with anxiety-provoking situations is graded exposure.  This is covered in more depth on the course, but the basic premise is to gradually build up your interaction with feared situations in order to learn that you can cope and it’s not as scary as it was in your mind.  The process allows your body to ‘get used to’ situation until it is no longer scary (habituation).

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