Anxiety can have crippling physiological effects, says "Your Name is Not Anxious" author Stephanie Dowrick. Photo / Getty Images
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It’s no wonder we’re all feeling anxious, psychotherapist and bestselling author Stephanie Dowrick tells Joanna Wane, but it doesn’t have to define us.
Women, some studies would have us believe, suffer from anxiety at almost double the rate of men. Or do they? Stephanie Dowrick, author of self-therapy book Your Name is Not Anxious, isn’t so sure. Originally from Wellington, the Sydney-based psychotherapy researcher, award-winning writer and “A-grade worrier” talks to Canvas about anxiety reaching plague proportions in the world and why the “snowflake generation” has her sympathy.
How do you explain the gender gap when it comes to anxiety — is it that women are more able to openly express their feelings while men often tend to suppress them?
I think it’s also that quite a lot of men are unaware that their irritability or their reactiveness or their competitiveness is actually a form of anxiety and they don’t identify it as such. They might be overworking, doing insane amounts of fitness or going from one relationship to another hectically. I would say it’s actually a lack of understanding of the different forms that anxiety can take. Irritability and anger are very prominent. We often think of anxiety as a kind of passivity, but no.
Anxiety seems to have become such an overused buzzword to describe virtually any feeling of awkwardness or mild discomfort. Are we in danger of medicalising everyday life?
It’s when your life is changed by it, when your mind is consumed by fear, dread and catastrophic thinking. We have to make a distinction between a bit of anxiety, quite a lot of anxiety and anxiety that really has taken over, where your entire existence, from waking to sleeping — if you ever sleep — is ruled by anxiety. That’s a very tough place to be. And treatment is absolutely necessary because it’s life-threatening.
I write very frankly about my own perfectionism and catastrophic thinking, which has its origins in the trauma from my mother’s death when I was 8. At the same time, we do need strategies to deal with the ordinary complexities of everyday life so that they don’t overwhelm us. Being anxious is only a part of who you are, it doesn’t define your identity. And not believing that our thoughts are inevitable is a huge, liberating change.
In your research, were you surprised that stress and anxiety are so inextricably linked?
I thought I knew quite a lot about anxiety, but the physiological effects of stress were a huge discovery for me. When we’re feeling stressed, we’re flooded with stress hormones, including cortisol, which has a whole range of adverse effects - not just sleeplessness but, for example, it affects our body weight, it affects our judgment.
When we are in a state of high alert, our thinking functions — which include planning, strategy, initiating or responding really thoughtfully — are not just diminished, they may even be almost unavailable to us. If any of us are feeling acute or chronic anxiety, we have to find ways to reduce stress. It’s not optional. Otherwise, we’re living in this kind of heightened state of alertness that physically manifests and is very, very undermining psychologically.
The notion that so-called mood disorders are just in the mind and therefore not to be taken seriously or are a kind of psychological weakness is completely absurd. It’s even more absurd in the 21st century when we understand so much better than we ever did about the inevitable interactions between brain, body and mind.
Millennials have been described, not always kindly, as the most anxious generation in history. Are they really “snowflakes” or do they have every right to be worried?
I’m having conversations with young people who feel they can’t have children because of the climate anxiety their generation feels or they’re making decisions about where they will live and what career they will pursue based on the fact that life is so very uncertain. Every generation that’s older needs to take some responsibility for that.
And let’s face it, in New Zealand and Australia, we have an overwhelming presence of self-medicating. There are people who might be very dismissive of anxiety but can’t get through a day without emptying a bottle or overworking or expressing [stress and anxiety] somatically through pain.
There are two really good stories in the book from young people who talk a lot about how their generation perceives anxiety and are actually kinder to each other about it. But they also notice that some areas of their life will be very much shadowed by anxiety. For example, a lot of high-achieving young women have very serious, very acute anxiety around performance — doing well — and are extremely hard on themselves by standards that are cruel.
Tell me about what you call “the dopamine dilemma”.
Dopamine is a neurotransmitter that’s released when we are anticipating pleasure. On social media it’s undoing us. We’re driven to get some sort of satisfaction from constantly checking our phones, whether what we actually get is good or bad. With younger people, their phone has become an extension of their arms.
What’s your own relationship with social media?
I use my public Facebook page to be fairly frequently in touch with readers, and I use Twitter for social activism and to stay in touch with events I think are important, for example, what happened in Australia around The Voice referendum. Race, justice and peace activism have been important to me since I was a child.
I like your idea of doing a regular “stress audit”. What’s yours?
I have a mild version of OCD. So if I notice that I’m becoming obsessive about whether I’ve locked the door, I need to look at what else is going on in my life. Am I too crowded with concerns about this, this, and this? Am I not sleeping well? Am I rushing past something that would sustain me? One of the things I suggest is noticing patterns and then deciding in which bit of the pattern there could be a shift. Often, we feel we don’t have time to do what we most need.
In the book, you share the story of a woman who started an ocean swimming group called The Numbskulls in Victoria, where the water temperature is as low as 8 degrees! She’s found it transformative for her mental wellbeing — have you tried it?
I haven’t, because I’m a terrible swimmer. I live mostly in Sydney, but I also spend some of the time in Darwin and we don’t plunge into the sea there because it’s full of jellyfish. They can be more dangerous than crocodiles.
Australians seem to have a sunnier disposition than New Zealanders, who can be quite introverted and glum. Do you think Kiwis are more predisposed to suffering from anxiety?
I’d say the opposite. Sydney and the other big cities are very stressed. Economically, it’s a disaster. I think this is an extremely stressful nation. We have a massive gap between rich and poor, and the most incarcerated [First Nation] people in the world. So I don’t think Australia is a fair or particularly happy country.
There’s also a brutality in the political landscape that worries me a great deal. New Zealand has some of the same problems, but how they’re talked about here is very different. The Murdoch media, for example, is defensive of the indefensible in such a powerful way. I’ve explored the interdependence of brain, mind and body, but I believe in our collective interdependence as well. How could I possibly do well and feel great at your expense? That comes from my New Zealand childhood, and it’s been with me my whole life.
* Your Name is Not Anxious, by Stephanie Dowrick (Allen & Unwin, $32.99) on sale now.
* The NZ Herald’s 10-part web series, Unravelling Anxiety, can be found at nzherald.co.nz/topic/misconceptionsnz
Anxiety is a rational response to a world like ours, writes Dowrick, but you can reduce its sting. “Learning and practising ways to soothe yourself is basic self-care — and makes so much more sense once you know what involuntary physiological and neurological effects accompany chronic or acute anxiety.” Here are some of her self-therapy strategies.
Press your pause button
Those of us who feel anxious, overwhelmed and subject to occasional catastrophising are likely to have some favourite habitual distractions: overnight TV show binges where you are already exhausted, that extra-large block of chocolate when you’re not hungry, late-night shopping for clothes you can’t really afford. Not acting on impulse is a powerful means of putting you back in the choice seat. Ask yourself: What am I feeling right now? What would I prefer to be feeling? What’s stopping me?
Do a regular stress audit
Stress and anxiety are inextricably linked. Understand your own warning signs, and make a commitment to check in regularly by observing your thinking and where it is taking you. What are you making time for? What are you neglecting? Notice when you feel particularly vulnerable or most triggered. Establishing who or what will provide your safety net is basic self-care.
Calm the body first
If you’re feeling agitated, take a brief warm shower, then run the water as cold as you can bear it. Focus on the feel of the cold water on your body — even if it is for less than a minute initially. Enjoy the shock! Don’t think, feel. Note the physical sensations that take you into your body and out of your head. This will send a message to your nervous system to slow down.
Settle your stress hormones
Slow, focused breathing tells your body: “The crisis is over or passing.” Count in/out breaths in rounds of 10, directing your breath down into your trunk, the base of the spine, the legs and the place where the soles of your feet meet the Earth. Do this twice a day for 5-8 minutes for general health benefits. In a crisis, do it for 3-4 minutes, take a very short break, then repeat until you feel calmer and more inwardly collected.
Change the pattern
Morita Therapy is a Japanese philosophy that suggests acknowledging whatever your feelings are, rather than attempting to shift or ignore them. However, instead of being ruled by those feelings, choose to do something because it needs to be done. Action can shift feelings, favouring your power to choose over habits of anxiety and conditioned responses that might otherwise hold you back. Choose to do something because it needs to be done, or because it can make a positive difference.
Find your ‘mushroom’ equivalents
As Superwoman author Shirley Conran famously said, “Life is too short to stuff a mushroom.” Ruthlessly determine what is essential and what has to wait or drop off the list. Do this with a light heart, not guilt, and silence your inner critic. You are not failing, you are stressed — and taking action on that.
This story was originally published on July 8, 2023
Let’s take a look at the science.