Welcome back, all my WIMBAs. I hope you are doing amazing as you listen to this episode. But if you’re anxious, you are in the right place because today we are going to dive into anxiety and how to override your anxious mind. But before we do that, let’s zoom out and talk about what anxiety is really about, what causes anxiety for women in medicine, and how anxiety gets perpetuated. I have some client stories to share with you as well.
To start us off, let me first say that anxiety is about control. When you lack control over your environment and feel unsafe either physically or emotionally, you might develop anxiety due to all your worries. So a big part of anxiety is worried thoughts.
One of the principles you’ll hear me talking about over and over again is that our thoughts create our feelings. You have an interpretation of your circumstances and if you get stuck in a thought loop, you will likely feel anxious.
Let’s look at different example of how this plays out for women in medicine.
Remember when you were a medical student? Perhaps you were asked a question while on hospital rounds. If you answered incorrectly, you may have been encouraged to look up the correct answer or embarrassed in front of your team. If that happened to you, or if the culture where you studied was cut-throat, you might have become anxious about getting the answer wrong.
One of my clients shared that she becomes anxious when she gets put on the spot. Her mind goes blank. Her belief was that she was going to get it wrong – say the wrong thing, do the wrong thing. So in addition to culture, sometimes the pressure of the situation can produce anxiety.
Other clients expressed anxiety about getting their medical treatment wrong because their patients’ lives are a huge responsibility. They want to do their due diligence, but their job and all their training don’t come with a guarantee.
The medical field is inherently uncertain for the reason I just mentioned. In addition, it is often coupled with high demands. This may contribute to excessive worry and a lack of perceived control or learned helplessness.
As I mentioned earlier, anxiety is about control. When we feel out of control in our lives, we try to control things in our mind, but overthinking, ruminating, and catastrophizing never helped anyone.
Many women in medicine are filled with self-judgment. This comes into play especially for those of you who are perfectionists. If you have such incredibly high standards, you will be more likely to judge your performance, to compare yourself to others, and to feel anxious about making mistakes or not doing a good enough job. Which brings me to…
Often, anxiety is around the fear of being judged by others or about disappointing others. One of my clients became anxious when she made a mistake because she believed that she would disappoint people and that they would lose trust in her. On a rational level, she didn’t believe it, but a part of her believed it enough that she struggled with anxiety for long periods of time. What are you worried about? Notice if those worries are about what others will think in the future.
If you have problems in your personal life, this may take a toll on you that can affect your mental health and therefore your performance at work. This can be your health, relationships, or any other matter that emotionally depletes you.
In addition, all of these scenarios that I shared are exacerbated when you have unresolved traumas, when your stress is chronic, when you have a family history of mental illness, and when you have physical conditions that affect either your hormones or create pain and discomfort.
I just want to mention that there’s a difference between feeling anxious and having an anxiety disorder. People have fleeting anxiety in the same way that people experience sadness. You might be watching a sad movie and find yourself tearing up. That wouldn’t constitute a depressive episode. In the same way, if you’re worried about your presentation tomorrow, that’s normal. It’s when your anxiety is chronic and debilitating that it affects either your performance or wellbeing or both, that it should feel concerning.
Here’s what you want to understand about anxiety. It happens in a cycle.
First, you overestimate the probability of threat and its cost to you. We see this with people who are always on edge and people who catastrophize about worst case scenarios always. When you start thinking in this way, your brain starts paying more attention to threats, thereby missing cues of safety. In most situations, what we know, is that the brain focuses on the negatives as a means of keeping us out of danger, but what you focus on grows. If you’re in an anxious state, you’ll only think worried thoughts. But in the event that you turn your attention toward other details or help you calm down, you’ll notice that you’re able to see things that were there all along but that your mind missed.
Have you ever bought a new car and suddenly saw that brand of car everywhere? It’s the same principle. Those cars were there but you never noticed them until they became top of mind.
As a result of paying attention to any and all signs of danger or threat, you become worried about your uncertain future and start to avoid things.
From a biological perspective, this all makes sense. And that’s what your subconscious mind is programmed to do. It’s why as a species, we’ve stayed alive all these thousands of years. The problem is that your brain doesn’t differentiate between true threats and psychological threats. It treats that speech you have to give in the same way as it would a tiger that is about to pounce on you.
Any time there is uncertainty, it’s a breeding ground for your mind to panic.
The more you avoid, the more you feel safe, the more you want to avoid. Makes sense.
But the truth is that when you avoid, you actually stay anxious.
Let me explain.
Think about what happens when you have a fear of flying. If you avoid flying, you avoid experiencing that anxiety of being on an airplane. But you also get to keep your fear of flying. It doesn’t get cured. If, instead, you faced your fear, you would feel anxious and realize that your anxiety doesn’t kill you, that you can survive the flight, and with enough exposure, your fears will vanish.
One thing to note is that this phenomenon is true not only with anxiety, but with all negative emotions. We often feel anxious about any discomfort so if we find our emotions uncomfortable, we are more likely to avoid feeling them at any cost. That’s where addictions sometimes come in. People are finding ways to mask their emotions. This is a form of avoidance.
Now that you understand what anxiety is and have some scenarios in mind that create anxiety in you, let’s talk about what you can do to override your subconscious mind.
I recently worked with a client whose pattern was that she’d get anxious and that anxiety prompted her to make a choice. After the fact, she’d realize she didn’t think her decision through. In other words, she’d become impulsive in her decision making as a way of dealing with her fear of missing out. She was worried that if she didn’t grab the option in front of her right then and there, it would disappear for good. What helped her was reminding herself that the world wasn’t going to end.
It all started for her with a spiral of “what if” thoughts. These led to impulsivity. Then she’d be back to wondering if she made the right decision. She’d be filled with self-doubt and to escape the negative emotions, she would drink.
For other people, the anxiety works in just the opposite way. They are so worried about making the wrong decision that their thoughts stay in a loop and they procrastinate making a decision.
Another client of mine was in a car accident. For months afterward, she felt anxious about being in another accident anytime she was driving. This is an example of reliving your past. One thing to note is that while depression is usually focusing on the past, anxiety is about something bad happening in the future. But in the case of my client, you can see how sometimes your mind plays tricks on you and makes you believe that you are experiencing your past in the present or worrying about it happening in the future. This anxiety doesn’t usually keep you safe. It only sucks the joy out of your current experiences. So it’s important to notice your thoughts and bring yourself back into the present moment.
I’ll share one more example. I had a client who would catastrophize every time she had a fight with her boyfriend. She worried he would leave her. As it turns out, when she was growing up and her parents would fight, her dad always asked her mom, “Do you want me to leave?”
So now that I’ve outlined different ways in which anxiety can manifest, I want you to consider ways to turn this around:
If you’re worried about a future event, ask yourself, “What might happen?” And if that were to happen, what would you do? It’s a good idea to think this through and see yourself managing the situation. You can even have a plan B and a plan C in case your original plan doesn’t work out.
If you’re worried something bad will happen and there is nothing you can do about it, remind yourself that you have control over the things you do and say. You don’t have to self-sabotage.
Another way to reduce the sense of threat about the future event you’re dreading is to ask yourself, what is the likelihood that this will happen? I asked this of my client who was worried her boyfriend would leave her and she said, “Not likely at all.” Then she was able to see that staying focused on a highly unlikely scenario is a huge waste of energy. That said, ask yourself, “What is more likely?” And you know what she said? “We’re going to move in together and have new adventures.” And that’s what happened.
One thing to note is that you probably catastrophize in areas where you feel less confident and you feel anxious when you have a low sense of control. Remember, true control is in the mind, in the way you manage your thoughts. So the next time you feel anxious, remember that you can turn your anxiety around simply by shifting the way you think.
It will help you feel more powerful, more in control, and more energized than the alternative. What’s better than that?