Generalized Anxiety and Panic

Somatic and cognitive manifestations of anxiety.

Generalized anxiety is not simply "excessive worry"; it is a physiological and cognitive state of constant alertness that wears down the nervous system.

It is characterized by chronic activation of the sympathetic system, resulting in physical symptoms such as persistent muscle tension, gastrointestinal disturbances, tachycardia and a feeling of shortness of breath.

On a cognitive level, the mind becomes trapped in a "what if" loop, anticipating future disasters that rarely occur.

This hypervigilance creates a self-fulfilling prophecy: the body responds to imagined fear as if it were a real threat, reinforcing the belief that danger is imminent.

The disorder sets in when this response interferes with daily functioning, preventing rest and concentration due to a pervasive sense of fear without an immediate justified cause.

Emergency interventions for panic

For panic attacks, where anxiety reaches an acute, disorganized peak, cognitive interventions are often ineffective in the moment. DBT proposes direct physiological interventions, such as TIPP skill.

The use of drastic temperature changes (such as immersing the face in ice water or holding ice) activates the "dive reflex," which forces the heart rate to immediately slow down.

Likewise, slow, controlled breathing counteracts hyperventilation, sending safety signals to the vagus nerve.

These techniques act as a biological emergency brake, reducing the intensity of the seizure enough for the individual to regain access to his or her prefrontal cortex and think clearly.

The avoidance trap and the exposure pathway.

The mechanism that maintains and aggravates anxiety is avoidance.

When you avoid a feared situation (such as speaking at a meeting or driving on a highway), you experience immediate relief, which reinforces the flight behavior.

However, this confirms to the brain that the situation was actually dangerous and erodes self-efficacy.

Treatment requires reversing this pattern by gradual exposure and prevention of the flight response.

By remaining in the anxiogenic situation without escape, the nervous system eventually habituates and anxiety naturally decreases.

This process teaches the body, through direct experience, that