Tension: a physical manifestation of anxiety?

Do you find yourself feeling tense at the end of a day, or even from the very start? Maybe this tension is accompanied by headaches or other muscle aches, or grinding of your teeth. What's going on with tension?

Tension in the body - tightness and contraction of the muscles -  is often a physical manifestation of stress and anxiety - stress being the process of how we respond to stressors and anxiety being a common emotional response to such stress. Our response to stress often exacerbates the whole process, e.g. if you work harder because you are stressed by the volume of work you need to complete by a certain deadline then that will make you feel more tired, your muscles more tense and result in you worrying more about not completing the task in time. As you notice the symptoms so you worry more, becoming more anxious and so more aware of the symptoms - a vicious cycle. And then you can't sleep properly to unwind and relax the body. That in turn affects how you might interpret similar situations in the future,  developing into some deeply rooted assumptions or beliefs about the world and your interaction with it.  Sometimes, of course, tension may be the result of a physical injury, resulting in pain. But anxiety about that pain can also exacerbate it significantly.

Focused attention on your symptoms is all part of the 'fight or flight' response of anxiety - a fear that something bad is going to happen and you won't be able to cope - along with racing heart rate, sweaty palms, shallow breathing etc. And in such a focused state you will invariably find the body tense; muscles tensing as if ready to fight or flight. So how to deal with it? Shifting attention away from yourself and the symptoms is key, connecting more to the outside world, using all your senses in the present moment, and connecting to other people and things. Mindfulness techniques can enable you to unlock the spiral of negative story-telling that feeds the anxiety and the tension. And then various applied relaxation techniques can help you let go and really, fully relax! 

You may never have experienced real relaxation before, until you have acquired the skills to let go and bring about the 'relaxation response' - the opposite of the flight or fight response that causes anxiety. Have you ever been to a physiotherapist or osteopath and they've told you to relax your arms or legs, but you couldn't? It's not uncommon for people who suffer from anxiety to be anxious about relaxing, letting go, perhaps feeling they don't feel in control if they let go, or maybe they've no right to be relaxing instead of getting 'stuff done'. 

So relaxation isn't likely to be a solution on its own, unless you tackle the root cause of the anxiety first,  especially the 'thinking errors' that are likely to underpin the anxiety, and bring yourself more into the present moment, instead of ruminating about things in the past or worrying about things in the future, neither of which are reality. The starting place for all this is a full assessment and conceptualisation of what is going on, so an evidence-based treatment plan can be put in place to help resolve it; evidence-based because there are tried and tested CBH techniques for helping to resolve many forms of anxiety and associated symptoms.

Bill Sheate, 13 October 2018