Sunday, April 14, 2024

Anticipation Is Worse Than Arrival -- Are You Thinking Too Much?

 

"The present time is seldom able to fill desire or imagination with immediate enjoyment, and we are forced to supply its deficiencies by recollection or anticipation."

Anticipation is so real and often heartbreaking. I often believe anticipating anything -- good or bad -- is the toughest part of a wide range of worries: from loneliness, to surgeries, even to just waiting for a possible event that may or may not come. We all know that worry is destructive, yet we wait and anticipate so much as we age. As our body becomes weaker, we find spontaneity is long gone (which can include welcome surprise) and "spur of the moment" rarely experienced. Thus, worry, wait, and expectancy can ruin a person's desire to carry through with nearly anything. Old minds are much more prepared to look "backwards" instead of "ahead." The added uncertainty of what is to come lights the flames of  uneasiness and even severe dread.

Specifically, on the bright side, expecting forthcoming events allows active preparations in cognitive, affective, and behavioral strategies which ensure survival in the changing and potential challenging environment. Sol we must anticipate to live.  Anticipation involves the neural circuitry underlying the waiting (planning)

 for future events related to well-being; however, exaggerated negative anticipation contributes to the development and maintenance of emotional-related disorders

Medically speaking, anticipation "appears before the appointed time of a periodic symptom or sign." Plus, the profession tells of anxiety being during a progressively earlier age of manifestation of a hereditary disease in successive generations. This may be 

1. Factitious (because of heightened awareness of early signs of the disease or because these signs are more conspicuous in the young).

Or ...

2. Authentic (because of progressive loss of epistatic and modifier genes by recombination and segregation, or because of expansion of unstable alleles in successive generations). Understand? 

Still confused, I googled further:

"Epistasis is a phenomenon in genetics in which the effect of a gene mutation is dependent on the presence or absence of mutations in one or more other genes, respectively termed modifier genes. In other words, the effect of the mutation is dependent on the genetic background in which it appears. Epistatic mutations therefore have different effects on their own than when they occur together. Originally, the term epistasis specifically meant that the effect of a gene variant is masked by that of different gene.

 (Gros PA, Le Nagard H, Tenaillon O (May 2009). "The Evolution of Epistasis and its Links with Genetic Robustness, Complexity and Drift in a Phenotypic Model of Adaptation". Genetics. 182 (1): 277–93. doi:10.1534/genetics.108.099127. PMC 2674823. PMID 19279327.)

(Rieger R, Michaelis A, Green MM (1968), A Glossary of Genetics and Cytogenetics: Classical and Molecular, New York: Springer-Verlag, ISBN 978-0-387-07668-3.)

While some level of authentic concern about the future is common and acceptable,   anticipatory anxiety involves an excessive or debilitating level of worry that tends to focus on negative outcomes.

Anxiety disorders in older adults are fairly common, affecting 10% to 20% of people. However, anxiety disorders often go undiagnosed. Anxiety is found more often than depression and cognitive disorders in older adults.

Generalized Anxiety Disorder (GAD) is the most common type of anxiety disorder diagnosed in older adults. This is followed by phobias, panic disorder, and Obsessive-Compulsive Disorder (OCD). These and Post Traumatic Stress Disorder (PTSD) are the most common types of anxiety disorders diagnosed.

Anticipatory anxiety is a symptom of other anxiety disorders, such as:

  • Generalized anxiety disorder (GAD): Affecting 3.1% of the population in any given year, GAD causes persistent and excessive anxiety about various activities and events.
  • Social anxiety disorder: This disorder, which has affected an estimated in 1% of U.S. adults in the past year, is characterized by anxiety and avoidance of social situations due to embarrassment or self-consciousness.
  • Specific phobias: People with phobias experience major anxiety and fear when they anticipate or are in the presence of a specific object, place, or situation. In the past year, an estimated 9.1% of U.S. adults had specific phobia. 
  • Panic disorder: Affecting 2-3%  of Americans in a given year, panic disorder causes repeated attacks of panic and intense anxiety that peak within a few minutes. 

That means a great many people are anxious at any time with a variety of symptoms. Experts still do not fully understand the causes of anxiety disorders. However, they may result from a combination of:

  • Genetics: Anxiety disorders often run in families.
  • Life experiences: Traumatic events or high levels of stress, for example, can trigger anxiety in some people.
  • Medical conditions: Some medical illnesses, such as heart disease or thyroid disorders, can contribute to anxiety.
  • Medications: Anxiety can be a side effect of some medications, or withdrawal from medications or drugs.

And, yes, dear reader, if you are like me, I exhibit symptoms of all of the causes above -- 15% or more of us do suffer acute anxiety, and many treat our disorders with a combination of regular medication and professional counseling. And, believe me, we take lots of pills to help cure our anxious psychiatric conditions.

 (Ashleigh Golden, PsyD ."What to know about anticipatory anxiety." https://www.medicalnewstoday.com/articles/anticipatory-anxiety. Medical News Today. 2024.)

15% estimate? I believe this number is far too low. Consider how many people never seek medical help for their extreme anxiety and misaligned epistasis-related anticipation. With all the daily stress, restlessness, poor nutrition, and irritability in daily living, it is apparent there is a need for more anxious sufferers to carry out a psychological evaluation. Yes, consult a psychiatrist -- he or she may save not only your suffering but also your life. I am one decades-old patient who still occasionally suffers from depression and obsessive compulsive disorder. My trusted psychiatrist has helped me out of so many deep holes that threatened my mind and very existence.

FOGO stands for the fear of growing old. Aging does have its challenges. How could you combat those fears? “Turn fears into healthy actions,” recommends Freda Lewis-Hall, M.D., former Chief Medical Officer at Pfizer. “People of all ages should start thinking about how they want to age and turn fears into healthy actions.”

Another 2014 survey of 2088 Americans age 18 and older had some interesting findings. According to this survey, conducted online by Harris Poll, 23 percent of Americans worry about a decline in their physical ability, 15 percent worry about memory loss, 12 percent fear running out of money, and 12 percent are concerned about chronic illness. Only 10 percent say they fear dying, an astoundingly low percentage.

(Meg Selig. "Do You Have "FOGO?" Taming the Fear of Getting Old." Psychology Today. June 29, 2021.)

Seliig says besides living a healthy lifestyle, exercising, and establishing proper eating habits, a person finds FOGO declining as he/she maintains good social connections.

Suggestions:

  • Cherish your friends and connect often.
  • Make friends of all ages.
  • Cherish your family and keep in touch.

Remember to attack FOGO by various means. Anticipation is a widely studied phenomenon within a number of different disciplines, including biology and brain studies, cognitive and social sciences, engineering and artificial intelligence. 

Also consider that foresight is not anxiety-filled anticipation. The amygdala and medial prefrontal cortex of the brain are activated during anticipation for positive events relative to neutral events, and MPFC activities are positively correlated with the levels of well-being. The findings may be consistent with the goal theory of well-being and provide the dynamic, future-oriented view on well-being.

Experts hypothesized that the amygdala and MPFC would be activated during anticipating positive stimuli. Also, given the key role of amygdala in emotion processing  and different functional coupling between amygdala and prefrontal areas in various emotion processing.

(Yangmei Luo, XuhI Chen, et al.
 "Well-being and Anticipation for Future Positive Events: Evidences from an fMRI Study" National Library of Medicine. 2017; 8: 2199.)

Catastrophic predictions -- like having a panic attack, making a complete fool of yourself, or damaging a relationship -- can lead to incapacitating anxiety that stops you from proceeding. Anticipatory anxiety can make it seem like avoidance is your only choice. Not so.

"Effective treatment of anticipatory anxiety, like all forms of anxiety, is targeted at the factors which maintain it. As always, too much thinking is not solved by more thinking."

Successful therapy aims for a shift toward sensory input, a modification of attitudinal factors, and a change in one’s relationship with inner experience. "These include gently redirecting the attention to the present moment rather than the imagined future, while allowing for and not struggling against the experience of anxiety."

"Metacognitive factors which maintain the anxiety, such as the false belief that anxious and doubting thoughts signal danger or predict the future, need to be addressed." And escape planning, ruminative entanglement with doubts and worries, and other forms of avoidance such as empty self-reassurance must be discouraged.

Good, timely thoughts; doubting upcoming doom and danger; and acting in the "now" can reduce bad anticipation. That may be a hell of an order for older folks, but the proof lies in not overthinking. Uncontrollable worry can eventually destroy a person, or that person can take control and redirect the negative brain behavior. 

Confront the pressures; don't avoid them until they become habit-forming cancers in your mind. Pump up your notions of your own future well-being to neutralize anxiety. Your vim and vigor may be suffering from unsubstantiated fears. Never let them paralyze you -- see the doctor at first signs and receive proper medical and mental health tools to aid you in your fight. 

Such assistance may save you countless years of suffering. Be you, not another person or thing you perceive is threatening your existence. My mom always used to say, "Think good thoughts and not about upcoming disasters or past failures." Finally, employ new strategies in your own brain to help cure anxiety -- staying "down" only leads to further, more brutal self-punishment. Whether fictitious or authentic, allowing anticipation to drag you out of the mainstream is treading in dangerous waters. You may be surprised how doing less thinking leads to peace and relaxation.

 

Anticipation

 How beautiful the earth is still, 
To thee - how full of happiness!
How little fraught with real ill,
Or unreal phantoms of distress!
How spring can bring thee glory, yet,
And summer win thee to forget
December's sullen time!
Why dost thou hold the treasure fast,
Of youth's delight, when youth is past,
And thou art near thy prime? 

When those who were thy own compeers,
Equals in fortune and in years,
Have seen their morning melt in tears,
To clouded, smileless day;
Blest, had they died untried and young,
Before their hearts went wandering wrong,
Poor slaves, subdued by passions strong,
A weak and helpless prey! 

Because, I hoped while they enjoyed,
And, by fulfilment, hope destroyed;
As children hope, with trustful breast,
I waited bliss - and cherished rest.
A thoughtful spirit taught me, soon, That we must long till life be done; That every phase of earthly joy Must always fade, and always cloy: This I foresaw - and would not chase The fleeting treacheries; But, with firm foot and tranquil face, Held backward from that tempting race, Gazed o'er the sands the waves efface, To the enduring seas - ; There cast my anchor of desire Deep in unknown eternity; Nor ever let my spirit tire, With looking for what is to be! It is hope's spell that glorifies, Like youth, to my maturer eyes, All Nature's million mysteries, The fearful and the fair - Hope soothes me in the griefs I know; She lulls my pain for others' woe, And makes me strong to undergo What I am born to bear.
Glad comforter! will I not brave, Unawed, the darkness of the grave? Nay, smile to hear Death's billows rave - Sustained, my guide, by thee? The more unjust seems present fate, The more my spirit swells elate, Strong, in thy strength, to anticipate Rewarding destiny!

 By Robert Burns

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