Understanding Anxiety — When Worry Becomes Overload

Introduction: Anxiety Is More Than Just “Worry”

Everyone feels anxious from time to time — before a difficult conversation, a medical appointment, or an unexpected change. But for many people, anxiety becomes more than temporary worry. It becomes a constant presence that affects daily routines, relationships, and overall well-being.

For individuals with developmental disabilities, mental health conditions, or dementia, anxiety often looks very different from the stereotypical “I feel worried.” Instead, it appears through changes in behavior, body language, and emotional responses. What may look like agitation, withdrawal, or refusing tasks is often the nervous system saying:

“I don’t feel safe right now.”

At EmpowerLiving Community Services Society, we recognize that these behaviors are not signs of defiance or overreaction—they are signs of distress. Anxiety can show up in many forms:

• pacing

• refusing activities

• repeating questions

• becoming overwhelmed

• sudden crying or anger

• shutting down or going silent

Understanding how anxiety works is the first step toward responding with compassion and helping individuals regain calm, confidence, and a sense of control.

What Anxiety Really Is: The Brain’s Alarm System

Deep inside the brain is a tiny, almond-shaped structure called the amygdala.Despite its small size, it plays one of the most powerful roles in human survival:it constantly scans the environment for danger and activates our protection system.

The amygdala does not wait for full information or logical reasoning.Its job is simple and instinctive:

“If anything feels unsafe, respond immediately.”

When the amygdala senses a threat — whether it is real, imagined, or misunderstood — it sends a message through the nervous system that flips the body into emergency mode. This happens in a fraction of a second, much faster than our thinking brain can respond.

This survival reaction is known as the Fight / Flight / Freeze / Fawn response.

🔹Fight

The body prepares to defend itself.This may look like irritability, snapping at others, clenched fists, raised voice, or sudden anger.

🔹 Flight

The body tries to escape the threat.This may look like avoiding situations, refusing tasks, leaving the room, or “running away” emotionally.

🔹 Freeze

The nervous system becomes overwhelmed and shuts down.This may look like going silent, blank staring, not responding, or looking “checked out.”

🔹Fawn

The person tries to create safety by pleasing others.This may look like over-apologizing, excessive kindness, agreeing to everything, or clingy behavior.

These reactions are automatic and unconscious.They activate before the logical brain — the prefrontal cortex — has time to think, plan, or understand what is happening.

This is why anxiety can feel sudden, powerful, and out of control.It is not a sign of weakness or overreaction.It is the body’s ancient survival system, designed to protect us long before humans had language or reasoning.

When we recognize anxiety as a protective alarm — not a choice — we can respond with more compassion, patience, and understanding.

2. How Anxiety Affects the Body

Anxiety is not just a feeling in the mind — it is a whole-body reaction.The moment the brain’s alarm system switches on, the body prepares itself for survival. These physical changes happen automatically, without permission, and often before the person even realizes they are anxious.

When the amygdala sends the “danger” signal, the body releases stress hormones such as adrenaline and cortisol. These chemicals are meant to help you run, fight, or protect yourself, but in everyday life they can create uncomfortable sensations that look like sudden behavior changes.

Below are the most common ways anxiety shows up in the body:

🔹Racing Heart or Chest Tightness

Blood pumps faster so the body can respond to danger.To the person, this may feel like:

• “My heart is pounding.”

• “Something is wrong.”

• “I can’t breathe.”This can cause fear of a heart problem, even though it is an anxiety response.

🔹Fast or Shallow Breathing

The body takes in extra oxygen to prepare for action.But shallow breaths can create dizziness, tingling, or feelings of choking.Someone might clutch their chest, gasp, or suddenly become distressed.

🔹Muscle Tension

The nervous system tightens muscles in case the body needs to move quickly.This may cause:

• stiff shoulders

• clenched jaw

• headaches

• stomach aches

• trembling or shaking

Parents or staff sometimes think the person is “acting out,” but the body is simply bracing for danger.

🔹Sweating, Restlessness, or Fidgeting

The body is trying to cool down and release extra energy.People may tap their feet, pace, rub their hands, or appear unable to relax.

🔹Stomach Upset or Digestive Problems

During anxiety, digestion slows down because the body prioritizes survival.This can cause nausea, loss of appetite, stomach aches, or sudden bathroom urgency.

🔹Difficulty Sleeping

Even when the mind feels tired, the body may stay alert.A tense, overactive nervous system makes it hard to fall asleep or stay asleep.

🔹Behavioral Expressions of Physical Anxiety

For individuals with developmental disabilities, autism, or dementia — who may not have the language to describe physical discomfort — these sensations often appear as behaviors:

• refusing to participate

• withdrawing or shutting down

• crying unexpectedly

• snapping in frustration

• clinging to caregivers

• repeating questions

• pacing or wandering

These are not personal choices or “misbehavior.”They are the body’s way of saying,

“Something feels unsafe inside me.”

Understanding the physical side of anxiety helps caregivers respond with patience rather than correction. When we recognize that the body is struggling, we can offer support that calms the nervous system rather than escalating fear.sbehavior.

Why Anxiety Happens for No Clear Reason

One of the most confusing parts of anxiety is when it shows up suddenly — on a calm day, during a peaceful activity, or when nothing stressful is happening. Many people describe it as a wave rising out of nowhere:“I was fine a minute ago… then suddenly I wasn’t.”

But even when anxiety feels random, there is always something happening inside the body and brain that explains it. The “reason” is often hidden, subtle, or stored in the nervous system rather than in conscious thought.

Here are the most common underlying causes:

🔹 A Sensitive Nervous System That Reacts Too Quickly

Some people have a nervous system that stays on high alert, even during quiet moments.This can happen when:

• they’ve experienced long-term stress

• their sensory system becomes overloaded

• they live with trauma history

• they have autism, ADHD, or cognitive disabilities

• their body hasn’t fully recovered from anxiety the day before

When the system is already tense, even small sensations can trigger a big response.

🔹 The Body Remembers Stress Longer Than the Mind

You may forget a stressful moment, but the body does not.Muscles stay tight.Breathing stays shallow.The heart stays slightly faster.

These leftover physical signals can suddenly activate the alarm system again — even when the person feels emotionally calm.

This is why someone may feel anxious during a relaxing moment:their body is still processing old stress.

🔹 Invisible Triggers We Don’t Notice

Anxiety can be activated by things we barely register:

• a sound in the background

• a certain tone of voice

• a smell linked to a past memory

• a fluorescent light

• sudden movement

• unexpected social pressure

• hunger or dehydration

• changes in routine

• too many choices

• temperature changes

Even if the person is not consciously aware of these cues, the amygdala notices — and reacts.

🔹 Sensory Overload Without Awareness

For individuals with developmental disabilities, autism, or dementia, sensory information can feel overwhelming even when the environment seems “normal” to others.

A room might be:

• too loud

• too bright

• too crowded

• too busy

• too unpredictable

When the brain cannot process all the sensory input, the body becomes tense and anxious.

🔹 Internal Physical Changes

Sometimes the body triggers anxiety from within:

• low blood sugar

• hormonal changes

• lack of sleep

• caffeine

• medication reactions

• chronic pain

The person may not notice these changes consciously, but the body responds as if something is wrong.

🔹 Anticipatory Anxiety

Sometimes anxiety shows up before the person consciously realizes they are worried.For example:

• Before going out

• Before meeting new people

• Before a change in routine

• Before bedtime

The body often reacts to anticipation before the mind understands why.

🔹 Emotional Memory (Subconscious Triggers)

The brain stores emotional memories deeply.A harmless situation can remind the body of something stressful without the person realizing it.

Example:A certain hallway, smell, or time of day may trigger anxiety because it subconsciously resembles a past negative experience.

This is especially common in:

• dementia

• developmental disabilities

• trauma survivors

The person cannot explain the fear, but the body feels it.

Why This Matters for Caregivers

When anxiety seems to appear “for no reason,” caregivers sometimes respond with frustration:

• “Why are they upset?”

• “Nothing happened.”

• “Why are they acting like this?”

But the truth is:Often, something did happen — just not something obvious.

When we understand hidden triggers, we can respond with compassion rather than correction.

The goal is not to find the perfect reason, but to give the nervous system what it needs:

• calm voice

• predictable routine

• space to breathe

• grounding activities

• reassurance

• reduced stimulation

These help the body feel safe again, even when the mind can’t explain why the alarm went off.urns.

The Science of Anxiety: Why It Hijacks the Mind

Anxiety does not only affect the body — it also temporarily changes how the brain works. When the alarm system turns on, the brain shifts into survival mode, and this dramatically affects thinking, communication, and decision-making.

This section is essential for caregivers, because many behaviors that appear “difficult” or “irrational” are actually the result of the brain protecting itself.

🔹 The Amygdala Takes Control

When the brain senses danger, the amygdala becomes the leader.It stops waiting for logic and instead reacts instantly:

• scanning for danger

• predicting worst-case outcomes

• focusing on threat

• activating fight/flight/freeze/fawn

The amygdala acts fast because its job is survival, not accuracy.

🔹 The Prefrontal Cortex (Thinking Brain) Turns Off

The prefrontal cortex is responsible for:

• planning

• reasoning

• problem solving

• impulse control

• communication

• remembering steps

• understanding consequences

When anxiety spikes, this part of the brain becomes less active, sometimes almost silent.

This is why someone who is anxious may:

• struggle to follow simple instructions

• forget familiar routines

• act impulsively

• misinterpret neutral expressions

• shut down or freeze

• seem “irrational” or “overreactive”

• be unable to make a basic decision

• repeat questions they already know the answer to

They are not being difficult.Their thinking brain is offline.

🔹 Emotional Logic Takes Over

When the prefrontal cortex is quiet, the brain starts thinking emotionally:

• “What if something bad happens?”

• “People are upset with me.”

• “I can’t handle this.”

• “I need to get away.”

These thoughts feel true, even when they are not.Anxiety makes the emotional world feel louder and more real than the logical world.

🔹 Memory Becomes Unreliable

During anxiety:

• short-term memory weakens

• focus becomes scattered

• familiar things seem confusing

• the person may forget steps instantly

This is especially noticeable in:

• autism

• ADHD

• dementia

• intellectual disabilities

• trauma survivors

Caregivers sometimes interpret this as stubbornness or lack of cooperation, but it is actually a sign that the brain is overwhelmed.

🔹 Perception Changes

An anxious brain views the world differently:

• neutral faces look angry

• small noises feel loud

• simple tasks feel hard

• normal routines feel threatening

• people seem less trustworthy

The environment hasn’t changed —the brain’s interpretation has changed.

🔹 Why This Matters

When we understand how anxiety hijacks the brain, we stop asking:

• “Why are they doing this?”

And start asking:

• “What is their nervous system experiencing right now?”

This shift allows caregivers to:

• slow down

• simplify instructions

• reduce stimulation

• validate feelings

• offer calm instead of correction

• create safety instead of stress

Behavior improves naturally when the brain feels safe again.

Common Myths About Anxiety — And the Truth Behind Them

Anxiety is one of the most misunderstood emotional experiences.Many people think anxiety is “mental weakness” or “overreaction,” but the truth is deeper, more biological, and far more human.

Here are the most common myths — and the facts caregivers need to know:

❌ Myth 1: “Anxiety is just worrying too much.”

✔ Fact: Anxiety is a biological survival response, not a choice.

It involves the amygdala, nervous system, and hormones.Even when the mind feels calm, the body can still be sending danger signals.

❌ Myth 2: “If nothing bad is happening, they shouldn’t be anxious.”

✔ Fact: Anxiety can be triggered by hidden or internal factors.

Many triggers are invisible:

• past memories

• sensory overload

• subtle stress

• physical changes

• nervous system sensitivity

The cause is often inside the body — not outside in the environment.

❌ Myth 3: “They’re doing it for attention.”

✔ Fact: Anxiety is a distress signal, not manipulation.

Behaviors like crying, pacing, or refusing tasks are ways the nervous system expresses fear.Many people (especially those with developmental disabilities or dementia) cannot verbally explain their anxiety.

❌ Myth 4: “They can stop if they try harder.”

✔ Fact: No one can “will away” anxiety.

The thinking brain shuts down during anxiety.This means the person cannot:

• problem-solve

• think clearly

• control impulses

• follow instructions

It’s not about motivation.It’s biology.

❌ Myth 5: “Talking about anxiety makes it worse.”

✔ Fact: Talking reduces shame and helps the body calm down.

Acknowledging feelings tells the nervous system:

“You’re safe to feel what you feel.”Avoiding or ignoring emotions makes anxiety stronger.

❌ Myth 6: “Being tough will make them overcome anxiety.”

✔ Fact: Harshness increases fear.

What actually helps?

• gentleness

• predictable routines

• warm tone

• validation

• sensory adjustments

• calm presence

Safety heals, not toughness.

❌ Myth 7: “Anxiety only affects the mind.”

✔ Fact: Anxiety is physical, emotional, and cognitive.

It affects:

• heart rate

• breathing

• digestion

• muscles

• sleep

• thinking

• perception

Anxiety is a full-body experience.

❌ Myth 8: “Anxiety is the same for everyone.”

✔ Fact: Anxiety looks very different depending on:

• developmental disabilities

• autism

• age

• trauma history

• dementia

• personality

• communication style

Some people panic outwardly; others shut down silently.

❌ Myth 9: “If they aren’t saying they’re anxious, they aren’t anxious.”

✔ Fact: Anxiety often shows through behaviors, not words.

Especially in:

• dementia

• autism

• intellectual disabilities

• communication challenges

The person may show anxiety through:

• pacing

• anger

• withdrawal

• clinginess

• repetitive questions

• refusing tasks

Behavior is communication.

❌ Myth 10: “Anxiety means they’re weak.”

✔ Fact: Anxiety is a normal human survival system.

Every brain on earth has an alarm system.Some alarms are just more sensitive or activated more often.

Anxiety means the body cares about survival —not that the person is fragile.’s nervous .

Calming Techniques That Support the Nervous System

When someone is anxious, the goal is not to force calm — but to guide the body back to safety.

Here are the most effective grounding and soothing strategies:

🔹 1. Breathing With Longer Exhales

Breathing out longer than you breathe in tells the body to turn off the fight-or-flight response.

Try:In for 4 seconds → Out for 6 seconds

Caregiver tip:Do it together. People naturally mirror the breathing rhythm of the person beside them.

🔹 2. Grounding Technique (5-4-3-2-1)

Helps bring the brain back to the present moment.

Ask the person to identify:

• 5 things they can see

• 4 things they can touch

• 3 things they can hear

• 2 things they can smell

• 1 thing they can taste

This pulls the brain away from fear-based thinking.

🔹 3. Sensory Regulation

Many individuals with DD, ASD, or dementia are highly sensitive to sensory input.

Tools that help:

• soft textures (blankets, sweaters)

• calming scents (lavender, warm tea)

• noise-reducing headphones

• weighted items

• dim lighting

Reducing sensory load helps the nervous system relax.

🔹 4. Movement

Movement helps release adrenaline and tension.

Options include:

• short walk

• stretching

• rocking in a chair

• slow, repetitive motions

• gentle hand movements

Movement is especially helpful for people who cannot express panic verbally.

🔹 5. Predictable Structure

Routine reduces fear of the unknown.

Strategies:

• visual schedules

• timers

• same caregiving order (morning, meals, activities)

• predictable transitions with warning (“5 minutes left”)

🔹 6. Comfort Objects and Familiar Items

A favorite object can provide emotional grounding:

• stuffed animal

• photo

• personal item

• familiar blanket

• music playlist

These offer emotional safety.

🔹 7. Co-Regulation: Calm Together

Co-regulation means:“I will help your body feel calm by being calm myself.”

This is the most powerful anxiety-reducing tool caregivers have.

Your tone, posture, breathing, and energy directly influence the person’s nervous system.

Closing Reflection

Anxiety is not a flaw, a weakness, or a behavior problem.It is a protective system — sometimes overprotective — trying its best to keep someone safe.

When we understand the brain’s alarm system, physical reactions, and hidden triggers, we no longer ask:

• “Why are they acting like this?”

Instead, we ask:

“What is their nervous system experiencing right now?”

This shift changes everything.It helps us respond with patience instead of frustration,compassion instead of correction,and support instead of shame.

At EmpowerLiving Community Services Society, we believe that emotional understanding is a form of care. When individuals feel safe, seen, and supported, their world becomes more manageable — and hope becomes possible again.

“Safety calms the body.Understanding calms the mind.Compassion heals both.”

Join Our Community

If you or your loved one is looking for a supportive, inclusive day program in the Tri-Cities area, we would love to meet you.

Email: contact@elcss.org

Phone: 604-945-2117

Website: https://www.empowerlivingsociety.org/

Together, we can create a community where every individual — regardless of ability — is empowered to live, learn, and belong.