You don’t just “beat” an anxiety disorder and never have to deal with it ever again. As you know, anxiety is not something that ever goes away. It’s a necessity to life.
The difference is, when you successfully treat an anxiety disorder, the anxiety no longer interferes with your life or distresses you. It’s an incredible feeling! But hold on for a second… You do need to consider that sometimes the problematic anxiety can come back. We know that people who have a history of an anxiety disorder are at a higher risk of developing an anxiety disorder in the future when compared to the general population.
We don’t know for sure, but here are a couple of ideas:
- Some behaviors that maintain the anxiety remain and can build up over time. For example, with social anxiety, if you still avoid talking in certain situations then this can quickly generalize to other areas and develop anxiety further.
- A person with anxiety may have a genetic predisposition to be anxious, meaning it could develop again.
- The environment a person lives in can create a vulnerability for anxiety. If the environment is the same, then it’s possible the anxiety can come back.
- The fear association can spontaneously show up again. We don’t know why.
How Do We Reduce the Risk of Relapse?
The good news is that there is evidence that we can actually substantially lower the risk of relapse. Psychologists call this process as “relapse prevention.”
What Is Relapse Prevention?
It’s simply working to prevent the anxiety disorder ever developing again. There are lots of ways to help make it less likely that anxiety will ever develop again. The method I’m going to focus on is called “the exposure lifestyle.”
The Exposure Lifestyle
I remember when I was 24 or so, my brother showed me how to work out and use gym equipment. I tried to bench press and could only lift about 100lbs and I couldn’t believe that people were lifting 135lbs using the big 45lb plate weights. I worked super hard and eventually got to the place where I could lift that amount. I felt so accomplished! Now, what would happen if I then stopped doing my training? Pretty soon my muscles would atrophy and I would lose the ability to lift that much. This process is the same for pretty much any goal you have, whether it’s being able to lift weights, run faster, or learn a new language. If you stop practicing, you get worse!
When you finish anxiety treatment the same principles apply. If you stop doing exposures to everyday things, you risk losing ground. Imagine you have successfully treated your contamination OCD, where you used to worry about getting sick when touching things. If you start washing your hands after touching things (e.g. shaking someone’s hand, touching bathroom door, picking something up from the floor) then it could be a slippery slope towards more safety behaviors. This is where the exposure lifestyle comes in.
The exposure lifestyle is living a life where every now and then you purposefully challenge yourself to do difficult things. If you know that contamination is a risky thing for you, then you need to purposefully continue doing the things that helped treat this anxiety in the first place, such as exposures to being contaminated. If you suffered from social anxiety, then small things like talking to a stranger or changing your order at a restaurant can really prevent it from coming back. Today I went to a bike store and purposefully asked the guy several additional questions requiring some extra checks on my bike, because I know that’s exactly the type of thing I would ask my patients to do. Doing these small and everyday exposures is what’s called the exposure lifestyle. It is like weight lifting for your brain. It keeps it strong so that anxiety is less likely to return.
Look out for my more regular blog posts, coming soon, called “the exposure lifestyle” where I describe exposures that I complete regularly.
Thanks as always for reading!
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