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Relaxation techniques may worsen the symptoms of some people suffering from anxiety or depression due to a seemingly counterintuitive coping mechanism, new research suggests.
People with anxiety may resist relaxation and continue to worry in order to avoid being caught off guard if something bad does happen – a phenomenon dubbed "relaxation-induced anxiety", or RIA. Those who become anxious from relaxation may do so because they are fearful of becoming anxious and losing control of their anxiety responses.
It’s sort of like a person who suffers from allergies 365 days of the year. Then, one day that person wakes up without any symptoms. Instead of feeling positive and grateful, it evokes a feeling of “what is wrong with me?” as that person begins to worry about once again exhibiting histamine responses.
“People may be staying anxious to prevent a large shift in anxiety, but it’s actually healthier to let yourself experience those shifts,” said study author Michelle Newman, from Penn State University, in a statement. “The more you do it, the more you realize you can do it and it’s better to allow yourself to be relaxed at times. Mindfulness training and other interventions can help people let go and live in the moment.”
Generalized anxiety disorder (GAD) is different than feeling anxious in that someone with the diagnosis experiences “excessive and controllable worry and anxiety about a broad range of negative events.” Relaxation typically decreases anxiety, physiological tension, and can curtail spirals of anxiety and worry. Writing in the Journal of Affective Disorders, the authors note that relaxation techniques are still better than not even though they may incite a temporary or occasional feeling of increased anxiety.
Though the specific cause of RIA is unknown, Newman and her team believe that it could be connected to contrast avoidance theory. This theory suggests that those with anxiety symptoms fear emotional shifts from neutral or positive emotions to negative states. As a precaution, incessant worry becomes a constant, unsurprising baseline that is used to avoid the risk of an uptick in emotion.
“The theory revolves around the idea that people may make themselves anxious intentionally as a way to avoid the letdown they might get if something bad were to happen,” Newman said. “This isn’t actually helpful and just makes you more miserable. But, because most of the things we worry about don’t end up happening, what's reinforced in the brain is, ‘I worried and it didn’t happen so I should continue worrying.’”
To test this, the researchers studied nearly 100 participants, about a third of those with GAD, a third with major depressive disorder (MDD), and the remaining with neither. MDD is a mood disorder related to anxiety defined as a persistent sense of sadness or loss of interest in normal activities, according to the Mayo Clinic. Researchers first led them through relaxation exercises before having them watch videos that may spur fear or sadness. Respondents were then asked to answer questions designed to measure how sensitive they were to changes in their emotional state. They were then asked to fill out a second survey designed to measure anxiety levels.
People with GAD are more sensitive to changes in negative emotions, such as going from a relaxed state to one of fear. Similar, though not as stark, results were seen in those with MDD.
The authors note the limitations of generalizing such findings, especially those that are subjective and self-reported. Given the short time intervals between the study phases, it is also difficult to determine whether symptoms of RIA were a lingering negative response to the videos or if feelings of anxiousness were directly related to relaxation techniques. Regardless, they say that their findings may help treat people with anxiety in the future.
