Anticipatory anxiety is awful. Am I right? And it so often accompanies panic, perhaps being the precursor to avoidance phenomena such as agoraphobia and social anxiety. Of course, anyone can experience anticipatory anxiety, just as anyone can experience measures of panic and social discomfort. But within the context of the anxiety disorders, anticipatory anxiety generally comes in buckets. Well, let’s talk about it; as that’s always the first order of business when approaching relief.

Can you relate to this scenario? You haven’t flown in three years, so it isn’t hard to understand why you’ve lost your flying edge, assuming you really ever had one. It’s April 1, and out of nowhere Cousin Ralphie calls inviting you and the family to his daughter’s high school graduation happenings. After you’ve convinced yourself this isn’t an April Fool’s joke, you say yes (though you really didn’t want to), and a weekend trip becomes reality. Yes, in two months you’re traveling 1500 miles away from home. Of course, you’re gonna’ have to fly, though you thought long and hard about driving, taking a train, a bus, a cab, even hitchhiking. Oh man, the trip. And coming to realize flying is your only option. It’s like getting hit upside the head with a two-by-four and the shockwaves rush through your body for hours, even days, after.

So, okay, you’re able to manage your fear and anxiety for a few weeks. I mean, after all, the trip’s still a decent amount of time away. But before you know it you’re within two weeks and your life is beginning to spin out of control. Every minute of every day finds you obsessing over the coming events as your body and mind are stuck in a chronic state of anxiety and alarm. And all sense of focus, patience, drive, and hope for relaxation has hit the skids. Hello! This is anticipatory anxiety. And like that cousin of yours, it isn’t going to go away without some effort.

Perhaps you can identify with the flying example. Maybe you’ve experienced anticipatory anxiety before a medical or dental procedure, public speaking event, or dinner engagement. It’s a sensation of 100% dread and all-consuming doom, as if there’s a dark cloud following you 24/7 that could open at any time spewing forth oceans of rain and frightening amounts of thunder and lightening. Am I right? Ah, just what you need, another tough issue with which to deal. But it’s something that must be approached and defeated if you’re truly to be set free from the bondage of anxiety and panic.

If you’ve read my eWorkbook, Panic! …and Poetic Justice, you know that the anatomical and physiological foundations of our thoughts, feelings, and behavior fascinate me. So here’s yet another bit of research I believe is kind of neat. Anticipatory anxiety, indeed, any sort of long-term anxiety may be controlled by a part of the brain called the bed nucleus of the stria terminalis (BNST). The BNST, a small structure located between the thalamus and the amygdala, the home field of our fear circuitry, is involved with our autonomic and behavioral reactions to frightening stimuli; phenomena such as rapid heartbeat, sweating, dilated pupils, and elevated blood pressure. The key players driving the work of the BNST are