In part 1 I talked about the fight and flight arousal response of Anxiety, and how it can cause a sufferer to be in a state of chronic stress and cause the world to “turn inwards”.

Chronic stress is unhealthy, and is also damaging to relationships.

Stress makes people irritable, tense, causes a lack of sleep (increasing irritability), etc. None of these are positive conditions for relationships.

Relationships also require empathy, and a focus on your partner and the idea of “we”. So adding the tendency to focus inwardly and think primarily about yourself compounds the issue.

But that’s not even the worst part; the worst part is probably doubt.

Anxiety can make people question love.

This can happen in two ways – doubt about the feelings someone has for you, or doubt about the feelings you have for someone else.

Doubts about what someone feels for you tends to lead to a need for constant reassurance. When there are doubts about what YOU feel however, the normal response is to withdraw. Anxiety can lead to either of these types of doubt, and in some cases it can even lead to both.

Daniel Smith talks about this doubt in his book on living with anxiety, and there are also countless other stories of this same sense of doubt.

Here’s one I found particularly poignant:

My depression/anxiety has a particularly pernicious aspect in that my negative thoughts are almost entirely focused on my boyfriend: including thoughts I don’t love him, he isn’t attractive enough, I will never find him sexually attractive and that things will never work out.

This is particularly frustrating because I will have ‘moments of clarity’ either whilst with him or apart from him where I realize all of this thinking is ridiculous, I have an amazing relationship and we have so much in common, and I find him very attractive. Whenever I get to the point of asking myself: ‘do I want to leave the relationship?’ the answer is always a very clear ‘no’ in my head.

Yet my thoughts plague me every time I see him. Sometimes I can shut the thoughts to the back-burner, other times they overwhelm me and I feel incredibly sad. We have been together for a year and half now, and I’m kind of at the end of my tether.

Because this has continued to plague our relationship since its beginning, I’m often forced to ask myself “Is it all just the relationship?” and I don’t know how to get the perspective to figure that out.

I have certainty that I love my boyfriend because I miss him when we are away, I get rushes of pleasure and happiness when we kiss, I relate to him on a really strong intellectual and emotional level. We never have conflict or disagreements, because we hold the same views.

Yet when I’m down I get plagued by recurring thoughts: Is this how I am supposed to be feeling? Do other people feel differently about their partners? I should be feeling more, shouldn’t I? Do I find him attractive? If I don’t find him attractive now, does that mean it is all a lie? Have I tricked myself into feeling this way? If the sex was average, does that mean our sex life is terrible? Maybe we have no physical chemistry? etc etc

I then feel guilt and sadness for being unable to figure out my feelings and for having doubts. After all, it isn’t really fair to him is it? Then there is a cycle of questioning: Do I really love him? Am I wasting my time?

Then when I think of breaking up with him, I get another rush of sadness and guilt because part of me really doesn’t want to, even though another part of me is sick of the doubt and would rather leave to end it all.

The problem with doubt is that it can be very destructive. Like many things, relationships are all about effort. What you get out of them is very closely related to what you put in.

When you doubt, you are less likely to invest the time or effort in a relationship that it requires. After all, why put effort into something that isn’t going to work out anyhow? But by not putting the effort in, you all but ensure the relationships failure (or at the very least minimize the level of satisfaction you are able to have).

This sense of doubt that anxiety can create is perhaps the most damaging aspect of the condition. Incidentally, the person who wrote the story above found that after trying medication (SSRI’s) the doubts cleared up, resulting in a happier and healthier relationship.

The “Dance” of Doubt

The doubt comes from the combination of catastrophizing and rumination, and creates a pattern of doubt and withdrawal:

1. Mounting Uncertainty. Anxiety leads someone to question the feelings they have for their partner. Maybe it’s not actually love. Maybe it was just infatuation, desperation or loneliness. Maybe this relationships is not what they really want
2. Withdrawal. Due to doubts about the relationship, you withdraw from the relationship emotionally, and stop putting any effort in. Or worse, you may become outright neglectful or hostile in a passive aggressive way of expressing unhappiness in the relationship.
3. Blowback. The behavior displayed while withdrawing causes the relationship to start to break down. Arguments start, and the environment starts to become toxic for both partners
4. Retreat. Realizing the damage that is being done, the anxious partner starts trying to repair the damage.

This process continually repeats, as the anxiety leads the relationship to go through cycles that do increasing amounts of damage to the relationships each time. Left unchecked, it can destroy the relationship.

In his book Daniel Smith describes his own experience with this process:

Over and over again, I pushed Joanna away and pulled her back, drawing her into an abusive four-step dance.

First, I would grow increasingly uncertain. “Was I truly in love with Joanna?” I would ask myself. How could I be when we didn’t appreciate all the same books, the same music, the same movies? Was it possible that what I called love had been merely infatuation, lust, desire?

Second, torn by my doubts, I would grow withdrawn and sullen, even openly hostile. I would ignore Joanna, make nasty little remarks, put her down in front of her friends.

Third, Joanna would start to fight back. Neglected and mistreated, she would respond with anger and sadness. Why was I being so cruel? What had she done to deserve this?

Fourth, horrified by my behavior, I would try urgently and with great remorse to repair the damage. I’d buy her flowers, send her cute messages during the day, hang on her every word.

Then, after a short respite, the dance would begin again.

The Breakdown of Intimacy

What is intimacy? Though they are often used interchangeably, intimacy and sex are NOT the same thing.

Intimacy is about closeness, and connection. It requires vulnerability, and a willingness to open yourself up to the other person. Intimacy requires trust.

Well, what is anxiety?

Anxiety is a condition that causes chronic stress and tension, and causes people to overthink and imagine the worst in situations. It causes doubt, and fear. It leads people to put up emotional walls to “protect” themselves, pushing people away instead of letting them in.

A common complaint of anxiety sufferers is the sense of being “uncomfortable in my own skin”. The hypersensitivity to the outside environment also extends itself to a sense of self, and a feeling of self-consciousness around others about how they look.

With this discomfort in your own skin there is a tendency to pull away. Touch, seen as a sign of closeness and comfort for most people, is often a source of discomfort for people with anxiety.

Anxiety can create almost the polar opposite of the conditions required for intimacy.

Behaviors impacting Relationships

Anxiety can lead to a number of different actions and behaviors which sabotage and break down love (list copied from the site referenced):

• Cling – When we feel anxious, our tendency may be to act desperate toward our partner. We may stop feeling like the independent, strong people we were when we entered the relationship. As a result, we may find ourselves falling apart easily, acting jealous or insecure or no longer engaging in independent activities.
• Control – When we feel threatened, we may attempt to dominate or control our partner. We may set rules about what they can and can’t do just to alleviate our own feelings of insecurity or anxiousness. This behavior can alienate our partner and breed resentment.
• Reject – If we feel worried about our relationship, one defense we may turn to is aloofness. We may become cold or rejecting to protect ourselves or to beat our partner to the punch. These actions can be subtle or overt, yet it is almost always a sure way to force distance or to stir up insecurity in our partner.
• Withhold – Sometimes, as opposed to explicit rejection, we tend to withhold from our partner when we feel anxious or afraid. Perhaps things have gotten close, and we feel stirred up, so we retreat. We hold back little affections or give up on some aspect of our relationship altogether. Withholding may seem like a passive act, but it is one of the quietest killers of passion and attraction in a relationship.
• Punish – Sometimes, our response to our anxiety is more aggressive, and we actually punish, taking our feelings out on our partner. We may yell and scream or give our partner the cold shoulder. It’s important to pay attention to how much our actions are a response to our partner and how much are they a response to our critical inner voice.
• Retreat – When we feel scared in a relationship, we may give up real acts of love and intimacy and retreat into a “fantasy bond.” A fantasy bond is an illusion of connection that replaces real acts of love. In this state of fantasy, we focus on form over substance. We may stay in the relationship to feel secure but give up on the vital parts of relating. In a fantasy bond, we often engage in many of the destructive behaviors mentioned above as a means to create distance and defend ourselves against the anxiety that naturally comes with feeling free and in love.

Anxiety and Sex

Intimacy and sex are two different things, and in a relationship intimacy is much more important. But maintaining a sex life is actually pretty damned important too.

Not surprisingly, Anxiety can also get in the way of the sexual side of a relationship.

Anxiety is an overwhelming form of daily stress. Many find that living with anxiety daily causes them to experience significant sadness and discomfort in their daily life, often leading to less enjoyment of the things that previously caused them happiness.

That’s why when you have anxiety, it’s not uncommon to also have a low libido. Your sex drive is directly affected by the way you feel, and anxiety is the type of condition that can make it hard to find your partner or the idea of lovemaking to be arousing.
–calmclinic.com

When anxiety impacts the sexual side of a relationship Calmclinic.com suggests the following:

When anxiety affects your arousal, don’t try to hide it. Trying to hide it and overcome it causes further stress, because you’ll find that you try too hard to get aroused. Arousal is an automatic function, and not something you can force, so the more you try to force it the harder it gets. If you talk to your partner about it, you’ll find that the added pressure of knowing that you’re open about the problem takes some of the stress off of you.

Extended time away from an active sex life can put strain on your relationship and potentially lead to more stress. If possible, try to make love anyway for fun. Talk to your partner, and don’t make it a stressful event. Make it something you do to keep your sex life going and try to remember the enjoyment you experience when you do get aroused. If making love isn’t physically possible, at the very least you should spend time being romantic and having fun in an intimate way to at least keep that component a part of your life.

Avoidance

In dealing with sexual problems, calmclinic.com recommends “talking openly with your partner”.

Sound advice.

Unfortunately, for people with anxiety communication is often not a strong suit. Discussing “difficult” issues causes the anxiety response, and it’s hard to deal with issues when the body is in fight or flight mode. As a result, for many anxiety sufferers the “preferred” way of dealing with problems is to simply avoid them.

Avoidance becomes the go-to communication style (though lack of communication style may be more accurate).

Many people say that communication is the foundation of a healthy relationship. Well, if communication is a mark of a healthy relationship, then avoidance is definitely a sign of trouble.

Fighting Back

Anxiety affects many people around the world to varying degrees, and it can put considerable strain on relationships. This isn’t to say that people with anxiety disorders can’t have healthy relationships, as they can. But to do that they need to actively fight back against the anxiety, and recognize that if they are in a relationship then the anxiety is not only affecting them – it also affects their loved ones.

One of the worst things an anxiety sufferer can do is resign themselves to it and say “this is just the way I am”. There is some truth to that, as anxiety sufferers will never get rid of the anxiety. Rather, they have to learn how to manage it instead of allowing it to control their life.

Accepting it will always be there is the first step to a healthy way of managing it. As one sufferer put it:

I think the issue facing many who deal with anxiety is that we want to be cured. We want to go back to that time period we can remember when it didn’t seem to overwhelm our every thought and impact us physically. We want to go back to that time in our relationships when we had no doubts and live there – because it seems as though once doubt sets in, you can’t shake it.

And sure, pills and therapy are fantastic ways to work on anxiety, but I think what we have to realize is anxiety can be managed, not cured.

I’ve found as I’ve worked on accepting that, I’m more receptive to negative thoughts associated with anxiety because I know they will pass – that yes, I have these thoughts which can ravage me emotionally, but that’s all they are – thoughts that my anxiety-distorted brain has come up with. It doesn’t take away the frustration and pain of having them, but makes them much easier to bear.

The next thing to do is educate yourself. The danger of anxiety is in that it is an automatic response or irrational thought. Increasing your knowledge of anxiety allows you to differentiate between rational and anxious thought.

One of the leading treatments for anxiety is Cognitive Behavioral Therapy (CBT). CBT takes the approach that thoughts and feelings affect behavior. Anxiety is based off of irrational thought, or cognitive distortions. So identifying these negative thoughts allows you to “fight back” against them.

There are also medications that can be used to treat anxiety and depression, and they can be helpful and even necessary at times (as anxiety is often tied to imbalances is brain chemicals like serotonin and dopamine). My personal opinion is that medication alone is never enough. It can help get anxiety down to a low enough level to start working on changing the underlying thought process. But without that work, you are simply masking the problem. And medication has a tendency to become less effective over time.

Anxiety is a very difficult condition, and not one that can be understood by non-sufferers. It’s not as simple as “don’t worry so much”, though it can often seem that way to outsiders.

But it is true that it’s “in someone’s head”, as it is a condition that originates in broken thinking patterns. Changing those thoughts and mindsets takes time and dedication. But the cost of not doing so is extremely high, as anxiety can infect all aspects of life.