In this episode:
Venessa, hosting the conversation
Molly, YouTuber
Justin Stephenson, Clinical Psychologist
Venessa: Technology: it connects us, it informs us, and it makes life easier in so many ways. But for someone with anxiety, it can also amplify uncertainty. Constant notifications, endless information, and the pressure to respond can keep the nervous system on alert.
Molly, can you share a moment when using your phone, social media, or even wearable alerts made your anxiety spike?
Molly: So I wore a smartwatch that I would constantly track my heartbeat, ECGs, stuff like that, and calorie counting, steps. I found, because I've got ADHD and OCD, I hyper-focus on that, and I find it really hard to shake it. I can't stop. So I had to just completely stop wearing the watch because where it was always there, I tried to limit the time, but it didn't work. So ultimately, cutting it off and not wearing it was the best thing for me.
And on social media, there's a lot of creators that I follow that have similar conditions to what I have, and I've had to unfollow them and sometimes even block them because they still come up on my feed. When you see something, it can trigger a lot of your feelings, and I find it really difficult to not, I can't just block it out. It's like, if I see it, I have to read it. And then it's like, "Oh, yeah, I forgot I had that, that happened to me." And then it triggers all those horrible, traumatic feelings again.
I fell down the trap of using a lot of AI apps and stuff like that, and it was hard for me to not want to ask loads of questions to AI rather than to professionals. It was almost like giving me free therapy, and I found it really difficult to break the cycle of, "I don't need to ask AI." So yeah. So I had to stop using that, too.
Venessa: Yeah. Justin, did you have anything you wanted to add?
Justin: Yeah. I just think, as Molly's saying, it's that sort of reassurance cycle people get stuck in because it is available 24/7. You could wake up in the middle of the night and speak to an AI. But it does create this reliance, and we always have to be checking, and that, again, creates an anxiety. It can sometimes give you the answer you're looking for.
Molly: That's it. It does.
Justin: And that creates an anxiety in itself, and then you get stuck, and you don't know when to stop.
Venessa: Yeah. And I think to expand on that, thinking about checking the news, googling symptoms, and looking for notifications can actually feel like you're taking control. But other times it can make things worse, like you were saying. How did you notice the difference?
Molly: So I recently went through an episode of illness, and everything that I was feeling, I was trying to validate using AI. And even, I had an endoscopy, colonoscopy, or had all of the actual medical procedures done. They were telling me that, "You've got this, you've got that," but AI told me I didn't, that it could be wrong. And so then I was questioning reality. And when I just happened to just think about it in bed one day, I was just thinking, "Why do I believe someone that isn't actually real, it's just a computer, a robot, over an actual doctor?" And that was the moment. It was like a, "Wow! Molly, get a grip. That's not okay." And it was like I went through a withdrawal stage. That was how much I relied on AI. I wanted to do it and do it and do it. It was a compulsion. And then I realised, actually, I'm okay. I'm safe without it. I had to really rely heavily on my gut feelings and try to remind myself that the people I do trust are trustworthy, and they've gained that title of GP. They're not just going to tell me I'm okay for the sake of it.
Justin: Yeah. You're describing what we sometimes call in cognitive behaviour therapy as a bit of a safety behaviour. So in the short term, it feels really helpful. It reduces the anxiety, but it builds the belief that we need to keep doing those behaviours to feel safe. And you said it there, what we ultimately want to do is build in a bit of delayed gratification. So by all means, I'm not saying don't see your GP if you have a health concern, but saying to yourself, "Can I wait 12 hours, six hours?" Whatever it is, and see if that feeling changes. If it's still there, rethink. "Can I wait a bit further? Is there something else I need to be thinking about?" But it's probably building that trust back in yourself that this is something I can manage.
Molly: And that's it. You do lose trust in yourself because you feel like you don't know what is true anymore and what's not. And that heightened anxiety does make everything feel fake. And you don't really know what you're actually trying to achieve by googling or AI and these things.
Venessa: Yeah.
Molly: So it's really difficult. And you're right, trusting yourself again is the process that I think I went through, and it does make things easier.
Vanessa: Thanks, Molly. That was great.
Molly: It's all right.
Venessa: So Justin, on that, so why does the reassurance-seeking sometimes backfire, even though it feels so helpful?
Justin: So I often say to people, where is the limit to that reassurance-seeking? And again, we can't be going to the GP every hour and things like that. So-
Molly: I would like to.
Justin: But then when we realise we can't, we think, "Well, how do I manage that?" And I think a big part of that is you're teaching the brain this is something we need to do. So you're effectively building a habit of reassurance-seeking, and you get stuck in these reassurance cycles. It's then saying, well, I want to be able to tolerate that, use perhaps something from my toolbox, and think about how do I regulate myself? And of course-
Molly: That's what exposure therapy-
Justin: Yeah
Molly: ... has taught me. Exactly like how you're explaining, you have to kind of put yourself in the uncomfortable position to feel comfortable and learn. You're basically learning to re-walk again in a mental kind of capacity. You're learning, actually, my legs are stable. I can walk.
Venessa: Yeah.
Molly: And you have to really trust yourself.
Justin: Absolutely. And I think it's also saying to yourself, it's okay to feel uncomfortable. Um, because we don't like feeling uncomfortable, but actually we do learn a lot by challenging ourself, by putting ourselves in those situations. And most people, I think, once they've been able to break a reassurance cycle, as you just said there, they normally go, "Actually I feel much better for not being stuck in that."
Vanessa: Aside from smartwatches, we have messages and that red bubble on our phone, which says how many messages are unread. What are your experiences? Molly first.
Molly: So, if you get an email, I might be like, "Oh, I'll do that in a minute." And then you'll get another one and you're like, "Oh, oh." And then you've got to keep trying to keep up with it, and sometimes I feel like that adds pressure. I'm not great with really strict timelines or deadlines. I like to feel like I'm in control, and when I'm not, it's like, "Oh, I'm losing control because all these things are popping up," and it makes me almost just shut down and not want to do it. Because I feel like I can just stop that and move on. The anxiety's gone, but then when you reopen the laptop, you're like, "Oh, now I've got 60 messages." And you're just thinking, if only I answered it on the first one. It really just makes, I think, simple situations, simple tasks, feel really clustered and really messy and chaotic sometimes.
Venessa: Yeah. Anything to say on that, Justin?
Justin: Yeah, so I think, as Molly's saying, it's this idea that technology, we're always available. So whether it's an email, whether it's a messaging service, whatever it is, everything's in our face in a couple of seconds. And particularly even gaming can sometimes do the same thing. But it creates quite a paradox in a sense because we have raised cortisol, which is a stress hormone that's part of anxiety. And cortisol is quite helpful for attention and focus, but if we're always having to focus and feel the attention, we run the risk of burnout, and you can feel quite overwhelmed by that.
Working with people sometimes they go, "The worst part is I log on 9:00 AM, I've already got 100 emails, and I haven't even started my day." And I think particularly when it comes to giving yourself permission to say, "Well, how do I want to feel about these emails? Is this something I want to do? Do I want to have my cup of coffee first? Do I want to tackle 10? Do I actually want to just not have that sort of response to them and look at them later in the day?" But I think it is really hard because it gets really normalised that we should always be available. If someone phones you, you haven't answered, they say, "Well, what's wrong?" rather than just assuming maybe you're having lunch. I think, as you said, the starting point is, how do I want to feel about these? And we're probably all different types of people. Some people have 1,000 messages unread, some people have a really neat inbox. It's sort of deciding what works for you in terms of managing that.
Molly: With gaming, I've found as well that I love Animal Crossing, stuff like that.
Venessa: Mm-hmm.
Molly: Where it's someone else's kind of village. I find things like that really soothing, but I've also found myself losing five or six hours on it when I'm only meant to be on it for an hour just to decompress in the evening, but I'm on it all night. And then it's like, "Oh God, I've got to get up at 7:00."
Venessa: Yeah.
Molly: You just lose track of time because you become so fixated because it takes you out of reality, and you're able to make the reality on the game of how you want it.
Justin: Yeah.
Molly: And I find it difficult sometimes to know when enough is enough. One hour is fine, but six, maybe not.
Justin: Not always the gaming itself, but the cost of, oh gosh, if I've gamed for five hours, what else have I not done? And then there's stress after that.
Molly: Yeah, and the guilty feeling you get.
Justin: Yeah. So the gaming almost can be a bit of a coping skill, but then switches into the safety behaviour that we have to do that to feel calm, to feel safe, and then we get so stuck in this, but I can't do that all the time, and then what happens?
Venessa: And staying on technology as well, you've mentioned how, and we've talked about how it can just not be helpful, but there are some ways that it can be helpful. So Molly, in a minute, I'm going to ask you about ways you think it can be helpful. But Justin, is there any example where technology doesn't take away the control and can actually be helpful if you're suffering with anxiety?
Justin: There are a lot of good apps out there, and even some good sort of videos online where it's about the person having choice in what they're doing, so it's a mindful engagement with tech or sort of software apps. It builds towards that degree of sort of autonomy or control you have in your own situation.
So I've worked with a lot of people who find sort of mood apps quite helpful, where they track their own mood, building up a record of how your mood has functioned, what stressors you've had, and that can be quite a helpful tool.
Equally, sort of apps that give you, I would say, sort of evidence-based information around sort of mental health, so things that are sort of scientifically backed, quite helpful. And people know, well, that's my one source I'll go to for that, and not feeling they have to sort of search the internet for multiple sources and things like that.
There are also quite a few good apps that if you're in a sort of particularly anxious space or having a panic attack and can't think, it will give you tools to try.
So it's just finding that balance between what is helpful in terms of information, but still creates a sense of autonomy rather than dependence.
Venessa: Brilliant. And Molly, have you got any examples?
Molly: So, I use an app called Flo. Um, it helps you track your menstrual cycle. That then helps me track where my moods are, and I know that, oh, I'm feeling more anxious this week because I'm coming up to my period. This is when I'm building up all those hormones. This is when things are happening. And when I'm able to track them, again, it becomes less scary because I think, "Oh, this week has been really, really tough."
Justin: Mm.
Molly: And then I look on my app and it's like, well, that's why.
Justin: Yeah, it normalises the reasons you feel that.
Molly: Yeah. And it makes me feel in control and I'm like, "Well, there we go. This week is going to be tough, but I'm tougher. I can get through it."
Venessa: I like it. It's tough, but you're tougher.
Molly: Yeah. That's it.
Venessa: That's right.
Molly: I can do it.
