For Some, Relaxation Triggers Anxiety

By Traci Pedersen
Psych Central
December 13, 2012

The admonition to “just relax” goes only so far for some people.

A phenomenon known as relaxation-induced anxiety occurs when people experience anxiety as a result of trying to relax. Activities such as listening to music or taking a vacation, for example, may trigger worrisome feelings.

Relaxation-induced anxiety is a fear of relaxation itself or an increased fear that is triggered just after relaxation is achieved, said Christina Luberto, a doctoral student in psychology at the University of Cincinnati.

“Someone with a fear of relaxation is able to initially relax,” said Luberto, who has developed a questionnaire, known as the Relaxation Sensitivity Index, to examine this fear. “But once they start to feel relaxed, they begin to feel anxious as a result.”

Relaxing activities don’t truly unwind people with this condition but rather make them feel wound up.  Their heart rates increase, their breathing speeds up, their muscles tense and they feel nervous and worried.

For example, some people with this condition may be scared of the unwanted thoughts that enter their heads when their minds quiet down. Still others may fear the social consequences of engaging in relaxing activities, such as appearing lazy, feeling a loss of control, or worrying they’re not relaxing “correctly.”

Preliminary findings of the study, which involved 300 college students — most of whom were 21 years old, female and Caucasian — revealed that about 15 percent experienced relaxation-induced anxiety.

Participants were asked to rank on a scale of 0 to 5 statements such as “I worry that when I let my body relax, I will look silly” and “When my mind begins to wander, I worry that I might be going crazy.”

These results reflect the frequency of this condition in relatively healthy young adults, but Luberto adds that relaxation-induced fears may run as high as 50 percent among people with anxiety disorders. And there’s still no information on its prevalence among those with other types of mood disorders or mental health problems.

Luberto said that relaxation-induced anxiety isn’t a diagnosis, and it doesn’t necessarily require treatment unless it interferes with a person’s life.

Source:  University of Cincinnati

http://psychcentral.com/news/2012/12/13/for-some-relaxation-triggers-anxiety/49051.html

Relaxation-Induced Anxiety

JAMES HAMBLIN
The Atlantic
NOV 16, 2012

Christina Luberto is a doctoral candidate in psychology at the University of Cincinnati. She is in D.C. today to present research on a concept called relaxation-induced anxiety (RIA). It is precisely what it sounds like: being relaxed, itself, actually triggers anxiety.

"I worry that when I let my body relax, I look unattractive."
RIA has been mentioned sporadically in medical literature since the 1980s, but never as a diagnosis in itself. Luberto looks at it as a disposition; a maladaptive process. She says about 15 percent of people have experienced it, and it's not outside the realm of benefiting from treatment. So she developed an index to identify exactly what part of relaxation is causing a person's anxiety, which should help inform targeted therapy.

RIA is different from just being the sort of person who doesn't find traditionally relaxing things to be relaxing. If those things (doing yoga, playing harp, brunching with Yanni, etc.) actually make you feel anxious -- but you then feel at ease, say, organizing socks -- that's not RIA. Because you are able to relax, albeit by atypical means. In this model, anything that elicits relaxed physiology (slow heart rate, decreased muscle tone, deep breathing) counts as relaxing.

It's also different from being straight-up unable to ever relax, as in severe chronic anxiety.

In RIA, you are able to relax (by whatever does it for you -- cooking, chilling, vacuuming), but it's not long before the relaxation triggers anxiety. You briefly enter a parasympathetic (chill) state, but then your heart rate spikes, and your respiratory rate increases, and you feel anxious.

So why does this happen? It varies, widely, but that's where Luberto's work comes in. She developed a 21-item self-examination that is supposed to help people with RIA identify exactly what part of relaxation triggers their anxiety. She calls it the Relaxation Sensitivity Index.

Luberto tested it on a group of undergrads, and it seemed to work. I asker her if we could publish the full version of the test, but she prefers to wait until her academic article is published, which will also include the dense rubric for interpreting and managing the results. She did release a few examples, though.

The prompts are broken down into three subsections, and each would be rated by the patient on a five point scale.

Social:

"I worry that when I let my body relax, I look unattractive."
"I worry that if I relax, other people will think I'm lazy."

Cognitive:

"I don't like to relax because I don't like it when my thoughts slow down."
"I don't like to relax because it makes me feel out of control."

Physical:

"It scares me when my breathing becomes deeper."
"I hate getting massages because of the feeling it creates when my muscles relax."
Treatment could then be tailored based on the responses.

And then, what do you mean by treatment? Luberto made the point that relaxation is often the prescription for anxiety. In this case, it can't be. At least not in the traditional sense.

She believes people with RIA will benefit from exposure procedures ("facing their fears," in a therapeutic context), which, yes, will involve controlled, supervised relaxation sessions. It's like when you take people who are afraid of commitment and force them to get married. Just kidding, that's not a thing. But there is a real TV show called Fear Factor where we make other humans do scary things. A relaxation-themed episode would be mildly interesting.

http://www.theatlantic.com/health/archive/2012/11/relaxation-induced-anxiety/265313/