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When choosing a salad dressing sparks an anxiety spiral

Aug. 21, 2012 at 8:36 AM ET

Anxiety for Daniel Smith is far more than a little worry about what the next day might bring. In an instant Smith’s brain can take even the most innocuous incident and spin it into a life-altering – even life-threatening – scenario.

Take a typical meal with friends or colleagues.

“I’m perfectly capable of going out to lunch and ordering a salad and freezing at the moment of deciding what salad dressing I should put on my lunch,” he told TODAY. “And then convincing myself that if I make the wrong decision it will lead through a cascade of events to my downfall.”

Smith imagines that his dining companion will perceive his indecisiveness as rudeness.

“That person will therefore not like me,” Smith continues. “That person will then call my editor and say, ‘you need to cancel Dan Smith’s book because he is a horrible person.’ I will therefore not be able to pay my rent. My wife will leave me. I’ll end up having to sell my body on the street for money and I’ll then end up diseased, disgraced and homeless.”

Smith understands on some level that the convolutions his brain runs through are “crazy,” but for years, he wasn’t able to help himself. The first negative thought would spark a conflagration. 

For those plagued by severe anxiety, like Smith, it can be almost impossible to bat away the brain’s flights of fantasy – or nightmare. And those anxieties, if untreated, can ruin a person’s life.

That’s the difference between the garden variety anxieties we all experience and those felt by people with an actual disorder, says Dr. John Walkup, a psychiatrist and director of the division of child and adolescent psychiatry at the NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

“Anxiety is a normal, healthy part of life,” Walkup told TODAY’s Savannah Guthrie Tuesday. “But there are people who are too anxious. And the major characteristic of people who are too anxious is that they are hyper-vigilant. They are always looking for something around them to worry about."

“They react to new things as if those new things are threatening to them. They’re all set up to have an anxious experience when they’re experiencing normal daily activities. That’s the difference between folks who are just anxious naturally and normally and those who have a condition.”

Smith’s anxiety eventually left him housebound and alone, a life he describes in his new book, “Monkey Mind: A Memoir of Anxiety.” That low point is what got Smith to seek help.

“I’d hit bottom,” he says. “I found myself unable to work, unable to really leave the house. I was weepy and an insomniac. I was just beating myself up mercilessly.”

Eventually, with the help of medication and a treatment called cognitive behavioral therapy, Smith learned to get his brain under control – most of the time. “My anxiety sometimes gets out of control – but not at the salad dressing level anymore,” he says.

The new therapist taught Smith to be more attentive to when his brain was starting to spiral out of control. “I learned to recognize when I was starting to feel anxious,” he explains. “There is a physical sensation that for me was a twinge in the chest.”

When Smith feels the twinge, he knows it’s time to do a reality check, to ask himself if the path he’s going down makes logical sense. “If I choose ranch dressing instead of balsamic vinegar, what are the chances that that is going to ruin my marriage and my life? Once I do that, humor sometimes takes over. You see how absurd it is. And that gets you out of the old rut.”

 His reason for writing his book – and publicly talking about it- is to help everyone understand what people with anxiety disorders go through.

“I want people who don’t suffer from anxiety to realize that anxiety is not just worry,” he explains. “It’s not just a simple matter of worrying too much. Anxiety is a full body experience. It’s something that is within you. It’s something that affects you physically. It’s something that affects your relationships. It’s something that affects your work life. It invades every aspect of your existence.”

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