Anxiety


What is anxiety?

Anxiety is a natural human response to the events of life, large and small. Minor anxiety has been shown to actually help people do well in a variety of situations; the degree of "optimal" anxiety differs from person to person, but, within limits, it can give us focus and keep us sharp. In excess, it can be paralyzing, ruining our ability to work and relate, and can cause major suffering both to mind and body. People tend to mistakenly identify anxiety with only one or the other of its main parts: the physical, which may be simple jitters if it is minor, or panic when it is major; and the mental, which consists of worrying about terrible events and consequences, or things getting out of control.


Anxiety and Fear

We often confuse anxiety and fear. The mental and physical aspects of anxiety and fear feel similar. Our heart may pound or speed up; we may sweat, we may have trouble concentrating or clearing our minds of negative thoughts. The difference is that fear is connected to a real danger that we can respond to, while anxiety is about what we imagine may happen. The worry-part of anxiety is usually about some event that cannot be controlled, and that therefore we fear will go badly - even if nothing has actually happened.

It may be "all in your head" (and body), but that makes it pretty real! The focus of anxiety can be anything that we do not personally feel comfortable with. This may have nothing to do with our actual strengths and weaknesses. A test; an imagined confrontation; a date with someone with whom we feel awkward; a sport for which we don't feel quite in shape. We are anxious over the expectation that things will go wrong, that we will not be up to some part of the challenge.

Some psychologists believe that anxiety is a kind of "signal" that we are conflicted about a situation, or a desire that we may not even be aware of, but with which we are somehow uncomfortable.


When anxiety becomes a disorder

Sometimes, the body can't relax. Our mind will not let go of the picture of things going badly, and the even worse consequences that we have somehow come to expect. We can't talk ourselves out of it, and we may be convinced that our anxiety is justified. In this way, we may end up getting some of the negative results we imagined. It can be hard to get out of this cycle. If it goes far enough, we can develop what is called an anxiety disorder.

Anxiety disorders often exist along with depression. The worry that things will not work out, that our efforts will amount to nothing, is also major aspects of depression. And, since depression robs us of energy and the belief that we can accomplish things, we feel less able to handle whatever comes our way - thus, more anxiety. This is when it becomes important to find help.


Five major types of anxiety disorders

Generalized Anxiety Disorder (GAD)

This is a fairly common version of anxiety, in which we feel overwhelmed by many things at once. We can't stop thinking about one problem of another, and as soon as one is taken care of, another starts to occupy our thoughts.


Obsessive-Compulsive Disorder (OCD)

Obsessions are unwanted thoughts that we cannot stop thinking about. Compulsions are behaviors that we cannot stop doing, though we may really want to. The behaviors may be excessive versions of normal things, like washing dozens of times a day; the overwhelming fear of germs would be the obsession. The thoughts and actions take up so much of our energy and time that they get in the way of normal life. Sometimes it isn't clear what the behaviors are meant to accomplish - such as touching every parking meter, avoiding cracks in the sidewalk, never letting a count end on a particular number. With careful reflection, we can often learn the secret behind the behavior.


Panic Disorder

Some people experience their anxiety in the form of sudden shortness of breath, pounding heart that feels like, but isn't, a heart attack, and thoughts that horrible things are happening. The person may feel like they are "going crazy". However, unlike psychosis (what people refer to as "going crazy") the experience doesn't include seeing or hearing things that are not there, and the thoughts that flood the mind don't seem to fit - the person doesn't necessarily believe the thoughts, but the experience is very intense and frightening nonetheless.


Post-Traumatic Stress Disorder (PTSD)

This occurs to people who have been through terrible experiences (such as war, being the victim of violence or severe abuse, seeing a disaster). One may play the experience over and over in one's mind, to the point that it becomes an obsession). One may have infrequent but sudden recurrences of intense fear, or other emotions that were part of the bad experience and flashbacks to the event, when faced with some reminder of the event, or similar circumstances. One may react strongly to people and in situations that resemble the traumatic event in some small way, but are mostly ordinary; the person may have put the trauma so far back into memory that she doesn't understand why she feels and reacts this way.


Phobia

A phobia is an intense fear of a particular thing or situation that is not in itself all that dangerous. Some people hate spiders and get nervous that they may encounter one; this is not a phobia, though it is very common. If a person becomes panicked at the sight of a small spider, or a web, or goes to great lengths to avoid even the possibility of encountering a spider, then the anxiety has grown into a phobia. A person may be "phobic" about almost anything - open spaces, heights, social situations, the number thirteen, cats, you name it. The reason is usually very personal, and the person may "know" on some level that there is nothing to fear, or that they aren't really likely to get hurt. However, this knowledge doesn't make things any easier.


Social Phobia (or Social Anxiety Disorder)

This occurs in people who are excessively worried about the reactions others will have to them. One may be very self-conscious that he will do or say something very wrong. A person suffering from social anxiety disorder may fear that others are talking about them. This may occasionally be strong enough to count as a phobia. However, more commonly, daily activities among people, and even social gatherings, are possible but very uncomfortable. It becomes a burden to deal with people, and one might really wish to live and relate more freely.


Treatment

Effective treatments for anxiety disorders are available. Anxiety disorders can have many causes, from the purely physical to the emotional, in which experience has prepared one to be painfully over-sensitive to life events. Medication is able to help control symptoms and free people to do more; it can be very effective if used properly, and for no longer than the doctor prescribes. However, the medications are seldom sufficient by themselves, and many of the most effective ones carry the risk of addiction and strong side effects. Obsessive-compulsive disorder, more than the others, is considered to often have biological causes, and to respond more effectively to medication than other disorders.

There are many non-medical ways to address anxiety. Counseling provide sinsight, comfort, ways to change behavior and troubling thought patterns, practice in relaxation and meditation and education in lifestyle changes that will make one more resistant to anxiety.


One more thing...

It is important to remember that psychological disorders are usually just extreme versions of normal emotions. Most of us can relate to the descriptions of these disorders, because they are made up of common human experiences. Diagnosing oneself is likely to result in misunderstandings and extra fears about what the diagnosis means. By all means, call and discuss the issues with a professional!