What is Anxiety
John was in a car accident three months ago. Now he chooses to stay home and avoid car rides. After several weeks of this behavior, he becomes fearful of going out in public places and starts getting panic attacks. Anxiety disorders are characterized by excessive and irrational feelings of fear and nervousness. These feelings are accompanied by thought and behavior patterns which make the symptoms worse. Anxiety usually develops when a person, event, or situation becomes associated with the feeling of danger or threat to one’s safety. This article briefly describes anxiety symptombs and some common anxiety disorders. We also discuss some simple steps for addressing anxiety.
Although used interchangeably, fear and anxiety are not the same. Fear is the emotional response to a real and imminent danger, while anxiety is a response to a future or undefined threat. Fear stimulates the fight-or flight-response as the body prepares to defend itself, escape, or limit the danger. Anxiety, on the other hand, leads to feelings of body tension and high levels of vigilance. Anxiety often results in cautious and avoidant behaviors. For example, checking the door locks several times before going to bed at night.
Anxiety also differs from transient fear or stress-induced behaviors. A trained mental health professional will consider the cultural and environmental contexts to determine if the anxiety symptoms are excessive or out of proportion with the level of threat. A trained mental health professional can determine the type of anxiety you or your loved one might be experiencing and offer solutions to help with the symptoms. The diagnosis always considers the cultural context, underlying medical problems, and the effects of substance use.
Examples of different types of anxiety diagnoses include:
Panic Disorder: The person experiences recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks. Panic attacks are sudden surges of intense fear or intense discomfort that reach a peak within minutes, accompanied by physical and cognitive symptoms such as shortness of breath, numbness and tingling, and a sense of doom.
Generalized Anxiety Disorder: Persistent and excessive anxiety and worry about various domains, such as work and school performance, that the individual finds challenging to control. The individual also experiences physical symptoms, such as restlessness, feeling on edge, being easily fatigued, having difficulty concentrating, mind going blank, irritability, muscle tension, and sleep disturbance.
Trauma or Stressor Related Disorder: If the phobia develops following a traumatic event, symptoms may develop into posttraumatic stress disorder (PTSD). PTSD is characterized by nightmares, flashbacks, feelings of numbness, difficulty focusing or sleeping, and avoidant behaviors
Agoraphobia: The person feels fearful and anxious about two or more of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd, or being alone outside of the home. The person fears these situations because they think that escape might be difficult or help might not be available if they develop panic-like or other incapacitating or embarrassing symptoms.
Social Phobia: The person is fearful and anxious and avoids social interactions or situations that involve the possibility of being scrutinized. The person may avoid meeting unfamiliar people, situations in which the individual may be observed eating or drinking, and situations in which the individual performs in front of others. The person strongly believes that he or she will be negatively evaluated by others, be embarrassed, humiliated, or rejected, or may offend others in some way.
Obsessive-Compulsive Disorder: The person’s primary fear or anxiety is of an object or situation related to obsessive thoughts (e.g., fear of blood due to obsessive thoughts about contamination from blood-borne pathogens such as HIV; fear of driving due to obsessive images of harming others).
Specific Phobia Disorders: The person is fearful, anxious and may avoid particular objects or situations. Similar to other anxiety disorders, there is no conscious rationale for the fear. The fear, anxiety, or avoidance usually subsides after removing the object or changing the situation.
Selective Mutism: This occurs when anxiety leads to the person’s failure to speak in social situations where there is an expectation to speak (for example school) even though the individual speaks in other circumstances. The inability to speak significantly affects achievement in academic or occupational situations.
Eating Disorders: When the avoidance behavior is exclusively limited to food and food-related cues, a diagnosis of anorexia nervosa or bulimia nervosa would be considered.
Much like depression, stressful life events can worsen anxiety symptoms. Common anxiety symptoms include body tension, difficulty focusing, restlessness, intrusive, persistent, racing thoughts, pressured speech, insomnia, irritability, and agitation. Cultural factors also determine how people respond to anxiety. While one person may deal with anxiety by exercising or meditation, another may self-medicate with substances.
Tips and Treatment:
Mindfulness
Deep breathing, body scan, noticing things in your immediate environment, yoga, meditation, praying, and journaling are activities that help you focus on the present. You are encouraged to participate in various activities with a nonjudgmental, open, and curious attitude, which allows you to gain a deeper understanding of your feelings and thoughts without trying to change or escape from them.
Awareness of automatic thoughts/feelings
Identifying your feelings and thoughts helps you understand yourself better and helps you direct your thoughts and behaviors in more productive ways. It is helpful to name these feelings and thoughts so that you can recognize the pattern of triggers and behaviors which accompany them.
STOP Exercise
The "STOP" acronym means "stop," "take a deep breath," "observe," and "proceed mindfully." You can use this tool to make short and occasional checks on your emotions and thoughts, decrease the build-up of body tension, as well as break the cycle of negative or catastrophizing thoughts.
Putting thoughts on trial (Pros and cons)
When you feel trapped in a negative thinking pattern, it is helpful to consider what is factual or not. When you are anxious about a future event, think about the advantages or disadvantages of taking specific actions to avoid or adapt to the anticipated situation.
Exercise
Regular exercise, stretching, and various forms of physical activity have been shortened to help calm the sympathetic nervous system (responsible for the fight-or-flight response). There are other long-term benefits of exercise, including improved focus, memory, and cardiovascular and metabolic benefits.
Nutrition
Certain foods and substances like caffeine, alcohol, and marijuana can worsen depression or anxious moods. Diets high in processed sugars and certain additives can indirectly exacerbate anxiety and depression symptoms. It is important to limit the use/consumption of such substances or food to help decrease depression/anxiety symptoms.
Sleep
Adequate sleep is essential to brain function. Developing a stable routine that provides adequate sleep is a great way to decrease anxiety and depression symptoms.
Relationships
Healthy relationships provide comfort, reassurance, and support during stressful times. Relationships also satisfy our need for belonging, feeling valued, and receiving affirmation.
Speaking with a professional
For moderate to severe anxiety, we encourage you to seek professional help by speaking with your primary care provider or contacting a mental health professional. Also, contact emergency services if you feel helpless, hopeless, and/or are thinking about hurting yourself or others. Obtaining treatment can significantly help people reduce their symptoms and improve their lives.