We all experience anxiety, but it is usually occasional and short-lived, and it does not cause us too many severe problems. Anxiety is the mind and body’s normal response to a threat. If you see a car coming towards you on the street …ding ding…the alarm rings and you run like hell. Anxiety can protect us by making us run away from, or fight against, a danger. But if we are afraid of being anxious, any little sign of nervousness will trigger the anxiety alarm (OH NO! I think if I go outside a car will hit me…I can’t feel anxious!) Ding. Ding. We experience more anxiety. When we are too afraid of anxiety, the anxiety mechanism can feed itself. Anxiety in response to a real threat protects us. But anxiety in response to an imagined (i.e., impossible) or exaggerated (i.e., unlikely) threat does not protect anyone. All it does is cause distress and limit our daily activities.
If we accept to feel some anxiety, we will be able to face difficult situations and gradually get more and more comfortable in them. If, on the other hand, we are scared to be (or look) nervous, any normal anxiety becomes threatening. The fear of fear mechanism will turn this mild anxiety into debilitating anxiety. In such cases, most of us avoid these situations and thereby never gain confidence.
Click here for more info on fear-of-fear and panic disorder / panic attacks
When the mental, physical and behavioural symptoms of anxiety are persistent and severe, and anxiety causes distress in our lives or it negatively affects our abilities to work or study, socialize and manage daily tasks, it may be beyond the normal range. Some signs that anxiety may be of concern:
1. Mental: we may have recurrent and distressing anxious thoughts (e.g., “I’m losing control,” “I’m going crazy”), predictions (e.g., “I’m going to mess up my words and humiliate myself”) and beliefs (e.g., “Only weak people feel like this”). These mental signs of anxiety can be distressing and can occupy a large portion of our time, staying in repetitive loops in our minds.
2. Physical: we may experience stressful bodily reactions to a situation (e.g., sweaty palms, adrenaline pumping). These physical symptoms of anxiety can be scary as they may be unpleasant and something we wish to avoid repeating.
3. Behavioural: We may be only barely able to tolerate the anxiety that certain situations (e.g., driving, public speaking) cause us, or we may need to avoid living through them. Avoidance can mean completely staying away from the situation (like calling in sick for an important presentation at work), or we may use subtle avoidance behaviours (to distract ourselves, e.g., talking more) or we may rely on safety behaviours (habits to minimize anxiety and feel “safer,” e.g., always having a cell phone on hand to call for help). Anxiety-related behaviours usually cause the most problems, because they prevent us from accomplishing things that life requires of us.
Although anxiety can be distressing, much of the time we may be able to cope with it. However, a few factors we can use to keep in mind whether the anxiety requires the attention of mental health professionals, include:
• if we have trouble determining whether our reactions are excessive, or instead if we are faced with an overly anxiety-provoking situation (e.g., an excessively stressful job or relationship)
• if the amount of distress caused by the anxiety symptoms is more than we can cope with
• if the anxiety interferes a lot with our abilities to work or study, socialize or manage daily tasks
• the context in which the anxiety occurs (how often does it occur in an important situation). For example, while it may be distressing and impairing to have a fear of spiders, we don’t often encounter them.
A clinical level of anxiety (one that is excessive, and causes real impairment or distress) is called an anxiety disorder. An anxiety disorder may make people feel anxious most of the time or for brief intense episodes, which may occur for no apparent reason. People with anxiety disorders may have anxious feelings that are so uncomfortable that they avoid daily routines and activities that might cause these feelings. Some people have occasional anxiety attacks so intense that they are terrified or immobilized. People with anxiety disorders are usually aware of the irrational and excessive nature of their fears. When they come for treatment, many say, “my anxiety is unreasonable, but I just can’t seem to stop it.”
What leads to anxiety disorders?
Like most mental health problems, anxiety disorders appear to be triggered by a combination of biological factors, psychological factors and challenging life experiences, such as:
• stressful or traumatic life events
• a family history of anxiety disorders
• childhood development issues
• alcohol, medications or illicit substances
• other medical or psychiatric problems (such as a chronic or serious illness).
Next: How are anxiety disorders treated?
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