Anxiety disorders are the number one mental health problem among adults and children. Approximately 1 in 10 people suffer from an anxiety disorder and 1 in 4 of us will experience significant problems with anxiety at some point in our lives. This means that over 400,000 British Columbians are currently suffering from at least one type of anxiety disorder.
What is anxiety?
Anxiety is a normal part of all human processes. It exists for most people in situations that are new, challenging, dangerous, etc. If our anxiety level increases enough, we may become apprehensive and notice physiological effects like increased heart rate, sweaty palms, butterflies in our stomach, etc. In most situations, anxiety is normal and healthy, and not something that needs to be treated. However, sometimes anxiety in situations such as giving speeches can rise to unhealthy (painful) levels. In situations such as those, the anxiety can be reduced to more tolerable levels through positive self-talk techniques, and relaxation and visualization techniques, which are aimed at reducing these kinds of anxious thoughts and feelings. However, some people suffer from anxiety disorders which can reach higher levels of physical discomfort. For these people, anxiety can become such a frequent feeling that it becomes the regular way to feel, and goes unrecognized by themselves and others. This is a big problem since ongoing anxiety can damage relationships and lower self-esteem.
What are the common symptoms of anxiety?
Symptoms of anxiety can be broken down into four major categories:
1. Emotions: The emotions associated with anxiety can be described as fearful, worried, tense, on guard, scared, apprehensive, frightened, “freaked out”, etc. These are usually accompanied by body responses, thoughts or behaviors that can at times exacerbate the emotions.
2. Body Responses: Anxiety causes a range of physiological changes in the body that can lead to the following symptoms: rapid heart rate, heart palpitations, pounding heart, sweating, trembling or shaking, shortness of breath or smothering sensations, dry mouth or feeling of choking, chest pain or discomfort (feels constricted), nausea, stomach distress or gastrointestinal upset, urge to urinate or defecate, cold chills or hot flushes, dizziness, lightheadedness or faintness, feelings of unreality or feeling detached from oneself, numbing of tingling sensations, visual changes (light seems too bright, spots, etc), blushing or red blotchy skin (especially around the face), muscle tension, aches, twitching, weakness or heaviness. While these symptoms are uncomfortable, they are not dangerous. However, some of these symptoms do overlap with symptoms of some medical conditions so it’s always a good idea to check in with your physician so that medical conditions can be ruled out.
3. Thoughts: When we are experiencing anxiety, our thinking can change. We are more likely to notice and think about things related to real or potential sources of danger. Some common thinking patterns associated with anxiety are: frightening thoughts, images, urges or memories, something bad happening to self (dying, not being able to cope, being responsible for something terrible happening, embarrassing oneself, etc), something bad happening to someone else (family member dying, a child being harmed, spouse having an accident, etc), some kind of bad event happening (house burning down, personal possessions being stolen, car crash, terrorist attack, etc), increased attention and scanning for things related to the source of danger, difficulty concentrating on things not related to the source of danger, difficulty making decisions about things not related to the source of danger, frightening dreams or nightmares.
4. Behaviours: Anxiety triggers a number of coping behaviours. Most of us feel a strong urge to do things that eliminate the danger or make us feel safer. There are referred to as “safety behaviours” and common examples are: avoiding the feared situation, experience, place or people; escaping or leaving the feared situation, experience, place or people; needing to be with a person or pet who makes us feel safe; getting reassurance from others; telling ourselves reassuring things (e.g.: “Everything’s going to be ok.”); finding a safe place to go to,; scanning the situation for signs of danger; trying to distract ourselves; self-medicating the symptoms with drugs, alcohol or food; sleeping or napping so we don’t have to think about it; carrying items that may prevent or help cope with a panic attack (medication, cell phone, vomit bag, etc); compulsive behaviours that we repeat in an attempt to feel better (e.g. excessive cleaning or washing, collecting thing, counting, or superstitious rituals); mental rituals that we repeat in our minds in an attempt to feel better (e.g. thinking the same word or phrase over and over).
These avoidance behaviours are only considered “safety behaviours” if the main purpose is to prevent or eliminate feelings of anxiety or panic. If safety behaviours become frequent, compulsive and disruptive they tend to increase the severity of an anxiety disorder. For example, many people with an anxiety disorder who take time off work often experience even higher levels of anxiety or end up on disability. Safety or avoidance behaviours do not empower people in their ability to cope with anxiety symptoms. Research has shown that people who don’t give up these unhelpful ways of coping have a higher rate of relapse compared to people who give up their safety behaviours.
How is normal anxiety different from an anxiety disorder?
All of us experience anxiety from time to time. Individuals with an anxiety disorder experience symptoms of anxiety on a regular basis for a prolonged period of time (months and years rather than just a few days or weeks). Assessment for an anxiety disorder should be considered under the following circumstances: symptoms have been excessive and difficult to control for an extended period of time (more than just a few days or weeks), symptoms lead to significant emotional distress and personal suffering, or symptoms lead to significant interference in work, school, home, or social activities.
Sometimes the symptoms of an anxiety disorder are present most or all of the time. And sometimes the symptoms are only present when facing certain situations, places, experiences or people. It is also common for symptoms of an anxiety disorder to fluctuate over time – they can get worse when we’re under stress or feeling depressed.
How are anxiety disorders different from stress?
A very common myth is that anxiety disorders are the same thing as problems with stress. One of the reasons for the confusion between stress and anxiety disorders is because many symptoms of stress are also symptoms of anxiety. Shared symptoms of anxiety and stress include: physical symptoms (rapid heart rate, muscle tension, upset stomach, etc), cognitive symptoms (distressing thoughts, difficulty concentrating, etc), behaviours (urge to escape the situation, urge to drinks alcohol or use drugs, etc), emotional symptoms (feeling upset, irritable or numb, etc). During times of stress, most of us will experience at least some of these symptoms. An anxiety disorder is only considered if the anxiety symptoms are excessive and the symptoms do not resolve when the stress is over.
If you suspect that you have an anxiety disorder, talk to your health care practitioner, physician, or a mental health professional. It may be helpful to go through the symptom list below and bring it with you to your appointment. You do not need to suffer needlessly when there are treatments shown to be effective at managing anxiety disorders. Effective treatment helps to lower symptoms, improve self-esteem, and get back to enjoying life again.
Enjoy your day,
The Vitality Team