Anxiety

Anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or a future event that is perceived to have a negative or an uncertain outcome.  Feeling anxious does not mean you have an anxiety disorder.  Symptoms related to anxiety disorders are persistent and interfere significantly in daily functioning.

Anxiety Disorders include social anxiety, generalized anxiety, separation anxiety, and phobias.

Social anxiety often involves the intense and/or persistent fear of being judged, perceived or evaluated in a negative way, or being rejected by others in a social situation or a performance situation.  These fears involve being thought of as shy, backward, awkward, incompetent, unintelligent, nervous, disinterested, 'stuck-up', boring, rude, or even as unwanted or a 'try-hard' or imposter. 

 

Individuals suffering from these symptoms may fear their discomfort shows and they imagine, fear, and avoid situations in which they may shake or tremble, stutter or stumble over words, blush or pale, 'go blank', and lose balance.  The experience of anxiety, fear, and distress is so overwhelming that those suffering this kind of anxiety will often avoid situations in which they may feel vulnerable or at risk by calling in sick, breaking or not making plans, and/or spending a great deal of time planning ready 'excuses' or 'escape' (safety) plans (e.g. standing near an exit, or bringing along a 'safe person').

As with most mental health challenges, those that are dealing with social anxiety disorder, often experience somatic complaints, or strong body/physical symptoms (e.g. increased heart rate, dizziness, nausea, perspiration, weak legs, ringing in the ears, gastrointestinal distress, etc.).  If the individual is experiencing multiple physical symptoms, they may be experiencing a panic attack.  

And, as with most mental health challenges, the individual likely recognizes that their fear and responses are excessive, beyond what would be considered 'normal' or normative, and they may feel as though they are acting irrationally or unreasonably, which may further cause feelings of frustration, shame, and guilt.

Social anxiety disorder moves beyond shyness and can cause upset and disturbance in a person's day to day functioning as it interferes with recreation, socialization, developing and maintaining relationships, and education or occupational opportunities.  Sometimes, Individuals who suffer with these symptoms may begin to cope with substance use or may begin to notice symptoms of depression if they become isolated or if they suffer diminishing self-esteem and poor self-concept.

People with social anxiety usually experience significant distress in the following public, social, or professional situations:

 

  • Introductions to people

  • Interactions with those in positions of authority

  • Having to speak in formal or informal settings

  • Not knowing what to say when caught off guard

  • Becoming embarrassed and blushing

  • Experiencing a shaking voice or trembling hands

  • Light-hearted teasing

  • Having attention brought to them

  • Being observed

  • Making eye-contact

  • Eating, writing, reading, having to speak on the phone 
     

Generalized anxiety describes experiencing worries and anxiety related to many and varied aspects to day to day life which; this anxiety and worry is beyond what would be considered expected for the situation.  Individuals challenged by this type of anxiety, also known as free-floating anxiety, may find themselves worried about family members, work or education issues or scenarios, current and future finances, health, driving, and decision making. 


Those suffering from generalized anxiety disorder may report somatic/physical, symptoms of distress including headaches, stomach upset or digestive issues, muscle tension, difficulty falling or staying asleep, restlessness, and mood changes, including irritability and depression.


People with generalized anxiety often engage in chronic worry and rumination, and find their thoughts and thinking troublesome. 

Common unhelpful thinking styles:

 

  • Magnification/Catastrophizing - blowing things out of proportion,

      "making a mountain out of a mole-hill", believing in the worst-case scenario

  • Minimizing - reducing or shrinking the importance of something

  • Disqualifying the Positive - dismissing or discounting positive, helpful, or good

       things that have happened to you or that you have done for yourself or others

  • Emotional Reasoning- believing that our feelings are facts

  • All or nothing thinking, or black-and-white thinking

       e.g. if something is one way, it cannot be the other

  • Over-generalizing - seeing a broad pattern based on one event

  • Mental Filtering - only noticing or paying attention to certain types of evidence

  • Jumping to Conclusions -imagining what someone else is thinking

       or predicting the outcome to a situation

  • Labelling - name-calling or assigning a label/meaning to ourselves or others

  • Should-ing/Must-ing/Ought-to-ing - putting pressure on ourselves or others

       with critical words like, 'should', 'must', or 'ought' in a context in which we or they

       feel guilt, shame, or as though we or they have already failed

  • Personalization - assigning inappropriate blame to yourself or someone else

 

The symptoms of generalized anxiety may result in sufferers avoiding people or places, using unhelpful coping, and they may notice effects intruding into and disrupting their lives in many areas: socially, occupationally, educationally, within their relationships, and in their ability to complete tasks.

 

Separation Anxiety was previously only thought to occur in children but is now recognized in adults.  Adults who suffer separation anxiety notice intense feelings of anxiety and fear when  or when anticipating the separation between them and attachment figures.  Often there is excessive worry about the health and safety of the attachment figure (parent, spouse, partner, child) while separated, and sometimes there is a refusal or failure to go to work, an educational institution, or another group or activity, often  previously attended and enjoyed.  Symptoms are similar to other anxiety disorders and may involve the same emotional and physical or somatic symptoms, with thoughts however being centred on perceptions of separation and risk, and behaviours involving frequent checking-in with the attachment figure or 'clingy' behaviour.

Phobia refers to an intense and extremely distressing anxiety, somatic/physical symptoms of panic, and sometimes terror, surrounding an idea or in response to the presence of a feared object or situation.  The reaction is outside what would be expected and may feel very extreme and irrational yet uncontrollable for the sufferer. 

Some common phobias are: 

  • Environmental phobias, e.g. heights, deep or open water, germs - including deep water, heights and germs

  • Animal phobias - dogs, cats, snakes, lizards, or spiders

  • Situational phobias - flying in an airplane, riding in a boat, crossing over a bridge or through a tunnel, or visiting the dentist

  • Blood/injection phobias - seeing or being exposed to blood, having blood drawn or receiving an injection

 

Anxiety disorders cause people to suffer:

  • emotional

  • anxiety

  • frustration

  • guilt

  • shame

  • nervousness

  • irritability

  • physical

  • headaches

  • sleep troubles

  • stomach problems

  • muscle tension

  • dizziness

  • light-headedness

  • chest pressure

  • a sense of being 'wired'

  • being easily fatigued

  • cognitive

  • unhelpful thoughts

  • unhelpful thinking styles

  • negative self-talk

  • altered or negative self-concept

  • poor concentration and attention

  • behavioural

  • avoiding

  • procrastinating

  • chronic worrying

  • overworking

  • seeking reassurance

  • having difficulty waking or sleeping

  • feeling overwhelmed or 'paralyzed'

  • vomiting

 

Therapy works to explore, in a safe, accepting, welcome environment, the origins of anxiety, the way anxious feelings and behaviours came to play a role in your life, how they may have helped you in the past, and how they are no longer working for you.  Investigating anxiety through a somatic and mindful lens provides options for self-regulation and responding, and allows the therapist and client to process previous experiences which may be contributing to the maintenance of anxiety.   Therapy works to improve self-awareness, self-talk, self-concept, and mood.  You can feel better.

 

 

Some signs and symptoms overlap other mental health concerns and for an individual to be appropriately diagnosed with a disorder, they need be examined through a mental health assessment; this may be completed by a physician, registered psychologist, clinical social-worker, or a psychiatrist.  There are pros/cons, helpful bits and unhelpful pieces, cautions and considerations when seeking a diagnosis that are important to discuss the risks of pathologizing and the benefits of diagnosis with your mental health care professional.