Taking a closer look at anxiety

Feeling anxious or stressed is a common human experience. However, there are different types of anxiety, which vary in different degrees. Meaningful Minds Psychologist, Jeanette, gives a detailed explanation of this diverse emotion.

In today’s fast-paced competitive society, probably most of us suffer from symptoms of anxiety at one time or another. Often, work demands cause us to feel anxious. We generally speak about feeling “stressed”. Anxiety is not necessarily all bad as it can motivate you to perform to the best of your ability. Too high a level of anxiety can however result in severe distress and can impact negatively on different areas of your life, whether it be at home, at work or in your social life.

What does it mean if we say we suffer from anxiety? Fear is how we respond emotionally to a real or perceived imminent threat, while anxiety is the anticipation of that future threat. States of fear and anxiety however overlap significantly. As a result, we may refer to feeling anxious when the actual threat is already present and what we are experiencing is fear. Fear is associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviours. Anxiety on the other hand is associated with muscle tension, being vigilant to prepare for future danger and avoidant behaviours. Anxiety disorders include features of both excessive fear and excessive anxiety.

There are many different symptoms of anxiety, including psychological and physical symptoms. Common symptoms include:

· Restlessness or feeling keyed up or on edge

· Being easily fatigued

· Difficulty concentrating or your mind going blank

· Irritability

· Muscle tension

· Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)

· Nightmares

· Heart palpitations

· Dizziness

· Headaches

· Stomach aches

· Nausea and vomiting

It is important to note that some of the symptoms of anxiety overlap with symptoms of depression, for example being easily fatigued, difficulty concentrating, sleep disturbance, and irritable mood in the case of children and adolescents. It is therefore always advisable to consult a mental health professional to assist you in teasing out what you are actually suffering from - anxiety or depression or even a mix of the two.

There are also many types of anxiety, as described below:

· Generalized anxiety means having apprehensive expectations about a number of upcoming events or activities, which leads to excessive anxiety and worry. Adults often worry about possible job responsibilities, health and finances, the health of family members, misfortune to their children or other minor matters. Children often worry about their competence or the quality of their performance.

· Social anxiety / phobia involves an intense fear or anxiety of social situations. You fear negative evaluation from others, that you may be judged as weak, crazy, stupid, boring, or unlikeable. You fear offending others and being rejected as a result. In children the fear or anxiety should be evident during interactions with peers and not only during interactions with adults.

· Other specific phobias involve intense fear or anxiety about a specific object or situation. The specific object or situation is called the phobic stimulus. There are various categories of phobic stimuli, including Animal (e.g. spiders), the Natural environment (e.g. heights), Blood-injection-injury (e.g. needles), and Situational (e.g. airplanes).

· Panic attacks are surges of intense fear or intense discomfort that can occur from either a calm state or an anxious state. A panic attack usually reaches its peak within minutes and can include symptoms like a pounding heart, sweating, shortness of breath, chest pain, feeling dizzy, fear of “going crazy”, and fear of dying. Panic attacks are viewed as expected when an obvious triggering event is present. Attacks are unexpected if the attack happens for no specific reason that one is consciously aware of. It is not uncommon to have a single panic attack. When you suffer from more regular unexpected panic attacks, you may need to ask for help.

· Agoraphobia means having marked fear or anxiety about the following situations: using public transport, being in open spaces such as parking lots or marketplaces, being in enclosed spaces, standing in line or being in a crowd, and being away from home alone. People typically think that something terrible may happen to them when they experience symptoms of anxiety in these situations.

· Separation anxiety means excessive fear or anxiety that one will be separated from home or from those whom you are attached to. Children typically display clinging behaviour, staying close to the parent. Children may even refuse to go to school. Although separation anxiety is more common in children, adults also suffer from it. Adults may find it uncomfortable to travel independently, for example sleeping alone in a hotel room. Depending on their age, individuals may fear monsters, the dark, burglars, car accidents, or plane travel as it presents danger to their family or themselves.

· Selective mutism is relatively rare. It involves not being able to speak in specific social situations in which one is expected to speak, for example at school, while you are able to speak in other situations. Children with selective mutism will very often suffer from another anxiety disorder too, most commonly social anxiety disorder. Children often outgrow selective mutism.

· Anxiety can be induced by certain medications and substances, including legal substances such as caffeine and tobacco.

· Lastly, anxiety can be caused by a medical condition, being a direct physical effect of the condition.

If you believe you suffer excessively from any of the types of anxiety mentioned above, it is recommended that you consult a mental health professional to obtain assistance in managing these symptoms. If certain criteria are fulfilled, you could be diagnosed with an anxiety disorder, for example generalized anxiety disorder or panic disorder. Treatment options for anxiety include good self-help information, psychotherapy (particularly cognitive behavioural therapy that teaches you how to recognize and change thought patterns and behaviours that trigger anxiety), and medication. Keep in mind that some types of anxiety medication can be addictive. Therefore, if you start taking medication, please discuss this with your medical practitioner. Practising mindfulness is another option worth investigating for managing symptoms of anxiety. Watch out for mindfulness workshops run by our practice from time to time.

Tip for the day

It is useful to remember that worrying about worrying acts to increase levels of anxiety. If you suffer from “normal” levels of anxiety, it is best to accept this as part and parcel of life instead of overanalysing and worrying about these symptoms.