Anxiety

by Sarah Chana Radcliffe, M.Ed., C.Psych.

ANXIETY – WHEN SHOULD I WORRY?

When is anxiety a normal human response to stress and when is it a psychological disorder? In other words, when is anxiety something to be anxious about? Knowing the difference between appropriate apprehension and inappropriate ruminating can help us effectively treat and alleviate this uncomfortable condition.

Everyone experiences anxiety. Like other emotions, anxiety is a beneficial signal, warning of possible threats to our physical or emotional well-being. Being anxious before an examination or a public performance warns us that loss of self-esteem is at stake: the anxiety motivates us to perform our best. Feeling anxious while walking along a dark, deserted street warns us that our physical safety is at risk: the anxiety causes us to be vigilant for signs of danger. The healthy purpose of anxiety is to optimize our level of functioning in times of need.

However, the anxiety alarm system can misfire, causing us to feel anxious even when there are no apparent threats in our environment. Although not harmful, anxiety is an unpleasant sensation involving many bodily systems – a sensation that we don’t want to experience any more than necessary. Intense anxiety, including panic symptoms, can cause chest pain, a choking sensation, sweating of the palms, nausea, hyperventilation, digestive upset, dizziness, numbing or tingling in the extremities, shakiness, palpitations and other physical symptoms caused by the activated sympathetic nervous system. These symptoms can be very frightening to experience – many people having anxiety attacks feel that they are going to pass out, have a heart attack or “go crazy.” Fortunately, none of that will happen. Anxiety creates these sensations by activating the “flight or fight” response in the body in reaction to perceived threat. The “flight or fight” response causes blood and oxygen to rush to the larger muscles in preparation for attacking or fleeing, and causes the body to ready itself for an emergency by altering breathing patterns and other body systems. The bodily sensations which accompany anxiety are just the result of the body’s efforts to prepare for emergency functioning.

Because anxiety attacks are so uncomfortable, people can become intent on avoiding them. Ironically, the desire to avoid panic can lead to increased anxiety and panic. People may develop anxiety disorders based on fear of panic. Such disorders may be manifested by attempts to avoid anxiety-inducing situations. For example, if someone has a fear of flying in airplanes, they may avoid flying by taking trains or driving. Simple fears like this may be called “phobias.” Phobias are fears of specific triggers like heights, insects, snakes, driving, blood, thunderstorms, elevators and so on. Social phobia is the fear of appearing foolish or inadequate in public. These sorts of anxieties can cause certain restrictions and inconveniences for the sufferer. Phobias are usually easily cured with modern brief psychological treatments. Panic attacks which are not associated with specific phobias, but rather occur spontaneously or in conjunction with other psychological disorders, respond well to various medications and therapeutic approaches.

More pervasive anxiety may cause people to try to avoid all situations which might lead to panic attacks. These people may restrict their lives to a much greater extent, sometimes barely leaving the safety of their homes for fear of experiencing panic in an unprotected environment. This condition is called panic disorder with agoraphobia and it, too, responds well to psychological and pharmocological treatments.

Anxiety which is not focused on specific fears, but rather centres on many worries and insecurities may form the basis of generalized anxiety syndrome. In this syndrome, the person’s general state is one of anxiety and worry, often characterized by uncomfortable physical sensations such as restlessness and muscle tension, sleep disturbances, irritability, fatigue, and trouble concentrating. Psychotherapy and/or psychotropic medication can help with this disorder.

An anxiety disorder which often starts in childhood or adolescence is obsessive-compulsive disorder. It is characterized by both obsessions (persistent, unwanted thoughts that intrude and cause distress or anxiety) and compulsions (repetitive behaviours occurring in response to an obsession or in accordance with strict rules – such as counting or checking things – in order to reduce anxiety). Obsessions and compulsions are actually attempts to soothe anxiety, but they end up creating anxiety themselves. Left untreated, this disorder can cause serious dysfunction in life, interfering with school, work and marriage. Obsessive-compulsive disorder does respond well to behaviour modification treatment and medication.

Anxiety can also exist in post-traumatic stress disorder – a syndrome affecting survivors of violent experiences. It can exist as part of a mood disorder such as depression. In addition, anxiety symptoms can be the result of physical disease, rather than mental disorder. If you are suffering from anxiety, see your doctor before you consult a therapist!

The tendency to become unnecessarily anxious is partially an inherited trait. It is also a learned trait. When we are anxious people, chances are some of our children will be anxious as well. If we reduce our anxiety, not only will our children not learn this behaviour from us, but even the ones who are genetically preconditioned to anxiety will have a better chance of avoiding the condition.

Chronic negative emotions of anger, sadness and fear are not good for our physical, emotional or spiritual health. However, it isn’t possible to “talk ourselves out of” these feelings. Knowing we shouldn’t have them does nothing to make them go away; in fact, the added guilt we feel for lacking bitochon or other appropriate spiritual qualities, only adds to our suffering. Indeed, those who experience chronic anxiety and its accompanying bodily distress, often get very depressed at their inability to rid themselves of this condition. Professional treatment, however, can provide relief from anxiety. Taking advantage of it can provide a new lease on life with increased opportunities for fulfillment and emotional well-being.