Anxiety 101

Anxiety is the number one mental health issue for American women according to the National Institute for Mental Health and the number two issue for men after addictions. Only a small percentage of those with this condition receive treatment despite the fact that over 40 million adults suffer from it.

The average person experiences some worry over everyday concerns such as finances, health, work, relationships, or abilities. The anxiety sufferer experiences constant fear and preoccupation with these issues, and avoidance of situations that might trigger further anxiety arousal. The anxiety can range from a mild disturbance to a full blown panic attack.

Why does anxiety seem to be on the rise? Stressors and the resulting stress experienced by the general population has been on the rise in the last 50 years. Americans report an increasingly uncomfortable level of stress in their lives. The pace of life is rapid, the time to adjust and accommodate to changes is diminished.  Different sources estimate that anywhere from 50 – 90 % of adults conclude that they are experiencing stress in at least one area of their life. A period of stress usually precedes a bout of anxiety.

Stress is an arousal response to a situation, distress.  Anxiety is a reaction to the stress response, that includes worry, nervousness and panic. Stress is defined as emotional, physical or mental strain usually precipitated by an external situation or event, a stressor.  Anxiety is a subjective state of tension or uneasiness whose source is unclear, where the focus is internal. When stressed, an individual may experience a gap between what is being demanded of him or her in a situation and the perceived resources he or she has available  to respond to the situation. When anxious, the danger may be unclear, the feeling  that “something bad is going to happen.”

Thoughts, feelings and behavior are affected by stress.  The physiological responses to stress include headaches, muscle tension, fatigue, changes in sex drive, sleep difficulties, chest pains, or digestive problems. Emotional responses include irritability, inability to focus, sadness, or tension.  Behavioral responses include an increase in addictive behaviors such as smoking or drinking, social withdrawal, or angry outbursts.

A major stressor can trigger anxiety. Anxiety affects the body, mind, and emotions and can range in severity from mild uneasiness to severe panic.  The anxiety sufferer gets caught in a worry cycle of constant concern about daily activities, exaggerated focus on possible dangers, or persistent apprehension of a catastrophe. Fears of dying, going crazy or loss of control are common.  The body responds with heart palpitations, trembling, shaking, nausea, dizziness, hot flashes, and shortness of breath. Concerns mount about facing one or more of the feared situations. This worry or anticipatory anxiety leads to persistent avoidance of situations that might trigger or worsen the symptoms.

Anxiety is an integral part of today’s lifestyle. Sometimes when anxiety  arises in response to a specific situation, it is a reasonable reaction. Events that have the potential for loss or failure are challenges frequently faced with some anxiety. The anxiety provoked in these types of situations can provide momentum for facing these situations with increased attention and preparation if it is manageable.

Situational anxiety is a specific type of anxiety that differs from fear in that it is unrealistic and overblown.  Fear of driving on freeways, fear of conflict, fear of dentists or doctors are examples of this type of anxiety. The anxiety has not yet progressed to the phobic stage where anxiety producing situations are consistently avoided but they still induce uncomfortable symptoms for the individual facing the activity.

Even thinking about a particular situation can create distress and uncomfortable physical symptoms.  This is called anticipatory anxiety.  It is on the severe end of the worry spectrum. Thoughts are persistent and have an obsessive quality especially when the sufferer is faced with the feared situation. Anticipatory panic is the label given to a  pattern of the the worsening and intensification of the anxiety symptoms.

These experiences make it difficult for the anxiety sufferer to experience a sense of stability in their everyday life.  Daily life becomes either mildly or extremely unpredictable. Completing everyday chores, work, or even taking care of oneself can become overwhelming. Sleep can be disrupted, as can relationships and careers.

Treatment is about coming home to to a more consistent and manageable response to work, relationship and life challenges. Recovery is about developing an increased ability to cope with the stressors that arise. Finding an internal sense of calm from which one can respond to life in a more relaxed, authentic way is the result of a clear, focused approach to the treatment of anxiety, not as just a collection of symptoms but as a treatable condition reflecting the individual’s lifestyle. Effective treatment addresses the individual, not just the body’s reactions.