Who Might Develop Anxiety?
In answering this question, it is important first to outline what we mean by ‘anxiety’. In terms of the everyday use of the word, anxiety generally means a collection of physical and psychological ‘symptoms’ that might cluster together; these are outlined below. Diagnostically however, there are different types of anxiety that might be experienced in different ways. For example:
- Agoraphobia (an anxiety about, or avoidance of, places or situations from which escape might be difficult)
- Phobias (anxiety provoked by a specific object or situation, often leading to avoidance)
- Obsessive-compulsive disorder (characterised by obsessions and/or compulsions)
- Post-traumatic stress disorder (linked to a traumatic event or situation with a number of associated symptoms)
- Acute stress disorder (similar to PTSD but over a shorter time period)
- Generalised anxiety disorder (persistent anxiety or worry, experienced over time)
Each of these anxiety disorders, as categorised by diagnostic manuals (such as Diagnostic and Statistical Manual for Mental Disorders version 5: American Psychiatric Association) detail a number of presenting characteristics – or criteria – that must be met for the diagnosis to be made.
As we can see, different diagnoses may occur depending on different situations – whether that be from a trauma, or other trigger. Anyone can experience high levels of anxiety, depending on circumstances and, as we will discuss later, anxiety can be a positive thing if managed or contained.
Anyone can find themselves caught in a ‘cycle of thinking’ that exacerbates anxiety; once started, anxiety can quickly become self-reinforcing so that anxiety creates anxiety. In addition, our tendency to want to avoid situations that we identify can make us anxious further reinforces it, as we also avoid situations that might help us to learn different ways of coping, or demonstrate that our ‘feared’ situation is something we can, in fact, manage.
So What is Anxiety?
Hallam (1992 p 2) offers a number of characteristics of anxiety:
- An unpleasant quality of subjective experience, varying from ‘tension’ to ‘terror’
- An awareness of imminent danger or harm, whether or not its sources can be specified
- An experience of bodily sensations associated particularly with activation of the autonomic nervous system
- A strong urge to flee to a place of safety
- A lack of control over fine motor movements
- Thoughts of a worrying or unpleasant nature over which there is little control
- An inability to think clearly or act in a coordinated manner, especially in novel, conflictual or threating situations
(Hallam, R (1992) Counselling for Anxiety Problems. London: Sage)
A first important point to stress is that some degree of anxiety can be really helpful: it can focus, motivate and enable us to undertake a particular task, such as an examination or piece of coursework, or perform in other ways. Many top athletes would state that anxiety and stress are critical to their high-level performance and that, without them, they would not achieve their targets. In that sense, anxiety is something, with practise, we can utilise and harness to help us progress. The problem is however, that prolonged anxiety or anxiety that is more generalised, i.e., not related to a specific identifiable factor, can be very difficult to manage and can, over time, bring serious detriment to our overall mental health and functioning.
Symptoms of Anxiety
There are a range of different ‘symptoms’ of anxiety, depending on the type of anxiety it is. While there is a diagnosis of ‘generalised anxiety disorder’, there are also a number of other different types of anxiety, such as social anxiety, health anxiety, obsessive-compulsive disorder, and so on. If you are struggling with anxiety and believe it to be causing problems to your life and how you are functioning, it is important that you speak with your General Practitioner (GP) or a counsellor to understand it more and get the right sort of help you need.
In general terms however, we might consider a number of symptoms that might indicate if you are struggling with anxiety; these can be split into emotional/psychological symptoms, and physical symptoms.
Emotional/psychological symptoms of anxiety
Anxiety can have a big impact on how we think and feel about the world. Symptoms might include:
- Feeling really exposed: that people are watching you and can tell that you are highly anxious
- Feeling as if you are observing yourself, like you are detached from yourself and spectating, with little direct control
- Fearing that you might die, or might be having a heart attack (if you are experiencing panic)
- Fearing that you are losing control
- Being hypersensitised to things and people around you – feeling sometimes startled by everyday things
- Feeling that the world is going too quickly, or too slowly
- Ruminating thoughts (intrusive, usually negative thoughts that might repeat, or that we have difficulty controlling)
Physical symptoms of anxiety
Anxiety also comes with a number of physical symptoms, which are very real. People sometimes hear the expression that, “it is only anxiety”, as if the symptoms they are experiencing are somehow not real. This is, of course, nonsense. It may be anxiety, but the symptoms are very real and can be frightening. They might include:
- A sense of your heart pounding, or of palpitations
- Feeling nauseous, or actually vomiting
- A tight band across your chest
- Feeling tense muscles
- Trembling or shaking, feeling physically agitated
- Hot flushes, or feeling cold
- Dry mouth, or an unpleasant taste in your mouth
- Difficulties in swallowing
- An urge to go to the toilet, or actually going to the toilet more regularly
- Feelings of tingling in the body, particularly hands and feet
- Fearing that you will faint, or collapse
A panic attack is when our body goes into ‘flight or fight’ mode. This is a ‘built-in’ mechanism most of us have that enables us to survive in times of difficulty. While most of us are not now involved on a daily basis in fighting sabre-tooth tigers, we have evolved with the capacity to make a quick judgement about a situation and respond accordingly. Such as, we might potentially be able to fight off an immediate threat, but are not likely to win if we decide to fight a bus heading towards us: sometimes we will ‘fight’, sometimes we will ‘flight’. Whatever our decision, we need an urgent physiological response to enable us to do so. Our bodies will release chemicals, such as adrenaline (a hormone), which activates a number of physical responses, e.g., increased heart rate, increased bloody supply to parts of our body, such as some muscle groups etc., which enables us to act quickly.
These chemicals are very strong and are responsible for the physical symptoms outlined above. Once the panic attack begins to subside (or the flight or fight response begins to subside), we slowly go back to our usual ‘resting’ state. Chronic anxiety is when there are such ‘stress hormones’, such as adrenaline or cortisol, in our body, thus causing both the physical and psychological symptoms of anxiety.
What Can I Do?
There are a number of self-help things we can do to support ourselves with anxiety. Additionally, the information across this website that relates to depression can be extremely helpful for anxiety too.
- Learn some breathing techniques, as these can calm us physically and slow down our responses, e.g., heart rate etc.
- Try to do some physical activity to ‘burn off’ some of the stress hormones
- Tell yourself that you will be okay: while it might be frightening, you are not going to die and the high anxiety or panic will naturally begin to subside of its own accord
- Try to find a safe space – this might be at home or, if you are out, a quiet table in a coffee shop, or a bench in a park. Somewhere where you can just allow yourself to ‘be’ for a few minutes while you use your breathing techniques
- Go to see a GP or a counsellor to talk about your anxiety and to explain how it impacts on you and your life
- Conduct an ‘audit’ of your current commitments, to try to identify if you are routinely taking on too much – think about what, if anything, you might be able to change
- Consider how you are looking after your physical health, e.g., how you are eating, sleeping, exercise etc.
- Consider how you are looking after your emotional/mental health, e.g., do you create any ‘stop-time’, how do you relax, what things do you do that you enjoy and are you creating time for them
- Try a more structured routine, such as mindfulness or meditation, to begin to take care of yourself