‘I can’t do this, I can’t do this, I can’t do this! I have to get out of here!’
It’s normal for all of us to feel worry about certain situations in life: anyone that denies this fact are just kidding themselves or are just putting up a facade for their mates. There is a distinct difference, however, between those that suffer from an anxiety disorder and those whose worry is justified for the situation that they are in.
What is anxiety?
Anxiety happens as a result of both our thoughts on a certain situation as well as a hormonal response: specifically, anxiety-triggering situations releases the hormone adrenaline (aka epinephrine) into the bloodstream, causing our cardiovascular system to go into overdrive with the heart racing and breathing becoming more rapid as well as the increasing production of sweat. This is also known as the ‘flight, fight or fright’ response: as the name suggests, there are three ways in which people respond to this release of hormones:
- Running away or towards the situation
- ‘Freezing’ in the spot that they are in
- Revving up for a fight
I can remember one particular situation in my life where I and people around me reacted very differently to what had happened. My cousin was driving for the first time ever and unfortunately she lost control because she hit the accelerator instead of the brake and crashed the car she was in through a glass windowpane of a nearby shop. There were five people who witnessed this crash, including myself, another of my cousins and my aunt. Once I heard the glass crashing, my instincts immediately kicked in and I start running almost instantly towards the crash site with my other cousin following suit to see if she had been injured: thankfully, apart from being shocked, she escaped without a scratch, albeit it could’ve been very different if the car had gone in at a different angle. The car itself wasn’t so lucky: after the accident it was written off due to the extensive damage on the front section and the windshield. Due to my medical training, I was able to take control of the situation until an ambulance arrived and only when the adrenaline started to dissipate after I left the site my emotions started to kick in. Oddly, though, instead of reacting, my aunt froze up and it took some major coercing for her to take it all in.
What circumstances trigger anxiety?
There are definitely some circumstances which can bring the adrenal response up to 11 in a large proportion of people, such as going up on stage or taking an exam, but there are some situations which affect only a small amount of the population. Even seasoned professionals that spend their lives on stage and screen still occasionally succumb to their nerves, but they have found their own unique methods in order to combat them. Under normal conditions, the nerves kick in just before said event and once it begins, the perspective begins to change based on how much they’ve prepared themselves and more often than not, the situation is generally less scary than what they had anticipated. Once this happens, the nerves begin to dissipate and after a while, they may go away completely and you may start to have fun with it.
For people that suffer an anxiety disorder, however, this normal reaction can go into overdrive and it can seriously affect the quality of your life by preventing you from coping with things that occur every day.
There are other things besides those examples I mentioned above which can trigger anxiousness in people and they can be split into four different categories:
- Stressful life conditions
As we grow up, different life circumstances may raise our stress levels. Work is a major stress factor for many people, and it can affect both the employed and the unemployed alike.
- For those in work, they may be in a high-pressure environment and/or they may have bosses that are unreasonable on them. They may freak out about reaching deadlines or things not working as they had originally planned i.e. machines or computers breaking down on them, or unexpected blackouts.
- For those out of work, they may have fiscal-related stress and they therefore feel the pressure to become employed.
As much as we Aussies complain about them sometimes (I myself am guilty of this!), fortunately, in Australia we have Centrelink to temporarily fall back upon if we happen to lose our jobs or if life circumstances change, but other countries do not have such a support system and have to rely on their savings to get by, and believe me, most of us don’t have enough to live comfortably on our savings alone for very long!
- For those fresh out of training or university, there is also a unique type of stress that can be felt when looking for their first job related to what they studied, as they are often caught in a vicious cycle of constantly getting knocked back, despite doing well in the interviews.
Before my last job, I was stuck in this cycle for two years, and it was very frustrating to say the least: it would’ve helped more if the interviews came back with some constructive criticism that I could use to improve my performance, but all some of them could come up with was ‘you’re qualified and you did well in your interview but you need more experience’. Well, I ask you this… HOW am I supposed to get more experience if I don’t get the chance to prove myself?
Another big one which has become more prevalent these days is going through separation and/or divorce.
On a personal level, I feel I’ve been relatively lucky in my case as I’m still close to my dad despite the fact my folks haven’t been married for more than 20 years, and I was young enough at the time to be spared from the emotional turmoil of my parents splitting up (due to my dad having an affair) and I was able to stay in my childhood house with my mum until I moved out for the first time early last year.
Unfortunately, my case is the exception rather than the rule; separation and divorce is a very taxing time for both the parents involved in the broken relationship and any kids that they might have, for both emotional and logistical reasons. In my humble opinion, I think the kids usually suffer the most stress from this particular situation, as more often than not, have to put up with both the annoyance of being shifted between two houses and (if the split was non-amicable) emotional blackmail from either one or both of their parents.
Other circumstances which can be stressful include the following:
- Pregnancy and labour, particularly if the pregnancy doesn’t run smoothly
- Moving house, particularly moving overseas or post foreclosure
- Being surrounded by family or friends that are ‘toxic’ i.e. they do not support you when it is needed the most; rather, they have their own selfish agendas
- Having an emotional shock (similar to the case I talked about above)
- Death of a loved one (whether it be family, a close friend or a beloved pet)
- Suffering through abuse of any kind, whether it be physical, emotional, social or sexual
2. Anxiety triggered as a side effect of drug use
- Some medications and illicit substances have hallucinogenic side effects which causes them to lose perception of reality. They are often caught within a vicious cycle where they try to wean themselves off the medication, however, they become more anxious about how they are perceived by other people when they are in withdrawal and more often than not, they go back to taking the drugs in order to compensate and they feel worse for doing so.
3. Physical problems
- Getting sick sucks, and we all have the occasional bout of the flu or a common cold which we can’t quite seem to shake. For most of us, these viruses and other infectious agents are annoying and we learn to live with them, but there are some people who unfortunately do not have a good constitution which allows them to bounce back after a short period of time (up to a couple of weeks, usually).
- There are also some physical conditions which some people are either born with or develop later on in life which stick with them for the rest of their lives, and these illnesses can be very taxing on the psychology in the long run, especially if complications begin to creep in later on in life. Some examples of such conditions include diabetes (type 1 or childhood/type 2 or adulthood), heart disease, asthma and other hormonal conditions such as hyper or hypothyroidism.
4. Mental issues
- It’s far more common for people living with a relative that has a mental problem to eventually develop the same one or something different themselves. Living in these conditions can also be very stressful for not only the person living with the condition, but for those that are taking care of them. Let me make something clear, though: just because you’re in proximity, it doesn’t guarantee that you will develop a mental issue yourself.
- People with certain personality traits are also more likely to be chronically stressed: individuals that are classic A-type personalities and those who are control freaks tend to get stressed more easily. I’ve gone into further detail into perfectionists here.
What is generalized anxiety disorder?
Everyone feels anxious at some point for a short period of time: this is also known as acute anxiety and, depending on circumstances, is considered normal or indicative of a certain type of phobia, which I go into more detail here. Generalized anxiety disorder or GAD, conversely, is characterized by chronic anxiety i.e. anxiety which has been felt on most days for more than six months at a time. People who suffer from GAD not only worry, but find it hard to stop worrying about their situation and in later stages, this type of anxiety starts to become debilitating to your life as things that people do everyday such as working and study as well as socializing become taxing on both your mind and body.
Other warning signs which can indicate that you may be suffering from GAD include the following:
- Being cranky for more than normal
- Becoming quickly fatigued despite maintaining a healthy lifestyle
- Suffering from insomnia due to brains’ inability to shut off during the night
- Becoming excessively restless or fidgety
- Having muscle pains which are not caused by high-intensity exercise, having a deficient blood magnesium level or having ‘growing’ pains during puberty
What types of conditions are linked to anxiety?
There are several types of conditions which stem from anxiety: they include panic disorders, obsessive compulsive disorder or OCD (which I’ve discussed more here), as well as social phobias, post-traumatic stress disorder or PTSD, and other phobias which I’ve written about separately here.
I’ll now talk about briefly about panic attacks and social phobias. These two conditions can be very debilitating for the individual suffering from them, as they can prevent people from enjoying the nuances of life.
What are panic disorders, and what are the symptoms?
Panic disorders are disorders that are characterized by panic attacks. If you’ve ever suffered from a panic attack, you’ll know that they are very intense and can feel overwhelming and it can be bloody difficult to pull yourself back together.
Panic attacks have multiple symptoms, and some of them can creep in at the same time unexpectedly. They include the following:
- Tachycardia (fast heart rate) combined with dypsnoea (shortness of breath)
- Choking sensation
- Shakiness (due to excess adrenaline)
- Becoming excessively sweaty
- Hot and cold flushes (not associated with menopause or fever)
- Dizziness or lightheadedness
- Fainting spells
- Becoming detached from reality or losing sense of self
- Fear of dying or going crazy
It’s true that normal fear can spark some of these symptoms, but there is a marked difference between this and panic attacks in that panic attacks can happen even when there is no justifiable reason for the fear to kick in and they can last longer than ten minutes at a time.
We’re all a little shy sometimes around strangers: how can I tell then if I have a social anxiety disorder?
Social anxiety disorder sufferers become petrified about meeting people for the first time. Unlike the majority of us who dread meeting only certain people (either because of what we’re told from people close to us or from stereotypical imagery) people with this disorder find the general concept of being let loose in a room full of people and being made to mingle overwhelming.
Other cases that can turn the anxiety level up to 11 in sufferers include the following:
- Being made to eat in public
This particular fear may also be linked to psychoses associated with anorexia or bulimia nervosa. It’s important to differentiate between the two.
- Speaking up at work
This may include asking for help or for a raise after a certain period of time, or talking within a staff meeting. Sure, some bosses are jerks (in that case it’s best to try and find a different job if you can), but any reasonable boss will take your concerns or requests under consideration.
What is the psychology behind this disorder, I hear you asking? Well, social anxiety disorder (SAD) is more often than not the result of the fear of being criticized by other people for being ‘stupid’ or ‘incompetent’. Occasionally, their fear is justified as unfortunately there are always jerks out there that pick on people in an attempt to hide their own issues, but more often than not, they may or may not recognize that the fear itself is unreasonable when compared to what actually happens. Sadly, this fear can lead sufferers to distance themselves from social situations in order to feel ‘safe’, however this defensive mechanism actually backfires on them as it can exacerbate the fear when they have no choice but to put themselves out there. Rather, in order to combat SAD, it’s best to tackle the neuroses that trigger the fear with a therapist and to take small steps in order to gradually lower the level of anxiety.
How do you treat anxiety?
Like I mentioned above, a common way to try and beat anxiety-related conditions is to talk with a therapist. The technique used in these therapy sessions is known as CBT or cognitive behavioural therapy. In essence, this technique helps to get to the root of the problem by finding out what pattern of thinking is triggering the anxiety and then a two-pronged attack is used to help treat the problem:
- When the critical and/or fearful thoughts are isolated, the therapist discusses with the anxiety sufferer where these thoughts come from and whether such thoughts are merited (most of the time, the fear is unreasonable for the situation). In these sessions, alternate thoughts on the situation (which are more realistic) are also talked over.
- In some cases, the therapist can be there directly to slowly reintroduce the person to the trigger and with their help, the anxiety suffer can slowly desensitize themselves.
In more severe cases, medications such as SSRIs (antidepressants) or benzodiazepines are prescribed to help the patient cope with anxiety attacks.
There are also certain techniques that can be applied day-to-day in order to help tackle anxiety head-on, such as:
- Taking time out for yourself.
This may mean having a vacation, but for most of us, we can’t afford them regularly or our commitments to study prevent us from taking them. There are cheaper methods which can mix between our working or studying life, such as taking a relaxing bath or swim, doing yoga, getting immersed in a good book or listening to music you like.
I strongly recommend this as this can not only be a major anxiety buster, but it can also elevate your mood through the release of endorphins, not to mention burning of calories, which is an added incentive! Varying your exercise routine and finding stuff you like doing is the key to success here, as boredom can set in if you’re doing the same routine all the time and it’s easy to lose motivation. If you have trouble with finding motivation to do it yourself and you cannot afford a personal trainer, maybe recruit a friend or your partner!
- Eating a healthy diet
One major source of anxiety for people, women especially, is anxiety surrounding food and calorie restriction. Speaking from personal experience (I’ve been on many a fad diet since my early teens) it can be a major load off your shoulders if you focus on eating everything in moderation and keeping up with exercise rather than counting every calorie (or kilojoule) passing your lips. Not only does this help with anxiety, but it can also elevate your mood: I’m sure I’m not the only one who’s gotten really grouchy and sad from starving myself or eating only rabbit food or soup diets in an effort to stay thin!
- Speaking up when you have an issue with something
For people-pleasers in particular this can be hard as you feel like you may be hurting the other persons’ feelings if you disagree with them. I know… until recently I was one of them: however, these days, I usually say something and I welcome different opinions if they are willing to respect mine, but if they aren’t, they’re not worth my time. (Mind you, I’ve also said stuff in anger that I now regret, it’s all about balance!) It can be hard to find the inner strength to say something unless you’re really passionate about the subject, but clearing the air can be a good thing, as it prevents the buildup of resentment which can be damaging not only to you (on both a mental and physical level) but to your relationships to your family, friends or partners. Speaking with a counselor or psychologist can help here for those who those who lack confidence in this area.
- Getting enough sleep
Adrenaline and caffeine can help us on red-eye shifts, but they can only get us so far: there’s nothing like a decent nights’ shut-eye to get us prepped for the next day. If you’re having trouble sleeping, you may need to alter your routine by having a book with you in bed instead of your laptop or TV, and you may use other techniques such as meditation or taking a hot bath or shower before going to bed. If these don’t work, however, it’s best to consult a health-care professional.
- Dedicate some time to ‘worrying’
If you’re one of those people who get anxious because they don’t want to ‘worry’ in front of others, take comfort in the fact that worrying occasionally is healthy: if we didn’t worry at all, we wouldn’t be human as we wouldn’t be able to extend empathy or compassion to those in need. It may be helpful to set some time aside in the day to give yourself permission to ‘worry’: if that means crying a bit or screaming in your pillow, so be it, you’ll be better off for it.