What is anxiety?
When we feel threatened most of us will experience anxiety or fear. Some experiences will trigger anxiety in most of us (e.g., thinking about giving a talk to a large number of people or thinking a bear might be following you while walking in the forest). In our daily lives the things that make us feel anxiety can vary from person to person. For example, some people feel very anxious about snakes or spiders, while others have them for pets.
When it comes to anxiety, ALL humans are naturally programmed to react with the “fight- flight” response. Anxiety and the fight- flight response is a normal alarm reaction. We would not have survived as a species if we did not have anxiety and the fight- flight response as it allows us to sense danger and react in a way that keeps us safe. Anxiety causes changes in the body that increase our ability to: defend ourselves against the source of danger (“fight”) get away from something dangerous (“flight”).
How is normal anxiety different from an anxiety disorder?
All of us experience anxiety from time to time. Individuals with an anxiety disorder experience excessive symptoms of anxiety and associated symptoms on a regular basis for a prolonged period of time (months and years rather than just a few days or weeks).
When is anxiety a problem?
Assessment for an anxiety disorder should be considered under the following circumstances:
- Symptoms of anxiety and associated problems have been excessive and difficult to control for an extended period of time (more than just a few days or sometimes weeks)
- Lead to significant emotional distress and personal suffering
- Lead to significant interference in work, school, home or social activities
Sometimes the symptoms of an anxiety disorder are present most or all of the time. Sometimes the symptoms are only present when facing certain situations, places, experiences or people. It is also common for symptoms of an anxiety disorder to go up and down over time. People with an anxiety disorder often find that their symptoms get worse when they are under stress or feeling depressed.
What are common symptoms of anxiety?
These can often be broken down into 4 categories: Emotions, Body Responses, Thoughts, and Behaviors:
Emotions (How we feel)
The emotions associated with anxiety can also be described as feeling fearful, worried, tense, on guard, scared, apprehensive, frightened, “freaked out”, etc. We usually know we are feeling the emotion of anxiety when we are also experiencing anxious body responses, thoughts, or behaviors.
Body Responses (How our bodies react)
Anxiety can trigger a range of body responses involving blood flow, the heart, the lungs, muscles, vision, hearing, skin, hair, digestion, saliva, and other body systems. Anxiety causes a range of physiological changes in the body that can lead to the following symptoms:
These symptoms of anxiety are uncomfortable but they are not dangerous (and can even be helpful). For example, our hearts pump faster when we feel anxious to help us get more blood to the muscles in our legs and arms that we need to run away, fight or remain still until the danger passes. We might also feel dizzy or light- headed due to the sudden increase in blood oxygen that happens as the heart pumps faster—this is a harmless side effect of the anxiety response. Some people also feel nauseous because the body shuts down our digestive system in the face of danger to save energy. The pupils in our eyes will often open up widely (allows us to see better) and often leads to light sensitivity or seeing spots. Each of the body symptoms listed above can be traced back to some kind of harmless or helpful change that is triggered by anxiety.
Note: The symptoms of anxiety do overlap with symptoms of some medical conditions. Always review any body symptoms of anxiety with your physician so that medical conditions can be ruled out.
Frightening dreams or nightmares
Behaviors (How we respond)
Anxiety triggers a number of coping behaviors. Most of us will feel a strong urge to do things that eliminate the danger or make us feel safer. These are referred to as safety behaviors and common examples are listed below:
These behaviors are only considered safety behaviors if the main purpose is to prevent or eliminate feelings of anxiety or panic. If safety behaviors become frequent, compulsive and disruptive they tend to increase the severity of an anxiety disorder. Most of the safety behaviors are used with good intentions. Unfortunately, they usually backfire and make the symptoms of anxiety worse in the long- term. For example, many people with an anxiety disorder who take time off work often experience even higher levels of anxiety when they avoid work. Safety or avoidance behaviors do not empower people in their ability to cope with anxiety symptoms. You don’t need to keep yourself safe from panic or anxiety by using safety or avoidance behaviors but you will never have a chance to find this out as long as you keep using them.
People with anxiety disorders often experience huge benefits in their symptoms if they are able to gradually decrease their use of safety behaviors. Research has also shown that people who don’t give up this unhelpful way of coping have a higher rate of relapse compared to people who give up their safety behaviors.
What causes anxiety disorders?
Many people wonder why there are parents with an anxiety disorder who have children who are free from anxiety problems or symptoms. Likewise, many children with an anxiety disorder have parents or relatives who are anxiety free. How can this be? The development of an anxiety disorder usually results from a complex combination of a large number of factors including our previous experiences, our beliefs, and our environment—not just genetic and biological factors. However, most research studies tend to focus upon investigating only one factor at a time. Try to keep this in mind the next time you hear about any kind of research that has identified a risk factor for anxiety disorders, the odds are it is only one factor among many.
Genetic predisposition
To date there has been substantial research in the area of genetics and mental health, including anxiety disorders. Researchers have attempted to locate specific genetic markers that are associated with the occurrence of specific disorders (e.g., panic disorder). From these types of studies, we know that the tendency to feel anxiety or to have an anxiety disorder does run in families. What this means is that if you do suffer from an anxiety disorder there is a higher chance (compared to someone who does not suffer from an anxiety disorder) that other members of your family (e.g., child, sibling, parent, cousin, etc.) will also experience anxiety. We think of it as a vulnerability to developing anxiety. However, we have also learned that even if one family member experiences anxiety problems it is not a given that other family members will also have the same problems (in regards to the type of anxiety or degree of symptom severity).
Perfectionism
Higher levels of perfectionism have been associated with higher levels of anxiety and related symptoms. Perfectionistic goals for ourselves and others are typically not obtainable so they often add to the stress and suffering of a person with an anxiety disorder. If we continue to reach for perfectionistic goals (rather than standards of excellence that allow for some mistakes and flaws) we will be more likely to worry, feel anxious and engage in unhealthy ways of coping (e.g., avoiding things unless they can be done perfectly, not being able to delegate tasks to other people, spending too long on certain tasks, etc.). Most of the research has focused upon the role of perfectionism in OCD or social phobia and it is considered a risk factor in the development of both these disorders. That said, many individuals who can be described as perfectionistic do not have an anxiety disorder.
Environmental factors
Most of us experience a range of stressful experiences throughout their life without them directly causing an anxiety disorder. We do know that some environmental factors can increase the risk of experiencing problems with anxiety and for some people these problems become a full blown anxiety disorder. For example, some people with anxiety disorders experienced high levels of family strife and tension during their childhood. These kinds of experiences can trigger anxiety and unhealthy ways of coping that increase the risk for anxiety disorders. Some people grow up observing and learning from parents or other role models who are very anxious and avoidant. If a child takes on the same coping style and doesn’t have a chance to learn healthier ways of coping they may be at increased risk for anxiety problems. Other times a person may develop a specific fear of a person, place, or thing after seeing something really bad or frightening happening. In summary, environmental factors are unlikely to be the main cause for an anxiety disorder but they are often one of several aggravating factors.