Understanding Anxiety

Studio 5 Clinical Psychologist, Dr. Liz Hale helps us understand differentiate between a normal and an over-the-top stressor reaction.

Anxiety is hardwired into all of our brains. It is normal to feel uncertain, troubled, or unprepared in the face of uncertainty. However, if everyday common events bring on severe and persistent panic that prevents you from living life fully, then it’s fair to consider an anxiety disorder. Anxiety disorders, by the way, are among the most common mental illnesses, affecting over 19 million American adults and millions of children. For each individual with an anxiety disorder, are many others affected by it, such as spouses, children, other relatives, friends and employers.

Individuals who don’t have anxiety disorders experience common anxious symptoms in response to genuine threats. The house is on fire or your car breaks down in the middle of the night on the freeway. The fight-or-flight reaction is a lifesaver, spurring you into action to flee the burning building or call the police for help. However, those with anxiety disorders face worry and fear in ordinary, relatively harmless situations. They spin their “neurological wheels,” so to speak. Here’s a list that explains further:


Worries Occasionally

Socially Self-conscious & Uncomfortable

Nerves, Random Jitters

Takes Common Precautions

Occasional Sleeplessness

Anxiety Disorder

Worry Chronic & Constant

Avoids Humiliation & Embarrassment

Persistent Panic Attacks

Uncontrollable, Repetitive Rituals

Ongoing Nightmares, Flashbacks

Anxiety is not a single condition it gets rather complex! There are several types of anxiety disorders. More than half of all people with one type of anxiety disorder also have another. Anxiety can also be a symptom of depressive disorders and depression can be a symptom of anxiety disorders.

Generalized Anxiety Disorder: Excessive, uncontrollable worry about everyday issues; school, work, money, relationships, health.

I received an e-mail with a views who lives with generalized anxiety. Depressed in Draper writes:

“I worry about everything and anything. I’m anxious about driving in the rain, my kids’ grades, a job review, my husband’s fidelity; anything! I wish I could stop sweating the small stuff but I can’t! I can’t sleep because my mind never shuts off….”

This is a very real and honest example of Generalized Anxiety Disorder. We’ll offer some suggestions to her in just a moment.

Social Anxiety Disorder: Social situations are unbearable due to extreme anxiety about being judged or ridiculed.

Panic Disorder: Attack of terror; feels like a heart-attack, or going crazy for no apparent reason.

Specific Phobia: Intense fear of object or situation; airplanes, elevators, highways, or heights.

Obsessive-Compulsive Disorder: Persistent, recurring obsessions or compulsions that manifest as repetitive behaviors or rituals.

Post-traumatic Stress Disorder: Several months or years after a traumatic experience, one continues to feel detached, traumatized, and avoidant.

There is also an anxiety disorder due to substance abuse (Ritalin) or an anxiety disorder due to a medical condition, because illnesses cause chemical changes in the brain that induce anxiety. It takes a skilled professional to diagnose the type of anxiety correctly, and remember that more than one disorder may be present at any one time, or one may simply follow another.

There seems to be a genetic underpinning of the particular causes of anxiety disorders. However, it’s the interaction of the nature and the nurture that are responsible for this link. There is not a single “anxiety gene” but many genes working together to induce an anxiety disorder. PET and fMRI’s have allowed scientists to observe the changes in brain activity when an anxiety attack is occurring. Not only do neurotransmitters play a role in anxiety, so do personality traits like shyness. An avoidant personality and anxiety sensitivity are additional risk factors. There is a gender-based difference as well – anxiety disorders affect women far more often than men. And, anxiety disorders are the most common mental health disorders among older adults.

The good news about anxiety disorders is that they are very real and treatable!! Whether you have common anxiety or an anxiety disorder, these strategies will help you cope:

Professional Intervention: See your physician to rue-out or rule-in an anxiety disorder. Most of the medications used to treat anxiety are antidepressants since the same kind of neurotransmitter abnormalities that promote depression can also trigger anxiety. Medications have there place.

Cognitive Behavioral Therapy: There are two parts: cognitive therapy helps one change patterns of thinking that prevent them from overcoming their fears; and behavioral therapy works to change one’s reactions in certain situations. CBT teaches you how to dial-down your inner thermostat.

Exercise: Motion helps with emotion.

Balanced Diet: Eat from all the food groups; don’t skip meals but skip caffeine.

Journal: Take note of concerns and worries and leave them there especially before you go to bed at night. You will have a better perspective through journaling.

Seek Social Support: May people with anxiety benefit from sharing their problems and triumphs with others. Get involved in activities and develop new friendships.

Time-out: Breath, step back, meditate, listen to music, get a message, relax and return, again, to the situation at hand with a renewed perspective.

Have Fun: Laughter is the best medicine. Have more fun and develop your sense of humor. Watch more comedy; read and collect good jokes – indulge yourself with things that bring pleasure: dark chocolate; a good book; bubble bath; or a massage.

Bottom Line: We have a great deal of control over many symptoms of anxiety. We can either make ourselves miserable or make ourselves strong. The amount of effort is the same.

Dr. Liz Hale is a licensed clinical psychologist and a regular contributor on Studio 5. Your comments and questions are welcomed! Please visit www.drlizhale.com to add your thoughts to today’s discussion or learn more about her private practice.

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