Demystifying & Understanding Anxiety: Symptoms, Causes, & Treatments
Table of Contents
Contrary to what we may hear these days, anxiety is normal, useful, and even essential for survival. Everyone experiences anxiety from time to time.
Anxiety alerts us to threats, protects us from danger, and helps us reach important goals. For example, it is normal to feel anxious when starting a new job, useful when deadlines are approaching, and essential when encountering a bear on a hike!
What is Anxiety?
Anxiety is a feeling of concern, worry, or fear about something that is happening or could happen. A stressful situation at work can cause anxiety, as can a fight among friends or family. For many people, anxiety is a normal, temporary, and non-debilitating feeling. For others, the anxiety “feedback loop” runs amok and becomes a problem in and of itself.
Anxiety is not dangerous and is adaptive. Although anxiety can feel uncomfortable and sometimes downright scary, it is temporary. The sensations we experience in an anxious situation are there to alert and activate our "fight-flight-freeze" response; our heart beats faster to pump blood to our muscles, so we have the energy to run away or fight off danger. Without anxiety, we would not survive.
Anxiety is abnormal when it becomes disruptive and life-altering, preventing you from moving forward at work or at home.
What Are Symptoms of Anxiety?
Symptoms of anxiety can include the following but are not limited to:
Emotions – anxiety is an emotion usually felt in the body but can also be described as nervousness, tension, "on edge," etc.
Physical responses – discomfort or pain in the stomach, nausea, headaches, chest pain or discomfort, sore shoulder muscles, dizziness, lightheaded, "unsteady feelings," "feeling foggy," or like things are unreal, feeling detached from oneself, very hot or cold, feeling of a lump in the throat, numbness or tingling, rapid heart rate, rapid breathing (hyperventilating), feelings of shortness of breath, or breath-holding, sweating, trembling, or shaking
*If four or more of these symptoms happen suddenly (within a few minutes) and intensely, you may be having a panic attack. Panic attacks are uncomfortable but not dangerous. The body is not designed to remain anxious for hours and hours but will settle back to a resting state. Symptoms may cycle.
Thoughts – worrisome thoughts about a current situation or some future event, these can range from reasonable to the extreme, sometimes we may be able to identify anxious thoughts, other times not
Behaviors – avoiding things, places, or social situations, such as the dentist, seeking reassurance, overlying on others, excessive fear of making mistakes or the desire to be "perfect" in appearance and work
What Causes Anxiety?
Anxiety is not fully understood. Traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety, stress due to an illness, stress buildup over time, certain personality types, other mental health disorders, drugs or alcohol, having blood relatives with an anxiety disorder, and inherited traits can all be factors.
*Medical causes – Your anxiety may be linked to an underlying condition if: you don't have any blood relatives with an anxiety disorder, you didn't have an anxiety disorder as a child or teen, you don't avoid certain things or situations because of anxiety, or you have a sudden occurrence of anxiety that seems unrelated to life events. It's always a great idea to check in with your family doctor.
How Has Our Understanding of Anxiety Changed Over Time?
Greek and Latin physicians and philosophers distinguished anxiety from other types of negative affect and identified it as a medical disorder; they suggested techniques reminiscent of modern cognitive psychology! Between classical antiquity and the late 19th century, cases of anxiety were reported but were not separated from negative affect, and they were just classified under different names.
Eventually, Sigmund Freud coined many of the terms used for various anxiety disorders in the DSM-I and DSM-II. The DSM-III introduced new disorders such as panic disorder, generalized anxiety disorder, and posttraumatic stress disorder.
With the DSM-5, we saw (b) the grouping of anxiety disorders into three areas (anxiety, OCD, and trauma-and stressor-related disorders) based on sharing of common features, and (b) the grouping of developmentally related disorders in the same chapters.
How is Anxiety Currently Treated?
Exercise & Lifestyle Changes
Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries
Exercise is a powerful stress reducer, and it may improve your mood and help you stay healthy; start slowly and gradually increase
Avoid alcohol and recreational drugs
Quit smoking and cut back or quit drinking caffeinated beverages
Use stress management and relaxation techniques, such as yoga (check out Yoga with Adriene) and meditation
Sleep, and if you can't, check in with your primary healthcare provider or ask your therapist
Eat healthily – lots of vegetables, fruits, and whole grains, and drink adequate water for your body weight
Practice mindfulness, paying attention to your thoughts, feelings, and physical wellness.
Counselling & Therapy
Counselling and therapy is an effective treatment for anxiety disorders. It is directed towards a person's specific anxieties and tailored to meet individual client needs
You and your therapist will discuss your thoughts, feelings, and behaviours to help collaborate on a treatment plan to reduce your symptoms
Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder.
Anxiety may occur along with other mental health problems such as depression or substance misuse
Cognitive Behavioural Therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Sign up for a free consultation to discuss it with one of our therapists!
Two CBT methods often used to treat anxiety, together or by themselves, are cognitive therapy and exposure therapy.
Cognitive therapy focuses on demystifying, challenging, and then neutralizing unhelpful or distorted thoughts underlying anxiety disorders.
Exposure therapy focuses on gradually confronting the fears underlying an anxiety disorder to help people engage in activities they have been avoiding. Exposure therapy is often used along with relaxation exercises or imagery to ensure you have the skills required to face your anxiety.
Medication
Medication often used alongside psychotherapy but not necessarily required.
Does not cure anxiety but helps relieve symptoms. Is prescribed by doctors (psychiatrists or primary care providers). Most common classes of medication include anti-anxiety drugs (benzodiazepines), antidepressants, and beta-blockers.
Have benefits and drawbacks and may require several different medicines before finding the one that improves your symptoms and has manageable side effects. They will take time to work, so it's important to give the medication a chance before reaching a conclusion about its effectiveness. Always consult your doctor before you stop taking them; the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
*In some cases, taking antidepressants may increase suicidal thoughts or behaviour, especially in the first few weeks after starting or when the dose is changed. Because of this, patients of all ages taking them should be watched closely, especially during the first few weeks of treatments
*Drinking caffeine, some over-the-counter cold medicines, illicit drugs, and herbal supplements may aggravate the symptoms of anxiety disorders or interact with prescribed medication – talk to your doctor
*Questions to ask your doctor:
How well will the medication work or improve my symptoms?
What are the benefits and side effects?
What is the risk for serious side effects based on my medical history?
Will the medication require lifestyle changes?
What is the cost of this medication?
How can I safely stop using the medication?
When Should You Seek Help for Anxiety?
When it becomes life-disrupting: stops you from participating in a variety of experiences such as attending higher education, pursuing meaningful work, joining social, athletic or recreational clubs, being in relationships, and more
When it interferes with your daily activities: you struggle to get up and ready in the morning, you're often late, or forget things, appear disorganized, unfocused
When you feel powerless to influence it
The sooner, the better!
Anxiety is Part of Life.
Trying to eliminate it from your life is almost impossible and inadvisable. Your therapist can help you identify coping strategies, resources, supports, and strengths to utilize in managing anxiety. Your therapist will also help you develop the confidence and skills to tolerate anxiety whenever it occurs and continue living your life!
Additional References
Anxiety Canada. (n.d.). ABC's of anxiety. http://www.anxietycanada.com/articles/abcs-of-anxiety-2/?_ga=2.257274178.879158136.1626128742-1258107074.1624420855
Anxiety Canada. (n.d.). Anxiety 101: What you and your child need to know about anxiety. http://www.anxietycanada.com/articles/anxiety-101-what-you-and-your-child-need-to-know-about-anxiety/?_ga=2.252548544.879158136.1626128742-1258107074.1624420855
Anxiety Canada. (n.d.). Anxiety in adults. https://www.anxietycanada.com/learn-about-anxiety/anxiety-in-adults/#anxiety-disorders
Crocq, M. A. (2015). A history of anxiety: From Hippocrates to DSM. Dialogues in clinical neuroscience, 17(3), 319–325. https://doi.org/10.31887/DCNS.2015.17.3/macrocq
National Institute of Mental Health. (2018). Anxiety disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders/
Mayo Clinic. (2018, May 04). Anxiety disorders. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
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