Anxiety

Anxiety

    Anxiety is the mind and body's reaction to stressful, dangerous, or unfamiliar situations. It's the sense of uneasiness, distress, or dread you feel before a significant event. A certain level of anxiety helps us stay alert and aware, but for those suffering from an anxiety disorder, it feels far from normal - it can be completely debilitating.

    In an anxiety-related disorder, your fear or worry does not go away and can get worse over time. It can influence your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are "normal feelings and experiences" but they are completely different than suffering from any of the seven diagnosable disorders plus substance-induced anxiety, obsessive-compulsive disorders, and trauma- or stressor-related disorders.

    Anxiety disorders keep people from sleeping, concentrating, talking to others, or even leaving their home. Anxiety that may need treatment is often irrational, overwhelming, and disproportionate to the situation. It makes sufferers feel as though they have no control over their feelings, and it can involve severe physical symptoms like headaches, nausea, or trembling. It becomes classified as a disorder when normal anxiety becomes irrational and begins to recur and interfere with daily life.

    Butterflies in your stomach before an important event? Worried about how you will meet a deadline? Nervous about a medical or dental procedure? If so, you are like most people, for whom some worry about major events (like having a child, taking an exam, or buying a house), and/or practical issues (like money or health conditions), is a normal part of life. Similarly, it is not uncommon to have fears about certain things (like spiders, injections, or heights) that cause you to feel some fear, worry, and/or apprehension. For example, many people get startled and feel nervous when they see a snake or a large insect. People can differ in what causes them to feel anxious, but almost everyone experiences some anxiety in the course of their life.

    Types of Anxiety Disorders

    There are many anxiety-related disorders, and they are divided into three main categories:

    1. Anxiety disorders: Anxiety disorders are characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) and can have negative behavioral and emotional consequences.

    2. Obsessive-compulsive and related disorders: Obsessive-compulsive and related disorders are characterized by obsessive, intrusive thoughts (e.g., constantly worrying about staying clean, or about one's body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). These behaviors are performed to alleviate the anxiety associated with the obsessive thoughts.

    3. Trauma- and stressor- related disorders: Trauma- and stressor- related anxiety disorders are related to the experience of a trauma (e.g., unexpected death of a loved one, a car accident, or a violent incident like war or sexual assault) or stressor (e.g., divorce, beginning college, moving).

    Your anxiety disorder may be a Specific Phobia if you have a persistent and excessive fear of a specific object or situation, such as flying, heights, animals, toilets, or seeing blood. Fear is cued by the presence or anticipation of the object/situation and exposure to the phobic stimulus results in an immediate fear response or panic attack. The fear is disproportionate to the actual danger posed by the object or situation. Commonly, adults with specific phobias will recognize that their fear is excessive or unreasonable. Learn more about Phobias here.

    An excessive fear of becoming embarrassed or humiliated in social situations, which often leads to significant avoidance behaviors may be an indicator of Social Anxiety Disorder (SAD). Find out more about social anxiety disorder - especially if your fear of social situations last for more than six months.

    Post-Traumatic Stress Disorder (PTSD) is the most well-known trauma- and stressor related disorder. These are disorders that are related to the experience of a trauma (e.g., unexpected death of a loved one, a car accident, combat, or a violent incident) or stressor (e.g., divorce, beginning college, moving). This category also includes Acute Stress Disorder and Adjustment Disorder. 

    Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry over events and activities and potential negative outcomes. The anxiety and worry must cause significant distress or interfere with the individual's daily life, occupational, academic, or social functioning to meet diagnosis. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.

    Panic Disorder reflects the experience of sudden panic symptoms (generally out of the blue, without specific triggers) in combination with persistent, lingering worry that panic symptoms will return and fear of those panic symptoms. Symptoms include recurrent expected or unexpected panic attacks that can last from a few minutes to up to an hour.

    Obsessive-Compulsive Disorder (OCD) is one of a number of related disorders that share certain characteristics. Repeated and persistent thoughts ("obsessions") that typically cause distress and that an individual attempts to alleviate by repeatedly performing specific actions ("compulsions"). Examples of common obsessions include: fear that failing to do things in a particular way will result in harm to self or others, extreme anxiety about being dirty or contaminated by germs, concern about forgetting to do something important that may result in bad outcomes, or obsessions around exactness or symmetry. Examples of common compulsions include: checking (e.g., that the door is locked or for an error), counting or ordering (e.g., money or household items), and performing a mental action (e.g., praying). Other disorders included excoriation (skin-picking), hoarding, body dysmorphic disorder, and trichotillomania (hair-pulling).

    Other categories of anxiety disorders include: Separation Anxiety Disorder, Selective Mutism, and Agoraphobia as well as disorders that are substance-induced or are a result of other medical conditions.

    Prevention and Coping With Anxiety

    All human beings experience anxiety. In many cases, anxiety can have some beneficial and adaptive qualities such as pushing one to study for an upcoming difficult exam or propelling a person to flee from danger. Although experiencing some anxiety with life stressors and worries is normal, sometimes it can be difficult to manage and can feel overwhelming. Below we provide a list of tips and strategies to help individuals prevent anxiety from reaching a diagnosable level. Even though not everyone will struggle with a diagnosable anxiety disorder, learning strategies to aid in relief from anxiety and to manage the "normal" anxiety experienced in everyday life can help you live the life you desire.

    Learning Relaxation Strategies

    Relaxation strategies, such as deep diaphragmatic breathing, have been shown to lower blood pressure, slow heart rate, and reduce the tension that is commonly associated with stress. Engaging in relaxation strategies can equip you to reduce anxiety when it occurs, by allowing your body to switch from its anxious state to a more relaxed and calm state in response to stressors.

    Guided imagery is another relaxation strategy that can help reduce or prevent overwhelming anxiety. Guided imagery involves directed mental visualization to evoke relaxation. This could involve imagining your favorite beach or a peaceful garden that can distract you from your anxious state and allow your mind and body to focus on the positive thoughts and sensations of the imagery exercise.

    Learning to utilize relaxation strategies as a coping strategy for anxiety can boost your confidence that you will be able to cope with anxiety during distressful situations. Relaxation strategies are a great tool for anxiety prevention because they are free, simple, and can provide instant results.

    Mindfulness, Meditation, and Yoga

    A simple definition of mindfulness includes the practice of being aware, without judgment, in the present moment. When feeling anxious, often, you might feel that you don't have control over your mind or your body's reaction to stress. You also might feel that anxiety causes you to focus and dwell on past mistakes or future fears.

    Mindfulness, meditation and yoga can increase one's awareness of the world around you and increase your control over how you experience situations and how you respond. Loss of feelings of control is often a symptom of anxiety when a person is feeling overwhelmed and stressed. Practicing these strategies can help you live life in the present moment and enjoy the present things in your life that bring you joy.

    Exercise, Healthy Diet, and Rest

    Another important prevention strategy for anxiety is to incorporate exercise into your daily activities. Exercise has been shown to decrease stress hormones that influence anxiety and also improve overall mood. Exercise can also help you disengage from worry and stress and focus on the current task of exercising. Exercises such as light jogging or brisk walking that can be incorporated into your daily activities can help reduce the impact of anxiety when it occurs.

    A healthy diet is also important to reduce and prevent anxiety. It seems counterintuitive that you can "eat your way to calm" but sustaining a healthy diet can really help you to feel more at ease on a regular basis, despite stressors. Some foods that are particularly helpful for reducing anxiety include foods with omega 3 fatty acids (i.e., salmon, walnuts, and flaxseed) and probiotics. Avoid greasy, sugary, high-fat, and processed foods. Additionally, avoiding caffeine when feeling anxious as well as unhealthy substances (i.e., alcohol) could be beneficial. Drinking alcohol might seem like a good way to calm down, but it can lead to sustained anxious symptoms. Incorporating a healthy diet into your lifestyle is fundamental to preventing and reducing anxiety.

    Not getting enough restful sleep can trigger anxiety. Stress and anxiety can also interfere with sleep and cause you to stay awake at night. It can be a frustrating cycle when the stressors of the day and future worries cause you to stay up at night. Take some time to wind down before bed, such as utilizing some of the above relaxation and meditation strategies. Also, instead of letting your mind continuously race at night, try putting your thoughts, worries, and plans for the next day on paper before bed - this will ease your anxiety about forgetting something you need to accomplish in the future and allow you to relax and rest.

    Awareness and Identifying Triggers

    A key component to the prevention of anxiety is awareness. Learning to recognize your anxious thinking patterns when they arise can help you manage and reduce them quickly. Awareness of anxiety begins with trying to identify the cause and/or trigger of anxiety and gaining an understanding of how it affects your mood and behaviors. Is it that your boss recently gave you negative feedback at work and you are worried each day that you are not doing well enough for their standards? Is it that you waited until the last minute to study for a test and are feeling anxious that you will not perform well? Awareness of the source of your anxiety is the first step to finding out the best way to relieve it.

    Sometimes there are things in your life that you already know trigger anxiety. It could be a big test, having to give a speech or perform in front of an audience, and/or the stress and anxiety related to parenting. Once you identify your triggers, you can start to practice coping strategies that can help calm your anxiety before and as it occurs.

    For example, if you know you often procrastinate when it comes to studying for a test and get significant test anxiety, try out study strategies that prompt you to start studying earlier and set realistic study schedules.

    If you can identify that after a long day of parenting you often feel exhausted and overcome with anxiety by all of the things you need to do, you can work to schedule in "me time" where you can make sure that you have time to relax, exercise or engage in an enjoyable activity that you know helps to reduce your anxiety. Taking care of yourself is important to be able to take care of others.

    It could be helpful to have a journal that you use to track your stressors, mood, thoughts, and behaviors that are impacted by anxiety. This will further help you identify the cause of your anxiety and notice when you may be engaging in unhelpful thoughts that only increase your anxiety.

    Supportive Friendships & Family/ Contact a Therapist

    Some research shows that people who have close and supportive friendships have a greater ability to fight mental and physical diseases than isolated people. The mind can be our worst enemy when feeling anxious and having a supportive network that you can discuss and decompress your deepest worries to could help prevent anxiety from consuming your life. Find trusted friends during times of anxiety that you can open up to and know that they will provide a listening ear and supportive feedback about your experiences.

    It should be noted that finding the right strategy that works for you to control your anxiety is important. Maybe you feel that you do not have the time to schedule "me time" with your busy schedule or kids, and you need to find another way to reduce your anxiety. A friend or therapist could be a great resource to turn to if you believe you need help with finding the right strategies to reduce your anxiety.

    Therapy services such as Cognitive Behavioral Therapy (CBT) have also been shown to help with the prevention of anxiety symptoms from reaching a diagnosable disorder. Even if you do not have a diagnosed anxiety disorder, attending therapy could be a wonderful resource to aid in gaining strategies to reduce your stress and anxiety.

    Recognizing the Disorder in Others

    Jennifer Stevens, PhD

    How do I recognize if someone close to me is having trouble with anxiety?

    Anxiety disorders are the most common mental health disorder in the U.S., affecting more than 18% of the population. They are even more common among children, affecting an estimated 25% of children between the ages of 13 and 18. The most common anxiety disorders are Specific Phobias, affecting 8.7% of the population, and Social Anxiety, affecting 6.8% of the population.

    Signs of anxiety in children

    You likely know someone with an anxiety disorder.

    Although there are several different types of anxiety disorders, each with unique features, there are some common symptoms that might be a clue that someone is suffering from an anxiety disorder:

    The person indicates excessive anxiety or worry about future events. Some examples could be social situations, work demands, or separation from "safe" people or places such as a parent or the home.

    The person has feelings of panic and accompanying physiological reactions (sweaty palms, heart racing, heavy breathing) in certain situations.

    The person experiences sleep disturbances related to the anxiety or worry.

    The person has difficulty concentrating as a result of the anxiety or worry.

    You may also notice general signs of distress, like neglect of personal hygiene, weight gain or loss, a decline in performance at work or school, major changes in mood, or withdrawal from activities or relationships.

    There are two important guidelines to think about, aside from symptoms. These are duration of symptoms and level of impairment. Anxiety is a normal reaction to stressful situations, and even high levels of anxiety can be healthy and beneficial at times. Disorders are only present when anxiety symptoms last for several weeks to months and significantly interfere with everyday function or cause long-lasting distress.

    Please note that it is not a good idea to attempt to diagnose or label a friend or family member. Only a mental health professional can diagnose an anxiety disorder, as many disorders have overlapping features, and can go together with other types of mental health difficulties. However, if you notice signs of anxiety, or just feel that something is not quite right with someone that you care about, it's a good idea to reach out to ask the person how they are feeling. You could start with something neutral and supportive like, "It seems like you haven't been quite yourself lately. Is there something going on that you want to talk about?"

    What can I do to help a family member or a close friend with anxiety?

    One of the most important things you can do is to listen to your family member or friend talk about the things in his/her life that are sources of stress. A first instinct might be to offer advice or ideas for a "quick fix." However, simply accepting your friend's stress levels can help them deal with their anxiety, knowing that they can rely on you as a source of support even when their symptoms might be tough to watch. Studies show that social support from family and friends can be one of the strongest protective factors against debilitating levels of anxiety.

    It may also be helpful to:

    Avoid shaming your friend for their anxiety. Comments like "just get over it" or "chill out" can be hurtful.

    Ask your friend how you can help.

    Be patient. If a friend is experiencing an episode of anxiety, it may not be helpful to intervene or try to fix it. It can be most helpful to be available and let your friend know that you support and love them.

    Support the idea of getting treatment. There can be a lot of stigma around seeking help for mental health difficulties. Showing your support for this may allow them to get over initial fears around taking that first step in getting professional help.

    What can I do to help my spouse or partner?

    Anxiety symptoms can put a major burden on relationships. In addition to seeing your partner experiencing high levels of fear or stress, you're also likely to have more than the ordinary share of everyday responsibilities. Here are four things you can try:

    Set goals: You and your partner can agree on key objectives, and you can recognize accomplishments. For example, if you and your partner agree that you're both feeling isolated, you could plan to attend one social occasion together every month.

    Support treatment: Research treatment options with your partner and encourage treatment. There are several useful types of treatment for anxiety, and a number of them actively involve the partner and family members. Find a therapist in your area.

    Ask how you can help: Don't feel like you should be able to read your partner's needs without asking. Ask what you can do to help, and listen carefully to what they say.

    Put yourself in their shoes: Acknowledge that you don't understand what your partner feels when they experience a significant bout of anxiety such as a panic attack.

    It's also important to take care of yourself. This is not selfish. You can't help your partner or support your family when you are completely overburdened. You could start by:

    Pursuing your own interests and hobbies. These activities will keep you energized, and remind you that you're a real and interesting person, outside of your role as partner or parent.

    Keep up important relationships. Your friends and family are an important source of support for you too! Your social network can provide emotional support and discuss problems that your spouse may not be able to deal with.

    Seek professional help if needed. Caregivers often experience symptoms of anxiety and depression themselves and may benefit from mental health treatment. You can take a look at how you are doing with this caregiver self-assessment tool.

     

    A helpful approach to distinguishing normal anxiety from an anxiety disorder is to identify the cause of the anxiety, and then assess whether the anxiety symptoms are a proportional response to it. Worries, fears, and intrusive thoughts that are extreme, unrealistic, or exaggerated and interfere with normal life and functioning could constitute an anxiety disorder. For instance, being concerned about getting sick and taking steps to avoid germs, like using hand sanitizer and avoiding touching door handles, does not necessarily constitute an anxiety disorder; however, if the concern about sickness makes it difficult to leave the house, then it is possible that the person suffers from an anxiety or anxiety-related disorder.

     

    Watch this short animation made by a student on coping with social anxiety

    How to Cope with Student Stress - https://youtube.com/watch?v=yO0xf4vywXg

    Social Anxiety Disorder - causes, symptoms, diagnosis, treatment, pathology - What is social anxiety disorder? Social anxiety disorder is characterized by a fear of social situations. Find more videos at http://osms.it/more

    Gratitude - a simple personal journal app where you can write about things that you are grateful for, being grateful or expressing gratitude helps to focus your attention on the positive things in your life.

    what is anxiety - http://au.reachout.com/articles/what-is-anxiety

    How to manage anxiety - https://www.calmclinic.com/anxiety/management

    How to manage anxiety -https://anxietyeducation.org/article/how-to-manage-anxiety/

    What happens during an anxiety attack - https://www.calmclinic.com/anxiety/attacks/what-happens-during-one

    Managing anxiety - https://www.verywellmind.com/manage-your-anxiety-2584184

    Anxiety self-help workbook to download to read or listen to. It aims to help you recognize whether or not you may be suffering from symptoms of anxiety, understand what anxiety is, what can cause it, and what can keep it going, overcome your anxiety by learning better ways of coping with it.

    Online Course Mindfulness Based Stress Reduction

    http://positivepsychology.com/mindfulness-based-stress-reduction-mbsr/#definition

    Mindfulness is a very effective tool to help you deal with anxiety or stress.This link will bring you to a Mindfulness Based Stress Reduction Online Course that you can use yourself at home- http://palousemindfulness.com

    If English is not your native language there are options to do this course in other languages.
    If your native language is represented by a flag in the upper-left corner of this page (Spanish, Portuguese, Russian, or Chinese), you are in luck! All of the core readings, worksheets, subtitles for videos, and audio recordings have been carefully translated by Palouse Mindfulness graduates who are native speakers of that language. By clicking on the row of flags, you will be given an option to go to one of these translated versions.