Each one of us has experienced anxious feelings such as fear and worry at one point or another. You may wonder how I can be so sure. The reason is that these are natural experiences. Fear and worry may show up before a test, interview, speech, meeting new people, trying something different, waiting for big news, or in the presence of something feared. These experiences may also include the physical symptoms of racing thoughts, shortness of breath, accelerated heart rate, sweating, nausea, a sinking feeling in your stomach, or difficulty concentrating. My guess is that you can relate to some of these symptoms because the bottom line is that we all have anxious feelings. The question is—if you experience anxious feelings—does this mean you have anxiety?
No, not necessarily. There is overlap between anxious feelings and meeting the criteria for an anxiety disorder diagnosis, but fear and worry can be experienced independent of anxiety. Let’s define our terms to make this point more clear. Fear is a universal emotion that comes up when we are faced with danger in the present moment, perceived or actual, and causes us to respond with protective measures. You see, when we become frightened our sympathetic nervous system activates, producing adrenaline and the stress hormone cortisol, and we experience physiological arousal in order to respond quickly. This system is responsible for our ability to fight, flight or freeze in the face of danger.
Worry, on the other hand, is our ability to think ahead about potential dangers or concerns. Worrying is tricky because it can be helpful and adaptive, such as worrying about a grade that leads to better study habits, or it can be maladaptive and focus on uncontrollable circumstances. Worrying about something uncontrollable means there is no action to take in order to minimize this worry and it often becomes time consuming and unproductive.
Anxiety encompasses both fear and worry on a larger scale where it is disruptive rather than helpful. According to the American Psychiatric Association (2013), anxiety deals with anticipation of a future threat and is “often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors,” (p.189). Anxiety disorders cause disturbances in one’s life and can vary depending on what objects and situations produce fear, anxiety, avoidance and associated cognitions (American Psychiatric Association, 2013). Specific anxiety disorders include Separation Anxiety, Selective Mutism, Specific Phobia, Social Phobia, Panic Disorders, Agoraphobia and Generalized Anxiety Disorder. For the sake of this blog, we will not focus on any of the specific Anxiety Disorders, but rather an overarching view of disruptive features and the way anxiety becomes maintained.
Why Anxiety is Disruptive
A piece of what constitutes anxiety is the overwhelming presence of anxious emotions, both fear and worry in additional to other symptoms. The overwhelming nature of this often interferes with a person’s life, limiting their ability to stay in the present moment, preventing new experiences, affecting sleep, physical health, relationships etc. Anxiety is disruptive because the sympathetic nervous system becomes triggered, pumping adrenaline and cortisol throughout the body without a direct cause, often at times when others most likely would not feel fear. This means the heightened sense of awareness and symptoms mentioned above (i.e., accelerated heart rate, shortness of breath, nausea, etc.) are activated and give all the warning signs that danger is present when in reality it is not. Anxiety tricks the body and mind. It causes a state of forward thinking, anticipating the next danger.
The Lie of Anxiety
Since nobody likes to feel in danger, anxiety often leads to avoidance behavior. This avoidance unintentionally leads to the maintenance of anxiety, trapping one in a cycle of intense fear, worry, avoidance and temporary relief only to start over again. The relief gives a false confidence that the avoidance behavior averted danger. But as I stated earlier, only the anticipation of danger is present. So individuals get caught in a false belief that they saved themselves and must continue to do so because it feels much better than experiencing the anxious feelings. This increasingly becomes more limiting because the person often finds they have to do more and more to avoid the unpleasant anxious feelings, causing the anxiety to keep growing.
Now that the Truth is Out
As previously stated, anxious feelings such as fear and worry are natural and can even be beneficial. However, when they become excessive, pervasive and limiting to a person’s life, treatment should be considered to prevent the maintenance of the disorder. Our Cherry Hill Center professional counselors are always here to help. Do not hesitate to call us if you or someone you know is experiencing anxiety. Expect to find more information in an upcoming newsletter about anxiety and ways to respond to it.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.