Anxiety

Don’t just cope with your anxiety or panic attacks, eliminate them!

What is it?

Anxiety is a normal emotion that we all experience from time to time. It is normal and appropriate to be keyed-up (or anxious) before a football game, before speaking publicly, at exam time, before an important job interview, at xmas time with preparations, or it can be nerve raking when travelling overseas for the first time. Anxiety around events such as these are healthy as we need a certain amount of stress/anxiety to help us achieve our lifes’ goals or to motivate us to grow.

All of us have felt intensely anxious at times and it is estimated that about 5% of the population suffer from chronic anxiety and eventually panic attacks. Anxiety becomes a problem when worrying thoughts start to become more frequent and when we start experiencing other intense physical, cognitive and emotional reactions.

Anxiety is characterised by fearful anticipation of a possible unpleasant event. It is important to distinguish between anxiety and fear because they are often used interchangeably.

  • Fear is the assessment of danger
  • Anxiety is the unpleasant feelings and symptoms evoked when fear is stimulated

A person suffering from anxiety experiences an unpleasant emotional state characterised by symptoms such as heart palpitations, feelings of uneasiness, tension, nervousness, tremor, nausea, dizziness, immobility, inability to think clearly and, on some occasions, even the inability to speak.

Professor Aaron Beck from the university of Pennsylvania claims that people with anxiety disorders have unrealistic fears because they erroneously assess the danger associated with a particular situation. These erroneous assessments are usually due to one or more of the following:

  1. Over-estimating the chance of a dangerous event, e.g “the bus in which I am being driven is likely to crash”
  2. Over-estimating the severity of the feared event, e.g “if I lose my job I will be finished and I can’t see anything else for me”
  3. Under-estimating coping resources (what you can do to help yourself)
  4. Under-estimating rescue factors (what other people can do to help you)

Anxiety is a problem when it occurs in the absence of any real danger or when it continues long after the stress is over. If these sensations occur when you don’t really have to take action, it feels unpleasant. This is when anxiety begins to interfere with everyday life and it becomes necessary to learn how to control it.

Types of Anxiety Disorders

Phobias

A phobia is a persistent anxiety reaction that is grossly out of proportion to the stimulus and the reality of the danger. There are a variety of things or activities in the world which produce inordinate and irrational fear in people – flying, snakes, spiders, mice, water, having to talk with strangers, elevators, crowded places. The point is that some relatively non-harmful object or activity produces these feekings. Even though there is the possibility of a plane crashing, or of being bitten by a spider, the chance of it happening is so low that the emotional response is totally out of proportion to the risk of being harmed. The type of response is a phobia.

The phobic reaction may interfere with the person’s entire life. I recently treated a person who hadn’t left her home in years. She was reliant on friends to gather her shopping needs. Such people will not leave their safe haven and the further away they are from this safe place the more anxious they feel because they fear being attacked, will die or lose control. Thus agoraphobia can severely restrict functioning and cause great emotional disturbance.

Generalised Anxiety Disorder

Many people become anxious when spontaneous, negative self-talk starts and distorts their perception of reality. Vague thoughts occur that danger is lurking, that you should not be having a good time as eventually you will suffer for it, or that others think badly of you and want to do you harm. These thoughts and feelings can produce symptoms of anxiety which is self defeating. Such individuals worry about events that have occurred in the past or that may happen in the future.

Worrying about these events will affect you, not the events themselves:

  • It is appropriate to be concerned about things that have happened or may happen, and to take appropriate action
  • It is inappropriate to be so concerned that your ability to function and deal with these events is impaired

For example, on Friday afternoon your superior (whom you do not like) asks you to see him/her first thing on Monday morning without saying what it is about. For some people this would be a terrible weekend, the party on Saturday night and the barbecue that had been planned on Sunday would not be enjoyed because of such thoughts as:

  1. “Am I going to be fired?” “Has my performance been poor of late?”
  2. “Am I going to be transferred?”
  3. “I can’t stand not knowing what it’s all about.”

Others would use rational response to challenge these irrational thoughts:

  1. “There may be some particular issues he wants to discuss and the worry and spoiling of my weekend will not help me at all”.
  2. “I know my performance has been satisfactory. My worrying about the discussion on Monday morning is not going to help. Moreover if I present myself in a nervous, agitated manner, my ability to argue my case will be affected.”
  3. “I am certainly concerned about what he will say, but I refuse to let myself to be inappropriately upset by the thought of it.”

Panic Disorder

How many of us at some time have been suddenly overcome with intense apprehension? Physically we feel jumpy. Cognitively we expect that something bad is going to happen. Such an attack comes out of nowhere; no specific object or event sets it off and the attack gradually subsides. However some people have frequent severe attacks; these people suffer from panic disorder.

Emotionally the individual is overwhelmed with intense apprehension, dread or terror. Physically symptoms appear – rapid heart rate, muscle tension, perspiration, trembling. Cognitively the person thinks they may die, go mad or lose control of themself.

Obsessive Compulsive Disorder (OCD)

Obsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing anxiety, or by a combination of such thoughts (obsessions) and behaviors (compulsions). Symptoms may include repetitive hand-washing; extensive hoarding pre-occupation with sexual aggressive impulses, or with particular religious beliefs; aversion to odd numbers; and nervous habits, such as opening a door and closing it a certain number of times before one enters or leaves a room. These symptoms can be alienating and time-consuming, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and come across to others as psychotic. However, OCD sufferers generally recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization.

Post-Traumatic Stress Disorder (PTSD)

Post traumatic stress disorder develops after someone is exposed to an extremely traumatic event and they reacted to the event with intense fear, horror or helplessness. Such traumatic events include:

  • war
  • torture
  • rape
  • child sexual or physical assault
  • physical assault
  • being kidnapped
  • terrorism
  • a natural disaster (e.g. a bushfire, flood or cyclone)
  • a major car accident
  • being diagnosed with a potentially fatal illness e.g. cancer
  • finding the body of someone who has committed suicide or been murdered

The Intrusive Symptoms include:

  • Distressing thoughts or images
  • Nightmares about the event
  • Feeling or acting as if the traumatic event were recurring
  • Intense psychological distress when exposed to something that triggers memories of the traumatic event
  • Physical symptoms such as sweating, muscle tension and rapid heartbeat when exposed to things that trigger memories of the traumatic event