Glimpses of Anxiety

‘I’ve always been anxious. Even as a child. I was always making sure everyone was ok. I could pick up if someone was in a bad mood in a flash. Sitting on the stairs waiting for bad stuff to happen. It’s like I was responsible for everyone else. Making sure the shoes are in a straight line, washing my hands a lot to make sure I’m clean and checking the doors are locked. Over and over and over again. When I grew up I became anxious about other things, driving, shopping, going out, making telephone calls. Sometimes I find it hard to breathe. Other times I think I’m going to pass out, maybe die even. I often wonder if I’m mad. I try to make sure I’m with someone if I go anywhere. People tell me to ‘chill out’. If only they knew.

What is anxiety?

Anxiety is an emotion we experience when we are facing a perceived threat or danger. The ‘fight or flight’ response is our body’s way of preparing for real or perceived danger – either we face the danger and tackle it or we escape from it. It is normal to feel anxious or fearful in times of danger and it can help to keep us safe. However, if anxiety is experienced frequently or intensely or lasts for long periods of time it can cause distress and erode confidence.

Anxiety is a distressing emotion which can prevent individuals from carrying out their day to day duties. It involves an increased perception of danger and a decreased perception of being able to cope with the danger. Anxiety can create a vicious circle of avoidance.

What is anxiety disorder?

The following are identified as anxiety disorders:

Panic disorder – Characterised by panic attacks occurring where there is no danger. These often occur without warning and can be very distressing. The physical symptoms of panic may include palpitations, hyperventilation, sweating, tingling, trembling, shortness of breath, nausea, chest pain. The sufferer anticipates a catastrophe occurring such as a heart attack or fainting and wants to escape from the situation. The result is that the person avoids places and adopts safety behaviours. It is estimated that 50{715e623df01486ed312d8f1b83ff0cc3fd44a590896731e6d51361f497f187b9} of people who suffer from panic attacks go on to develop the symptoms of agoraphobia.

Health anxiety – A concern with experiencing physical illness – may be based on misinterpreting the physical symptoms of anxiety as a sign of a health problem.

Social phobia – A fear of being evaluated in a negative way by others and worrying about being embarrassed or humiliated. The result may be that the person avoids situations and may start to feel isolated.

Generalised anxiety disorder – Excessive worry and tension sometimes triggered by stressful events and impacting on daily activities. May involve being worried about worrying itself. Clients with generalised anxiety disorder tend to overestimate the level of threat and underestimate their ability to cope.

Obsessive-compulsive disorder – Carrying out certain behaviours, for example counting rituals, in order to ‘correct’ an obsession. The obsession may be a thought or an image. The person may carry out the rituals for extended periods which disrupts their lives.

Specific phobias – A disabling fear of a particular situation. Examples include a fear of heights, seeing blood, certain animals. The person recognises that the fear is excessive.

Posttraumatic stress disorder – Development of symptoms following exposure to a trauma which may include ‘re-experiencing’ the event, anxiety and/or avoidance.

It is possible that different types of anxiety can co-exist with each other. It is also possible that anxiety co-exists with depression, substance misuse problems or physical illness.

What causes anxiety?

Stressful life events can create anxiety, for example work pressures, examinations, divorce. Some clients come to counselling and say things like ‘I have always been anxious’ or ‘I’m a born worrier. So is my mother’ or ‘I have an anxious personality’.
Other clients do not know why they are anxious and may even say that this is creating further anxiety. Possible reasons for anxiety may originate in childhood.

How do I know if I am anxious?

The following are some of the symptoms associated with anxiety:

Physical symptoms associated with anxiety

Changes in breathing.
Palpitations.
Tight chest.
Difficulty swallowing.
Sweating.
Tingling in toes or fingers.
Tense muscles.
Light headedness.
Abdominal discomfort.
Frequent urination.
Tiredness.
Poor sleeping.

Thoughts associated with anxiety

Believing that the worse outcome will occur.
Not being able to cope.
Overestimating danger.
Feeling vulnerable.

Behaviours associated with anxiety

Being irritable.
Trying to control events.
Avoiding situations.
Leaving situations.
Seeking reassurance.
Rushing home if feeling anxious.
Trying to get others to do things for us.

What can help to overcome anxiety?

Learning about anxiety

It can be helpful to learn about anxiety and to realise that it is a normal reaction to stressful situations. You will then be able to recognise if anxiety has become a problem because it is interfering with day to day functioning.

Often when people feel anxious and start to experience physical symptoms which they do not understand they can start to worry about these symptoms and may have thoughts such as ‘I’m going to pass out’ or ‘I’m going to have a heart attack’.

Many people find that when they understand the ‘fight or flight’ response, which is the way that anxiety can affect their body, they are able to accept that anxiety impacts on their body, behaviour and thinking. When someone is anxious their heart rate goes up. A common thought associated with anxiety is ‘I’m going to faint’ and this happens if your heart rate and blood pressure drop. Therefore, it is unlikely that you will faint from anxiety.

Relaxation training

It is not possible to be relaxed and anxious at the same time. Techniques such as progressive muscle relaxation and controlled breathing can help to alleviate anxiety.

Challenging unhelpful thinking

Anxiety can be reduced by examining and challenging thoughts about the perception of danger and/or the ability to cope.

Counselling

Talking through worries and problems can help to alleviate anxiety and help to understand the triggers to anxiety. Counselling may help you to gain a new perspective on your situation. As a Counsellor I integrate relaxation training and challenging unhelpful thinking if the client would like to work in this way.

Exposure therapy

When clients are faced with the situations which they fear it is common that they will try to avoid these situations and this will reduce their anxiety. This short term coping strategy does not enable the client to overcome their fears.

Exposure therapy involves creating a hierarchy of situations you have avoided and making a plan to face the feared situation in a gradual way starting with the least feared situation. For example if a client has a fear of spiders it may involve first looking at pictures of spiders to eventually being in the same room as a spider. The rationale underpinning exposure therapy is that the anxiety naturally reduces if the client remains in the feared situation.

Copyright 2010 Christine Bonsmann. All rights reserved.