Experiencing periodic anxiety such as changing jobs or financial stress can be a normal part of life’s emotional experiences of feeling anxious or stressed. Intermittent situational anxiety is something that every human will experience at some point throughout life’s journey, however, if excessive worry, fear, or panic constantly stops you from participating in events or social situations, this may be a sign of an anxiety disorder. Anxiety is the body’s way of preparing for a perceived or anticipated threat. It may foster caution about the future or increase situational avoidance. Anxiety disorders are persistent and excessive worry or fear that can be debilitating.
This is the result of a perceived threat being overestimated and disproportionate to the situation. As outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which is the diagnostic tool for mental health professionals published by the American Psychiatric Association and provides diagnostic criteria and features for appropriate diagnosing, the DSM-5 identifies several types of anxiety disorders. Here are some of the most common types of anxiety disorders.
Generalized Anxiety Disorder (GAD) is exorbitant worry that is difficult to control and includes three or more of the criteria experiences over six months or more over half the time. It is important to note that only one item is required in children. GAD symptomology includes restlessness, feeling on edge, fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances, such as difficulty falling asleep and/or staying asleep. Aforementioned, anxiety disorders are defined by intense anxiety, worry, or physical symptoms that are disproportionate to the actual threat and causes impairments socially, occupationally, or in other important areas of functioning.
Separation anxiety disorder is the presence of developmentally inappropriate and excessive
fear or anxiety about being separated from attachment figures, such as a parent or other
primary caregiver. Separation anxiety includes excessive distress, persistent worry about losing attachment figures or potential harm to the significant attachment figure such as death or harm, getting lost or kidnapped from the attachment figure, persistent reluctance to separation from the attachment figure due to fear of separation, such as going to school, refusal to sleep away from home without the attachment figure, repeated nightmares involving separation from the attachment figure, and negative physiological symptoms such as stomach aches or headaches when separation takes place or is anticipated.
Social Anxiety Disorder is determined by experiencing intense fear or anxiety in one or more social interactions, including peer settings in children. The environmental perceived risk includes fear of criticism and/or embarrassment causing avoidance and intense anxiety or fear of social situations. It is always important to remember that the fear is disproportionate to the situational exposure and symptoms must last for six months or longer.
Specific Phobias are marked by fear of specific situations or objects such as acrophobia (fear of heights), claustrophobia (fear of confined spaces), arachnophobia (fear of spiders) or mysophobia (fear of germs and dirt), just to name a few. Exposure or anticipated exposure to these phobias are anxiety-producing, fear-producing, and to the extent that exposure can be paralyzing to the person being exposed. Exposure inevitably triggers the fight or flight response, or potential freeze response, in the nervous system due to extreme fear.
Panic Disorder also referred to as panic attacks, is an involuntary inundation of intense fear in which four or more symptoms are present, causing you to go from calm to anxious within minutes. Symptoms of panic disorder include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, lightheadedness, tingling sensations, fear of dying or losing control, and perceived choking sensation. These symptoms are present for a month or more and persistent concerns about having another panic attack is present or you have made inappropriate adjustments in your life out of fear of having an attack. These symptoms are recurrent and unexpected panic attacks where no obvious trigger is present.
According to Harvard University, anxiety is among the most common mental illnesses humanity experiences, affecting roughly 40 million Americans. It is important to visit with a mental health professional to explore concerns about your anxiety for appropriate diagnosing. It is important to explore and rule all other causes for mental health symptoms that may be caused by the physiological effects of substance abuse or medications, other mental disorders, or medical conditions. Interventions for anxiety disorders vary depending on the type of anxiety disorder you are experiencing. Interventions can include psychotherapy, altering your diet, improving sleep hygiene, somatic therapies, exposure therapy, or exercise.
Cognitive behavioral therapy (CBT) approaches include the exploration and identification of
cognitive distortions contributing to anxiety. It helps individuals become aware of their thoughts and emotions and identifying CBT is the most effective therapeutic intervention for generalized anxiety disorders by exploring and challenging thought processes and behavioral patterns. This includes the best, worst, and the likely outcomes of a situation. This is accomplished by identifying the worst possible outcome (this is generally what you are afraid of), the best possible outcome (perfect world outcome), and reframe your thinking to the likely outcome (the most reasonable and possible outcome). Feedback is a great way to disarm involuntary hijacking of parts of the brain responsible for anxiety. For example, say out loud, “I am feeling anxious, but there is no danger here. Anxiety, you are not needed, thank you.” This allows you to identify the emotion and redirect it so it does not overwhelm you.
Grounding techniques is a great way to manage anxiety. Using your five senses to observe,
feel, smell, taste, and hear, allows you to embrace the present moment. Putting grounding
techniques into practice include describing something you see in the room, touching something in the room such as your hair or the floor under your feet, have a cup of tea which satisfies both smell and taste, and listen to the wind or the birds outside. The 5-4-3-2-1 grounding technique is a great reminder of how to put this technique into practice. Spend a few minutes using the 4-4-8 deep breathing techniques; breathing in for 4 seconds, hold for 4 seconds, exhale for 8 seconds. Repeat this technique for a few minutes to help calm the body. Afterward, identify five things you can see in your surroundings, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
There are a variety of interventions that can be used to manage anxiety in addition to CBT, such as exposure therapy. Efficacious outcomes are best achieved alongside a mental health professional for proper diagnosing, psychoeducation, intervention, and emotional support. No one should feel alone as they navigate through emotional challenges. There is support available through professionals who have the components to help facilitate improved functioning and decrease symptomatology of anxiety.
References: Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Association, 2013.