Anxiety
What is Anxiety
Anxiety is a state of being characterized by chronic worry, fear, and physical tension. You may have a hard time anticipating things going well. There is constant fear, coupled with attempts to avoid or suppress it.
Anxiety symptoms include:
Feeling restless or “on edge”
Trouble relaxing the body
Racing thoughts and ruminations
Difficulty concentrating
Feeling overwhelmed by seemingly minor tasks
Difficulty sleeping
These symptoms must persist over a period of at least 6 months.
It is estimated in a given year that roughly 20% of adult Americans experience symptoms of anxiety. Left untreated, anxiety tends to get worse over time.
Are anxiety and panic attacks the same?
Not quite. Anxiety can occur with or without panic attacks, whereas panic attacks do not occur outside of anxiety. Panic attacks are a separate specifier to an underlying anxiety diagnosis.
Are anxiety and stress the same thing?
No. While it is normal and natural to be stressed anytime we are faced with increased demands, anxiety involves overestimating current demands of a situation, or forecasting negative future outcomes that are unlikely to actually happen, combined with underestimating our capacity to respond to them if they do occur.
Can anxiety cause chest pain and other physical problems?
Yes. Anxiety can manifest as physical symptoms such as racing heart rate, shortness of breath, sweaty palms, headaches, stomach pain, chest constriction etc. also known as the fight-flight response. It therefore has a subjective experience similar to cardiovascular or gastrointestinal medical conditions. A medical workup can determine if there is an underlying physical issue can be safely ruled out.
Is anxiety considered a mental illness?
Anxiety is a medical condition with mental components being important determinants. Anxiety involves disproportionate threat appraisal. Although it does not feel that way, the fear that is felt is disproportionate to the situation at hand. Also, anxiety manifests cognitively in the form of racing thoughts, reoccurring negative looping thoughts, catastrophic story lines etc. which underlie the automatic physiological reactions of the fight-flight system.
Since it is unpleasant to feel anxiety symptoms, many people turn to drugs or alcohol to cope. While drugs and alcohol offer temporary relief, they worsen anxiety symptoms in the long run by undermining physical strength and a sense of agency. They also encourage avoidance of the feared stimulus, which re-enforces the stimulus as menacing.
When anxiety becomes too much
Therapy can help. Exposure therapy is also a well established effective therapeutic technique to enhance distress tolerance and boost self-efficacy. Mindfulness based relaxation techniques serve to disengage the chronic running of the fight-flight response. Cognitive therapy helps to reverse problematic thinking patterns, also known as cognitive distortions, by reality testing the nature and extent of the threat, as well as our ability to handle it.
Medications (through prescribing providers like a family physician, psychiatrist, or nurse practitioner) can also help to reduce symptoms of anxiety and to improve well-being. They are a particularly useful tool for reducing panic attacks.