Anxiety: Lifting You Up Or Weighing You Down?
Anxiety is something many people are familiar with and may have experienced at some point in their lives, on occasion or perhaps on a daily basis. It is an important survival mechanism that has developed evolutionary to warn us of impending threats or danger. This is differentiated from fear as anxiety alerts to unknown or perceived threats, whereas fear is a reaction to a known external threat, even though the unpleasant sensations of increased heart rate, sweating and restlessness are very similar. A certain level of anxiety can be beneficial in our day to day lives, as it can make us more vigilant, productive and drive us to perform at our best; however, excessive levels can have the opposite effect, causing functional impairment that decreases productivity and creating significant distress.
As one of the most common psychiatric disorders, anxiety is typically more prevalent amongst women, with 30% of women at risk of experiencing significant anxiety in their lifetime as compared to 19% of men. The exact cause or etiology of anxiety is still not fully understood, but theories include genetic predisposition, chemical imbalances of neurotransmitters in the brain, environmental exposures or learned behaviour in childhood, amongst others. Symptoms of anxiety include palpitations, elevated heart rate, tremors, light-headedness, diarrhea, urinary urgency, tingling in the extremities, sweating, and upset stomach. While anxiety is a blanket term for these symptoms, there are actually many different subcategories of anxiety, each with slightly different symptoms, triggers and impacts on functionality.
Panic attacks are brief episodes of feelings of panic (sweating, racing heart rate, chest pain, dizziness, etc.) that last between 10 – 30 minutes and resolve spontaneously. These can occur on a daily basis for some individuals and be precipitated by certain environments, events or substances. If this leads to significant worry of future attacks or behavioural changes to avoid attacks, this becomes “panic disorder”.
There is often a misconception of agoraphobia, with many believing it is a fear of leaving the home. In fact, agoraphobia is a persistent fear of places that may be difficult to escape (ie. a large crowd, public transportation, elevators, open spaces, etc.). This often results in reluctance to leave the home, where the individual feels most safe, or insistence upon being accompanied by a family member or friend when leaving the home.
This is simply a fear of a specific object, situation or event. Many people have certain phobias, for example a fear of spiders, flying or heights. It becomes problematic for the individual in the event it produces symptoms of panic that leads to functional impairment in social or occupational situations.
Social Anxiety Disorder
Social anxiety can also be considered a phobia specifically of social situations and is mainly due to a fear of being judged harshly or embarrassed, not necessarily due to the circumstance itself. This most commonly presents in teenage years, but can be persistent throughout one’s lifetime, and often leads to avoidance of social interactions (such as having conversations with strangers, public speaking, or eating in front of others).
Generalized Anxiety Disorder
Excessive worry with muscle tension or restlessness that leads to dysfunction in social or occupational functioning in considered generalized anxiety disorder. Often these individuals worry about many different areas of their lives, such as work, school, family, etc. Associated symptoms include restlessness, fatigue, trouble with concentration, irritability, muscle tension or pain, difficulties falling or staying asleep.
Living with anxiety can be very distressing and disruptive to your daily life. Fortunately, there are many treatments for the above anxiety disorders. Treatments include psychodynamic psychotherapy, cognitive behavioural therapy or exposure therapy, often in combination with pharmacotherapy, including selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors and possibly benzodiazepines short term. There are also many different medical or psychiatric conditions that can appear similar to anxiety, so if you are concerned it is important to speak with your family doctor for appropriate diagnosis and to determine the best treatment options for you.