All of us have experienced some form of anxiety. An overwhelming sense of panic? Shortness of breath? Racing heart? Dry mouth? Or even some of the more extreme symptoms of numbness and contractions in the muscles1 . But when does anxiety go from being useful, which it can be, to become a problem?
Before we discount anxiety in it’s entirety, it is important to discuss why we have anxiety in the first place. When trying to understand danger, or when we are at risk, we need to make a decision. Anxiety, and fear, increases adrenaline and other hormones which allow us to choose a decision which will be most beneficial for ourselves. We can look at this classically as the “fight or flight” response.
You’ve probably heard of it, but let me break it down for you. You’re out in the woods and you see a bear. In that small moment your body has to become prepared for either fight, or flight. Your muscles tense up , you become more focused and you make a snap decision. You either choose to go for the bear with your spear, fight, or run away from the bear, flight. The issue is, for the most part, we don’t come across bears in our everyday lives, but we do come across situations that can make us equally as stressed. For example, public speaking, social encounters and the like 2.
Anxiety is different to fear, however, and this must be noted. When we fear things, we are more likely to exhibit responses seen by fight or flight. Anxiety is where we focus on the future threat, become tense, vigilant in preparation and are more likely to avoid the situation. These two states regularly overlap, but they are distinguishable 3.
When, in fact, does anxiety become a problem? If we all experience it on some level, surely it’s not a big deal? The difference is when it begins to control our lives and stop us from doing the things we deem as normal. From the DSM V, there are a 6 criteria that define generalised anxiety disorder 4. These are:
- Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
- The individual finds it difficult to control the worry.
- The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):
- Restlessness, feeling keyed up or on edge.
- Being easily fatigued.
- Difficulty concentrating or mind going blank.
- Muscle tension.
- Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
- The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
- The disturbance is not better explained by another medical disorder
There are huge list of anxiety related disorders, which you can look at here, so I’m only covering the main one in this post.
For a lot of us, we might see this, and nod along, having had one if not all of these symptoms. The major difference between getting anxiety diagnosed as a disorder, and feelings of worry, is what we call state or trait anxiety. Cattell (1996) discussed the importance of distinguishing between anxiety as an emotional state and individual differences in anxiety as a personality trait. Those who have state anxiety, may exhibit certain responses in a specific situation/event/object or demand. Once the threat goes, then the person no longer exhibits the anxious response; It’s a temporary condition. Say, for example, you have to do a presentation at University. No one likes those. They are horrible. In the days before the presentation, you think about it all the time, you’re worried and you exhibit anxiety. Once the presentation is over you feel much calmer and don’t consider it much again.
Now, we compare this to trait anxiety. Whilst the anxiety is still in response to a threat, the duration, it’s intensity and the situations it develops for are different. Trait anxiety, and those who suffer from it, are more likely to have more intense periods of anxiety to a broader range of subjects than those who simply evince state anxiety. This becomes a personality characteristic rather than a temporary feeling. Example: a fear of people being sick when you cannot escape, so avoiding enclosed spaces.5
So there we go, my somewhat brief introduction to anxiety. There is so much more I could cover, but here we have a solid groundwork. If you are concerned about any of this, please go and see your doctor. I’m not an expert in disorders, just someone with a passion for mental health and a couple of psychology degrees. If you have any questions please ask and I’ll try to help.