Everyone experiences nervousness, or anxiety under certain circumstances. It might relate to a test situation, a job interview, or an impending life change. In today’s world there is a great deal of pressure to perform well in our professional and personal lives. We are exposed to performance reviews and many workers have certain quotas they must meet. Additionally, many adults face pressure to perform in multiple roles, such as meeting the demands of employment, marriage, and parenthood. Pressure is also felt by school age children and college students to achieve academically. Standardized tests, GPAs, and admission requirements put a great deal of stress on students to perform, above and beyond.
Feeling anxious is a normal reaction to stress. It prompts us to prepare for important events, follow through with assignments and obligations, and plan our time carefully. In itself, anxiety is not a negative thing as it can serve the purpose to be able to sense danger, be extra vigilant about our environment, and be able to engage in the “fight or flight” response should there be a dangerous situation.
We must keep in mind that there is a concrete difference between having situational anxiety and an anxiety disorder. When someone has an anxiety disorder intense and excessive anxiety will be present with debilitating symptoms. Many people with anxiety disorder will begin to avoid situations that trigger or worsen their symptoms. This can have detrimental effects on a person’s life and emotional wellbeing.
The American Psychiatric Association lists the following symptoms for Anxiety Disorder:
- Overwhelming feelings of panic and fear
- Uncontrollable obsessive thoughts
- Painful, intrusive memories
- Recurring nightmares
- Physical symptoms such as feeling sick to your stomach, “butterflies” in your stomach, heart pounding, startling easily, and muscle tension (“Anxiety Disorders,” n.d.)
The American Psychological Association (APA) has created a list of the major types of anxiety disorders and their characteristics:
- People with generalized anxiety disorder have recurring fears or worries, such as about health or finances, and they often have a persistent sense that something bad is just about to happen. The reason for the intense feelings of anxiety may be difficult to identify. But the fears and worries are very real and often keep individuals from concentrating on daily tasks.
- Panic disorder involves sudden, intense and unprovoked feelings of terror and dread. People who suffer from this disorder generally develop strong fears about when and where their next panic attack will occur, and they often restrict their activities as a result.
- A related disorder involves phobias, or intense fears, about certain objects or situations. Specific phobias may involve things such as encountering certain animals or flying in airplanes, while social phobias involve fear of social settings or public places.
- Obsessive-compulsive disorder is characterized by persistent, uncontrollable and unwanted feelings or thoughts (obsessions) and routines or rituals (compulsions) in which individuals engage to try to prevent or rid themselves of these thoughts. Examples of common compulsions include washing hands or cleaning house excessively for fear of germs, or checking work repeatedly for errors. Once the patient stops the rituals he will immediately experiences anxiety
- Someone who suffers severe emotional trauma such as from a natural disaster or serious accident or crime may experience post-traumatic stress disorder. Thoughts, feelings and behavior patterns become seriously affected by reminders of the event, sometimes months or even years after the traumatic experience.
According to the APA, symptoms such as extreme fear, shortness of breath, racing heartbeat, insomnia, nausea, trembling and dizziness are common in these anxiety disorders. Although they may begin at any time, anxiety disorders often surface in adolescence or early adulthood. There is some evidence that anxiety disorders run in families; genes as well as early learning experiences within families seem to make some people more likely than others to experience these disorders. (“Anxiety Disorders and Effective Treatment,” June 2010)
Anxiety Disorders are treatable. Depending on the severity of the symptoms, treatment can be sought from a psychotherapist, or psychiatrist. Typically, in the case of mild or moderate anxiety working with a qualified counselor or psychotherapist is sufficient. Available treatment methods are: Cognitive Behavioral Therapy (CBT), Exposure Response Prevention (ERP), Systematic Approximations, and psychodynamic work.
When anxiety is severe, or extremely severe it is important to seek the services of a psychiatrist to establish a diagnosis and consider pharmacotherapy (using medication in addition to therapy). A psychiatrist is a mental health professional who is a medical doctor with specialization in mental health disorders. A psychiatrist is uniquely qualified to examine possible physiological reasons for anxiety and to prescribe medications that act on the brain, also called psychotropic drugs. It is during the psychiatric evaluation that that a mental health diagnosis, or diagnoses (comorbidity), is established. It is not unusual for people suffering from anxiety to also have depression. Once a clear diagnosis has been established a treatment plan is developed which could encompass therapy and medication, or just therapy.
Ideally a collaborative effort should take place between the treating psychiatrist, the therapist, and the patient during which progress is noted and challenges discussed. This will maximize the therapeutic experience for the patient.