What is anxiety?
Everyone feels anxious at times, for example before giving a presentation at work or school, when doing something new for the first time or going into a situation with strangers. Anxiety affects the physical sensations we experience in our body, our emotions, our thoughts and our behaviour. We probably all know the feeling of “butterflies in the stomach”, muscle tension, elevated heart rate and tingling, sweaty palms - these are physical sensations typical of anxiety. Anxious thoughts associated with anxiety are usually related to future events, and involve intense apprehension that these events may turn out to be unpredictable or difficult to manage. Behaviour associated with anxiety is often dominated by avoidance - we can probably all recall a time we feigned illness to avoid a social event that was triggering anxiety! One of the many ways anxiety can impact negatively on our lives is when we seek to avoid anxiety-provoking situations and as a result restrict or narrow our lives and experiences.
So why does anxiety seem to show up whenever we have something important going on? It appears that moderate amounts of anxiety are good for us – psychologists have known for some time that we perform better, both physically
and intellectually when we are somewhat anxious. The state of being anxious motivates and organises our behaviour, and allows us to predict and therefore prepare for future events. In this way we can see that anxiety is a future-oriented mood state.
Anxiety becomes a problem if anxiety levels are too great. Then our apprehension about being able to predict or control upcoming events feels overwhelming, so that it interferes with our capacity to complete the presentation or maintain conversations at a party full of unfamiliar people. There are a range of so-called "anxiety disorders" , and they are all involve the experience of excessive and distressing amounts of anxiety. The anxiety disorders include phobias such as social phobia where a person has an intense fear of social situations, post-traumatic stress disorder where a person experiences intense anxiety associated with memories of earlier trauma, obsessive-compulsive disorder in which a sufferer engages in repetitive hard-to-control behaviours in attempts to reduce anxiety, and generalised anxiety disorder which is dominated by excessive "worry thoughts".
What is the difference between panic and anxiety?
Panic is often confused with anxiety but it is quite different both physically and psychologically. Panic is associated with the fear response. Unlike anxiety, which is in essence a future-oriented state, fear is an immediate emotional response to a current threat or danger. Fear is associated with a strong escape urge and is the result of a surge of activation in the sympathetic nervous system, producing changes in our body that help us run away or fight off the threat. These changes include elevated heart and breathing rate and increased blood shunted to large muscle groups. A panic attack is basically a false alarm – a person is experiencing this sudden surge of intense fear, in the absence of a threat. Unlike anxiety, panic attacks occur unexpectedly and onset suddenly, and may escalate quickly as well, in the sense that the sufferer becomes frightened of the sensations of fear, eliciting further panic. A person may experience episodes of anxiety and panic attacks, and a psychologist may use some different techniques to help with each.
Treatment for anxiety
There are several evidence-based treatments for anxiety. Evidence-based treatments means treatments shown by rigorous scientific research to be effective. These treatments include Cognitive Behaviour Therapy, or CBT for short, and Acceptance and Commitment Therapy, or ACT for short. These treatments both address the main components of the anxiety, namely the experience of physical sensation in the body, the kinds of thoughts that show up during episodes of anxiety, and the avoidance behaviours that often occur as a result of anxiety.
People who struggle with excessive anxiety often have depressed mood as well, and there is significant evidence that the combination of psychological therapy and medication is the most effective treatment combination for many people suffering with anxiety and depressed mood.
As a clinical psychologist I have extensive experience in providing treatment for mixed patterns of anxiety, panic attacks and depressed mood. If you or someone close to you struggles in this way, please contacting me and making an appointment.