Anxiety is a word we often hear, and many of us experience it in various forms. However, there is a difference between feeling anxious from time to time and living with a diagnosable anxiety disorder (anxiety that endures longer, is more severe, and that can negatively impact one’s life). Let’s break down some of the differences.
The Emotion of Anxiety
Anxiety is a natural human emotion and falls under the umbrella of the core emotion of “fear”. Fear has helped humans survive for thousands of years. When we perceive a threat, our bodies react with the fear response (a.k.a. the fight/flight/freeze response) which prepares us to either face the danger or escape it. In this sense, fear is highly protective and serves the essential function of keeping us alive and safe.
Anxiety is, perhaps, a more modern version of fear…at least when we zoom out and look at the trajectory of human evolution. As human brains evolved over time, certain areas of the brain emerged (e.g., the prefrontal cortex) that allowed higher level thinking and processing. As our mental processes became more complex, the emotion of anxiety developed as an adaptive response. If fear is the emotion we feel when we face an immediate threat to our safety or wellbeing, anxiety emerged as the emotion that arises in anticipation of a perceived threat. Thus, humans became better able to detect and manage threats before they even occurred, as we learned to register the restlessness, agitation, discomfort and unease associated with anxiety. These sensations and corresponding thoughts of impending doom or uncertainty sent us clear messages: “A threat or challenge is coming- do all that you can to stay safe and in control!!”
One can easily see that both fear and anxiety have served us well. However, it’s equally easy to imagine how anxiety can backfire. If a big life change is approaching (e.g., the birth of a child, a move, or a new job), anxiety can be a highly understandable experience. We can effectively “use” our anxiety to make sure our home is safe for the baby or to ensure we are well equipped to cope with the demands of the new job or city. This form of anxiety is usually temporary and situationally-based, and once the situation resolves, the anxious feelings typically subside. However, anxiety can quickly morph into something else entirely, causing individuals to become stuck in anxious cognitive and behavioral patterns. The individual perceives threats and challenges everywhere, maintaining a constant state of hyper vigilance and chronic stress.
When Anxiety Becomes More Problematic
An anxiety disorder is diagnosed when anxiety becomes overwhelming, persistent, and interferes with daily functioning. This is where it can be tricky because this is highly subjective, varying from person to person. Further, many individuals do not fit neatly into the predefined diagnostic categories for the various anxiety disorders. As always, it is crucial to inquire into how individuals specifically experience their anxiety symptoms and how it impacts their life.
*(A quick note on the term “disorder”. Personally, I don’t love the term, especially when it comes to anxiety… I have always approached my clinical work with clients from a strengths-based, non-pathologizing perspective. However, I recognize that we live in a world where diagnoses are helpful to guide treatment, and insurance companies need them for reimbursement purposes. And certainly, for many individuals, having a name for something that has caused them significant pain can be deeply validating. What’s tricky for me with many diagnoses is that we put so much of the onus on the individual to “get help” and “get fixed”, and we ignore the larger, societal and systemic factors that greatly contribute to these struggles. Alas…this is a topic for another day.) *
There are several forms of anxiety disorders, according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), each with its own specific symptoms:
Generalized Anxiety Disorder (GAD): Characterized by excessive, uncontrollable worry about a variety of topics, such as health, finances, or relationships. People with GAD often find it challenging to relax and may experience physical symptoms like restlessness, irritability, and difficulty concentrating or sleeping.
Social Anxiety Disorder: Involves intense fear of social situations where one might be judged or embarrassed. This fear can lead to avoidance of social interactions, which can significantly impact one’s personal and professional life.
Panic Disorder: Characterized by recurrent panic attacks, which are sudden, intense episodes of fear accompanied by physical symptoms like chest pain, shortness of breath, and dizziness. The fear of having another panic attack can lead to avoidance behaviors and increased anxiety.
Separation Anxiety: Marked by an excessive fear or anxiety about being separated from a primary attachment figure, usually a parent or caregiver. It is most commonly seen in children but can also occur in adults. Individuals with separation anxiety may experience intense distress when anticipating or experiencing separation, including physical symptoms like stomachaches or headaches.
Specific Phobia: Involves an intense, irrational fear of a particular object or situation that poses little to no actual danger. This fear leads to avoidance behavior and significant distress when faced with the feared object or situation, such as fear of heights, animals, or flying.
Agoraphobia: Characterized by an intense fear of being in situations or places where escape might be difficult or help unavailable if a panic attack or severe anxiety occurs. This fear often leads to avoiding public places such as open spaces, crowded areas, or situations where one feels trapped, such as being on public transportation or standing in line. In severe cases, individuals with agoraphobia may become homebound, unable to leave their homes without significant distress.
Selective Mutism: Marked by a consistent inability to speak in certain social situations, despite being able to speak normally in others, such as at home with close family members. This condition typically begins in childhood and can interfere with social, academic, and occupational functioning.
(*Obsessive-Compulsive Disorder (OCD) is not listed under anxiety disorders in the DSM-5, but rather is included in the section under Obsessive-Compulsive and Related Disorders.)
Anxiety is a natural part of the human experience, existing on a spectrum from temporary feelings of worry to chronic, debilitating conditions. While feeling anxious at times is nothing to fear, it is essential to recognize when anxiety may be crossing the line into something more serious. Understanding these distinctions and becoming familiar with your own relationship with anxiety is the first step in finding ways to manage it effectively.
If you or someone you know is struggling with anxiety that interferes with daily life, seeking professional help from a mental health expert can make a significant difference. Remember, help is available.