Anxiety: An overview

When trying to understand what anxiety is, many people really don’t differentiate very well between what it is and what isn’t. A good example might be in defining the difference between fear and anxiety which would have several different features. When individuals are afraid, their fear is usually directed toward some specific situation or external object. You might fear failing in sports or in an exam, or being unable to pay bills or any number of things related to specific circumstances or individuals. When you experience anxiety you often times can’t really be specific about the source of your anxiety. You experience more of an internal sensation rather than external. It may be a reaction to a unrecognizable or vague danger. Many times people feel an internal sensation of losing control over yourself or a situation.

Anxiety: The whole body effect
Anxiety may affect your whole body. Many people describe it as having psychological, physical and behavioral effects. On a psychological level, anxiety is an internal sensation of uneasiness and apprehension. In an extreme form that may cause you to fill detached from yourself or you may even feel fearful of going crazy or dying. On a physiological level you may feel anxiety in the form of specific bodily reactions such as sweating, dry mouth, rapid heartbeat, and muscle tension. On the behavioral level it can absolutely undermine your ability to express yourself or deal with certain circumstances that are essential to your daily life.
The fact that anxiety may affect you on these three different levels makes it much more difficult to reduce the debilitating effects. Some psychologists have found that a more complete program of recovery from an actual anxiety disorder must be to intervene at all three levels to:
(1) Reduce your physiological reactivity.
(2) Eliminate behavioral avoidance.
(3) Change the internal representations which continue the state of apprehension and worry such as through the use of “self talk”.
Anxiety and Anxiety Disorders:
Anxiety and what we define as anxiety disorders appear in many different forms and levels of intensity. It can be manifested in anything from a small worry and a subjective feeling of uneasiness to severe anxiety culminating in a panic attack with symptoms such as disorientation, heart palpitations and even a sense of terror. Anxiety that comes out of the blue with no warning is referred to often as free-floating anxiety or in very severe instances a spontaneous panic attack. The difference between these two spontaneous episodes of either free-floating anxiety or spontaneous panic attack may be defined by whether you experience four or more of the following symptoms at the same time. The experiencing of four or more of the following symptoms may define a panic attack:
• Trembling or shaking
• Sweating
• Choking
• Heart palpitations
• Shortness of breath
• Numbness
• Nausea or abdominal distress
• Hot flashes or chills
• Dizziness unsteadiness
• Feeling of detachment
• Fear of going crazy or that you are out of control
• Fear of dying

Anxiety and anxiety disorders are usually differentiated between how specific they are to certain specific circumstances or are generalizable to many situations. If your anxiety arises only related to specific circumstances it is called a situational anxiety or phobic anxiety. Situational anxiety is very different from every day fears in that it tends to be very unrealistic and out of proportion to the specific circumstances but is not debilitating. For example, if you have an apprehensive feeling about confronting others, going to the doctor or driving on the freeway it may qualify as a situational anxiety. Situational anxieties become phobias when the anxiety is high enough in intensity that you begin to avoid those specific circumstances or situations. If you absolutely avoid confronting others, going to the doctors or driving on the freeway, you may have developed a phobia due to the persistent avoidance of the specific situation.
Anxiety: It’s the thought that counts
Unfortunately, anxiety can also be brought on by thinking about the situation. If you become severely distressed by merely the thought of what may happen when you have to face one of your phobic situations, you may be developing what is referred to as anticipatory anxiety. If the level of distress is not too severe, your anticipatory anxiety may be unable to be distinguished from ordinary worrying. Sometimes however, anticipatory anxiety can become very severe and may be referred to as anticipatory panic.
There are some very important distinctions between spontaneous anxiety (or panic) and anticipatory anxiety (or panic). If you have spontaneous anxiety, it has a tendency to come out of the blue and hit its peak very rapidly and has a tendency to subside. Studies have found that the peak in intensity is usually reached within five minutes, which then subsequently seems to be followed by a gradual tapering off over an hour or more. Anticipatory anxiety however, tends to gradually build up in response to either thinking about or encountering a threatening situation and then usually drops off quickly. Frequently, people will “worry themselves to death” about something for an hour or two and then seem to let go of the worry as you find something else to occupy your mind.
Anxiety in conclusion:
It’s not enough just to say that we are anxious and just expect it to be resolved somehow. In order to have any type of understanding and resolution we have to define the specific circumstance of anxiety and how it is manifested in various forms which ultimately could even become an anxiety disorder. Anxiety disorders are much more intense and disabling then the every day experiencing of anxiety, fear or stress
By Paul Susic Ph.D, licensed psychologist