“An emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure”. (APA)
When is Anxiety Adaptive?
When we are faced with an environmental stressor or trigger, anxious arousal is adaptive or necessary for survival. For example, when faced with a predator in the wild, we would experience increased blood pressure, hypersensitivity, and a faster heart rate. This would allow us to react appropriately to the threat. The stressor or trigger (in this case the predator) would also prompt the release of adrenalin (a chemical that triggers these anxious reactions), which results in the ‘fight-or-flight’ response.
Presently, anxiety is triggered by work, finances, relationships, physical health, and other issues. These triggers require our attention but do not necessarily demand the ‘fight-or-flight’ response. The prevalence of these triggers results in extended periods of anxious arousal, which can be damaging to mental and physical health. When the duration and intensity of anxious arousal are disproportionate to the threat, there is a move from anxiety to an anxiety disorder.
Several anxiety disorders are defined in the DSM-V (the Diagnostic aide used by therapists to determine a diagnosis for a mental health condition). The most famous and prevalent of which is Generalized Anxiety Disorder (or GAD).
There are several symptoms associated with anxiety disorders, such as:
- a sense of dread
- feeling “on edge”
- difficulty concentrating
- a noticeably strong, fast or irregular heartbeat (palpitations)
- muscle aches and tension
- trembling or shaking
- excessive sweating
- shortness of breath
- feeling sick
- difficulty falling or staying asleep (insomnia).
Some of the other common anxiety disorders include:
- agoraphobia – fear of leaving home, large crowds, and travelling alone.
- post-traumatic stress disorder (PTSD) – caused by distressing and/or disturbing events, e.g. war, abuse, accidents.
- panic disorder – recurring and/or regular panic attacks
Diagnosing Anxiety Disorders
If you are experiencing uncontrollable and recurring worry and distress, which affects your functioning, e.g. work, school, relationships, you should speak to your GP to get support in dealing with your anxiety.
A GP will ask you questions about your physical symptoms (e.g restlessness and insomnia) and psychological concerns (e.g. what worries you and your struggles with dealing with these worries). An anxiety disorder will typically be diagnosed if the symptoms persist daily for at least six months.
If diagnosed with an anxiety disorder, you may be given medication and/or psychological treatments to help alleviate your symptoms.
Several medications can alleviate the symptoms of an anxiety disorder, the most common of which are selective serotonin reuptake inhibitors (SSRIs). This medication works by increasing levels of serotonin (stabilizes mood, feelings of well-being, and happiness) in your brain. The most commonly prescribed SSRI is sertraline or Zoloft. SSRIs need to be taken on a long-term basis, i.e. six months or more but can take a few weeks to start working.
The most common and effective psychological treatment for anxiety disorders is cognitive behavioural therapy (or CBT). CBT supports you with re-routing/questioning negative and anxious thoughts and cognitions to allow you to overcome unrealistic anxiety. You would typically attend 1-hour sessions every week with a trained therapist for up to three months.
A combination of treatments (i.e. medication and psychological interventions) is typically most effective in alleviating the symptoms of anxiety disorders.