Anxiety is a basic emotional reaction that enables us to respond effectively in potentially dangerous situations. If for example we step in front of a moving car and the driver honks, we respond by quickly moving out of the way. The body’s central nervous system is activated almost instantaneously – breathing becomes deeper and faster to maximize oxygen intake, digestive processes are suspended, the heart pumps more vigorously resulting in greater blood flow to the muscles facilitating greater muscular strength, there is a decrease in blood flow to the skin, hands and feet giving rise to cold or tingling sensations, we break out in a sweat to prevent the body temperature from rising dangerously, and attention narrows to focus on the threat itself. Our response is reflexive, normal and healthy. It is designed to help ensure our safety, and subsides once the danger has passed.
Some people however experience anxiety reactions even in the absence of actual dangers. Such anxiety can be overwhelming, unmanageable and incomprehensible. It can take the form of sudden and completely unexpected panic attacks, agonising and constant worry, a sense of tension or restlessness, and/or fears about future attacks. Anxiety can also be focused on specific entities such as heights, public transport or cats. Some develop so-called “safety behaviours,” i.e. responses that serve to keep anxiety at bay. One might for example insist on never being alone, always having a telephone handy, avoiding crowded places, or repeatedly checking doors and windows before leaving home.
Physiological signs of excess anxiety vary between people. Some of the most common ones are:
- Racing heart
- Chest pressure
- Difficulties breathing
- Trembling or shaking
- Chills or hot flushes
- Abdominal distress, e.g. nausea, pain
- Dizziness or light-headedness
- Tingling or numbness in the extremities
For some, anxiety can trigger the urge to flee the feared situation or object, while for others there is a sense of paralysis. Most experience that their anxiety wanes once they have escaped the anxiety-provoking circumstance, e.g. breathing and heart rate return to normal upon leaving the crowded shop or train.
In instances where anxiety interferes with one’s ability to function normally, therapeutic intervention can be helpful.
Anxiety states
Panic disorder
Panic disorder is experienced with the onset of sudden, unexpected anxiety attacks characterised by intense physiological symptoms. Attacks seem to come “out of the blue,” and are often accompanied by fears of losing control, going crazy or dying. Such attacks can arise in connection with other types of anxiety, for example when someone with an elevator phobia is forced to use an elevator.
Agoraphobia
This is the Latin term for the phobia characterised by a fear of being away from home in open or public spaces. The phobic fear relates to being helpless in an inescapable or embarrassing situation, such as not being able to get help in the event of a panic attack. Agoraphobia is therefore often experienced in conjunction with panic disorder. People suffering from agoraphobia often try to avoid being by themselves, especially when they must leave the safety of their home.
Social phobia
Social phobia involves an extreme fear of being observed or judged negatively by others. Situations where there is the risk of being criticised or embarrassing oneself are avoided. Social phobia can be situation-specific, such as a fear of making a speech or eating in front of others; it can also be more generalised, e.g. fear of being disliked or ridiculed wherever and whenever others are present. People with social phobia fear that their discomfort is obvious to others, perhaps due to their blushing or trembling. This self-consciousness tends to further heighten the person’s discomfort and his or her desire to escape.
Simple phobias
Simple phobias are associated with specific objects or experiences. One might for example be terrified of spiders, enclosed spaces, dental appointments or flying. These are perceived as highly threatening, even though the actual risk of danger is relatively small. The fear reaction is therefore considered disproportionate or irrational.
Generalised anxiety
Generalised anxiety describes a constant state of agitation or worry in the absence of fears connected to specific objects or experiences (simple phobias). Worries are often focused on possible disastrous future events, and are highly exaggerated in relation to the actual likelihood of such events occurring. One may for example worry endlessly that relationships with loved ones are in jeopardy, or that losing one’s job is right around the corner. These concerns continue even though the current state of affairs is relatively peaceful. Symptoms such as muscle tension, stomach or headaches, and difficulties concentrating or sleeping are common.
OCD – Obsessive Compulsive Disorder
OCD is characterised by persistent anxiety-provoking thoughts (obsessions) and repeated actions that serve to keep anxiety reactions from surfacing (compulsions). The sufferer experiences being unable to control either of these, and is highly distressed by them. One might be obsessed with thoughts about dirt or infection and consequently engage in compulsive hand-washing or other hygienic routines. Constant worries about household damage may prompt multiple checks before leaving home to make sure doors and windows are secured and all appliances are turned off. Sufferers of OCD experience that their anxiousness is intensified when they are prevented from engaging in their compulsive routines.
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