What is anxiety and how to recognize it in yourself or others?

Anxiety is a state of inner restlessness that occurs in the absence of real danger (“fear without object”) and is associated with muscle tension and alertness.

 

Medically reviewed article by Dr. Adriana-Valentina Șeicăreanu – resident psychiatrist

 

Table of content:

1. How is anxiety defined?
2. Types of anxiety
3. Causes and symptoms of anxiety
4. Anxiety test
5. When does anxiety disappear?
6. The difference between anxiety, fear and depression
7. How is anxiety treated?
8. What to do when you have anxiety?
9. Anxiety in children
10. Prevention of anxiety

 

 

1. How is anxiety defined?

Anxiety is a state of inner restlessness that occurs in the absence of real danger (“fear without object”) and is associated with muscle tension and alertness. Many of the situations in daily life can cause it, as it is a normal reaction of the body when subjected to stress. If the feeling is prolonged and interferes with daily activities then you may be experiencing an anxiety disorder.

 

2. Types of anxiety

Anxiety is a common factor in all anxiety disorders, but the objects and situations that induce it are different. Thus, several types can be distinguished:

• Panic disorder and agoraphobia – spontaneous panic attacks that may be associated with fear of open spaces or crowds
• Generalized anxiety disorder – events, circumstances or conflicts trigger excessive concern
• Specific phobia – intense anxiety when a person is exposed to the object of phobia (water, heights, snakes, etc.)
• Social phobia – anxiety, fear or avoidance when a person is exposed to social situations (public speaking or eating, romantic encounters, events with many people, etc.)
• Obsessive-compulsive disorder – anxiety occurs if the person tries to resist his obsessions and compulsions
• Post-traumatic stress disorder and acute stress disorder – anxiety is caused by a major traumatic event that is relived in dreams or flashbacks
• Anxiety disorder due to a general medical condition
• Substance-induced 
• Mixed anxiety disorder
• Other anxiety disorders (adjustment disorder, anxiety secondary to another mental disorder, situational anxiety, death anxiety, separation anxiety, anxiety related to loss of self-esteem or self-control, anxiety related to addiction or intimacy, anxiety related to guilt or punishment)

 

3. Causes and symptoms

The causes of anxiety are not fully elucidated, however, the most common are:

• Family history
• Stressful events
• Medical conditions: thyroid disease, asthma, diabetes, heart disease, depression
• Substance use
• Personality

Depending on the type of disorder, the symptoms may be different. The most common manifestations would be:

• Anxious thoughts or uncontrollable beliefs that end up interfering with everyday life, tension, fear that does not disappear, but on the contrary worsens over time.
• Physical symptoms: strong or rapid heartbeat, unexplained pain, dizziness, sweating, shortness of breath, tremor, fatigue, redness or pallor, sleep disturbances, diarrhea, feeling of “knot in the throat” or “butterflies in the stomach”
• Behavioral changes while avoiding activities that cause anxiety

 

4. Anxiety tests

There are certain tests that can guide the diagnosis. Among these there are:

• Rorschach test – Animal movements, intense color, unstructured shapes may indicate anxious responses
• Bender – Gestalt test – Possible spread of productions on page in anxiety disorders.
• The “Draw a man” test – In anxious people, the speed with which the drawing is made is noticeable
• Minnesota – II Multiphasic Personality Inventory (MMPI) – Increases in hypochondriac scales, psychasthenia, hysteria in anxiety
• Zung Self-Assessment Scale for Anxiety – A 12-item questionnaire that assesses anxiety
• Hamilton Anxiety Scale (HAM-A) – A 14-question questionnaire that assesses moods, fears, and stress, as well as physical, mental, and behavioral traits.
• Beck Anxiety Inventory (BAI) – 21 questions that assess the severity of anxiety
• Social Phobia Inventory (SPIN) – 17 questions that assess the level of social anxiety

 

5. When does anxiety go away?

It should be seen as any other feeling you experience, it appears and disappears depending on the actions you are subjected to. It is not always a bad thing, it can be present in normal situations in everyday life, such as an interview, an exam or an important meeting. However, when you face an anxiety disorder that negatively affects your life, you will need treatment to regain control.

 

6. The difference between anxiety, fear and depression

Often, people confuse or misuse these 3 terms. Anxiety, fear and depression are different notions, but they are related to each other and can sometimes coexist.

Anxiety is a state of inner restlessness triggered by the anticipation of a danger, it can also be called “objectless fear”.
Fear is the emotional response to a known cause, “fear of the object.”

Depression is characterized by a persistent state of sadness and loss of interest in activities that previously caused pleasure, leading to an inability to carry out daily activities.

7. How is it treated?

In some types of anxiety disorders (eg post-traumatic stress disorder), psychotherapy is recommended for the first time, while others (generalized anxiety, obsessive-compulsive disorder) are treated medically or with a combination of medication and psychotherapy.

Drug treatment

Your doctor may prescribe treatment with benzodiazepines, antidepressants, beta-blockers or anxiolytics. These are the classes of drugs that have been shown to be effective in patients with anxiety disorders.

Psychotherapy

Cognitive therapy – focuses on changing the patterns of thinking that trigger anxiety.
Behavioral therapy – exposure is the main component of this therapy and involves deliberate confrontation with factors that cause fear and anxiety

Alternative treatment

People often use aromatherapy as a natural remedy and there is a wide range of essential oils that you can use for this alternative treatment.
Herbal supplements could be helpful. Valerian, lavender, chamomile, passion flower, lemon balm have proven effective in relieving anxiety.

 

What to do when you have anxiety

It can be unpleasant and can influence your daily activities, but with proper treatment you can overcome it. There are many strategies you can try to manage it, you just have to find the right ones for you. Here are some options that might work:

• Breathing exercises – when you are anxious your breathing becomes fast, try to control your breathing, inhale and exhale slowly
• Progressive muscle relaxation – try to tense and then slowly relax each muscle group to reduce accumulated tension
• Face your fears – don’t avoid situations where you feel anxious, try to expose yourself to them
• Try to look at reality objectively, don’t overestimate the danger you are subject to, and don’t underestimate your ability to cope.
• Find out about your condition, it’s good to be informed

 

Anxiety in children

It affects about 20% of children and adolescents, being one of the most common mental illnesses among them.

Of all types, separation anxiety is the most common in children and occurs especially when they have to go to kindergarten or school or when they have to sleep alone. The signs that indicate anxiety in the young child are: irritability, crying crises, sleep disorders, watering the bed. In the older child there can be observed: avoidance of activities, situations or people, outbursts of anger, fears or worries about daily activities, sleep disorders or the insistent desire to sleep with parents. Therapeutic approaches are similar to those mentioned above.

If you have a child who is suffering from anxiety, it is important to be with him, to discover what is causing this problem and to help him overcome it. If your child’s symptoms cannot be managed, do not hesitate to ask for specialist help.

 

Prevention

Because the exact causes of anxiety disorders are not known, prevention is difficult. However, there are some steps you can take to reduce the symptoms and episodes:

• Early intervention – the sooner you recognize your pathology and ask for help, the easier it will be to manage and treat
• Try to reduce stress – relax, walk, exercise or any other activity you enjoy
• A balanced life – try to eat healthy, get enough sleep and exercise
• Avoid alcohol, smoking, excess coffee or other substances that may make your anxiety worse.