anxiety and panic

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Chances are you have found my website because you are experiencing some form of anxiety. Anxiety is incredibly common (the most common psychiatric illness affecting children and adults according to the Anxiety and Depression Association of America - ADAA.org), and comes in many forms. 

Following are common symptoms of anxiety:

• Constant worrying, problem solving, or optimizing
• Difficulty with concentration
• Restlessness or feeling wound-up or on edge
• Tiredness and fatigue
• Irritability
• Muscle tension or soreness
• Sleep difficulties (low quality sleep, issues with falling or staying asleep)

Symptoms of panic attacks:

• Sudden and repeated panic attacks involving intense fear
• Intense physical sensations, such as chest pain, hyperventilating, intense sweating, tremors
• Experiencing shifts in perception (dissociation, derealization, depersonalization)
• Fears of losing control or “going crazy"
• Fear that physical symptoms of panic will result in death

When someone has experienced panic attacks, they may also develop panic disorder. This is when the person becomes preoccupied with when another panic attack may occur, and starts to avoid places/events that may trigger a panic attack. 

It is quite common for people to have more than one anxiety disorder at a time, or across their lifetime. Anxiety disorders include:

• Generalized Anxiety Disorder (GAD) - Persistent worries about common life situations and the future
  • People with GAD have great difficulty being present in their lives (have trouble shifting their attention away from their worries)  
• Social Anxiety - fear and avoidance of being judged by others
  • Often includes hyperawareness of their symptoms of anxiety and belief that others perceive them and will judge them for being nervous
  • Often experience "social perfectionism" - believing they need to say or do things perfectly in social situations 
• Health Anxiety - fears specific to possible health conditions. 
  • Often are highly vigilant about parts of their body (looking for signs and symptoms)
  • May either avoid doctor visits, or excessively seek out doctor visits
  • Often using internet resources such as WebMD, Reddit forums, etc. to seek out information about feared health conditions
• Specific phobias - fears that are highly specific
  • Vomiting (emetophobia)
  • Animals or insects
  • Natural phenomenon (heights, storms, ocean)
  • Flying or driving
  • Medical procedures (needles, medication, etc.)
  • Elevators or confined spaces (clausterphobia)
  • Entering "unsafe" spaces that would be hard to escape, such as crowds, enclosed spaces, leaving home (agoraphobia)

Some of these have a lot in common with the Obsessive Compulsive Disorder (OCD) cycle:

1. Some internal or external trigger for fear or worry
2. Feelings of severe anxiety and discomfort
3. Engaging in some action in effort to alleviate this discomfort (safety behaviors)
4. The fear or worry comes back over and over, usually even bigger

This cycle is one of the primary differences between a person without an anxiety disorder having an intrusive thought* and a person with. This is why effective treatment lies in learning how to respond differently when these thoughts occur, not just finding more ways to avoid them. Treatment for anxiety disorders is highly successful when approaching these fears with lots of compassion, courage, and keeping yourself oriented to what really matters. 

*By the way, did you know that according to a study at the NIH about 90% of people have endorsed having unwanted, intrusive thoughts from time to time? And what are the chances that the other 10% were just too embarrassed or ashamed to admit that they have them? Let’s get good at normalizing that our brains sometimes do wacky, unhelpful things, and learn how to not let those unhelpful thoughts dictate how we show up for ourselves and others in our lives.

The annoyingly semantic answer to this question is that you have anxiety because you are human, and all humans have anxiety. In fact, most, if not all, animals have anxiety. This is just one of the emotions we have, but it's a really big one, and a really important one. We need anxiety, it is part of what has helped our ancestors survive, and it is part of what helps us succeed today. Our minds have the ability to predict and imagine future outcomes, and a deep drive to keep ourselves safe and problem-free. These two put together means we are really good at imagining all the terrible things that could happen. 

The less literal interpretation of this question is, "Why do I struggle with anxiety more than everyone else seems to?" I think there are a few possible answers to that question. 

1. Chances are you are hiding at least some of your anxiety from others. Many people do. And if you are hiding your anxiety, what are the chances that at least some of the other people you interact with do too? It may seem that others aren't struggling with anxiety as much as you are, but according to Anxiety and Depression Association of America 19% of Americans are. That's about 1 in 5 people. More people are struggling than you know. 
2. Genetics and environment. Nature and nurture. Some people are more anxious than others because their genetics set them up to be more alert, more sensitive, more imaginative .... And some people have childhood learning that influenced these same parts. 
3. Let's look back up at that anxiety cycle above. It makes sense that people engage in safety behaviors. After all, it works in certain  other areas of your life. If you touch a hot stove, we learn to pull away, and not touch that anymore. In fact, avoiding touching the hot stove is protecting you. However, when we use this same strategy to avoid emotions, the strategy no longer works. Emotions keep coming back, and in fact, come back stronger. 

Anxiety disorders develop when people use strategies to manage or control what cannot be managed or controlled.  Given that you can't control your thoughts (remember everyone has unwanted, intrusive thoughts), and you can't control your emotions, what can you do to recover control in your life? You can learn how to get good at having unwanted thoughts, uncomfortable feelings, so that they no longer have so much influence over your choices. You can learn how to ride through urges, respond to the mind, and gently, kindly keep directing your time, energy, and attention on what's more useful and meaningful to you.