Anxiety is all about uneasy anticipation of things yet to come. In contrast fear is about something that is happening in the moment. For example, if while you were sitting in your living room an intruder were to burst into your home. In that moment you would be experiencing fear as the danger was occurring in that moment. However, if the next day after the intruder was long gone and you experienced feelings of uneasiness and apprehension while sitting in your living room, then you are then experiencing anxiety as you are now predicting another intruder is going to come versus one actually being present. This illustrates how powerful our minds are- just the thought of something happening in the future can cause the body to respond as though that imagined event is actually occurring right now.
Symptoms of anxiety
When I talk to people about their anxiety, most are able to quickly identify their bodily symptoms of anxiety as they find those symptoms very distressing. Common physical symptoms of anxiety are as follows:
- Increased heart rate
- Breathing faster/hyperventilation
- Feeling flushed
- Stomach distress/nausea
- Tightness in the chest
- Restlessness/inability to sit still/feeling fidgety
For some it is harder for them to identify their anxiety symptoms as they are experienced more behaviorally, such as by these symptoms:
- Hypervigilance, which is like being a guard on a watch tower constantly on high alert and scanning for upcoming danger
- Reduced concentration
- Decreased patience or inability to tolerate stress
Anxiety is also experienced heavily in our minds. Mind based symptoms can look like the following:
- Preoccupation with the things that you are worried about happening
- Intrusive/unwanted thoughts
- Racing thoughts
As noted in the symptoms of anxiety article, anxiety can show up in a multitude of ways. When we are talking about what makes something an anxiety disorder, we are referring not only a specific cluster of symptoms, but also an impairment or decrease in functioning. What makes something inherently a disorder is that it impedes your functioning, such as significant changes in your sleep, eating, hygiene, and engagement in everyday tasks. As such, you can experience intense feelings of anxiety without having an anxiety disorder. Let’s take a look at some of the more common anxiety disorders.
The predominant feature of Panic Disorder is reoccurring panic attacks that are not due to having taken a substance or other medically based reasons such as a thyroid condition.
What is a panic attack?
The term panic attack is often used interchangeably with the term anxiety attack. When someone experiences a panic attack it can either feel like it is coming out of the blue or it can be in direct response to a stressor, such as finding out you are losing your job. Panic attacks are one hundred percent thought based, which for most people feels very counterintuitive. Panic attacks are the result of meta anxiety e.g. anxiety about anxiety. Once people have one panic attack what often happens is that people become anxious about having another panic attack.
Symptoms of panic attacks are intense, but short-lived, usually resolving in about 10 minutes. People experiencing a panic attack may experience four or more of the following as noted in the DSM which is the manual professionals use to assist with the diagnosing process: :
- palpitations, pounding heart, or accelerated heart rate
- trembling or shaking
- sensations of shortness of breath or smothering
- feeling of choking
- chest pain or discomfort
- nausea or abdominal distress
- feeling dizzy, unsteady, lightheaded, or faint
- feelings of unreality (derealization) or being detached from oneself (depersonalization)
- fear of losing control or going crazy
- fear of dying
- numbness or tingling sensations (paresthesias)
- chills or hot flushes
A distinguishing feature of panic disorder is if you experience agoraphobia. Some people feel unsafe to leave their homes due to their anxiety that they will have a panic attack and as such develop agoraphobia which is a fear of open or public spaces.
Social anxiety is the same as social phobia. However, it is not the same thing as being shy. Being shy is not a disorder as you can be shy and it does not necessarily get in the way of your life. People with social anxiety may or may not be shy. You can be extroverted and still experience social anxiety as social anxiety is about having intense fear of your performance in social situations to the extent that it decreases the quality of your life. This often leads to people avoiding those situations as they experience a lot of distress in response to social situations such as going to work or school or even a date. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) , the “fear, anxiety, or avoidance is persistent, typically lasting 6 or more months." It is important to note that someone with social anxiety will often want to engage in these social activities, but they feel the pull to avoid is too strong.