Look up any mental health disorder online and you’ll find a
laundry list of symptoms that could vaguely be any mental or physical health
disorder. Don’t get me wrong, these quick symptoms lists can be helpful in
pointing people in the direction of help—what a wonderful outcome! However, it
seemed to me like there’s room to expand beyond the symptoms to understand what
the disorder really looks like.
Thus begins my new series on what “it” looks like.
Disclaimer: This post—like all my content—is NOT intended for the purpose of diagnosis or treatment. It is for informational purposes only. The only place you can truly receive diagnosis and treatment is with a YOUR professional, qualified treatment provider following the proper assessment(s). Proceed with caution and use this post and all posts for information purposes ONLY.
You’ve seen the memes, digital comics, and graphics
depicting different aspects of an individual’s anxiety. Everything from looking
calm on the outside and drowning on the inside to seeing the world in demands
and put-downs. They all say, “this is what anxiety looks like,” so it can be
quite confusing to get a picture of what anxiety really is.
Anxiety is…normal. Yes, normal. Anxiety is the anticipation
of danger and helps prepare us for the fight or flight response when we perceive
something is wrong.
For example, you might notice warning signs at your job that
the company is closing and that could produce anxiety related to being laid
off. Being without a job would be perceived as dangerous because it’s how you
provide for yourself and your family (aka, survive). This anxiety can be adaptive
because it can lead you to do something about the situation such as search for
another job, focus on saving funds, and gain more information about the company’s
status.
Anxiety becomes maladaptive when it is; A) uncontrollable or
difficult to control; B) not related to any perceivable threat; and C) gets in
the way of your functioning somehow. Using the example above, imagine if you
believed your workplace was closing but no one else there thought there was
anything to be worried about, you talked to management and they assured you all
was well, and you’ve been saving funds just in case.
Even after all of those
efforts that should ease your anxiety, it continues to be there disrupting your
time off making you feel uncontrollable urgency to do SOMETHING and it keeps
you up at night with worry. You leave
for a different job and later regret leaving as the company continues to
flourish. Now the anxiety from above looks much different.
So we know the difference between adaptive and maladaptive
anxiety, but what anxiety are people referring to in the symptoms lists, memes,
and social media posts? The answer is: that depends. There are a number of
different anxiety disorders and, while they may have similarities, they tend to
look quite different. I won’t be discussing all of them here, but will focus on
the most common.
Generalized Anxiety Disorder
When many people say they have anxiety, as a counselor, I
first assess for generalized anxiety disorder. As the name suggests, the
maladaptive anxiety a person experiences is generalized across many types of
situations. The worry can be about your health, the health and safety of your
family members and friends, finances, social performance, job performance,
school performance, appearance…and so on.
These thoughts may have some relevance in reality (there is
always some distant threat to most of the above examples) but the worry is out
of proportion to the “threat.” To use a personal example, I frequently feared
failing every major exam throughout my seven years of college despite the fact
that I consistently maintained straight A’s semester after semester. Some might
say that the anxiety drove me to do well. I say the anxiety reduced the time I
had to study because I was so distracted by catastrophe, I couldn’t focus for
periods at a time. If I was less anxious, I probably could have done just as
well with less time spent on studying and completing assignments, leaving more
time for self-care. Ultimately, my worry
was well out of proportion to the threat.
As described earlier, this anxiety is difficult to control,
so thoughts just keep playing in your head on repeat. This is particularly so
when you aren’t occupied with a distracting task. Many people notice it most when
trying to go to sleep which results in a sleep disturbance.
Further, relaxing can be difficult overall. Muscle tension
and restlessness can get in the way of letting yourself rest and enjoy activities.
Tension and restlessness are like that of the fight or flight response and can
be distracting.
Lacking sleep and using up large amounts of anxious energy
on a variety of worries leads to fatigue. It is an overwhelming feeling of
tiredness that makes you more vulnerable to your anxious thoughts, because it’s
harder to reason when exhausted. It creates a cycle of anxiety sucking up your
energy, disrupting your sleep, and leaving you tired.
When overly tired and distracted by anxious thoughts, you
might find yourself more irritable. The irritability can come out as being
short with others, giving up easily on challenges, crying at small setbacks, and
negative self-talk.
All of the above gets in the way of concentration and focus.
Many people—myself included in the past—can feel foggy and notice problems with
short-term recall. When you can’t focus, it’s hard to take in information and
code it into your brain.
To surmise, generalized anxiety looks like a looping record playing
in your head and each time you turn one off another one turns on. It changes
how you interact with yourself, others, and your work because of your poor
sleep, fatigue, irritability, and concentration problems. It may feel like it’s
driving you as you ignore the exhaustion and you press through until one day it’s
too hard to ignore.
As you may already know from reading my previous article onmy own anxiety journey, this is not a hopeless disorder. It is very much manageable
and treatable. Finding the right providers, supports, and self-care is an
important part of healing.
Social Anxiety Disorder
Unlike Generalized Anxiety Disorder, social anxiety disorder
is focused on just one worry: social performance. Worry around social
performance could occur related to something many people find nerve-wracking
such as giving a speech or something commonly done without thinking like
walking into a grocery store. Given that humans are social creatures, it’s easy
to see how this can majorly impact daily function.
With social anxiety, you might feel like everyone is judging
each move you make negatively, fear being humiliated in front of everyone, have
difficulty getting to know new people or interacting with friends, and
criticize every move you make in public the way you assume others are
criticizing you. This often gets worse leading up to an event with social
expectations like a school or work presentation or Halloween party.
Often, this worry leading up can create nausea, trembling,
and sweating that will continue the cycle of the anxiety. It may even lead to
proving you “right” that you feel humiliated due to the impact of the disorder.
The fear, then, continues forward in life and becomes intense enough to impede
the activities and interactions you want to be a part of if not for the
anxiety.
This type of anxiety can feel lonely because it may result
in isolation. Social anxiety is not exclusive to this disorder but it is the
major focus of this one. Just as above, this is a treatable disorder with the
right care.
Panic Disorder
Many other anxiety disorders can include panic attacks but
in panic disorder the panic attack is the focus. Panic attacks can feel like
sweating, shaking, nausea, dizziness, feeling outside yourself, shortness of
breath, heart palpitations, chest pain, fear of dying, fear of losing control,
hotness or coldness, and numbness. On the outside, they may look like distress
or sickness, or nothing at all, even.
When you have panic disorder you experience panic attacks.
At some point, they become so scary you become anxious about having them. You
begin to be so anxious about having them, you avoid places and situations you
think might invoke one.
Any stressful situation might invoke a panic attack such as
going to the doctor, to work, or to a family gathering. Once that happens, you
become fearful it will happen again and start avoiding these situations. The
avoidance increases because once you start to think the event a panic attack
comes on proving you shouldn’t go.
This is a highly physical disorder because panic attacks ARE
almost entirely physical reactions. Getting the physical reaction under control
helps with the treatment of this disorder. Again, it takes the proper support
team to address panic disorder.
If there are only three things you take away from this post
let it be these; 1) anxiety is not all the same; 2) it is a physical experience
with implications in functioning; and 3) it can be overcome. I hope this has
helped you better understand the experience of anxiety and how it can vary
widely. Let me know if you want to see more articles like this one in the
comments below.
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