Welcome to part one of "The Anxiety and Panic Series: An Exploration of the American Brand of Fear." Over the next month, it is my goal to take you on a deep dive into the world of anxiety and how it presents in American culture. Today, let's define it. Let's get familiar with the names we call it. And let's start to examine signs of anxiety you might notice in yourself or in folk you know.
What IS Anxiety?
Originating from the Greek word, "angho" meaning "to squeeze" or "to burden," anxiety is essentially uncomfortable anticipation and uncertainty about some future event, real or imagined. The terms fear, worry and apprehension are often used interchangeably with anxiety - though some subtle differences do exist. When apprehension is provoked by an obvious threat, it is called fear. When the threat is unclear or the person's response to an upcoming event is more apprehensive than typical, they are said to be experiencing anxiety.
Here's an example:
I once knew a young man that wanted to become a doctor. He was absolutely brilliant. He had the best grades in our science courses. When he took the practice Medical College Admission Test (MCAT), he scored off the charts. Everyone knew he'd get into medical school with absolutely no problem, but he actually never did. Every time he'd prepare to take the MCAT, he would cancel his test date - saying he wasn't ready. A few times, he actually registered and sat for the test, only to leave the room during the exam and cancel his scores. He was beyond prepared. He would have probably had one of the highest scores in the country. But his mind told him (unreasonably) that he would fail. Unfortunately, severe test-taking anxiety stole his chances of becoming a physician.
Psychiatrists and other mental health care providers use a guide called the Diagnostic and Statistical Manual of Mental Disorders as a standard for diagnosing mental conditions. We call this guide the DSM-V (currently on the fifth edition). In this guide, all types of anxiety are listed. They are:
Social Anxiety Disorder
Generalized Anxiety Disorder
Separation Anxiety
Panic Disorder
Panic Attacks
Agoraphobia
Phobias
Selective Mutism
Anxiety from drugs, medicine or medical conditions
What Do We Call Anxiety?
If you read my last blog post, you know that I am big on being precise when describing our feelings and emotional experiences. I think to not do this assumes too much, and leads to misunderstanding and ineffective attempts at improving our condition. As stated above, "anxiety" is often used interchangeably with words like fear, worry, or apprehension. But what other words or expressions do we use when we really mean "I feel anxiety" or "I feel anxious"?
Sometimes I've heard people say they feel "scared for no reason." Other times people say they're "freaking out" (which may actually mean they're having a panic attack). Many people say they're "creeped out," are "trippin'" or "buggin'", are "paranoid" or describe themselves as being a "hot mess" or having "bad nerves." All those terms highlight the fact that a person knows their reaction is more intense than needed for the particular stressor they're facing at the time.
I notice a lot of people use the term "paranoid" to describe anxiety. I think what they mean is that they are hyperaware of their surroundings, which can happen in anxiety and not be associated with any serious mental illness or psychotic experience.
When it comes to your own experience, what do you call anxiety?
What Does Anxiety Feel Like?
Most people with anxiety have both mental and somatic manifestations of this state. That just means they can feel it in their minds, and their bodies. Anxiety can cause one to have a general sense of being "revved up" in a very unpleasant way. A person may be sweaty, restless, fidgety, or even have a small tremor. They may not be able to grab ahold of their thoughts to slow them down or shift them. They are often thinking of worst-case scenarios or wondering "what if" something goes wrong.
People have told me their experiences of anxiety feel like:
Being frozen in place with a racing mind
Burning or being on fire
Electricity or a "buzzing" sensation running through their body
Constantly being on the verge of vomiting
Having a hard, fast heartbeat
Shaking inside
The need to move to keep from exploding
All these symptoms can be present in both anxiety and in panic attacks. However, in panic attacks, symptoms are typically unprovoked and very intense. A person may be sitting and talking to their family, then all of a sudden become gripped with terror. They may burst into tears, have difficulty catching their breath, have hot flushes, and have the distinct sense that they're about to die. Essentially, anxiety is always present during a panic attack, but not all anxiety amounts to panic or has panic associated with it.
Please watch this brief video of what it is like for some people living with anxiety. This is pretty close to what many of my patients experience. The young man in the video is from the United Kingdom, where about 10% of the adult population experience anxiety disorders. In the US, 18% of the adult population, or over 40 million adults, live with anxiety.
*Video courtesy of Ton Mazzone
In the next blog post, we will discuss all the various types and diagnoses of anxiety. For a head start, please review my article on anxiety by clicking here. You may also be interested in my blog post on Social Anxiety Disorder here.
Please share any questions or comments you may have. We'll see you in part two!
* The information in this article does not constitute medical advice and should not take the place of an evaluation/treatment by a mental health professional. If you or a loved one is having a mental health crisis, please call 911, go to the nearest ER, or call 1.800.273.TALK.