What causes anxiety?
Anxiety is a part of normal life. Most people feel anxious when facing a threat or a new challenge. An examination, job interview or important sporting contest can all produce normal anxiety. Indeed, anxiety is often helpful in these situations. But while too little anxiety might make us complacent, too much can make life very difficult.
How does anxiety affect us?
Anxiety affects us in a number of ways. Mentally, it can make us feel worried, interfere with our attention and concentration, and cause a subtle bias in the way we think — making us see the world as a scarier place than it really is.
Anxiety also produces a range of physical effects, such as a rapid pulse, dizzy turns, shaking, digestive upsets, sweatiness and a tendency to breathe too quickly — hyperventilation. It frequently leads to insomnia.
Anxiety also affects our behaviour, leading to an avoidance of situations we think will make us anxious.
Anxiety is abnormal when the amount of anxiety experienced is inappropriate for the situation. This abnormal anxiety may show itself as one of a group of illnesses, known as the anxiety disorders.
Conditions classified as anxiety disorders
- Panic disorder: This produces recurrent sudden episodes of intense anxiety and fear, often with no obvious cause. Panic disorder may be compounded by agoraphobia, in which the affected person will avoid public places and crowds, for fear of having a panic attack.
- Phobias: These are intense, irrational fears. Specific phobias commonly involve a fear of animals (e.g. spiders, dogs); natural environments (e.g. heights, storms); medical procedures (e.g. needles, operations); or situations such as plane travel or being in enclosed spaces. Exposure to the phobia causes extreme anxiety and avoidance if at all possible.
- Social phobia: This is like an extreme form of shyness, with an intense fear of negative judgement by others. It may be limited to intense anxiety about public speaking, or it may involve all situations where people feel ‘on display’ such as at parties or other social gatherings.
- Obsessive compulsive disorder (OCD): This is a condition where the person has obsessions (recurring ideas, thoughts and impulses) and compulsions (repetitive behaviours in response to the obsessions, such as repeated hand washing, checking that taps are turned off or doors are locked). The intrusive thoughts are often of an unpleasant or even violent nature, and the person may feel very embarrassed by them and afraid they will somehow carry them out, but they never do. Most people with OCD are aware that their behaviour is excessive or unreasonable.
- Post-traumatic stress disorder: This is particularly common in war veterans, but can affect anyone who has been exposed to distressing events which are outside the normal range of human experience. A common trigger for PTSD is sexual assault. Often the traumatic event is relived and recurs in flashbacks and dreams.
- Generalised anxiety disorder: In this condition there is an overwhelming and almost continuous feeling of anxiety. Generalised anxiety disorder will frequently cause a number of puzzling physical symptoms and many tests may be done looking for diseases of the heart, digestive system or nervous system.
Treatment for anxiety
There are several effective ways of treating anxiety disorders. Treatment may involve lifestyle measures, relaxation, counselling and anxiety disorder medication.
Cognitive behavioural therapy (CBT) is a commonly used form of counselling for anxiety disorders. It incorporates education about anxiety and techniques like problem solving. As the name suggests, it helps people understand the way their thoughts about the anxiety-provoking situation shape their response to it, and how these behaviours can perpetuate the anxiety. The therapist works with the anxious person to start challenging these thoughts and modify their behaviours in a way that diminishes the anxiety.
CBT can be a highly effective form of therapy for a range of anxiety disorders and is generally preferred over medication for long-term treatment. CBT requires considerable practice on the part of the person being treated, and successful treatment will involve exposure to some anxiety along the way.
2. SANE Australia. Anxiety (updated 2011). http://www.sane.org/information/factsheets-podcasts/158-anxiety-disorders (accessed Nov 2012).