Anxiety and Panic
- Feel anxious more often than not throughout my day?
- Have I restricted my activities as a way of coping with anxiety?
- Experience panic or panic-like symptoms in certain predictable situations?
- Am I intensely fearful of specific situations or things (e.g., animals)?
- Do I experience acute anxiety in social situations?
- Have I developed elaborate rituals or thought-processes to manage anxiety?
- Is my anxiety related to a specific, traumatic event?
If you answered yes to some of the previous questions, you may have more specific questions about the anxiety symptoms you have been experiencing. The following are various conditions for which anxiety is the predominant feature.
Types of Anxiety
A panic attack is defined as a period of intense fear or discomfort accompanied by physical symptoms such as sweating, trembling and chest pain as well as cognitive symptoms such as fear of losing control and/or dying. A panic attack can be associated with any of the anxiety disorders, but panic disorder itself is characterized by recurrent, unexpected panic attacks and persistent concerns about having additional panic attacks.
The anxiety in specific phobia is associated with persistent, excessive and unreasonable fear when there is an anticipated or actual encounter with a specific object or situation. There can be significant anxiety and sometimes panic whenever a phobic person is exposed to the feared object or situation. Some examples of specific phobias include fear of certain animals, fear of heights, fear of blood or fear of places such as bridges or elevators.
Social phobia is defined as a marked and persistent fear of a social situation or a performance in which embarrassment is considered to be a likely outcome. A fear of public speaking is one of the more common forms of social phobia. In all instances of social phobia, there is acute anxiety whenever the feared situation or performance is anticipated or encountered and there is frequently a strong desire for avoidance.
The presence of recurrent obsessions and compulsions which are time-consuming, impair life activities, and are recognized by the person as being excessive or unreasonable are features of this condition. An obsession is defined as persistent ideas, thoughts, impulses or images which are intrusive, anxiety-provoking and distressing. A compulsion is a ritualistic behavior which is intended to modify or reduce the anxiety through activity or behavior. The most frequent compulsions involve washing and cleaning, counting, seeking assurances, checking and/or repeating actions.
Post-traumatic Stress Disorder
The anxiety in Post-traumatic Stress Disorder is clearly associated with a traumatic event that the person experienced or witnessed and was associated with intense fear, horror or helplessness. In addition, there are recurrent, intrusive recollections of the events which are anxiety-provoking and distressing to the person. There may be avoidance of any situations associated with the original trauma and other anxiety-related symptoms such as hyper-vigilance or exaggerated startle response.
Generalized Anxiety Disorder
The primary feature of Generalized Anxiety Disorder is excessive anxiety and worry which occurs more days than not for a period of at least six months. In addition, symptoms of restlessness, fatigue, concentration problems, irritability, muscle tension and sleep disturbance may be present. The anxiety is perceived by the individual as being difficult to control or regulate.
Treatment of Anxiety
If anxiety symptoms are interfering with your ability to do routine, day-to-day activities, or if you have restricted your life activities as a way of coping with anxiety, you should consider seeking professional help. There are currently a variety of highly effective interventions available for the treatment of anxiety, including psychotherapy, cognitive-behavioral therapies, and medication. If you seek treatment, the recommendations you receive will likely depend on the specific symptoms you are experiencing. All of the anxiety disorders are treatable and many individuals experience a full recovery from their symptoms.
What Can I Do?
It is usually helpful to identify the events surrounding the experience of anxiety:
- What provokes the anxiety?
- What thoughts or physical sensations accompany the anxiety?
- How distressing is the anxiety?
- How are you coping with the anxiety?
Exploring these accompanying events may provide useful information about the nature of the anxiety as well as possible strategies for reducing it. In addition, there are specific changes you can make that may help alleviate anxiety symptoms:
- Exercise or engage in some form of daily physical activity
- Eat a nutritious, well-balanced diet
- Obtain an adequate amount of sleep
- Seek emotional support from friends and family
- Focus on positive aspects of your life
- Establish realistic, attainable goals which do not rely on perfectionistic values
- Monitor how you think about stress and reduce and/or change thoughts which are negative
- Identify activities which feel overwhelming and reduce your involvement or seek ways to make them more manageable
- Consult with a physician if you are experiencing any medical problems
- Consult with a mental health professional if you continue to be concerned about your anxiety
- Reduce or eliminate the use of alcohol and drugs and limit caffeine intake
- Don’t engage in “emotional reasoning” (e.g., “because I feel awful, my life is terrible”)
- Don’t assume responsibility for events which are outside of your control
Helping an Anxious Person
If someone you care about has been experiencing anxiety symptoms, you can be a valuable resource. There is often tremendous shame associated with anxiety. If you talk candidly with the individual regarding your concerns for his or her well-being, it will often bring the problems out into the open. Emphasize that your primary objective is to convey feelings of concern and assistance. You can also always consult with a mental health professional yourself if you are concerned about how to talk with your friend.
Suggestions for intervening with an anxious friend:
- Be empathic and understanding
- Don’t minimize the severity of anxiety symptoms
- Avoid critical or shaming statements
- Encourage coping strategies which don’t rely on avoidance of anxiety-provoking stimuli
- Challenge expressions of hopelessness
- Don’t argue about how bad things are
- Don’t become angry even though your efforts may be resisted or rejected
- Advocate for treatment of anxiety
- Consult with a mental health professional if an anxious friend refuses necessary treatment
The National Mental Health Association Website
An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder. (2000). Elke Zuercher-White. Fine Communications.
Mastery of Your Anxiety and Worry: Client Workbook. (2000). David Barlow and Michelle Craske. Psychological Corporation.
The Anxiety and Phobia Workbook. 2nd edition. (2000). Edmund J. Bourne. New Harbinger Publications.
The Relaxation and Stress Reduction Workbook. 4th edition. (1997). Martha Davis, Matthew McKay, Elizabeth Robbins Eshelman, and Valerie Winemuller. New Harbinger Publications.