March 5, 2012

Symptoms of Anxiety

When we’re anxious, we enter a “threat mode” that is meant to keep us safe. The body enters fight-or-flight, and we’re prepared to run away or to fight whatever threat we’ve identified. When we enter our threat mode of functioning, a host of changes occur physiologically, cognitively, and behaviorally, and these changes will sound familiar to anybody with anxiety.

Physiology in Anxiety

Often the changes in the body are easiest to identify as anxiety symptoms. The body responds to danger by giving us what we need to fight or flee to safety. Thus we get lots of energy, thanks to increases in adrenaline, our heart-rate goes up, our breathing becomes shallow and fast to get more oxygen into our system, our blood pressure spikes. In case we get cut in a fight, our blood moves away from our periphery to center around our organs. We slow down digestion. These changes explain our subjective experiences in anxiety –

  • our churning stomach
  • difficulty catching our breath
  • rapid heartbeat
  • shaking
  • tense muscles
  • difficulty sleeping.
Cognition in Anxiety

Our thoughts change when we’re anxious. Our focus becomes centered on the threat we’ve identified. In fact, when we’re anxious it can be hard to think about anything else. Although we might get distracted, we often end up coming back to our fears. We start to identify any possible current or future threats. We consider possible problems and ask ourselves, “what if…?”

Some examples of these what if thoughts are –

    • “what if I do badly and they reject me?”
    • “what if I panic in there and I can’t get out?”
    • “what if I feel like this forever or I go crazy?”
    • “what if Amy isn’t answering her phone because she’s been in an accident?”

We imagine things that can go wrong, and all the negative consequences that would result if it came true. Often, this focus on threats and dangers leads to try to come up with solutions or ways of preventing fears from coming true. Anxiety spikes if we can’t identify acceptable solutions.

Behavior in Anxiety

Anxiety leads to changes in our behaviors, often in attempts to cope with perceived dangers. The most common way to deal with anxiety is to attempt to avoid danger – the flight part of fight-or-flight. This leads people who experience social anxiety to try to avoid situations in which they might be negatively evaluated, like parties, meeting new people, or speaking in public. Or if they are stuck in them, to avoid eye contact, speaking, or movement. People who experience panic will try to avoid situations that have triggered anxiety in the past, or situations in which it would be inconvenient to have a panic attack, like traveling on public transport. Those with specific phobias will avoid places they might come into contact with their fear stimulus – avoiding basements if afraid of spiders, or the dentist or physician if afraid of needles.

Many people identify anxiety itself as dangerous, and thus try to do what they can to avoid the sensations of anxiety. They might try to avoid exercise or anything that raises their heartbeat. People with OCD will engage in rituals to make anxiety go away and avoid feared repercussions. Other will try to avoid the internal experience of anxiety when it arises by drinking or using substances, or by trying to sleep or control their breathing.

One of the unfortunate aspects of anxiety disorders and a central reason why anxiety disorders are chronic and impairing is that avoidance makes anxiety worse. Although it lowers anxiety in the short-term, avoiding the things we fear make anxiety stronger and stronger over time. The person with social anxiety who avoids a social gathering whenever they feel uncomfortable will find they become ever more anxious next time they attend a social gathering. There is a cycle here, because this increased anxiety will make it more likely that the event is avoided, leading to increased anxiety.