Anxiety can make a person do strange things.
It can trigger someone with Obsessive-Compulsive Disorder (OCD) to wash their hands until they bleed. It can lead a person with Social Anxiety Disorder to avoid social situations even when they feel lonely. It can result in a person with Generalised Anxiety Disorder (GAD) to seek perfectionism in everything they do, causing them to spend an inordinate amount of time on trivial tasks or to avoid tasks altogether.
And so on.
Of course, everybody, to some degree, feels anxious (worry, fear, nervousness) in response to various situations throughout their lives. Anxiety is how we prepare for a challenge, such as giving a presentation or facing a conflict at work. It's a normal response to threat or stress, and it underlies our ‘fight, flight, or freeze’ instinct. But it shouldn’t be there all the time, in response to minor and low-risk situations.
Anxious responses to stressful situations, like an upcoming exam, are psychologically different from experiences of ongoing anxiety. One is a normal and passing emotional state, the other is a mental disorder. Both involve feeling uneasy and apprehensive, but the nature of these feelings is different, and they have different implications for our behaviours and our health.
It can be hard communicating what these difference are, so I’ve tried to break anxiety down.
1. Anxiety has different stressors from worry
Worry and nervousness are reasonable responses to specific threats, like being late for an important meeting or messing up in an interview. Even a person who worries a lot, may do so in response to realistic concerns. This doesn't necessarily mean they have an anxiety disorder.
Unlike worry, anxiety is often irrational or disproportionate. For example, a person with OCD might obsess over small things, like switching off a light, or feel unable to face situations that others don't even think about, like touching the keypad on a phone to make a call.
Anxiety can also be particularly diffuse, like feeling nervous about travelling in general and not knowing why. In the case of GAD, a person might feel an underlying sense of unease on a day-to-day basis, and not be able to pinpoint the source. It can therefore be hard to find productive solutions to anxiety.
Adding to this, anxiety is characterised by internalising behaviour. This means that negative thoughts and feelings emerging from an anxiety disorder are often triggered by ourselves and are directed inwards, rather than being a measured response to an identifiable stressor.
2. Anxiety is excessive
Anxiety is also characterised by the nature of the fear, worry, or nervousness: how intense it is, how long term it is, how intrusive or uncontrollable it is, and how disruptive to everyday life it is.
Intensity: Anxiety is nervousness on steroids. Even if an anxious person is reacting to a legitimate stressor, their reaction may not match the severity of the threat or risk.
Length: Anxiety also tends to linger, often lasting much longer than a situation merits (if there is a triggering situation at all).
Intrusiveness: A person with anxiety can find it hard to relax or put things out of their mind. They might ruminate over past situations much more than others do, and worry excessively about what might happen.
Disruptiveness: The intensity, length, and intrusiveness affect daily life. The fear of failure, the the need to perform certain actions, the imposter syndrome – all taking bites out of a person’s time, energy, and ability to interact with other people.
3. Anxiety is not a case of needing to "calm down"
You have to give a presentation in front of a large audience. Perhaps your heart rate increases a little; perhaps you start to feel fidgety; perhaps you even feel a bit sick. In more extreme cases, a stressful event might trigger a panic attack, characterised by specific, short-lived and intense symptoms, such as chest or stomach pain, feeling weak or lightheaded, or having a racing heartbeat. There are many things you can do to calm yourself down in these situations, from self-care, like regulating your breathing, to pharmaceutical remedies, like medication for slowing down your heart rate.
But anxiety isn't limited to these more acute symptoms. A person with anxiety may, in fact, never feel this rising unpleasant peak in anxiety, followed by a descent back down to calm normality.
A person with claustrophobia, for example, might panic whenever they get into a lift, but would be able to avoid feelings of anxiousness altogether by simply avoiding lifts. This person – a person with an anxiety disorder – can’t just “calm down” because there is usually no peak in anxiousness to climb downwards from. Their behaviour (avoiding lifts), however, is still driven by an underlying anxiety.
4. Anxiety feels different
Many of the symptoms of an anxiety disorder sound the same as experiencing worry or anxiousness, like feeling tense or being unable to wind down. But these descriptions can seem inadequate to someone who has experienced an anxiety disorder.
Unlike normal worry, which is situation-specific, measured, and time-limited, it can feel like anxiety and its symptoms are building inside you over time, and this can become overwhelming.
Perhaps you’ve felt uneasy by yourself in your house at night: jumpy and concerned about small noises in the dark? You’re hyperaware without knowing what you’re looking out for. You might feel a general sense of danger, dread, or doom, up until the point that you run up the stairs and jump into the safety of your bed as quickly as possible.
Anxiety is this type of lingering unease and apprehension, occupying your mind and making you feel on-edge or in need of reassurance. It can flare up and clatter around in your head, like an unruly alarm, but it can also wane into a soft murmur, vibrating under the surface. Regardless, the underlying cause – the anxiety itself – is always there. It's a parasite that feeds on your self-confidence and ability to cope with commonplace situations. It feeds on you every day.
5. Anxiety is anxiousness plus ...
An anxiety disorder rarely exists in isolation. Anxiety is anxiousness plus other psychological, emotional, and physical symptoms. Specifically, people with anxiety can also:
Have an exaggerated startle reflex
Suffer from long-term sleeping disorders, such as insomnia and parasomnias
Are over-whelmed
Feel tired and exhausted
The long-term consequences
The key difference between feeling anxious and an anxiety disorder is the impact that an anxiety disorder has on daily life. Normal worrying causes mild emotional distress but doesn’t impact personal and professional functioning to the degree that an anxiety disorder does. Anxiety feeds self-doubt. It ruins relationships before they begin. It prevents us from making decisions. Etc.
People with anxiety often attempt to manage their symptoms by:
Occupying their minds and distracting themselves;
Avoiding stressors, sometimes also withdrawing from people in general; and
Excessively checking or trying to control their surroundings.
In more concrete terms, this means that an anxiety disorder might cause you to work to the point of burn out as you strive for flawlessness in even the smallest things. Or it can paralyse you, stopping you from doing what you want to do as you withdraw, procrastinate, or back away from opportunities. Specific to these modern times, with the help of multiple screens (TV, phone, and laptop, sometimes all used at once), we're always able to distract ourselves, at the expense of being productive.
These are symptom-relieving behaviours that make us feel better in the short term. In the long term, however, these behaviours help us validate rather than tackle anxiety, allowing it to continue interfering with our own and others’ lives.
It's not all doom and gloom!
Anxiety is hard for you, and it’s hard for the people around you, but it can be tackled.
Anxious thoughts and feelings are delivered and maintained by an anticipatory voice inside the person’s head. It sounds like their own voice, but it doesn’t say the reassuring things they would say to someone else in their position. It repeats back to them the things that they fear and don’t want to hear.
It's possible to challenge that voice. This might involve actively replacing negative thinking with realistic and fact-based thinking. It might involve breaking down an anxious feeling into its parts, and tracing these parts back to where they come from. And it might involve labelling your thoughts to recognise them for what they are: cognitive distortions.
This isn’t easy because it means calling bullshit on your own thoughts, and that takes practice. You need to form new habits so that it becomes easier to overcome the deeper-rooted anxiety over time.
It’s a bit like making a new route through overgrown grass instead of taking the well-trodden but anxiety-ridden path you’re used to taking in your mind. Each time you take the new route, the grass gets flatter and easier to pass through.
Being aware of your anxiety and developing strategies for dealing with it doesn’t necessarily mean it goes away, but it should make you better able to function. Taken in combination with some of the positive aspects of anxiety – yes, they exist (being astute, empathetic, conscientious) – this can make you highly effective in personal and professional life.
