What is Anxiety?

Everyone gets nervous sometimes, and some of us are nervous a lot! It’s important to know when the nervousness is at “normal” healthy levels, and when it crosses over into being something that is diagnosable (but therefore treatable).

If you’re nervous about an upcoming presentation, meeting someone new, driving to a place you’ve never been or are experiencing something very important and impactful to your future like a job interview, it can be helpful and healthy to be a little bit nervous. It can push you to prepare more effectively before those big events or to pay more attention and be more focused in the moment.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) now on the 5th edition is our diagnostic “bible” of sorts. All of the current possible diagnoses related to mental health, developmental and substance use disorder are located in this manual that is just under 950 pages long. This manual is always under review and as new research comes out, diagnoses are amended, removed or added over time.

Let’s talk more about the clinical definition of Anxiety and what some signs and symptoms are that can help you know if it’s time to get help from a professional.

The DSM-5 describes anxiety as “…the anticipation of future threat.” It goes on to say that “…anxiety is more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors.” Anxiety can manifest in a variety of ways with a variety of symptoms. Common anxiety disorders include Separation Anxiety Disorder, Generalized Anxiety Disorder, Specific Phobias, Social Anxiety Disorder, Panic Disorder, Agoraphobia, and Substance-Induced Anxiety Disorder.

Let’s dig into Generalized Anxiety Disorder (GAD) as it’s one of the most commonly diagnosed mental health conditions in the United States. Symptoms of GAD are:

• Excessive anxiety or worry occurring more days than not for at least 6 months about a number of events or activities

• Difficulty controlling the worry

• Worry associated with 3 or more of the following: restlessness or being keyed up/on edge, easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance (difficulty falling or staying asleep)

• Anxiety or worry and physical symptoms cause clinically significant distress or impairment in social, occupational or other areas of functioning

• The anxiety is not due to the effects of a substance or medication

  Other facts about anxiety:

• Twice as many females as males experience generalized anxiety disorder

• The median age for diagnosis of GAD is 30, though it can begin earlier or later

• Physical symptoms often accompany GAD including sweating, nausea, diarrhea, exaggerated startle response, muscle aches or soreness, trembling, accelerated heart rate, shortness of breath, dizziness, headaches or irritable bowel syndrome.

If you’ve been experiencing any of these symptoms - there is help. Treatment for GAD is via talk therapy, medication management or a combination of both. The gold standard of treatment for GAD is Cognitive Behavioral Therapy, or CBT. CBT helps you to identify and understand how your thoughts, emotions and behaviors are all linked together. When irrational thoughts are present in your mind, often negative effects come from this. Learning to identify, stop, and change your thoughts that are negative or irrational is a focus of CBT. Many therapists (including me) use CBT. It is also utilized for other diagnoses such as depression or helping people make changes with other behavioral or physical health problems as well.

I want to leave you with one thing that I often teach my clients that helps GAD - a grounding technique. I call it 5-4-3-2-1. In practicing it you’ll either think of, write down or speak out loud 5 things you can see in the room you’re in or an imaginary place that you’d like to be in right now. Then 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. In doing this, it brings you into the present moment and out of your thoughts which may be rapid, negative, overwhelming or repeating unnecessarily. It also helps to bring you in touch with your body - with physical sensations of touch, taste and smell. This technique can be used anytime you need it - while driving, while in a room full of people, when trying to fall asleep or after awakening from a nightmare.

If you or someone you know may have anxiety - reach out to a professional and encourage them to do the same. Treatment works and you can lessen your symptoms and learn ways to be calmer and more grounded and present in the moment, no matter the circumstances.