What exactly is an anxiety disorder?

We all have moments of fear or worry, but those with an anxiety disorder often experience intense moments of worry or fear, emotions often triggered by ordinary, everyday moments.

Anxiety can be defined as an ongoing worry about something that hasn’t happened yet.

Anxiety is an absolutely normal phenomenon in human life. In fact, when the level of intensity is manageable and within normal parameters, we don’t even think of using the word “anxiety”, rather we say that we “feel nervous”.

These emotions can be triggered by many life situations: you have to take an exam, you have to speak in front of a group of people, you have a romantic encounter with someone you really like, and so on.

The emotions associated with these events just show that you care about the outcome of those situations and that you are emotionally invested in what happens to you.

Involvement is usually a positive thing, and people should do more and more things they care about and less and less things they don’t care about. Ideally, at least.

The problem arises, however, when the intensity of these emotions exceeds a certain threshold that makes them difficult or even impossible to control and thus negatively affects one’s life and functioning.

At that point we are talking about an anxiety disorder.

Anxiety from an Adlerian perspective

From an Adlerian perspective, anxiety paints a false picture of what is happening to us. The person suffering from anxiety senses imminent danger and believes that they do not have the resources to cope with it. “Fear is the mistaken thought that you can’t handle a situation” (Jim Skinner) This person thus allows themselves to become overly concerned about the effectiveness of their actions and unduly preoccupied with themselves. At the same time, he feels that he is not in control of what is happening to him, or that he is losing control of what is happening to him. “Anxiety is fear about the future” (Erich Fromm)

Anxiety is fuelled by fear and, from an Adlerian perspective, one of the essential human fears is the fear of not belonging (to a place, a group, a role in society, ultimately). Every child is born with the need to belong, and the sense of belonging to their family of origin makes them feel important and significant to the world in which they live.

Adler in 1956 said that adaptation was crucial to survival. He believed that humans had to cooperate because they were so poorly equipped physically compared to other species. Humans are social animals that flourish when they form connections with other humans. Communication and the ability to abstract and project into the future allowed humans to learn not only from their own experience, but also from the experience of others. The adaptive value of not having to learn only from one’s own experience has been enormous and is a key element of humanity’s success.

There was, however, one problem. People had to have a group to learn from, and that group had to accept them.

This is the theory behind the specifically Adelerian notions of social interest and community feeling. When we feel a connection to the group, when we feel that the good of the community depends on us and that we have an obligation to contribute to that good, we are likely to use those impulses in a constructive way, for example by being careful not to leave litter behind us in the woods or on the beach, even if there is no one nearby to see us or to be immediately and directly affected by that litter. Having a sense of community means being aware that other people remain on this planet long after we are gone, and our actions today will have an effect and echo long into the future.

What causes anxiety?

In Adlerian theory, all behaviour is seen as having a purpose, consciously or often unconsciously.

From the Adlerian perspective, the purpose of anxiety is to resolve the fear of failure, and, as a consequence of failure, not being worthy of belonging. The erroneous idea is “I am never good enough to belong”, and then the mind creates a story to justify this idea.

Adler looked at the transformation of anxiety as a process with several milestones of progress:

Acceptance of one’s own imperfections – “the courage to be imperfect.”
The language of praise is replaced by the language of encouragement
Locus of control shifts from external to internal (the cause of what happens to us becomes internal, in other words, we take responsibility for our own lives)
The mind shifts from “I” to “we”, i.e. from competition to cooperation

Emotions should therefore be understood more as motivators of behaviour and less as causes of mental pathology.

How can you tell the difference between an anxiety disorder and a normal level of emotion? Different forms of anxiety

The most important indicator that you are dealing with an anxiety disorder is that your life and general state of mind are affected in a significant way.

What does this mean? It means that your life has changed dramatically since your symptoms began. You don’t do as many things as you used to, you don’t see people as much or when you do you don’t feel like seeing them, you get angry more often and more quickly and you don’t like the things you used to like.

Here’s what anxiety looks like in its different forms. Each manifestation calls for therapeutic intervention:

1. Excessive worrying: all people worry sometimes, but if over several months you find yourself worrying several times a day about both important things and all sorts of little things, then you may have a problem (a typical symptom of this is feeling chronically tired and seemingly unable to escape).

2. Sleep problems: having insomnia from time to time is not unusual (often before a very important event for you) but if you often find it hard to fall asleep and lie in bed with all sorts of thoughts, if you wake up restless and as if you haven’t slept at all, ask a specialist for help.

3. Performance anxiety: you feel like you’re freezing whenever you have to sit an exam, take part in a sports competition or do something else in front of a lot of people.

4. Public speaking anxiety: you get nervous whenever you have to speak in front of a group of people. You tell yourself you’ll get the shakes, sweat will pour down your forehead and everyone will realise you’re nervous. You imagine how your mind will be empty and you won’t be able to get a word out, how you’ll make a fool of yourself and everyone will laugh at you.

5. Social anxiety: you are emotional and overly preoccupied with yourself when attending social events, you tell yourself that everyone seems relaxed and charming, everyone except you, that is, because you have nothing interesting to say. You tell yourself that others probably think you’re a freak and wonder what’s wrong with you. And you’re convinced that only you have such thoughts.

6. Panic attacks: you are overcome by sudden panic attacks that come on suddenly and make you feel dizzy, with tingling in your fingers and your heart pounding in your chest. You tell yourself you’re having a heart attack, that you might faint and never wake up, you feel like you can’t breathe and you think you might suffocate to death. But it passes and you no longer think you’re going to die in the next second, but you remain confused and fearful at the thought that the whole experience will be repeated at some point in the future.

7. Irrational phobias: phobias, as they are also called, are forms of anxiety disorder, except that phobias are related to specific situations (fear of heights, fear of open spaces, fear of certain animals and so on).

8. Agoraphobia: You are afraid to leave home for fear of the horrible things that might happen to you. For example, you might have a panic attack and no one is around to help you. Other things that might frighten you are wide open spaces (such as large intersections or markets), crowds, public transport (especially when it’s crowded) or queuing in a supermarket.

9. Obsessions and compulsions: you are plagued by obsessive thoughts that you can’t get rid of and the compulsive need to perform certain rituals or superstitions in an attempt to control your fears. For example, if you are tormented by a fear of germs, you may tend to wash your hands excessively throughout the day, for example, whenever you touch another object around the house. If you’re worried about burglars breaking into your home, you may feel the need to go back several times to check that you’ve locked your front door. Or you might interrupt your sleep repeatedly to check if you’ve left the stove on for fear of dying in your sleep from carbon dioxide poisoning.

10. Post-traumatic stress disorder: you are haunted by memories of extremely traumatic events you experienced months or years ago such as physical assault, rape, torture and others.

11. Worries about your appearance (body dysmorphic disorder): you are obsessed with the idea that you have a physical defect or a repulsive body deformity, even though friends or family assure you that there is nothing wrong with you. Those affected by this disorder may spend hours in front of the mirror looking for defects or trying to figure out what’s wrong with their bodies, they may visit cosmetic surgery clinics, convinced that everyone sees the defects but dare not say so, lest they get upset (DSM-V)

12. Health concerns (hypochondriasis): you go to numerous doctors complaining of various aches and symptoms. All the doctors see you and tell you there’s nothing wrong, but you’re convinced you have some rare and exotic disease that the doctors just haven’t detected (Burns, 2006).

13. Exaggerated muscle tension: it is common for people with anxiety disorder to suffer from back or shoulder pain, sore neck muscles, frequent clenching of the jaw or fists, all in response to perceived danger.

Other psychological symptoms:

Physical symptoms of anxiety

Anxiety is a complex emotion that is made up of several elements. Some of these elements are somatic (related to body manifestations), some are cognitive in nature and some are emotional.

Anxiety is an important emotion that aims to remove the individual from the source of anxiety. This mechanism aims to increase the individual’s chances of survival.

In humans, anxiety appears to be triggered in the hippocampus and amygdala, two regions of the brain.

The physical symptoms of anxiety are caused by messages the brain sends to different parts of the body to prepare the fight or flight response.

Thousands of years ago, when man was a hunter-gatherer and foraged for food in the wild, anxiety helped him avoid becoming food for a predator himself. If such a predator suddenly appeared around him, anxiety was triggered and helped our ancestor to survive: he either fought the beast or ran away until he reached shelter.

This survival mechanism produced a number of changes in the body, such as:

The hair on the body would stand up and thus give the impression that the person was bigger than they really were.

Hands and feet begin to sweat, the sweat providing a better grip for gripping or climbing.

Adrenaline discharged into the bloodstream gives extra energy.

Breathing becomes shallow and heart rate increases, as does blood pressure.

Digestive and cellular repair functions are slowed or even stopped and all resources are redirected to the muscles to increase endurance and strength. The muscles also receive an increased amount of blood, which, in addition to the effect of increasing strength, also makes them increase in volume, i.e. makes the individual appear larger (similar effect to raised body hair).

The lungs, heart and other parts of the body start working faster.

The brain triggers stress hormones, especially norepinephrine, adrenaline and cortisol.

Under extreme conditions, the body will trigger excretion to reduce its weight.

The sense of sight and hearing are heightened.

Under the dangerous conditions of life in the Stone Age, we can imagine how these reactions helped our species survive. But in the modern times in which we live, anxiety often rather confuses us. When you’re stuck in traffic, for example, anxiety won’t make other cars get out of your way.

For this reason, with the disappearance of many direct threats to our lives, anxiety has become a problem rather than a solution. Because the conditions in which we live have changed but our bodies have not adapted so quickly to these changes.

Other common physiological symptoms of anxiety

The following symptoms often (but not necessarily) occur:

• cold and/or sweaty hands or feet

• palpitations

• chest pain

• dry mouth

• difficulty swallowing

• excessive muscle tension

• emotions of fear or panic (panic attack is a severe form of anxiety disorder)

• feeling persistently tired or exhausted

• inability to sit still and relax (popularly known as “can’t sit still”)

• feeling dizzy or nauseous

• breathing problems (feeling choked, shallow breathing)

• sleep disorders: difficulty falling asleep, interrupted or restless sleep

• unexpected hot flushes or chills

• frequent urination

Subtle symptoms of anxiety

In addition to the physical symptoms, there are a number of other symptoms of anxiety that are more subtle and easier to overlook, especially if you haven’t been very concerned about anxiety.

But these are important, especially for identifying anxiety in its less acute forms.

Digestive problems

Digestive problems often accompany anxiety, whether it’s irritable bowel syndrome, constipation or diarrhoea. The reason is that the digestive system contains hundreds of millions of neurons, strung along the digestive tract. Yes, the human body doesn’t just have neurons in the brain. These neurons in the digestive system have been given the name the second brain or the brain in the stomach.

In medical terms, these neurons form the enteric nervous system and comprise more neurons than those in the spinal cord or peripheral nervous system.

These neurons transmit information from the stomach to the brain via the vagus nerve (in fact, 90% of the information that travels here is from the stomach to the brain, not the other way around).

That’s why the state of your digestive system has an important influence on your mental state, and why you should also be careful about what you eat, not just what you think.

Perfectionism

I could write a whole article about perfectionism (and probably will at some point) but until then, it should be said that perfectionism often hides a fear of failure or of being criticised or rejected. And perfectionism is the solution found by the person who fears these things. He tells himself that if everything is perfect, no one will be able to criticise and so he will not be rejected.

Even if the intention is positive, the result is often catastrophic: the perfectionist ends up imposing ridiculously high standards on himself, so high that they become impossible to achieve, and so he ends up unable to get anything done, because he constantly goes back to his work to tweak something, make another correction and so on.

Those who have a habit of going back over their work know what usually happens when you do this: you mess up more than you fix, which causes new frustrations and defects to be fixed.

Real physical pain

Although anxiety is a condition of the mind, it still creates a powerful physiological response. When the brain senses danger (real or imagined, from the brain’s point of view it doesn’t matter if it’s real or not), it activates the fight-or-flight response, which floods the body with a combination of hormones and adrenaline. This phenomenon is as normal and healthy as it gets, because it prepares the body to face danger, making it more alert, stronger and faster.

However, when the danger is gone, there is no more activity to consume this hormonal cocktail. These hormones, built up in the body and not consumed, can give extremely unbearable physical symptoms, symptoms such as claw in the chest, palpitations, nausea, headaches, muscle tension, stomach pain and more.

It’s also the reason why many anxiety sufferers have motor restlessness (can’t sit still): it happens because their body pushes them into action to consume those hormones it’s loaded with. And for the same reason, people who do sport find that they can control their anxiety better with the help of sporting activity.

All the details, now

From the outside, wanting to know as many details about a situation as possible may seem like just a way to control things, but it’s often just a way to calm anxiety.

Difficulty making decisions

An anxious person can weigh a situation from different angles and think about problems before others do. But anxiety can also lead the person to overcomplicate things (see also previous point), to over-analyse and finally to give up deciding.

Make plans, then give up

If someone frequently changes their mind about plans already made and looks for reasons to back out, it is likely that this attitude is driven by anxiety, even if from the outside it might just appear to be a person who is not serious. In fact, the person in question is less avoiding the situation itself and more avoiding the negative emotions that they assume the situation will trigger.

Avoids meeting people, crowded places and generally shies away from the unknown

These behaviours are driven by the same reasons as in the previous point. They try to avoid anxiety, not necessarily the situation itself.

Unexpected tears

When someone bursts into tears, it is not always because of sadness, it is often anxiety that is the real cause. This happens because anxiety makes the amygdala (a region of the brain) hyper-sensitive. And this region of the brain also controls emotions, which can cause sudden and seemingly unwarranted emotional outbursts.

How can anxiety disorder be controlled?

The first step in treating anxiety is to control the symptoms. To put this control into practice, you can take a few steps that will help you better deal with the symptoms that are giving you trouble:

First of all, it is recommended to eliminate the consumption of any energy drinks or foods: tea, coffee, energy drinks, chocolate.

Secondly, changes can be made to your diet and lifestyle so that symptoms are reduced: the best things you can do in this regard are to consult a nutritionist (for nutrition) and to start doing sport, if you are not already doing so.

Thirdly you can learn relaxation exercises or practice meditation or yoga. This will teach you how to control anxiety symptoms when they occur. You can buy a quick fix for treating anxiety symptoms here.

But if you really want to eliminate anxiety, psychotherapy is the answer. Although it may seem like it’s nothing more than learned or out-of-control behaviour, anxiety also originates from events in your life and through psychotherapy all the stresses that cause anxiety can be reduced or even eliminated.

If you feel that these things fit you, don’t put off treatment because, as has been shown by numerous research studies, left untreated anxiety tends to amplify and generalize rather than reduce itself.

Anxiety treatment: can anxiety be cured?

Unfortunately, many people assume that anxiety is untreatable, viewing the disorder as an expression of a fundamental flaw in their personality and, as such, untreatable. Or they have lived with anxiety for so long that they have become accustomed to it. Or, and this is usually part of the problem, they are too afraid to face their own anxiety.

There are studies that have shown that about 70% of anxiety sufferers receive inadequate treatment or no treatment at all. As a result, many suffer from the effects of anxiety for long periods, years or even their whole lives. They may develop related disorders such as alcohol dependence or substance abuse, depression or disability. Untreated, anxiety can be one of the most debilitating conditions a person can suffer from.

There is hope

Anxiety can come with many advantages. Everyone who suffers from anxiety wishes they didn’t have it, but it can also shape a person for the better.

First and foremost, you should know that feeling anxiety does not mean that you have failed or that you have a fundamental flaw. It is just part of the human experience.

An anxious mind is actually a powerful mind, and it proves this whenever it manages to defeat logic and reason. What if you used these resources to your advantage, rather than against you?

Anxiety is the brain’s response that thinks trouble is coming and responds by making the person more alert, stronger and quicker to meet the challenge. But, like all good things, used in excess it can harm.