“All of a sudden it was like I forgot how to breathe!” *Stephanie recounted. “My chest was really tight and then I began to hyperventilate. I felt weak and my hands began to sweat like crazy! I had no idea that seeing him would make me feel that way after all this time.” She was rehashing the panic attack she experienced when she saw her estranged husband for the first time since he left her. What Stephanie described in terms of symptoms, is quite common when dealing with Anxiety. But what exactly is anxiety? Is an anxiety attack and a panic attack the same? Or are they completely different?
What is Anxiety?
Anxiety is defined as “an emotion characterized by tension, worried thoughts, and physical changes like increased blood pressure” as per the American Psychological Association’s (APA) website (www.apa.org). Sweating, trembling and dizziness are also some of the physical symptoms associated with anxiety. Psychology Today describes it as a more natural response stating, “Anxiety is both a mental and physical state of negative expectation. Mentally it is characterized by increased arousal and apprehension tortured into distressing worry, and physically by unpleasant activation of multiple body systems—all to facilitate response to an unknown danger, whether real or imagined. The cognitive feelings of dread in anticipation of some bad outcome and physical sensations such as jitteriness and a racing heart are designed for discomfort. Anxiety is meant to capture attention and stimulate you to make necessary changes to protect what you care about.”
Anxiety as a Disorder
So, if anxiety can be described as a survival mechanism of sorts, then why can it leave us in a debilitated state? This is what happens when anxiety becomes a disorder. Occasional periods of anxiety are natural and can even fuel productivity. When it becomes all-consuming and pervasive, however, anxiety then has the power to disrupt our everyday lives and functioning. When this occurs, and the anxiety is disproportionate to a situation or not age-appropriate, then it can be diagnosed as a disorder.
Anxiety is so common, that the American Psychiatric Association has stated that anxiety disorders are the most common of mental disorders and “affect nearly 30 per cent of adults at some point in their lives” (www.psychiatry.org). Wow! That means if you have a get together (current covid-19 protocols observed); 3 out of the 10 people in your gathering could be suffering from an anxiety disorder! Women are also twice as likely as men to experience symptoms of anxiety. Unfortunately, there isn’t much research on anxiety and anxiety disorders in the Caribbean, but as a practitioner, I can safely say that it is becoming more prevalent and/or persons are simply more open with their mental health struggles.
Types of Anxiety Disorders
There are several types of anxiety disorders:
- Generalized Anxiety Disorder (GAD)– involves “persistent and excessive worry that interferes with daily activities.” (psychiatry.org). This should occur for most days over a 6 month period for diagnosis. The fear, worry and anxiety usually revolve around things such as “personal health, work, social interactions, and everyday routine life circumstances” (www.nimh.nih.gov); and can result in a disruption in significant areas in life. Symptoms include feeling easily fatigued, uncontrollable feelings of worry, difficulty sleeping and being irritable, to name a few.
- Panic Disorder– involves unexpected, recurrent panic attacks. Symptoms tend to closely resemble those of a heart attack or respiratory disorder, such as heart palpitations, chest pains and difficulty breathing. These are usually accompanied by feelings of impending doom and a fear of dying.
- Phobias/Specific Phobia– A phobia is an intense fear of an object or situation that is generally not harmful. This fear tends to be excessive and usually not within the person’s control. Persons with phobias also tend to go to great lengths to avoid the situation and experience great degrees of stress, fear and worry should they encounter the object or situation. Examples of Specific Phobias include fear of flying, heights and lizards.
- Agoraphobia– Fear of being in a situation where escape may be difficult or embarrassing. People with this fear tend to avoid open and enclosed spaces, public transportation, standing in a line or being in a crowd; and being outside of the home alone. In its severest forms, these persons can become housebound. There is an active avoidance of the situation or a companion is required.
- Social Anxiety Disorder– Persons with this disorder experience great distress at the prospect of being humiliated or rejected in social situations. They feel their actions will be negatively evaluated, and as a result, avoid social activities. Examples of this include public speaking or meeting new people.
- Separation Anxiety Disorder– These persons have intense fears about being separated from those to whom they are attached/love and care about. Fears include the other being harmed or dying while they are separated. As a result, they usually do not want to be without the other person. This can begin in childhood and carry through to adulthood.
What’s the Difference Between Anxiety and Panic Attacks?
Although these two terms are used interchangeably and they do share some symptoms; they are actually different. An anxiety attack occurs usually as a result of feelings of excessive worry/anxiety about a specific object/situation that has grown over a period of time. The stress can then manifest as an attack, once it becomes overwhelming to the individual. Anxiety symptoms can be continual and long-lasting e.g. muscle tension, disturbed sleep, difficulty concentrating, irritability, etc.
A panic attack occurs quite suddenly and intensely; sometimes without any trigger and other times as a reaction to a known stressor, such as a phobia. These episodes usually last about 5-20 minutes, generally peaking within 10 minutes; but can last longer or have multiple episodes occur in quick progression. Symptoms include heart palpitations, nausea, dizziness, fear of dying, feeling detached from reality, etc.)
In both cases, there are mental and physical symptoms.
Treatment
Psychotherapy or “talk” therapy has proven very effective in treating anxiety. Cognitive Behavioral Therapy (CBT) helps people with different ways of thinking about and reacting to situations/objects that can be anxiety-inducing. Medication is also helpful in relieving physical symptoms.
*Name has been changed
