Unravelling Anxiety: Understanding Symptoms, Medication, and Social Anxiety

Introduction

In today's fast-paced world, it's not uncommon to experience bouts of anxiety. In fact, while most of us don't like the feeling of anxiety and most people who come to see me are pretty keen for me to help them 'get rid of it', there are some benefits which we don't often pay attention to. But, before we talk about its benefits, what does anxiety look like? Anxiety disorders are among the most common mental health conditions worldwide, affecting millions of individuals. Further, excessive and prolonged anxiety can significantly impact our mental wellbeing.

Criteria for Anxiety Disorders

Anxiety disorders are diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To meet the criteria, individuals must experience excessive worry or fear, which is out of proportion to the actual threat or circumstance. These feelings must persist for at least six months and cause significant distress or impairment in daily functioning.

Common Symptoms of Anxiety

Anxiety disorders present a wide range of symptoms, which can be both physical and psychological. Physically, individuals may experience increased heart rate, shortness of breath, muscle tension, trembling, and gastrointestinal discomfort. In my own experience, it felt like a knot in my stomach, like I was 'on edge', and as though the 'volume dial' on all my symptoms was turned up so loud it was hard to pay attention to anything else. Psychologically, anxiety often manifests as excessive worry (also called 'rumination'), restlessness, irritability, difficulty concentrating, sleep disturbances, and a sense of impending doom.

Medication for Anxiety

Treatment for anxiety disorders often involves a combination of therapy (cognitive behavioural therapy involving exposure is the 'gold standard') and medication. Medications commonly prescribed for anxiety include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and beta-blockers. SSRIs and SNRIs are antidepressants that help regulate neurotransmitters associated with anxiety. Benzodiazepines can provide immediate relief but are usually prescribed for short-term use due to their potential for dependence. Beta-blockers are primarily used to manage physical symptoms of anxiety, such as rapid heartbeat and trembling.

What about Social Anxiety?

There are different forms or 'subtypes' of anxiety and this really just refers to the things that provide triggers for your anxiety. Social anxiety is one such subtype that revolves around intense fear and anxiety triggered in social situations. Those of us who've experienced social anxiety will be familiar with worrying about being judged, embarrassed, or humiliated.

What Social Anxiety Looks Like

Symptoms may include blushing, trembling, sweating, rapid heartbeat, avoiding eye contact, difficulty speaking and struggling to engage in conversations. Social anxiety can significantly impact one's personal and professional life, making it challenging to form relationships or participate in social activities.

Individuals with social anxiety might have difficulty attending parties, giving presentations, or participating in group activities. They may experience an overwhelming fear of judgment or rejection, often leading to self-isolation and a diminished quality of life. In such settings the socially anxious amongst us tend to imagine ourselves performing poorly, and assume the consequences of this will be disastrous, and even worse – word of this will spread like wild fire... We also hold negative beliefs about ourselves and likely fear we will be overwhelmed by anxiety. We might also hold excessively-high performance standards and are generally very concerned about impression management. Some might've experienced problems in one's professional life resulting from avoiding higher roles or positions with perceived greater scrutiny. For others it might've impacting ones’ dating or social life through avoidance of meeting new people.

Conclusion

Anxiety disorders can be debilitating, affecting individuals' overall wellbeing and daily functioning. Recognizing the criteria and symptoms of anxiety is essential in seeking appropriate treatment. While medication can provide temporary relief, it is important to complement it with therapy, such as cognitive-behavioural therapy (CBT), which helps individuals develop coping mechanisms and address underlying issues. Social anxiety, in particular, requires empathy and understanding from friends, family, and society to create inclusive environments that support those affected. By raising awareness and fostering compassion, we can help individuals battling anxiety find solace and reclaim their lives.

Wait, What about those Benefits?

First things first – Anxiety has kept our species alive and we wouldn’t be here today in the form that we are without it. What does that mean? Well, anxiety is part of the ‘fight or flight’ response generated by our sympathetic nervous system. When our ancestors left the safety of their shelter and went hunting and foraging it was imperative that they were alert to danger. That crack of a stick in the bushes? Could mean death. Get ready. Move. Enter, anxiety. Without anxiety in such a situation, in fact replace that anxiety and fear with curiosity and you get certain death. In fact, an early (and in my mind, unethical) study involved removing from ten poor monkeys the part of the brain that regulates fear and anxiety (the amygdala). Those monkeys were then returned to the wild and what happened? Every single one of them died. Because they weren’t afraid – of cracking sticks, angry bears, loud rushing-at-you trucks – of anything. So, back to our ancestors. The ones who weren’t afraid, died. The ones who approached danger with curiosity, died. And we have descended from these folks. We should really thank them.

Ok, so there are no bears and tigers in today’s suburbia, certainly not in Australia. But what might these benefits look like in our modern world? Here are a few advantages of anxiety:

  1. Heightened Awareness and Alertness: Anxiety can increase our alertness and sensitivity to potential threats or dangers in our environment. This heightened state of awareness can help us stay vigilant and respond effectively in situations that require quick thinking or immediate action. The other night I was awoken in the middle of the night by a loud sound. Sat bolt upright in bed, wide awake, ready to act. Then my slower thinking brain caught up and realised the wind outside had knocked my bin over.

  2. Motivation and Drive: In some cases, anxiety can serve as a motivator. When we feel anxious about a particular task or goal, it can push us to work harder, be more focused, and strive for success. The desire to overcome anxiety and prove ourselves can fuel our determination and drive. Anxiety has motivated me to prepare thoroughly for tests, exams, reports, and get essays and assignments in on time. In fact, I probably should thank anxiety for getting me my degrees.

  3. Improved Preparedness: Anxiety often arises from a fear of the unknown or potential negative outcomes. As a result, individuals with anxiety may be more inclined to prepare thoroughly for various situations. This preparedness can enhance their ability to anticipate challenges, plan ahead, and be well-prepared for potential obstacles. Anxiety motivated me to prepare for a long trip in my van around Australia. Imagining some of the things that could go wrong assisted me to pack safety equipment, install a CB radio, research mobile phone coverage etc. It probably got me to most of my job interviews on time.

  4. Heightened Empathy and Sensitivity: Individuals who have experienced anxiety themselves may be more empathetic and understanding towards others facing similar struggles. Their own experiences can enable them to relate to others' emotional states, offering support and compassion. I regularly connect with people I work with through a shared understanding and experience of the difficulty and ‘ickiness’ of anxiety.

  5. Enhanced Problem-Solving Skills: Anxiety can trigger a hyper-vigilant mindset, leading individuals to consider multiple scenarios and potential solutions to perceived problems. This analytical thinking can contribute to the development of strong problem-solving skills, as individuals actively seek ways to mitigate their anxieties.

  6. Increased Self-Awareness: Dealing with anxiety often involves introspection and self-reflection. Through this process, individuals can gain a deeper understanding of their own emotions, triggers, and thought patterns. This heightened self-awareness can aid in personal growth, fostering a greater sense of self-acceptance and resilience.

  7. Adaptive Survival Response: Anxiety is an inherent part of the human fight-or-flight response as already mentioned. This has played a crucial role in our survival as a species. Anxiety can activate this response, preparing our bodies to react to potential threats. While excessive anxiety can be detrimental, in moderate amounts, it can help keep us safe and out of harm's way. RIP, poor monkeys.

Obviously, these advantages of anxiety should not overshadow the challenges and negative impact it can have on your wellbeing. If anxiety becomes overwhelming or interferes with your daily life, seeking professional help from mental health experts is crucial for effective management and support. I have tools and proven methods to help you dial that anxiety down.

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