Around 1 in 4 people in the UK experience a mental health problem each year. 1 in 6 report symptoms of common mental health issues such as anxiety each week. I, myself, have suffered with anxiety in the past. Although this is something I have largely overcome, it is still ingrained within me. There is much stigma surrounding mental health, despite the growing knowledge of it in recent years, 90% of those with mental health problems report experiencing stigma. Today I would like to raise awareness, educate and correct those stigmas.
Understanding Anxiety
Let’s first look at what anxiety is. Anxiety can be likened to the feeling of fear. However, you may feel fear if you see a spider in the bathroom (me!) whereas anxiety is a less intense, prolonged physiological response. All of us feel anxious at some point or another, but this is very different from an anxiety disorder. An anxiety disorder is when the anxiety impacts your life, and you struggle to go about day-to-day tasks because of it. Anxiety symptoms can include difficulty breathing, irregular heartbeat, feelings of unreality, and many more. However, what anxiety involves is different for everyone. There are many different types of anxiety, but we’ll focus on the main 5:
1. Specific Phobia: When someone experiences anxiety symptoms, in response to a specific stimulus.
2. Social Anxiety Disorder: An extreme fear of social situations. This is not the same as being shy; this is a crippling condition which renders the individual filled with anxiety and panic.
3. Panic Disorder: Someone with Panic Disorder will frequently experience panic attacks. Panic attacks are associated with chest pain, racing heart and a feeling that you are going to die. They are horrific to experience and, those with Panic Disorder, are often in constant anxiety of experiencing another panic attack, due to their unexpectedness.
4. Agoraphobia: Someone with Agoraphobia will avoid public places, where escape may be difficult (for example on a train). Agoraphobia is often associated with Panic Disorder, as many with Agoraphobia also experience persistent panic attacks, when in a triggering enclosed public space.
5. Generalised Anxiety Disorder (GAD): GAD, by nature, is less specific in what triggers it. Those with GAD will experience anxiety all the time and will worry excessively about every-day things. Though they may recognise this worry to be unrealistic, they cannot stop it.
The most common treatments for anxiety include Cognitive Behavioural Therapy (CBT) (which we visited a few weeks ago) and Graded Exposure. CBT attempts to break the cycle of anxiety by changing negative thoughts, which in turn alter behaviour. Graded Exposure is more intense and effectively gets the person to face their fear (this isn’t necessarily as effective with GAD, as there is no specific trigger). As we will find out, the physiological response to anxiety can only persist for a relatively short time. Therefore, once the adrenaline begins to decline, the person can form new, positive associations with the situation, rather than mask them through avoidance behaviours.
The feeling of anxiousness itself is caused by the fight or flight response. The purpose of this response is to protect the body when a threat is perceived (like when I see a spider in the bathroom). When we perceive a threat, a signal is sent to the nerves in our body. One section of the nervous system is called the autonomic nervous system (ANS). This is split up into the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS releases chemicals called adrenalin and noradrenalin from the adrenal glands in the kidneys. This often results in aggression (fight) or the urge to escape (flight). This cycle can only stop in two ways: either, the chemicals eventually decay, or the PNS comes into play, which has a more calming effect (a bit like good cop; bad cop!). Many can still feel anxious even after these effects have reduced, as adrenaline and noradrenaline take a while to break down in the system. As the intention of the fight or flight response is to alert your attention to threat, this makes it difficult to concentrate on anything else. When there is no immediate threat, this causes you to look inward and get more anxious, as you may believe there is something wrong with you (this isn’t the case). These feelings of anxiousness can sometimes result in a panic attack. This is not something over which people have control, therefore, if you do have a friend or family member with anxiety, you should never blame them for feeling this way; it isn’t as easily prevented as you might assume.
What Causes Anxiety?
It is thought that those with an anxiety disorder, perceive the world differently from others. Perception can be thought of as how we experience the world. For example, when we see something, put simply, the image is projected into the eye, which gets turned into a neural signal, and goes to areas of the brain to tell us what it is that we saw. However, perception can be very different from reality; think of optical illusions! Offir Laufer and others found that those with anxiety disorders tend to overgeneralise dangerous situations. For example, if I experienced a stressful situation with a spider, I may overgeneralise this fear and become anxious that I may have another experience like this (very oversimplified, but this is the idea). They found that areas of the brain called the dorsal anterior cingulate cortex (dACC) and the putamen, became more active during activities of loss and gain. This means that someone anxiety disorder may overgeneralise experiences, to infer that an event may occur in another instance (like my spider situation). This means that telling someone with an anxiety disorder that they’re overreacting, is not a very good way of helping them.
Myth Busting
When I was younger, I used to watch a programme called ‘Myth Busters’. On Myth Busters, they used to ‘debunk’ myths using science. Despite mental health being better understood now, many still believe misconceptions when it comes to anxiety. Let’s do some myth busting with regards to anxiety!
1. People with anxiety can just snap out of it. In a word, no. If it is the case that someone perceives the world fundamentally differently to you, it wouldn’t make sense if they could just turn it off. Trust me, if they could, they would!
2. If you feel anxious, have a drink! Some people believe that having a drink will make the person feel more relaxed. In some cases, this might be true, however this is not true for all people. The feeling of relaxation actually comes from the belief that your anxiety may be reduced. There is no evidence to suggest that alcohol reduces anxiety itself. So, don’t tell your anxious friend that they just need a drink! Alcohol can have different effects on different people (a bit like if you’re an angry drunk or an upset drunk). You should not assume that alcohol may reduce someone’s anxiety because that isn’t the case.
3. People with anxiety just worry too much. Anxiety disorder is very different to just worrying. Many people worry a lot, but that doesn’t mean that they have an anxiety disorder and vice versa. Worrying too much doesn’t have a massive impact on your day-to-day life; anxiety disorder does.
4. If you have an anxiety disorder, you should avoid the things which make you feel anxious. Not true. As I said before, certain types of anxiety disorder can lead to avoidance behaviours. This is because those with anxiety disorder want to avoid the thing which is making them feel this way (very understandable, given how awful anxiety can be). For example, if someone had social anxiety disorder, this may lead them to avoid seeing their friends. However, this actually reinforces the notion that social avoidance helps, and prevents the person from gaining disconfirming evidence. Treatments such as CBT, Graded Exposure and others are better coping mechanisms. Having said this, if you do experience your friend distancing themselves, this doesn’t mean you should tell them what to do; you don’t know what they’re going through. It can be tough if your friend keeps cancelling but try to support them as much as you can.
I hope this blog post has taught you a little more about what anxiety is and what it is not. By educating people, we can get closer to a more accepting society with regards to mental health. If you or someone you know is suffering with anxiety, I have included a few helpful links below. Don’t forget to subscribe on the homepage to keep up to date with my future posts. Happy learning!
Overcoming Anxiety: A Self-Help Guide Using Cognitive Behavioural Techniques Kennerley, H. (2014).
Can I tell you about Anxiety?: A guide for friends, family and professionals by Willetts, L., Waite, P. and Tay, K. (2014).