Anxiety Isn’t a Disorder
According to recent statistics, a large number of Americans will experience an anxiety disorder at some point in their life. It seems like many friends, family members, and coworkers are reporting higher overall levels of anxiety over the past few years. So what’s the difference between having anxiety and having a “disorder”?
Anxiety can be described as a mostly cognitive process (running through possible “what if” scenarios in your mind), though it is often accompanied by changes in the body (such as tension, rapid heart rate, or changes in temperature or breathing). The main function of anxiety is that it helps us to foresee potential problems, plan out effective solutions, and prepare for challenges. It is a healthy and necessary (albeit uncomfortable) state for us humans. Without it, we would never foresee real danger - we would show up to job interviews in our pajamas, and we would fail college exams, we would never make it to our flight on time. In this sense, anxiety is both healthy and helpful (though occasionally uncomfortable) and ultimately helps us perform.
On more of a “survival” note, without healthy anxiety, we would never be able to learn about things that keep us safe in modern life such as looking both ways before crossing the street. In other words, without healthy anxiety, we’d walk into traffic and then find ourselves panicking the moment we are about to be hit by a car (entirely by surprise). In that situation, fear might still mobilize your body fast enough to jump out of the way, but one thing is for certain - we’d be having a lot more near death experiences if not for healthy anxiety.
At Let’s Talk! Counseling and Services, we offer therapy in Orlando and online throughout Florida that can help you determine if what you’re experiencing may be an anxiety disorder. If you find yourself worrying and avoiding things in ways that seem to be making your life smaller, we can help. If you had no idea anxiety could be a good thing, read on.
Healthy anxiety includes thinking ahead, running through potential problems and “what if” scenarios, and feeling anxious, jumpy, or nervous when:
You are doing something new for the first time (e.g. your first day starting a new job, your first time learning to drive, or your first time buying your own car)
You are doing something that proves to be difficult and challenges your sense of competence (e.g. learning to speak Spanish and practicing with a native speaker, taking organic chemistry, or learning to play the guitar)
You are in a new social group of some kind (e.g. the first week of class, attending a networking event, or going to a wedding as a “plus one”)
You are doing something you do not do often (e.g. flying when you haven’t flown in over two years, driving yourself around if you live somewhere you mostly take public transit, or filling in for a coworker even though you used to do that job yourself)
You are doing something in which you are concerned about others’ perceptions of you and want to perform well (e.g. giving a presentation to the bigwat work, going on a job interview, meeting your future in-laws)
You become aware that a potential problem is coming but has not yet arrived (e.g. you do not have the money to pay rent and it is due it 3 weeks, you get a notice from HR that your position will be terminated in one month, you are on academic probation and if you don’t get your grades up you’ll be kicked out next semester)
Something which was previously planned, certain, or understood becomes altered, uncertain, or unknown (e.g. your partner says maybe she doesn’t want to have children after all like you’d previously agreed to, you get a notice that your job is going to be making cuts to your department but you’re not sure if that includes you, the schedule gets changed last minute at an event you’re supposed to present at, or a friend doesn’t show up for a movie night like you planned)
An anxiety disorder is an entirely different beast. There are many different types of anxiety disorders. Some of the ones that we see the most often include:
Generalized Anxiety Disorder (What if I can’t stop worrying about “what if” scenarios?)
Panic Disorder (What if I have a panic attack?)
Illness Anxiety Disorder (What if I’m really sick and I don’t know it?)
Social Anxiety Disorder (What if I embarrass myself?)
Having an anxiety disorder is different from just feeling anxious. Here are some of the common things we see among clients with anxiety disorders:
1) They have an intense desire to feel certain about something (or everything). We typically feel uncertain about new things, unfamiliar things, and potentially risky things. People with anxiety disorders, however, often feel they can’t tolerate normal feelings of uncertainty. They want to know for sure… like for sure, for sure. They want a guarantee that there isn’t even the slightest chance of the situation they fear coming to pass.
For example, we all know people get into car accidents. It’s a sad and unfortunate fact of living in the modern world. Regardless, we continue to drive to work, to pick up our kids from school, and to run errands on the weekends. In other words, we do all this driving knowing that it’s entirely possible (no matter how small the odds) that we will be in a car accident at some point while driving to and fro. In other words, we accept this uncertainty and let the thought fade mostly to the back of our minds.
For someone with an anxiety disorder, however, this same uncertainty stays front and center. They want a guarantee that it’s safe and no harm will come to them before they’re willing to get behind the wheel. Without that, they ruminate about the possibility of getting into an accident. Even if the odds of something bad happening are 1 in 5,000, they would rather “be safe than sorry.” The irony here is that people with anxiety disorders feel perpetually unsafe, especially compared to people who are able to accept a degree of uncertainty in order to go about living their lives. Moral of the story, the more risk you can accept as a natural part of living a full life, the safer you’re likely to feel.
2) They behave in certain ways with the (misguided) hope of feeling less anxious. We all avoid doing things we don’t like sometimes. We all occasionally put off doing things that make us uncomfortable. Avoidance behavior that usually accompanies an anxiety disorder is a whole other level of avoidance.
People with anxiety disorders will often avoid being in situations that remind them of the things they worry about. Continuing our previous example, if a woman is worried about possibly getting into a car accident, she may avoid driving. That may seem obvious, but it usually goes beyond that. She might change the channel when a car commercial comes on that lists safety ratings. She may dip out of conversations if someone starts talking about an accident. She may change the radio or tv if the news mentions an accident on I4 as part of the traffic report. She may stop talking to a friend who was in an accident for fear of having to hear about it. She may avoid saying the word accident at all and simply strike it from her vocabulary. She may come to believe that repeating certain numbers in her head or only riding in red cars will prevent her from being involved in an accident. She might ask her partner repeatedly if it’s safe to get in the car with a friend for a planned outing. You get the idea. Anxiety disorders almost always lead to some type of avoidance behavior. The irony with this one is that most of these behaviors actually make anxiety worse over time, not better.
3) Their anxiety and avoidance behaviors significantly impact their ability to function in a major way. The hardest hit areas of life include relationships, school or work performance, and daily tasks of life.
Impacts on Relationships
For someone with an anxiety disorder, we almost always find that their relationships (or lack thereof) are directly impacted by their anxious thoughts and coping behaviors. They may have an almost non-existent social life if their anxieties involve interacting with other people. Examples include anxiety around a fear of embarrassing themselves (such as with social phobia) or fears of losing loved ones to catastrophic accidents (such as with generalized anxiety).
Other impacts on relationships often come in the form of giving loved ones an active role in maintaining their anxiety. Yes, you read that right. Most people with anxiety disorders will involve partners and close family members in safety and avoidance behaviors that only serve to keep their anxiety going. Examples include things like providing excessive reassurance or doing things (such as driving or making phone calls) so that your partner can continue avoiding the situations that make them anxious.
Impacts on Work or School Performance
A little bit of anxiety is actually necessary for peak performance in all things, but most commonly in work or school settings. It’s just enough to make you think faster, move with more precision, and have a little bit of edge when taking on a challenge. Too much anxiety, however, can have the opposite effect. We usually see this either in the form of physiological anxiety symptoms that come up during performance situations or with avoidance behaviors.
Physiological symptoms such as increased heart rate, breathing changes, and lightheadedness can make it difficult to focus and perform in situations such as test taking, public speaking, or physical tasks. These symptoms can redirect vital attention away from the task at hand (which obviously makes the task harder) and back toward yourself (which only makes the symptoms get worse). This usually creates a vicious loop.
Avoidance behaviors can also be so severe they take a major toll. For example, you might avoid speaking up at work to ask for information you need to complete a project (leading to poor performance because you weren’t exactly sure what your boss wanted from you). You may avoid doing work until the last minute if you’re worried you might mess it up, or find yourself turning things in late if you had to check and recheck it a hundred times first.
Impacts on Daily Life Tasks
Tasks of daily life, however, is where an anxiety disorder really sets itself apart from uncomfortable but totally normal levels of anxiety. For example, many people feel a tiny bit anxious before making a phone call because the anxiety helps us to prepare what we need to say or ask while on the call in order to accomplish a specific task or resolve a problem. For someone with an anxiety disorder, however, they may avoid making phone calls at all which can make it difficult to sort out potential problems (i.e. handling appointments, banking, and insurance issues to name a few). In addition to phone calls, people with anxiety disorders often avoid common everyday activities that many of us take for granted such as driving, going into grocery stores or restaurants, or working.
My hope with this article is that we can begin to normalize healthy anxiety for what it is - an alert system that helps us to perform and prepare. I have noticed a growing trend of pathologizing even healthy uncomfortable emotions such as healthy anxiety and/or trying to medicate it away. A certain amount of uncomfortable emotions are unfortunately a necessary part of life and actually help us to function better when we don’t try to snuff them out. In other words, trying to stop feeling anxious or avoid feeling anxious is actually likely to lead to feeling way more anxious, way more often. If you need help working with your anxiety, we offer therapy in Orlando and online throughout Florida to help with anxiety disorders. We’d be glad to help!
We can help.
If you or someone you love is struggling with anxiety, please reach out. We offer anxiety treatment with CBT Therapists in Orlando and online throughout the state of Florida. Call today or send us your info and we’ll reach out for a free consultation to see if one of our therapists would be a good fit.
