What is anxiety?

Anxiety is a normal emotion hardwired in human beings with a specific purpose: to warn us of imminent threats or danger in the environment. This means that anxiety is absolutely necessary for our survival, so wanting a completely anxiety-free life is an unrealistic expectation. Feeling nervous before an exam or public speaking is natural, and the majority of us will feel apprehensive before giving a presentation, going on a date or having a job interview. In fact, this level of anxiety is a natural motivator to keep us active and functioning.

Anxiety may become a disorder when the fear experienced is out of proportion, ends up causing major distress or discomfort, or limits our life in social, academic and work areas. The main difference between an anxiety disorder and normal levels of anxiety is the intensity, the duration and the persistence of that feeling of dread.

It helps to understand when anxiety becomes a problem if we observe it as an alarm system. Our internal “alarm system” is referred to as the fight, flight or freeze response, an important hardwired system that works to keep us safe from danger, similar to a house alarm used to protect us against potential intruders. But suppose your house alarm goes off constantly with a shrilling siren because a squirrel runs across your backyard or a leaf falls from a tree? Unhelpful anxiety occurs when our alarm system’s response to a perceived threat is disproportionate or persistent.

Fear and anxiety

Anxiety and fear are not the same. If we fear a specific object or situation and we perceive it as threatening or dangerous, we might say “I’m fearful of snakes. They can bite and they’re poisonous.” We fear snakes in the presence of them. Anxiety is future oriented and fueled by the worrying thought of “What if...?” For example, we’re invited to spend a weekend at a friend’s cabin and we decline the invitation because “What if there are snakes in the surroundings? ”or we avoid a TV show because “What if there’s an image of a snake?” Anxiety anticipates a dreadful situation and our mind can create endless alarming scenarios, such as “What if I forget what to say?” or “What if I look silly?” or “What if something bad happens?”

Symptoms of anxiety

Anxiety can produce a variety of physical, cognitive, behavioural and emotional symptoms.

Physical: Dizziness, shortness of breath, accelerated heart rate, restlessness, increased sweat, sleep disturbance, dry mouth, digestive problems and the feeling of butterflies in the stomach.

Cognitive: Constant worry, catastrophizing, “what if” thinking, images of dreadful threats, poor concentration and intense thoughts of helplessness. We exaggerate the level of threat (“OMG, the worst is coming!”) and we minimize our ability to manage the problem (“I can’t deal with this.”)

Behavioural: Avoidance of what we fear and procrastination, which decreases the discomfort of anxiety in the moment but contributes to increase anxiety in the long run. We also use safety behaviours, preparing ourselves if anxiety hits, such as “I’ll bring a bottle of water with me, just in case I feel anxiety and my mouth is dry.”

Emotional: Fear, dread, alarm, tension or feeling on edge.

Coping, managing and treating anxiety

The following are evidence-based approaches to treating anxiety:

‍Cognitive Behavioural Therapy (CBT) can help us reduce inaccurate thoughts by learning to capture the negative automatic responses to anxiety (for example, the “what if” or catastrophic thoughts), and replace them with more realistic ways of thinking.  

Exposure therapy, a CBT method, is successful in treating avoidance by exposure to the difficult situations that we are avoiding avoiding. By gradually increasing the exposure to what we fear, we discover it’s not dangerous and we increase our ability to cope.

Distress tolerance and self-regulation skills can be very helpful. Learning these techniques helps to increase our tolerance to the discomfort of anxiety. By increasing our tolerance for anxious feelings, we are more easily able to calm and settle, and we are able to regain some of the control we may feel we have lost to anxiety. Some helpful self-regulation skills are:

• Breathing deeply and from the abdomen. Watch Your Wellness Moment on breathing techniques to learn how to breathe deeply to reduce stress.
• Self-soothing: Calming ourselves by taking a warm shower, reading an inspirational phrase, listening to serene music or picturing in our mind a place, person or colour we like.
• Grounding: Instead of focusing on our internal thoughts and feelings, we pay attention to external elements surrounding us and we use our five senses (e.g., holding a cube of ice with our hands, eating something slowly and describing the sensation, naming things we see around us).
• Mindfulness: Being here and now, in the moment, as opposed to “what if” thinking.
• Meditation: Brings a sense of awareness and teaches us to let go of automatic judgmental thoughts.
• ‍Self-compassion is a practice that helps us accept ourselves, including our imperfections and limitations. It can build self-confidence and resilience by learning to embrace who we are, and speaking to ourselves with warmth and kindness as if we were talking to a friend.

Learning to overcome anxiety every day

• Find flexibility in your way of thinking. A mistake isn’t the end of the world.
• Learn not to avoid what you fear; facing fears teaches us we’re capable of dealing with them.
• Identify inaccurate thoughts.
• Be kind to yourself by using non-judgmental self-talk and lowering unattainable standards.
• Create a new habit of self-care by practicing daily physical activity, such as dance or yoga.
• Invest time in social relationships with people you feel safe with and care about.
• Reach out for help if you think you need it.
• And most importantly: believe in change and in yourself!

Remember: We don’t get less afraid; we become more courageous.