Anxiety in Adults
Do you find that that many of the following apply to you...
- I am often startled by the smallest thing
- I worry that something terrible will happen to me or others
- I am easily irritable
- I get sudden fears of dying or doing something out of control
- I often worry that something has not been done correctly even though I know I completed the task properly
- I am extremely worried about disease (e.g. germs, infections, dirt, dust, contaminates, cleanliness)
- I need constant reassurance
- I often find myself doing things repeatedly (e.g. hand washing, showering, tooth brushing)
It can drive us to be creative under pressure, warn us of danger or spur us to take action in the face of a crisis. It can also freeze us in our tracks. Like it or not, anxiety is an intense state that we all experience from time to time.
Anxiety affects us physically, emotionally and in all aspects of our life situations. Normally, it plays an important role in survival. When we encounter a threatening situation, our bodies prepare for danger by producing more adrenaline and increasing the blood flow and heart rate, among other things. This instinctive "fight or flight" response can help a person survive a physical attack or an earthquake, for example.
Nevertheless, most modern "dangers" such as unemployment are not ones a person can fight with their fists or run away from. With no outlet for release, the body may remain in a state of constant mental and physical alertness that can be extremely draining over the long term.
When anxiety persists for weeks and months, when it develops into a relentless sense of dread or starts to interfere with a person's daily life, then anxiety has moved beyond the realm of ordinary anxiety. When a person has this degree of anxiety, outside help can be required to feel safe again.
Emotionally, people with anxiety may feel apprehensive, irritable, or constantly afraid that bad things will happen to them and people close to them. Depending on its intensity, anxiety can make people feel trapped in their homes, too frightened to even open the door.
Anxiety is the most common mental health condition, and affects about 12% of the population in Western countries in any given year.
A number of different factors can increase the risk of developing an anxiety disorder including past experiences, learned behaviours (e.g. avoidant coping style) and a genetic predisposition, to name a few. There is not one single cause and it is usually a combination of these types of risk factors that lead to the onset of an anxiety disorder for any one individual.
1. Panic Attacks
- Panic attacks involve a sudden onset of intense apprehension, fear and terror, as well as feelings of impending doom. These attacks may cause shortness of breath, rapid heartbeat, trembling and shaking, a feeling of disconnectedness from reality and even a fear of dying. Though they last only a short time, panic attacks are frightening experiences that may increase in frequency if left untreated.
- People with phobias have overwhelming feelings of terror or panic when confronted with a feared object, situation or activity. It is interesting to note that we probably evolved to have many of these phobias because having 'just enough' of them probably helped with human survival in the early days. For example, having a fear of spiders and snakes would be healthy because it probably helped our ancestors avoid dangerous, poisonous spiders and snakes.
Types of phobias include:
- Claustrophobia (Fear of enclosed spaces)
- Aviophobia (Fear of flying)
- Arachnophobia (Fear of spiders)
- Ophiophobia (Fear of snakes)
- Agoraphobia (fear of crowded places): individuals with agoraphobia feel terrified of being in crowded situations or public places, or any situation where help is not immediately available. Their anxiety may become so intense that they fear they will faint, have a heart attack or lose control. These people often avoid any situation in which escape may be difficult (e.g., in an airplane), impossible or embarrassing. In some cases, people with agoraphobia may become house-bound for years.
3. Obsessive Compulsive Disorder (OCD)
- OCD is a condition where individuals have obsessions and/or compulsions.
- Obsessions are recurrent, unpleasant thoughts (such as "I am dirty"), which leads to a behaviour (such as repeated handwashing) as a way to reduce the anxiety of the obsession. Washing one's hands provides a momentary respite from the anxiety of the obsessive thought, but since the relief is usually short-lived, the compulsive behaviour is often repeated over and over. People caught in this cycle may wash their hands repeatedly until the skin is rubbed raw.
- Common obsessions include: recurring thoughts of specific images, numbers or words.
- Common compulsions include repeatedly checking that a door is locked or that a stove is switched off.
4. Post-Traumatic Stress Disorder (PTSD)
- Some people who have survived a severe and often violent physical or mental trauma may have a sense of reliving the trauma many years later. They may develop post-traumatic stress disorder, which involves re-experiencing traumatic events such as a car crash, rape or a life-threatening robbery through nightmares, night terrors or flashbacks.
- Among the symptoms of post-traumatic stress disorder are numbing one's self emotionally, experiencing an overall sense of anxiety and dread or feeling plagued by guilt about one's own survival. War veterans are particularly vulnerable to this form of anxiety which can affect one's memory and ability to concentrate and sleep
The good news is that there are many things that can be done about anxiety. There are many self-help strategies can be used to help oneself cope with anxiety.
Get enough sleep. Lack of sleep can contribute to anxiety problems, because lack of sleep is a stress on your body. Try your best to get at least 8-10 hours of sleep.
Eat a healthy diet. Try your best to eat a healthy diet, because studies show that diets rich in processed foods or fast foods can contribute to mood and anxiety problems.
Get enough exercise. Throughout most of human history, human beings moved throughout most of the day. In our modern society, we are largely sedentary, which is out of balance with the original conditions we evolved under. Try your best to walk or stand whenever possible, rather than sit. Try your best to get at least 30-60 minutes a day of walking or other exercise.
Learn to meditate and practice mindfulness. The practice of mindfulness, which is learning how to focus your mind on the present, and clear out distracting, anxiety provoking thoughts, has been proven to be a powerful intervention for anxiety. Learn yoga and how to breathe and meditate.
Learn about cognitive behaviour strategies for anxiety such as:
- Identify the worry thoughts that make you anxious. Replace those worry thoughts with more helpful thoughts.
- Expose yourself gradually to feared situations.
If your anxiety does not improve on its own, then the good news is that there are various professionals that can help with your anxiety.
Start by seeing your family physician, who can help make sure that there aren't any medical conditions contributing to your anxiety.
Your family physician may be able to provide counseling/therapy for anxiety, and/or refer you to someone who can, such as a psychologist, social worker, or certified counselor/therapist.
Cognitive-behavioural therapy: Many people benefit from cognitive-behavioural therapy (CBT) which is based on the idea that people can alter their emotions and even improve their symptoms by re-evaluating their attitudes, thought patterns and interpretations of events. An effective treatment plan may also include medication, self-help groups, and relaxation techniques. Also beneficial is education about the nature of anxiety, its effects on the body and the role it can play as part of a healthy survival instinct. With time, most people can learn to identify the early signs of a fear episode and manage their symptoms before they develop into full-blown anxiety.
- Medications: In certain cases, medications, prescribed by a physician, may also be very helpful for anxiety.
- BC Medical Association. (2004). Stress: Straight talk from your doctor. www.bcma.org/public/patient_advocacy/patient_pamphlets/stress.htm
- Health Canada. (2002). Anxiety disorders. In A report on mental illnesses in Canada. (Chap. 4). www.phac-aspc.gc.ca/publicat/miic-mmac/index.html
- Institute for Healthcare Communication. PREPARE to be partners in your health care: Six steps to help you get more out of your doctor's visit. www.healthcarecomm.org/index.php?sec=courses&sub=special&course=1
- Sareen, J., Cox, B.J., Afifi, T.O. et al. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: A population-based longitudinal study of adults. Archives of General Psychiatry, 62, 1249-1257.
Adapted from Here to Help BC http://www.heretohelp.bc.ca/publications/factsheets/anxiety
Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.
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Date of Last Revision: Oct 8, 2016