It is completely normal for people to experience worry or anxiety from time to time. In fact, some worry can actually be useful as it can motivate us to act when otherwise we may not feel internal pressure to make change or take action on a matter. Anxiety, which uses the same physiological system as fear, developed over time as a way for our bodies and mind to let us know if there is a potential threat to our physical or emotional wellbeing. Noticing and responding to anxiety, stress, and worry appropriately can be quite useful in our day-to-day lives.

However, when anxiety happens often and is intense or pervasive, it can be problematic. This is particularly true when we experience anxiety in the absence of a physical or emotional threat. Not only can anxiety interfere with happiness and enjoyment in life, but high levels of anxiety can impede on productivity (at work, school, and home) and create significant disability. Recognizing anxiety and distinguishing it from everyday stress is not always easy. Education about anxiety can help you in determining if what you are experiencing is something that may warrant attention.

Below are a few facts about anxiety that you may not know, but may be useful in learning about anxiety. 

1. Anxiety disorders make up the most prevalent mental health disorders among adults in the United States. Although not as sensationalized as some mental health disorders by the news and other media, anxiety affects more individuals in the US than any other mental health concerns. The National Institute of Mental Health (NIHM) estimates that 40 million American adults are affected with anxiety. While anxiety disorders respond well to treatment, approximately only 1/3 of those suffering from anxiety will seek/obtain effective treatment. Therefore while common, many people dealing with anxiety on an everyday are either not receiving care or not receiving adequate care. Given the staggering number of people experiencing anxiety, it is very likely that you know someone, or you yourself, may be experiencing an anxiety disorder. 

2. Anxiety doesn't look or feel the same for each person. Although there is a set of symptoms, or diagnostic criteria, a person needs to experience to be diagnosed with an anxiety disorder; the expression of the symptoms is not the same for each individual. Moreover, there are different types of anxiety disorders such as Generalized Anxiety Disorder, Posttraumatic Stress Disorder, Obsessive Compulsive Disorder, and phobias to name several. There is a shared set of symptoms consistent amongst these disorders such as uncontrollable worry about something or many things, avoidance of thoughts, situations, and triggers that increase anxiety, and a sense of dread. However, the worry thoughts themselves, the way that any one individual may cope with that worry, and other symptoms may differ between disorder and between different people with the same disorder. Just as what you or I may experience as worrisome will not necessarily affect someone else the same way—for example one coworker avoiding public speaking at all costs and another will welcome the chance to speak in front of others—the way different people experience anxiety varies too. 

3. Anxiety changes the way you think—and the structure of your brain. The way we think, how we perceive our environment, and how we categorize information is all affected by context, including emotions. In the context of anxiety, our brain works very differently than when you are in a calm or more neutral mood. Not only is one more prone to think catastrophically (e.g., believing that the worst possible outcome may happen in a given situation), but we also attend to information differently when anxious. We may actually only be aware of information that confirms our catastrophic belief and be completely unaware of information that would mitigate this belief. In fact, it is not at all uncommon for individuals with anxiety disorders to report memory impairment (and to worry about this as well). The majority of the time, it is not an issue with memory, rather an issue of attention. When a person has very distressing thoughts and worries that take over, all of that person's attention is focused on those worries and they do not attend to other thoughts or situations. If you are so distracted by thoughts that you do not attend or attend well to anything other than your thoughts, important information does not get the opportunity to be remembered.

Over time, the change in the way a person with anxiety thinks can alter neuronal connections, neuronal chemicals and even brain anatomy that actually contribute to increased anxiety. This perpetuates an anxiety cycle where increased anxiety leads to more worry and distress and this distress in turn contributes to disruptions in typical brain functioning. 

4. Genes, environment, personality, and experiences can all influence the development of anxiety. Some people report a lifelong history of anxiety recalling worry-tinged thoughts at even their earliest of memories. Others report having developed anxiety later in life—maybe after a particularly difficult situation or a series of events that changed their way of thinking. Why, when, and how someone develops anxiety is not always clear-cut. It often involves a complex interaction between one's genes and environment, and interaction often referred to as nature and nurture. Contributions from the genes we are born with can interact with experiences and lead to the development of anxiety or act as a buffering agent against the development of anxiety.

Lets take, for example, identical twins who share the same genetic makeup. At birth, the twins would have equal likelihood of developing anxiety or not, based on the specific genes they were born with. However, if those twins are adopted into different homes—one full of caring support and the other an abusive home—the twin in the latter home would be more likely to develop a mental health disorder based on environmental factors. Of course the above example oversimplifies all of the various situations that can contribute to the development of a mental health concern like anxiety including learned coping skills, trauma, personality differences, and resiliency to stressors. That being said, anxiety is not simply a result of someone needing to learn to relax. There are neurological differences in an individual experiencing an anxiety disorder versus an individual who is not experiencing a mental health concern. Whether these differences are from genes, are acquired, or both, treatment for long-term reduction or management of anxiety requires hard work to change or mitigate these differences.                                                            

5. CBT for anxiety disorders can be as effective as medication. For many people, when they begin to experience high levels of anxiety, the first stop is a physician's office. This makes sense, if you feel unwell going to a physician is a likely first step. Often, this leads to a prescription to treat the anxiety and relieve distress. Medication is an incredibly useful tool and often alleviates anxiety quickly for those who take it. Given the presence of today's pharmaceutical companies advertising on television, magazines, and social media most people are aware that medication exists to treat anxiety disorders.

What you may be less aware of is that some therapies are as effective as medication and Cognitive Behavioral Therapy (CBT) is one such treatment. When examining individuals before and after treatment, there is no difference between those treated with medication versus CBT for certain anxiety disorders at the conclusion of treatment. This means that the results look the same between anxiety sufferers there was just a different path to get the same relief from anxiety. However, one major benefit of CBT over medication is that for most individuals when they discontinue medication, the symptoms return. As CBT teaches individuals skills to cope with anxiety, change their way of thinking, and change environments for a healthy life the changes are sustained much longer and in some cases, indefinitely when the skills are used regularly. CBT is also a good choice if a person cannot tolerate medication due to side effects, is unable to take medication (e.g., some medications are contraindicated when pregnant or nursing), or are unwilling to take medication.

For others, medication or therapy alone is not enough and person may chose to take medication and attend therapy for maximum benefit. It is often helpful to speak with a prescribing physician, such a s psychiatrist, as well as a psychologist to develop a plan that is best for you and meets your individual needs if you are considering medication, therapy, or both. 

If you think you may be suffering from an anxiety disorder or worry is negatively impacting you, there is no shortage of available help to aid you in regaining control of your life. Therapy and medication can change the way your brain operates and give you a sense of being back in the driver's seat of your life.

Photo by Steve Halama