conley6.gif (2529 bytes)


Worry wart
When worrying morphs into anxiety, and when to seek professional help


March 2016

It happens to the best of us: you’re lying in bed, trying to get some sleep, when your mind starts racing. Am I prepared for tomorrow’s work presentation? Did the kids finish their homework? Will I be able to pay all my bills? What if I lose my job? What if my parents fall ill? What if I do?

In a world that seemingly never sleeps, it’s easy to get lost in a sea of worry. After all, we’re only human. But if you find yourself tossing and turning more often than not, or experience the same rash of fears throughout the daytime, it may be more than just a case of rattled nerves. It might be anxiety.

Anxiety disorders are the most common mental illness facing Americans today, affecting more than 40 million adults, or roughly 14 percent of the population, according to the National Institute of Mental Health. The most common types of anxiety include generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder, social anxiety and posttraumatic stress disorder (PTSD).

In an effort to better understand each type of anxiety, we went straight to a nationally credible source — the Anxiety and Depression Association of America. Signs and symptoms for each are outlined below.

General anxiety disorder: Individuals who suffer from GAD "expect the worst" and experience excessive anxiety and worry, even when there isn’t an apparent reason for concern. Symptoms include fatigue, feeling on edge, difficulty concentrating and trouble sleeping.

Obsessive compulsive disorder: People with OCD suffer from unwanted and intrusive thoughts ("Did I lock the door?"), often compelling them to repeatedly perform ritualistic behaviors and routines (repeatedly checking that the door is locked). They are typically aware of these irrationalities, but often feel powerless to stop them.

Panic disorder: Panic disorder is diagnosed in people who experience out-of-the-blue panic attacks and who live in fear of recurring attacks. Panic attack symptoms can feel very scary and may include palpitations, a pounding heart, sweating, feelings of choking, shortness of breath or a fear of dying, leading many people with the disorder to visit the ER.

Social anxiety: Are you afraid of being judged? More than 15 million adults with social anxiety disorder have an extreme fear of being scrutinized in social or performance situations. Often mistaken for "shyness," symptoms may be so extreme that people avoid social environments or relationships, making them feel alone, powerless or ashamed.

Post-traumatic stress disorder (PTSD): People who have witnessed or experienced natural disasters, a serious accident, a terrorist attack, sudden death of a loved one, war, sexual abuse or other life-threatening events may suffer from

post-traumatic stress disorder. The disorder can result in severe depression and anxiety and be accompanied by flashbacks and nightmares, for months or even years.

Anxiety disorders range in severity and can develop from a complex set of risk factors, including genetics, brain chemistry, personality and life events.

So how do you know if you’re experiencing worry or suffering from anxiety? When worrying starts to get in the way, says Michelle Sasha, an assistant professor in the department of psychiatry and behavioral medicine at the Medical College of Wisconsin.

"Everyone has periods of feeling nervous that occur within predictably anxiety-provoking circumstances — public speaking, a big exam, a first date, etc., (and) sometimes a bit of nervousness can be motivating," she says. "Troublesome anxiety is quite different and recognizable for its painful impact on the ability to engage with work, with love and with life, generally."

One of the biggest distinctions between everyday worrying and an anxiety problem is how long the fears last. In anxiety disorders, persistent worrying can last several months — or even years — and is often accompanied by problems with restlessness, concentration, muscle tension, sleeping and panic.

Unfortunately, many people tend to brush off these feelings. In fact, despite the high numbers of people who experience persistent anxiety, only about one-third actually seek treatment to find relief.

"As is often the case with many emotional struggles, some people feel shame about the ‘weakness’ associated with anxiety," explains Sasha. "Sometimes people think ‘I should be able to deal with this,’ or ‘It could be much worse.’ These may be legitimate questions, but they are harsh and interfere with thoughtful and potentially productive reflection and growth."

She suggests reframing worrying thoughts to gauge whether or not a person is thinking about a problem clearly or setting unrealistic expectations. Using a journal to document when certain physical or emotional symptoms arise may help pinpoint the problem.

For those who are able to identify the problems on their own, Sasha encourages they incorporate exercise, meditation and relaxing activities to help alleviate anxious thoughts. That may not be enough.

"An (anxiety) symptom is a signal that other things, outside of our awareness are bothering us — usually things we’d rather not deal with," says Sasha. "If worry is persistent and cannot be curbed with these efforts, it may be worth talking to a professional who can help identify causes and optimal solutions."

Those solutions may include counseling, cognitive behavioral therapy, prescription medicine or a combination of treatments.

"Sometimes, people don’t readily connect their anxiety to their causes," Sasha says. "The work of therapy always begins with understanding a person’s concerns from their perspective. The process of telling is often as important as the content of what is told." 



This story ran in the March 2016 issue of: