Anxiety & Panic
"Man is not worried by real problems so much as by his imagined anxieties about real problems."
"Every tomorrow has two handles. We can take hold of it with the handle of anxiety or the handle of faith."
-Henry Ward Beecher
What is Anxiety?
You enter a large room crowded with strangers. Everyone seems to know somebody except you. You wonder if others can see how anxious you are, how out of place you feel. As you entertain such thoughts, your heart begins to race, and your palms begin to sweat. Your head feels encased in shrink-wrap. You feel an urge to bolt from the room.
Anxiety is part of our natural defensive system – a close cousin to fear. With fear, however, the threat is more readily identifiable. For instance, someone is waving a gun. A dog is barking, crashing against the cyclone fence.
Like fear, anxiety is the body’s red warning light that something is amiss. The brain releases adrenaline. The pupils dilate. The heart pumps out blood like an engine on steroids, gearing the body to stand up and fight. Or perhaps to run faster than we ever imagined.
A manageable amount of anxiety can actually enhance our performance — by motivating us to prepare for a test, to drive with care, or to gird ourselves for a difficult confrontation. Anxiety also might carry important information. For instance, if I’m anxious at home, it might be helpful to reflect on what’s wrong in order to figure out ways to change it. Perhaps my roommate makes me uncomfortable or maybe I need to have a conversation I’ve been avoiding.
Anxiety becomes problematic when it is disproportionate to the situation or is so paralyzing that we are unable to act. Generalized Anxiety is when anxiety becomes pervasive and free floating, no longer linked in any recognizable way to specific tasks, challenges or threats. Those in the grips of this sort of anxiety often worry about the future thinking of possible scenarios and imagining the worse.
What Causes Anxiety?
Anxiety is a child with many parents. Recent research suggests that there may be a genetic predisposition. At the same time, one might learn the habit of anxiety from caretakers, e.g., a parent who worries a lot and worries excessively about us. Experiences that are physically and/or psychologically traumatic can leave one with a deep-seated belief that the world is unsafe and that bad things are likely to happen. Personality factors can be at work in anxiety as well. If we lack self-confidence and self-esteem, we may not trust our ability to face difficult situations that arise. If perfectionism is at play, we may be hampered by the chronic fear of making mistakes.
Social anxiety may take the form of fearing large groups, speaking up in class, meeting new people, or going out on a date. Some anxiety when interacting with strangers is quite normal. There may be something biological here since, after all, human beings are the most dangerous animals on Earth. Social anxiety becomes problematic when it keeps us from interacting with others or getting close to them. The person who is socially anxious may doubt whether he or she is smart enough, attractive enough, likeable enough, etc. In sum, this individual may feel socially undesirable and inadequate, uncertain how to connect with others in a meaningful way. Fear of bieng judged is a common complaint. Nonetheless, even a socially anxious person may feel comfortable within a narrow circle that includes close friends, roommates, and/or family members. This illustrates that the experience of anxiety is not black or white but rather occupies a continuum.
What about Panic Attacks?
Panic attacks are episodes of extreme anxiety often accompanied by such physical symptoms as shortness of breath, racing heart, sweaty palms, and dizziness. Sometimes a person experiencing a panic attack will think that he or she is having a heart attack or is dying.
Physiologically, panic attacks involve an activation of the sympathetic nervous system or fight-flight response. When we are faced with an extreme danger, this innate response mobilizes us to confront or escape the danger, preparing to perform what seem like “super-human” feats. This fight-flight response is designed to protect us, not to harm us. Panic attacks occur when this hard-wired, physiological response occurs in the absence of an actual threat. Instead of mobilizing us for action, the activation of our nervous system is channeled into anxiety.
One problematic complication of panic attacks is that the individual may learn to avoid situations in which the attack occurred. In more extreme cases, a person might develop a fear of leaving the house. This avoidance pattern can cause a person’s world to shrink down, depriving the person of the experiences that would allow the anxiety to dissipage naturally. Indeed, the fear of having a panic attack can actually precipitate an anxiety attack. Franklin Roosevelt's words to a nation in the depths of the Great Depression may offer wise counsel to a panic attack sufferer: The only thing to fear is fear itself.
The good news is that panic attacks can be addressed by many of the techniques described in our section on Overcoming Anxiety & Panic. In addition, there are some treatment strategies that pertain specifically to panic attacks.