On a daily basis, each of us may be confronted by challenges at work or in school, a decision that needs to be made, or concern about a loved one. In these cases, it’s typical for a person to temporarily experience fear or anxiety. Fear is described as an emotional response to a real or perceived threat. Anxiety refers to anticipating a future threat. However, when the fear or anxiety that you feel is excessive or worsens over time, you may be experiencing an anxiety disorder.
People who have anxiety disorders experience a level of worry or fear that seems excessive and perhaps paralyzing. Thoughts can be intrusive and obsessive in nature. Anxiety can impair social interactions and relationships, effectiveness and efficiency in work or school and limits a person’s ability to live in and enjoy the present.
Anxiety is a medical condition that can be treated. Treatment choices are usually medication, therapy or both. Anxiety disorders can cause people into try to avoid situations that trigger or worsen their symptoms. Job performance, school work and personal relationships can be affected.
In general, for a person to be diagnosed with an anxiety disorder, the fear or anxiety must:
- Be out of proportion to the situation or age inappropriate
- Hinder your ability to function normally
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, specific phobias, agoraphobia, social anxiety disorder and separation anxiety disorder.
Generalized Anxiety Disorder (GAD)
Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.
The core symptom of panic disorder is recurrent panic attacks, an overwhelming combination of physical and psychological distress. During an attack several of these symptoms occur in combination:
- Palpitations, pounding heart or rapid heart rate
- Trembling or shaking
- Feeling of shortness of breath or smothering sensations
- Chest pain
- Feeling dizzy, light-headed or faint
- Feeling of choking
- Numbness or tingling
- Chills or hot flashes
- Nausea or abdominal pains
- Feeling detached
- Fear of losing control
- Fear of dying
Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness and may go to a hospital ER. The average age for onset of panic disorder is 22-23 years old. Panic attacks may occur with other mental disorders such as depression or PTSD.
Social Anxiety Disorder (Social Phobia)
A person with social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety. Common examples are extreme fear of public speaking, meeting new people or eating/drinking in public. The fear or anxiety causes problems with daily functioning and lasts at least six months.
Separation Anxiety Disorder
A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations:
- Using public transportation
- Being in open spaces
- Being in enclosed places
- Standing in line or being in a crowd
- Being outside the home alone
The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.
Diagnosis and Treatment
The first step is to participate clinical diagnostic interview done by appropriately licensed clinician. If an anxiety disorder is diagnosed, the clinician will collaborate with you on the best treatment plan. Unfortunately, many people with anxiety disorders don’t seek help. They don’t realize that they have an illness that has effective treatments.
Although each anxiety disorder has unique characteristics, most respond well to two types of treatment: psychotherapy, or “talk therapy,” and medications. These treatments can be given alone or in combination. Medications will not cure anxiety disorders, but they can be temporary tool to provide relief from symptoms. Acceptance and commitment therapy (ACT) is a treatment modality that can help you transcend that natural fight-or-flight response that is part of anxiety disorders. At its essence, ACT helps people accept life’s challenges and problems, big and small, understand and overcome negative thoughts and feelings, choose life directions based on your own desires and values, and take action to shape your life.
Something ACT seeks to do is to increase psychological flexibility. Ideally, with a therapist trained in ACT or with self-help books dedicated to ACT, people learn to be fully present in each and every moment. By being present, we experience and live whatever it is that life brings. In doing this, we stop avoiding anxiety and stop avoiding our lives.
An important component of ACT is acceptance. When working with ACT, people come to understand their anxiety, their anxiety triggers, and their own anxious thoughts, feelings, and behaviors. Once we can fully recognize what’s going on around us and within us, we can face it and accept it for what it is, often our minds playing tricks and creating fear and worry and anxiety.
With ACT comes control and power. Or rather, anxiety’s control and power is drastically reduced while our own self-control and power over our lives is greatly increased. When we live in the moment and accept ourselves and our lives, we can then decide what it really is that we want for ourselves and our lives. ACT is an approach to anxiety that goes beyond the mere reduction of anxiety and helps us define our values and take purposeful action to live a good life, an anxiety-free life.
If you would like to stop avoiding anxiety, acceptance and commitment therapy might just be something you’d like to explore. Consider the exploration your first step in facing anxiety, accepting it and life’s challenges, and taking action to living an anxiety-free life.