Anxiety: Is it Just my Nerves, or Something More?

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by

Dawn Ferrara, Psy.D

 

Please don’t call on me.

Is that storm headed this way?

I have to get up and speak?

Did I lock the front door? Oh, My Gosh! Turn around!

 

Sound familiar? There are things in life that just make us nervous, anxious and sometimes, even worried. Really worried. And it can feel really, really uncomfortable. We all worry about something.

Sometimes our worry is the result of something we’re about to do, like having to give a speech. Other times it may be worrying whether something is going to happen – wondering if your love is going to propose. And other times it’s nervousness borne from fear – worrying about severe weather approaching.

The experience of worrying or being nervous can be really intense. When that happens, it’s not unusual for someone to say, “I’m freaking out. I’m having a panic attack.” But is that true?

Being nervous or anxious is a normal emotion and we all experience it. However, having “anxiety” and having a “panic attack” have become common expressions in popular culture for times when we are nervous or feeling unsettled. Let’s be real here. Being afraid and feeling lightheaded just before giving a speech is not an anxiety disorder nor is it a panic attack. The fact is, being nervous, having anxiety that is bothersome and panic are very different things. And the difference matters.

When It’s Nerves…

When you’re nervous, you get that antsy, worried feeling. You may even feel it physically. You might breathe a little faster and your pulse may quicken. Your stomach might be doing flipflops. You might even feel a little lightheaded. And then…

It’s gone. It’s over. You’re able to go on about your day.  What’s going on here?

Fight or Flight

Nervousness or stress is your body’s alert system telling you, “Hey, pay attention!” Your brain has detected something of concern that activates your body’s primal “fight or flight” response.1 Your nerves are telling you to be ready to move if you need to. And it doesn’t have to be a T-rex chasing you. It might be that podium you’re about to step up to that is looming large. Anything that evokes a sense of fear or apprehension can evoke the response. When the “threat” has passed, your body relaxes and you’re on your way.

Being nervous or anxious isn’t always a bad thing. Nervousness is your body’s way of moving you forward. If you know you’ve got to be somewhere on time, you’re going to be nervous about it, right? You’ll make sure your alarm is set to wake up. You’ll have your things packed and ready. You’ll leave in plenty of time. Once you’re on your way, that stress is over and you go about your business.

But what happens when the nervousness never stops? You’re worrying so much and not even sure what you’re worried about anymore. What happens when the worry just gets bigger and bigger and starts to take over your life? There are times when you feel like you can’t even breathe. That’s anxiety. And it’s a whole different level of nervous.

When It’s More Than Nerves…

When the nervousness doesn’t subside and/or keeps getting bigger, when it is intruding into your life, it’s likely you’re experiencing something more than just nervousness. These are signs of problematic anxiety and a possible anxiety disorder.

Anxiety is defined as “an abnormal and overwhelming sense of apprehension and fear often marked by physical signs (such as tension, sweating, and increased pulse rate), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it.” 2 The magnitude of the feeling and experience goes far beyond just a case of nerves.

Signs It Could Be Anxiety

The hallmark of anxiety disorders is excessive fear or worry that is persistent and affects someone across settings – home, work, school and even social and interpersonal relationships.3 It is more than just the worries that most people just brush aside. Basically, your worry moves to full-on anxiety when it starts to take over your life. Your worry becomes big and intrusive. It stops you from doing the things you want to do. That’s the time you probably need to consider the possibility that it’s more than nerves. And, if it’s affecting your functioning, it’s probably time to seek help.

 

Anxiety is also often accompanied by physical symptoms.3 Things like headaches, stomach aches, or poor sleep. Of course, you can have a headache totally unrelated to your anxiety. When we talk about physical symptoms, we’re talking about those physical symptoms that are not due to a medical issue and/or don’t get better with treatment. These tend to be stress-related.

Not all Anxiety is Created Equal

Anxiety is not one-size-fits-all. There are actually different kinds of anxiety, each dependent on what the primary focus of the anxiety is.

  • Generalized Anxiety – This type of anxiety is characterized by excessive worry about multiple things. Whether they are actually big or small things or even things to worry about doesn’t matter. The thoughts of worry are intrusive and are present on most days.3 It’s often the “what if” kind of worry sometimes referred to as anticipatory worry. And that is just what it sounds like. You worry about things that haven’t even happened and may never happen. You might even have some physical symptoms.

 

  • Panic – Panic is a different kind of anxiety that causes short, very intense bursts of fear. It comes on suddenly in response to a fear that something is happening right now. (It might not actually be but your brain thinks it is.) Your body’s fight or flight response is activated. You may experience rapid, shallow breathing, heart racing, lightheadedness or even chest pain.3 In fact, people having a panic attack often describe it as feeling like a “heart attack” or “feeling like I’m dying.” You’re not but it feels like it.

 

  • Social Anxiety – This type of anxiety is related to a fear of what people will think. The worry tends to create avoidance behavior so the person avoids situations in which they may feel judged or vulnerable. It can be quite intense.

 

  • Phobias – Phobias are fears of specific things – bugs, heights, flying, etc. These feelings can be quite intense and stop people from doing things they want to do.

 

  • Posttraumatic Stress Disorder – PTSD is a very specific type of anxiety disorder that is the direct result of a trauma. Symptoms can be quite intense and even debilitating if left untreated.

 

Breaking Anxiety’s Grip

The good news is that there are very effective treatments for anxiety. The goal is to stop the anxiety from occurring or at least minimize its intensity. Left to its own devices, over time the anxiety response can become something of a habit. Not intentionally, it just happens. Reacting intensely becomes the norm. So, the longer anxiety is left untreated, the harder it is to overcome.

Self Help

Depending on the type of anxiety you have and its intensity, you may be able to manage it on your own. Lifestyle changes can be helpful.

  • Manage your stress
  • Practice relaxation – mindfulness meditation, deep breathing, yoga etc.
  • Know your triggers and do what you can to avoid them
  • Get a support system – talking about your feelings instead of bottling them up is key
  • Challenge negative thinking – pay attention to your inner dialogue. Speak positively to yourself, think in positive terms.
  • Exercise regularly – great for stoking endorphins (feel good brain chemicals) and discharging stress energy

Counseling

Of course you can still do all those good self-help things, but often someone dealing with anxiety needs more help than they can do on their own. Cognitive Behavioral Therapy (CBT) is a popular and effective type of therapy used to treat anxiety.  A therapist can help you to identify triggers, challenge negative thought patterns that might reinforce your anxiety and help you to develop better coping strategies. Getting to the root of your anxiety is important and that’s when having a therapist to talk to can make a huge difference. Once you know where the anxiety is rooted, you can work to overcome it.

Maybe Medication

Sometimes, anxiety can be quite intense and overwhelming. Sometimes, counseling isn’t enough to overcome the anxiety or the symptoms are so intense, the person cannot participate in counseling. Whatever the reason, there are times when medication may be necessary to help manage symptoms. It doesn’t mean that self-help and counseling should go out the window. On the contrary, self-help and counseling can be part of an overall treatment plan. Medication helps manage the most bothersome symptoms. But it doesn’t make the anxiety go away or keep it away or get at the root cause. Research tells us that the best treatment for anxiety is a combination of therapy and medications, when needed along with good self-care. 4,5

Can Anxiety Be Prevented?

Worry and even a little anxiety are just part of life. We all experience them sometimes. So, in that respect there is no prevention. However, there are things you can do to minimize the effects and hopefully avoid the development of an anxiety disorder.6

  • Take it easy on caffeine. It can increase feelings of anxiety and the jitters.
  • Eat a well-balanced diet. There is some suspected brain-gut connection to anxiety that researchers don’t fully understand yet.7 So it makes sense to feed your body well.
  • Get enough sleep
  • Check with your healthcare provider before using herbal or OTC supplements that may make anxiety worse.
  • Exercise regularly
  • Have a support system
  • Journal – it’s a great way to explore and examine your feelings

The Takeaway

When it comes to anxiety, you have two choices. You can control it or it will control you. The good news is that there are lots of sound treatment options. Some folks can do it on their own but it’s hard to go it alone. And, if you’re not sure what type of anxiety you’re dealing with, how do you know what to do to treat it?  When in doubt, go to the experts. Your best option is to see a mental health professional who can accurately assess your anxiety and offer you treatment options that are right for you. There is no need to suffer in silence. Help is there and you can reclaim your freedom over your fear.

 

 

 

 

References

  1. David S. Goldstein & Bruce McEwen (2002) Allostasis, Homeostats, and the Nature of Stress, Stress, 5:1, 55-58.
  2. Definition of ANXIETY. (n.d.). Retrieved from https://www.merriam-webster.com/dictionary/anxiety
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:Author.
  4. Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. P & T : a peer-reviewed journal for formulary management, 38(1), 30–57.
  5. Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3.
  6. Illaggi, B., Provencher, H., Coulombe, S., Meunier, S., Radziszewski, S., Hudon, C., … Houle, J. (2015). Self-Management Strategies in Recovery From Mood and Anxiety Disorders. Global Qualitative Nursing Research, 1-13.
  7. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and practice, 7(4), 987.

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