The Worry Games: Anxiety

By Mrudula Akki

N, a working professional, worries about how his family will cope should something happen to him. 
K, has lost his job and is looking for employment. 
A has final exams in one month’s time, and 
S worries that her boss will find her work unsatisfactory.
We are all familiar with situations that elicit similar emotions in us.
The feeling of tension, accompanied by worried thoughts and changes in your body (like increased heart rate, sweaty palms, nervousness, etc.)is referred to as anxiety. 
Very often we tend to use the terms “stress” and “anxiety” interchangeably as both stress and anxiety are the body’s natural fight-or-flight response. In other words, the physiological response to stress and anxiety is the same, making it difficult to tell them apart.

However, stress can be distinguished from anxiety as:
    being short term, 
    in response to an identified threat or trigger, 
    accompanied by irritability, anger, nausea, anxious thoughts and 
    a feeling of being overwhelmed. 

Anxiety on the other hand is:
    more long term, 
    may not have an identifiable trigger,
    is characterized by restlessness, tension, nervousness and sweating and 
    a feeling of unease or dread.

Stress is the body’s reaction to threat and anxiety is the body’s reaction to stress.
Anxiety is normal and necessary, alerting us to the possibility of danger and ensuring that we take the required steps to fight or fly; i.e., face the threat or escape it. It is our aid to survival and a core part of the human defense system – helping us in our instinct to survive. It stimulates people to overcome challenges and improves performance. However, experiences and a prior history of harm can alter the threshold of reactivity making some individuals especially prone or easily overwhelmed with worry.

When the worry about possible dangers (what if I get COVID 19 if I step out) or negative outcomes (if I don’t get the job, I will cannot pay rent) arises 
    for no concrete reason, or 
    if it is disproportionate to the situation, or
    lasts beyond solutions to that problem, or 
    the worry causes you to avoid situations that may trigger symptoms, anxiety becomes a disorder. 

While occasional bouts of anxiety are unavoidable, when anxious thoughts persist or intensify, it can impair day-to-day functioning and lead to undue distress. Anxiety is characterized by both physical (bodily) signs and mental symptoms. A vicious cycle is created with the bodily symptoms and worrying thoughts feeding on each other, making it hard to control the thinking.

What really causes anxiety? Our ability of imagining a future. The core of anxiety is uncertainty and anticipation of negative outcomes. It is more often than not a mental state of apprehension about what might or what might not lie ahead; it reflects the uncertainty about future circumstances. This can be triggered by events in the real world or through thoughts of real or imagined threats.

Anxiety disorders can be differentiated into :
    generalized anxiety disorder
    panic disorder
    specific phobia
    agoraphobia
    social anxiety disorder and
    separation anxiety

All the different types of anxiety are marked by fear, vigilance (on the lookout) in anticipation of a feared threat or negative outcome, and behavior characterized by being cautious or avoidant.

Treatment typically consists of CBT and at medication. Cognitive Behavior Therapy has been recognized as the first line of treatment of anxiety as it helps people identify the triggers for their anxiety. As anxiety perpetuates the maladaptive response of avoiding uncomfortable situations, CBT targets the distorted thoughts, such as the expectation of disastrous outcomes to future events. People with anxiety are taught to identify and examine the evidence of their automatic, negative thoughts. Managing anxiety and finding ways to keep it from interfering with life is a more adaptive skill and is the desired goal in therapy.

Medication is also commonly prescribed for people with anxiety, in combination with therapy or alone. The effect of the medication can take a few weeks before a noticeable change is perceived. Deep breathing, exercising, maintaining companionship and engaging in play, relaxation strategies, practicing yoga, and mindfulness training have also been found to be helpful in the management of anxiety.
Seeking professional, psychological help is the first step to managing anxiety. Therapy enables skills that last beyond the therapeutic setting and instills confidence in your own ability to deal with anxious situations or thoughts in the future too.

“Anxiety does not empty tomorrow of its sorrows, but only empties today of its strength.”
—Charles Spurgeon

WHO estimates that 38 million Indians suffer anxiety disorders, and a study published in the Journal of Public Health (Biswas & Biswas) revealed that almost 50% of students reported moderate and moderately severe levels of stress in 2021. Students less than 20 years of age and female students reported feeling more anxious.

The author is a consultant psychologist based out of Hyderabad.

Also Read: Role of Social Media on Mental Health