Health and medicine
We all have things that we’re afraid of. Whether it’s seeing a spider, giving a speech, or jumping out of an airplane, some things just make our knees shake, hearts race, and our mouths dry up.
Evolutionarily speaking, fear is a good thing.
Fear is the emotional and physiological alarm that goes off in your body, signaling to you that there is an immediate threat that needs to be dealt with. But like any alarm, fear works best when it goes off at the right time and at the right intensity. Your alarm clock is great for getting you up in the morning, but if it were so quiet that you couldn’t hear it (or so loud that it was deafening) it might actually do more harm than good. You also probably wouldn’t be very happy if your alarm went off when you didn’t need to wake up (so much for sleeping in!).
This is the primary challenge facing people with anxiety disorders. Their response to perceived threats and challenges can be too sensitive (feeling fear when there is no danger) or too intense (feeling extreme fear when the risk of danger is low), which can lead them to engage in various behaviors to reduce their fear and anxiety. Sometimes these behaviors end up being harmful to the individual or others.
Fear, Anxiety, and Panic
To understand anxiety disorders, it’s important to understand three ways we respond to perceived threats: fear, anxiety, and panic.
Fear, as mentioned above, is the emotional and physiological response we have to an immediate threat (e.g., A bear is running toward you right now!) and is most associated with the body’s fight or flight response. Given the perceived urgency, there is typically a surge of energy with a focus on trying to escape or survive the scary situation (also called “escape behavior”).
Anxiety is the emotional and physiological response we have in anticipation of future threats (such as, “I’m nervous that if I leave my cabin there might be a bear out there”). Anxiety can make you hyper-aware of your surroundings and is associated with muscle tension and being on the look out for possible danger. The goal of feeling anxious is to avoid future danger.
Panic is a particular type of fear response in which you have an extreme emotional, physiological, and behavioral response in the absence of actual danger. Imagine you are waiting in line at the grocery store, and suddenly you think about a bear running at you. If your heart starts pounding and you feel dizzy and afraid, even though there isn’t a bear anywhere near you, you are experiencing panic.
While fear and panic tend to be a relatively brief experience, anxiety can be chronic and persistent, leading to serious negative outcomes. Chronic anxiety is harmful not only due to its effects on the body and mind, but also because of its effects on lifestyle and behavior, such as constantly avoiding fearful situations, social isolation, difficulty at school or work, and feelings of depression and hopelessness.
Types of Anxiety Disorder
While all anxiety disorders are characterized by intense and frequent fear, anxiety, and/or panic, they differ from each other in their specific symptoms and types of situations and objects that cause the symptoms to occur (we’ll get into this in more detail below).
In order to be diagnosed with an anxiety disorder, the symptoms related to anxiety and fear must interfere with normal functioning (day-to-day activities) and/or cause significant distress. For most disorders, the symptoms must not be related to drug use and must persist for more than 6 months.
People with specific phobias are afraid or anxious about specific objects or situations (called the “phobic stimulus”), and try to avoid them at all costs. Feelings of extreme fear start immediately in response to the stimulus and are out of proportion to the actual amount of danger present. People with specific phobias usually understand that their fear is excessive, but can’t seem to make it stop. Different types of phobias are categorized in the following groups:
- Animal (e.g., snakes, dogs, sharks)
- Natural environment (e.g., heights, lightning, water)
- Blood-injection-injury (e.g., needles, surgery)
- Situational (e.g., flying in an airplane, riding on an elevator)
- Other (e.g., clowns, choking, loud noises)
Social Anxiety Disorder
Social anxiety disorder (also known as “social phobia”) is characterized by persistent and unrealistically intense fear and anxiety about social situations, such as going to a party, working in teams, or even just being around other people. People with social anxiety disorder often worry they might be judged or scrutinized by others, or that they might embarrass themselves. People with social anxiety disorder avoid social interactions in the same way a person with a specific phobia would avoid their phobic stimulus. Given how important social interactions are to a healthy lifestyle, social anxiety disorder can have very serious consequences.
Panic disorder is characterized by recurring panic attacks, which are sudden and intense rushes of extreme fear or discomfort that gradually increases within minutes. This response is not related to specific situations or objects and can be brought on by worrying about having future panic attacks. Associated symptoms include:
- Accelerated heart rate
- Difficulty breathing
- Tingling sensations
- Fear of dying
- Feeling detached from yourself
After reading that list of symptoms, it’s easy to see why if you ever had a panic attack, you would do everything you could to avoid having another one! But, since the cause of the attack is often unknown, it isn’t always clear what should be avoided to prevent a similar event in the future.
Agoraphobia (translated from Greek, literally means “fear of the marketplace”) is defined by debilitating worry of being in a public place where it would be difficult or embarrassing to escape if intense anxiety or panic symptoms occurred. Until recently, agoraphobia was considered to be a subtype of panic disorder, but it is now an independent diagnosis. For some people, the fear of experiencing panic in a public place is so extreme that they are unable to leave their neighborhood, their house, or even their bedroom.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is characterized by persistent and excessive anxiety and worry about multiple events or activities. Examples of such worry include common concerns such as finances, health, career, and personal relationships. However, these individuals become consumed by their worry, making day-to-day life very difficult. Overwhelming worry such as this can result in restlessness, fatigue, irritability, and trouble sleeping.
Causes and Development of Anxiety Disorders
It’s important to remember that there is no single cause of anxiety disorders. Like all psychological disorders, there are many factors that influence chronic anxiety. So why do some people develop anxiety disorders and others do not? It may be helpful to think of having an anxiety disorder as being in a physical location.
If someone told you they were in New York City, would you know for sure how they got there? Maybe they took a plane, a car, a train, or maybe they walked there. Maybe they were born there! To go further, even if you found out how that one person came to be in New York City, would that tell you exactly how a different person got there? Probably not.
Rather than trying to find “the way to get to anxiety”, psychologists have worked to understand some of the common pathways to developing an anxiety disorder. Some pathways are related to a person’s biology, while others are related to a person’s environment and behavior.
The heritability of anxiety disorders ranges from 20-50%, depending on the specific disorder. You can think of this as meaning that 20-50% of people with anxiety disorders got there by way of the genes they inherited from their parents. However, this doesn’t mean that there is one anxiety gene, but rather that combinations of many genes may work together to result in a person being more likely to experience anxiety.
Overprotective and critical parenting, childhood abuse, and other traumatic events (like experiencing a natural disaster or witnessing violence) have all been linked to the development of anxiety disorders. As is the case with genetic factors, these environmental factors likely don’t directly cause anxiety disorders, but instead may increase a person’s vulnerability to anxiety.
Behavioral theories regarding the development of anxiety disorders (particularly specific phobias) suggest a two-step process that can lead to chronic anxiety.
- The initial reaction of fear/panic is learned through classical conditioning. This type of learning occurs when we associate a situation or object, which are often times neutral, with strong negative feelings. Even though the situation or object didn’t directly cause these feelings, these two factors may become linked in our minds.
For example: a big earthquake happened while you were driving over a bridge. Even though the earthquake is what actually scared you, every time you look at that bridge you start to feel nervous and scared.
- As a result, the person then tries to lessen their conditioned fear/panic by avoiding the situation or object evoking the response. This process (called operant conditioning) rewards people for avoiding the things they are afraid of, because doing so reduces their fear.
For example: the thought of driving over the bridge associated with the earthquake causes anxiety. So, even though it takes twice as long to reach your destination, you take a different route to avoid it.
How are anxiety disorders treated?
Although there is no cure for anxiety disorders, there are several effective treatments to help manage symptoms. Medications such as antidepressants, beta-blockers, or anti-anxiety drugs have been shown to reduce anxiety symptoms. While medication can be a short-term help, cognitive and behavioral therapies may have more long-term benefits.
Cognitive therapies focus on changing the thought patterns that cause and maintain anxiety. Working with a mental health professional, people can develop strategies to reduce anxiety and better deal with it when it arises.
Behavioral therapies are focused on breaking the cycle of anxiety by exposing the person to the situation or object that they have been avoiding. This type of exposure can take many forms, and is tailored to the specific needs of each person. Sometimes this is done gradually in a therapist’s office over the course of many weeks or months, while for others it may be appropriate to do so in a single session.
Want to join the conversation?
- How can I overcome the fear of standing up in front of a crowd to speak(13 votes)
- Based on my personal experience, first try to gain confidence in yourself and what you're doing. If you're not confident about the material, review the content more. You can even ask someone who has a greater understanding of the content to explain it to you more if the Internet sources aren't making any sense. When you gain confidence in your ability to present, you'll do fine. Practice the wording and think about what you want to emphasize. You can slow down slightly, enunciate even more or pause to emphasize certain parts. Once I boosted my self-confidence, it helped me a great deal with public speaking. However, you don't even have to look at people directly if you're in a big crowd. Choose target points and look at those points instead of into their eyes if you have trouble making eye contact. They'll think that you're looking them in the eye when you actually aren't if you can figure out how to look at these target points correctly.
Sometimes, I see people doing presentations and acting like they're the boss, so, I guess sometimes you need to own the presentation a little.
Before you present, calm down and make sure you're breathing is low and make sure to pronounce your words clearly and in a way that enables the audience to hear you for the entirety of the presentation.(18 votes)
- why is it that people with social anxiety can still talk to other people in chats on video games?(9 votes)
- Because the humanization is lost. There is a big difference between face-to-face conversation and a message board on the internet because it's impersonal.(24 votes)
- While researching common traits among intelligent people, I noticed that one trait that kept coming up in articles and researches was the fact that intelligent people experience higher percentages of anxiety as opposed to those with lower IQs, why might this be? Why would intelligent people be more anxious?(5 votes)
- Those with Higher IQ tend to internalize and self-criticize themselves. They tend to show perfectionist tendencies which leads to stress which can lead to anxiety. For example, if you have done well in school easily for most of your school career, and suddenly you come across something that is difficult. It can cause the fight or flight reflex. Overtime this kind of conditioning can lead to anxiety conditions as students and then adults strive to be the best at everything they do because they believe it is what expected of them not only externally but internally.(3 votes)
- What is the main cause of a panic attack?(6 votes)
- It's not known what causes panic attacks, but it can be biological, phobia, panic-provoking situations or environments.(8 votes)
- I am going on a class field trip on June 3rd. The trip is to six flags and I have bad anxiety over rides. How do I help feel calm to go on the rides with my friends?(5 votes)
- Maybe you can make sure to sit beside one of your best friends in the group. You might want to tell your friend how you feel, so they can reassure you. If you are a religious person, you may want to pray for help in feeling calm. But remember, if you don't want to go on a ride, you don't have to. Maybe you can find a less scary ride and go on it instead.
And it's okay. Not everyone likes roller coasters. I DON'T.
I hope you enjoy your trip anyway.
- Is it possible to stop a panic attack while it's happening?(2 votes)
- From personal experience you can try to hold it off but for not that long and not completely. All together you try distract yourself, keep busy or just try to treat each symptom at a time.(7 votes)
- Which gender is more likely to get anxiety disorders?
Females or males?(4 votes)
- can anxiety cause your muscles to not work(3 votes)
- A dear friend of mine suffers from panic disorder and chronic anxiety disorder,. While the panic attacks are occasional, the anxiety persists, and even in secure environments, she ends up feeling nervous, and afraid. I've talked to er through this, and it seems she does not know why she feels anxious, however she claims that her friends, especially me, have a calming effect on her somehow. IS there some way i can help her to come out of this, in a more permanent way than my temporary company??(3 votes)
- It is nice of you to want to take care of your friend, however, you know this site is not here to diagnose and treat individuals. People with anxiety should have a physical exam and tests to be sure that hormones, heart problems or other factors are not causing their response. If the health professional doesn't find such a problem, then they will likely encourage the patient to get "talk therapy" with a counselor as that can be very helpful. Counselors can help Individuals learn more about relaxation exercises, self-hypnosis and alternative ways to think about the situations that cause the anxiety. Exercising and eliminating caffeine and alcohol can help, also journaling to see if there is any consistent trigger of these events, but the heavy lifting of seeking a diagnosis and working on a treatment plan is something the patient has to pursue. However, you could check out some other web sites that are involved with treatment such as the Mayo Clinic etc.http://www.mayoclinic.org/diseases-conditions/panic-attacks/basics/definition/con-20020825
- What is the most common form of anxiety?(2 votes)
- I would personally say performance anxiety from what I've read. (Sorry I don't have any specific ones on hand.) This could include speaking in front of crowds, grades, work performance, even possibly relationships.(4 votes)