Laura L. Smith - Anxiety For Dummies

Anxiety comes in various forms. The word “anxious” is a derivative of the Latin word angere, meaning to strangle or choke. A sense of choking or tightening in the throat or chest is a common symptom of anxiety. However, anxiety also involves other symptoms, such as sweating, trembling, nausea, and a racing heartbeat. Anxiety may also involve fears — fear of losing control and fear of illness or dying. In addition, people with excessive anxiety avoid various situations, people, animals, or objects to an unnecessary degree.

Anxious people tend to be extremely sensitive to danger, rejection, the unknown, and uncertainty. They may pay close attention to unpleasant thoughts, feelings, and physical sensations. They also often dwell on the possibility of future calamities. Anxiety symptoms such as these have a tendency to cluster together. The following sections describe some of these major clusters.

The following subheadings roughly correspond to some of the major diagnoses discussed in DSM-5, but we think it’s more productive to focus on symptoms rather than technical diagnostic categories. (See the sidebar “The Diagnostic and Statistical Manual-5 [DSM-5]” for more information.)

Most people have heard of the term “worrywart” and immediately conjure up someone who constantly worries. Worrywarts have a chronic state of tension and worry. They often report feeling restless, on edge, and keyed up. They may tire easily and have trouble concentrating or falling asleep. Once asleep, they may wake up at 3 a.m. with racing, worried thoughts. Worriers also often report having achy muscles, especially in the back, shoulders, or neck.

Not everyone experiences chronic worries in exactly the same way. Some worriers complain about other problems — such as twitching, trembling, shortness of breath, sweating, dry mouth, stomach upset, feeling shaky, being easily startled, and having difficulty swallowing. No matter how you experience worry, if it’s keeping you from living life the way you want to, it’s a problem.

The following profile offers an example of what excessive worry looks like.

In a subway, Brian taps his foot nervously. He slept only a few hours last night, tossing, turning, and ruminating about the economy. He’s sure that he’s next in line to lose his job. Even though his boss says that he’s safe, Brian can’t stop worrying. He believes that he may end up broke and homeless.

His back is killing him; he shrugs his shoulders trying to loosen up his tight muscles. He struggles to concentrate on the blog that he’s looking at and realizes that he can’t remember what he just read. He notices his shirt feels damp. He thinks he might be sick. He is sick — with worry.

Brian has worked steadily at the same company since graduating from college six years ago. His work is highly technical. Most of the senior executives depend on his technology know-how. He has stashed away a nice amount of money for emergencies. Nevertheless, his anxiety has increased over the last year to the point that he notices that he’s making mistakes. He can’t think; he feels horrible and is in a constant state of distress.

The economy can make anyone anxious at times. But Brian’s worries appear to be out of proportion to his real situation. It seems unlikely that he’s in danger of losing his job. However, his extreme anxiety may, in fact, cause him to get in trouble at work. People with overwhelming anxiety often make careless mistakes because of problems with attention and concentration.

Some worries are perfectly normal. If you lose your job, it’s quite natural to worry about money. But if your name is Bill Gates or Jeff Bezos and you’re worried about money, perhaps you have a problem with anxiety.

When we were writing this section, we wondered where the original phrase “worrywart” came from. So, we looked it up. Turns out that Worry Wart was a character in a comic strip from the 1920s. The boy was a constant pest and annoyed his brother who christened him with the name Worry Wart. The meaning evolved into someone who is constantly beset with worries. The reason the word “wart” was used is that warts are an itchy nuisance that can’t be scratched away. In fact, the more you scratch, the worse the wart becomes, a bit like worry.

People who are socially phobic fear exposure to public scrutiny. These people dread performing, speaking, going to parties, meeting new people, entering groups, using the telephone, writing a check in front of others, eating in public, and/or interacting with those in authority. They see these situations as painful because they expect to receive humiliating or shameful judgments from others.

Social phobics believe they’re somehow defective and inadequate; they assume they’ll bungle their lines, spill their drinks, shake hands with clammy palms, or commit any number of social faux pas and thus embarrass themselves. Ironically, because they are so anxious, they actually do what they fear. Shaky, sweaty hands spill drinks. Lack of eye contact turns people away. They worry about what others are thinking about them — so much that they don’t listen well enough to keep a conversation going.

Everyone feels uncomfortable or nervous from time to time, especially in new situations. For example, if you’ve been experiencing social fears about a challenging new situation, that may be normal. A short-term fear of socializing may be a temporary reaction to a new stress such as moving to a new neighborhood or getting a new job. However, you may have a problem with social anxiety if you experience the following symptoms for a prolonged period:

You fear situations with unfamiliar people or ones where you may be observed or evaluated in some way.

When forced into an uncomfortable social situation, your anxiety increases powerfully. For example, if you fear public speaking, your voice shakes, and your knees tremble the moment that you start your speech.

You realize that your fear is greater than the situation really warrants. For example, if you fear meeting new people, logically you know nothing horrible will happen, but tidal waves of adrenaline and fearful anticipation course through your veins.

You avoid fearful situations as much as you can or endure them only with great distress. Because of your fears, you may miss a variety of events you’d otherwise like to go to (for example, family gatherings, work opportunities, or parties).

Check out the following prime example of a social anxiety and see whether any of it seems familiar.

Maurice, a 35-year-old bachelor, wants a serious relationship. Women consider him attractive, and he has a well-paying job. Maurice’s friends invite him to parties and other social events in an effort to set him up with women. Unfortunately, he detests the idea of going. Maurice conjures up a number of good excuses for backing out. However, his desire to meet potential dates eventually wins. Whenever he imagines scenes of meeting women, he feels intense, anxious anticipation.

When Maurice arrives at the party, he heads to the bar to quell his mounting anxiety. His hands shake as he picks up his first drink. Quickly downing the drink, he orders another in hopes of numbing his emotions. After an hour of nonstop drinking, he feels much braver. He interrupts a cluster of attractive women and spews out a string of jokes that he has memorized for the occasion. Then he approaches various women throughout the night, sometimes making flirtatious, suggestive comments. His silly, drunken behavior doesn’t get him any dates. The following day, he’s embarrassed and ashamed.