Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021

Anxiety: Are You a Worrier?

Anxiety (or dread) itself needs no description; everyone has personally experienced this sensation or to speak more correctly this affective condition at one time or other. (Sigmund Freud, A General Introduction to Psychoanalysis)

Our whole life is taken up with anxiety for personal security, with preparations for living, so that we really never live at all. (Leo Tolstoy, My Religion)

All of us know what it means to be anxious, and lots of things can make us anxious. We also know intuitively the difference between what psychologists call trait and state anxiety.

Trait anxiety means that a person is a ’worrier’: someone who is stress prone, easily made anxious. They often seem negative and cautious because so many things make them anxious. They tend to react more intensely to things that make them anxious, and to experience this reaction for a longer period of time. They have, in short, an anxious personality; sometimes they are called neurotic and they tend to be prone to depression, phobias and other problems.

State anxiety is the unpleasant reactions we all have when confronted with a particular object or event. We might witness a crash, or get threatened with violence. We may have to give a speech, sit an exam or receive an injection. These are anxiety-provoking situations for most people caused by some sort of threat. State anxiety is a temporary condition that arises when people are threatened or challenged.

REACTIONS

Most of us can recognize signs of anxiety in ourselves and others. Usually the heart rate increases, and people might sweat and even shake. They might experience a dry mouth and look shocked.

There tends to be three types of reactions to long-term anxiety and the stress it causes. They are:

Physiological symptoms: A noticeable decline in physical appearance, chronic fatigue and tiredness, frequent infections (especially respiratory infections), health complaints (such as headaches, backaches, stomach and skin problems), signs of depression, change in weight or eating habits.

Emotional symptoms: Boredom or apathy — lack of affect and hopelessness, cynicism and resentfulness, depressed appearance, sad expressions, slumped posture, expressions of anxiety, frustration, tearfulness.

Behavioural symptoms: Absenteeism from work, a tendency to have accidents, increase in alcohol or caffeine consumption, increased smoking, obsessive exercising or the avoidance of exercise, irrational behaviour, a hair-trigger temper, reduced productivity — inability to concentrate or complete a task.

THE AFFECTIVE DISORDERS (ADS)

Psychiatrists have identified various subtly different but identifiable stress disorders (ADs). These include generalized anxiety disorder (GAD), panic disorder (with and without agoraphobia), obsessive—compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). ADs are among the most common mental disorders, with prevalence rates ranging from 13.6 per cent and 28.8 per cent. Studies also report that specific phobias and social phobia (or social anxiety disorder) are the most common of anxiety disorders. For adolescents, social phobia and separation anxiety are the most common disorders; and research reports an even higher prevalence rate of 39.1 per cent for anxiety disorders overall.

Here are some classic cases which may bring the issue to life.

Panic Disorder: Derek is 27 years old and he was driving with his wife to a computer store when he felt dizzy. As soon as he noticed this sensation, he experienced a rapid and intense surge of sweating, accelerated heart rate, hot flashes, trembling and a feeling of detachment from his body. Fearing he was going to crash his car, he pulled off the road. After ten minutes the feelings passed and Derek began to feel better, but now he worries extensively that it will happen again and he is reluctant to drive long distances.

Agoraphobia: Celia, 19, suddenly came home from work at McDonald’s and screamed that she was going to die. While standing at her counter, she had experienced the worst sensations in her life. Her heart began to pound like a jackhammer, she was gripped by panic and dread, she felt the ground underneath her was about to give way, and she was convinced she was having a stroke or a heart attack. She spent the next two weeks in bed and, thereafter, she refused to walk beyond the front gate.

Social Phobia: John is a 21-year-old living at home with his parents. Since starting college last year, he has become even more shy than usual and has made only one friend. He would really like to make more friends, but he is scared that he will do or say something embarrassing when he’s around others. Although John’s work is OK he rarely says a word in class and becomes incredibly nervous, trembles, blushes and seems like he might vomit if he has to answer a question or speak in front of the class. At home, John is quite talkative with his family, but becomes quiet if anyone he doesn’t know well comes over. He never answers the phone and he refuses to attend social gatherings. He knows his fears are unreasonable but he cannot seem to control them and this really upsets him.

Post-Traumatic Stress Disorder: Alex saw a good deal of active combat during his time in the military. Some incidents in particular have never left his mind — like the horrifying sight of Gary, a close comrade and friend, being blown-up by a landmine. For months after he returned to civilian life, these images still haunted him. At night Alex had difficulties relaxing and falling asleep. Scenes from battle would run repeatedly through his mind and disrupt his focus on work. This also affected his day-to-day life; for example, when Alex was filling up at the gas station, the smell of diesel immediately rekindled horrific memories. He felt as though his emotions were numbed, and as though he had no real future. At home, he was anxious, tense and easily startled. He found himself avoiding social interactions, and became very fearful of being out in public.

REFERENCES

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. p. 189.