Understanding and Treating Anxiety

Everybody has some familiarity with anxiety. Anxiety is the feeling of worry, apprehension, fear and/or panic in response to situations
which seem overwhelming, threatening, unsafe or uncomfortable. You may experience anxiety as an intense worry before a final
exam, the nervousness felt before making a presentation, or the heightened alertness when you believe you are in danger. Anxiety
is your body’s way of alerting you that some kind of action is needed in the face of a situation that is perceived to be threatening or
dangerous. Therefore, anxiety can be useful or adaptive whenever it prompts you to take appropriate action in response to an
anxiety-provoking situation. For example, anxiety can motivate you to study for an exam or organize a presentation or leave a
situation that feels unsafe. However, anxiety can also be detrimental, especially if it becomes overwhelming and prevents you from
taking appropriate actions or prompts you to take actions that are counterproductive. Anxiety may be detrimental if you avoid
studying  for a major exam that worries you, or if you cope with worry about your relationship by getting unnecessarily suspicious
and then yelling at your partner. This brochure will help you distinguish between normal or expected anxiety that everyone
experiences and anxiety problems which may require intervention.

Because the feeling of anxiety is frequently intense and distressing, it is quite normal to want to avoid or eliminate these feelings.
However, this is not necessarily the best approach to anxiety. If you ignore or try to eliminate your anxieties, you miss out on valuable
information about your life and about your options for dealing with unavoidably stressful and demanding situations. It is often a better
approach to begin with assessing the degree to which your anxiety works for you or is excessive and a source of problems for you.

Since anxiety is a basic human emotion, like sadness, how do you know if anxiety is a problem? The following will help you determine
whether anxiety could be partly responsible for some of the problems you are experiencing:

Do I feel anxious more often than not throughout my day?
Have I restricted my activities as a way of coping with anxiety?
Do I experience panic or panic-like symptoms in certain predictable situations?
Am I intensely fearful of specific situations or things (e.g., animals)?
Do I experience acute anxiety in social situations?
Have I developed elaborate rituals or thought-processes to manage anxiety?
Is my anxiety related to a specific, traumatic event?

If you answered yes to some of the previous questions, you may have more specific questions about the anxiety symptoms you
have been experiencing. The following are various conditions for which anxiety is the predominant feature.

Types of Anxiety

Panic Disorder

A panic attack is defined as a period of intense fear or discomfort accompanied by physical symptoms such as sweating, trembling
and chest pain as well as cognitive symptoms such as fear of losing control and/or dying. A panic attack can be associated with any
of the anxiety disorders, but panic disorder itself is characterized by recurrent, unexpected panic attacks and persistent concerns
about having additional panic attacks.

Specific Phobia

The anxiety in specific phobia is associated with persistent, excessive and unreasonable fear when there is an anticipated or actual
encounter with a specific object or situation. There can be significant anxiety and sometimes panic whenever a phobic person is
exposed to the feared object or situation. Some examples of specific phobias include fear of certain animals, fear of heights, fear
of blood or fear of places such as bridges or elevators.

Social Phobia

Social phobia is defined as a marked and persistent fear of a social situation or a performance in which embarrassment is
considered to be a likely outcome. A fear of public speaking is one of the more common forms of social phobia. In all instances
of social phobia, there is acute anxiety whenever the feared situation or performance is anticipated or encountered and there is
frequently a strong desire for avoidance.
Obsessive-Compulsive Disorder

The presence of recurrent obsessions and compulsions which are time-consuming, impair life activities, and are recognized by the
person as being excessive or unreasonable are features of this condition. An obsession is defined as persistent ideas, thoughts,
impulses or images which are intrusive, anxiety-provoking and distressing. A compulsion is a ritualistic behavior which is intended
to modify or reduce the anxiety through activity or behavior. The most frequent compulsions involve washing and cleaning, counting,
seeking assurances, checking and/or repeating actions.

Post-traumatic Stress Disorder

The anxiety in Post-traumatic Stress Disorder is clearly associated with a traumatic event that the person experienced or witnessed
and was associated with intense fear, horror or helplessness. In addition, there are recurrent, intrusive recollections of the events
which are anxiety-provoking and distressing to the person. There may be avoidance of any situations associated with the original
trauma and other anxiety-related symptoms such as hyper-vigilance or exaggerated startle response.

Generalized Anxiety Disorder

The primary feature of Generalized Anxiety Disorder is excessive anxiety and worry which occurs more days than not for a period
of at least six months. In addition, symptoms of restlessness, fatigue, concentration problems, irritability, muscle tension and sleep
disturbance may be present. The anxiety is perceived by the individual as being difficult to control or regulate.

Treatment of Anxiety

If anxiety symptoms are interfering with your ability to do routine, day-to-day activities, or if you have restricted your life activities as
a way of coping with anxiety, you should consider seeking professional help. There are currently a variety of highly effective
interventions available for the treatment of anxiety, including psychotherapy, cognitive-behavioral therapies, and medication. If you
seek treatment, the recommendations you receive will likely depend on the specific symptoms you are experiencing. All of the anxiety
disorders are treatable and many individuals experience a full recovery from their symptoms.

What Can I Do?

It is usually helpful to identify the events surrounding the experience of anxiety:

What provokes the anxiety?
What thoughts or physical sensations accompany the anxiety?
How distressing is the anxiety?
How are you coping with the anxiety?

Exploring these accompanying events may provide useful information about the nature of the anxiety as well as possible strategies
for reducing it. In addition, there are specific changes you can make that may help alleviate anxiety symptoms:

Exercise or engage in some form of daily physical activity
Eat a nutritious, well-balanced diet
Obtain an adequate amount of sleep
Seek emotional support from friends and family
Focus on positive aspects of your life
Establish realistic, attainable goals which do not rely on perfectionistic values
Monitor how you think about stress and reduce and/or change thoughts which are negative
Identify activities which feel overwhelming and reduce your involvement or seek ways to make them more manageable
Consult with a physician if you are experiencing any medical problems
Consult with a mental health professional if you continue to be concerned about your anxiety
Reduce or eliminate the use of alcohol and drugs and limit caffeine intake
Don’t engage in “emotional reasoning” (e.g., “because I feel awful, my life is terrible”)
Don’t assume responsibility for events which are outside of your control

Helping an Anxious Person

If someone you care about has been experiencing anxiety symptoms, you can be a valuable resource. There is often tremendous
shame associated with anxiety. If you talk candidly with the individual regarding your concerns for his or her well-being, it will often
bring the problems out into the open. Emphasize that your primary objective is to convey feelings of concern and assistance. You
can also always consult with a mental health professional yourself if you are concerned about how to talk with your friend.

Suggestions for intervening with an anxious friend

Be empathic and understanding
Don’t minimize the severity of anxiety symptoms
Avoid critical or shaming statements
Encourage coping strategies which don’t rely on avoidance of anxiety-provoking stimuli
Challenge expressions of hopelessness
Don’t argue about how bad things are
Don’t become angry even though your efforts may be resisted or rejected
Advocate for treatment of anxiety
Consult with a mental health professional if an anxious friend refuses necessary treatment
Anxiety

Counseling Center at University of Illinois Urbana-Champaign
http://www.counselingcenter.illinois.edu
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