• Panic attacks
  • Generalized anxiety (persistent unfounded feelings of dread and worry)
  • A phobia of certain objects or situations
  • Social anxiety (intense fear and discomfort in social contexts)
  • Post-traumatic stress disorder (PTSD - having persistent anxiety following the experience of trauma), etc.

While the severity, symptoms, and experience of anxiety can vary broadly, all forms of anxiety disorder bring with them intense and often debilitating emotional and physical distress.

Whereas depression is often about the past, anxiety is about the future.

When you're feeling anxious you'll likely find yourself ruminating about what might happen, how you might be perceived, how you'll handle challenges, whether you'll be able to perform or measure up, and so on. And since anxious ruminating only imagines a bad outcome - we don't see ourselves soaring, we imagine ourselves failing, or suffering, or being humiliated - anxious thoughts cause a chain reaction of physical and psychological consequences.

For example, worrying that you'll make a fool of yourself if you get up and speak in front of a group will cause tightness in your chest, tension in your stomach, a racing heartbeat, sweaty hands, a flood of negative thoughts and self-evaluations, etc. That is, thinking about making a fool of yourself delivering the speech can feel just as noxious (on both a physical and psychological level) as if you had actually done it. 

We don't all have the same sensitivity setting when it comes to anxiety. While everyone goes through periods of experiencing high 'state anxiety' - feeling fear and worry in a situation that's scary or worrisome - some people are also high in 'trait anxiety', meaning that they are predisposed to worry and ruminate.

In the example above, giving a speech in front of a group of people is an experience that will raise anxiety for almost everyone - speaking in public is rated as the number 1 fear people hold (dying is rated number 2). Someone who is not high on trait anxiety is more likely to view the event as a challenge rather than a threat, and might approach this anxiety-provoking situation by using the anxiety as a spur - they might spend time preparing and rehearsing, might perhaps call on some friendly faces to be in the audience, etc.

Someone high in trait anxiety may instead ruminate on the negative predicted outcome ("I'll make a fool of myself"), find confirmation of that prediction in the physical and emotional consequences that follow that thought, and in turn become more and more convinced that they need to avoid this situation in order to avoid the dreaded outcome.

Anxiety and worry therefore become constant companions that colour our view of every real and imagined situation and consequently influence what we are and are not willing to do.

And that is the real pain of anxiety - it limits what we are and are not willing to experience. Releasing anxiety involves a process of learning to calm the body's physical responses, finding more realistic and soothing ways to talk to ourselves about our experiences, and avoiding the avoidance of anxiety that - paradoxically - only increases it.

Courage is fear that has said its prayers.

- Dorothy Bernard



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