Anxiety is basically creating conspiracy theories about ourselves all day long, and it is exhausting. I say this only partially joking. Anxiety is worrying about everything and anything for more days than not with difficulty being able to control the worry. Now this is the DSM-5 definition, but what does it feel like? We constantly feel on edge, feel full of apprehension, and mistrust our own instincts. We overthink everything all of the time and can feel completely paralyzed. We feel anxiety in our body and it is more than a feeling of nervousness or not being able to sit still. Our bodies feel restless and keyed up. We have to move, our heart can start racing, our breathing becomes more rapid and shallow, and our entire body can be tense throughout the day. Something does not feel right, and often times because anxiety is in our body—people cannot even identify what they are worrying about, we just know things are not okay.
Evolutionarily it makes complete sense why we developed this emotion. We needed to be able to sense something was not right in our environment so we could either run or avoid it. Anxiety creates fear and apprehension, which significantly contributed to survival and safety. Anxiety triggers activate the fight-flight-freeze system which releases hormones in order to help us engage appropriately with our environment. How, then do we know when what we are feeling is a reaction to our environment or something more? What is the key to understanding when anxiety is “normal,” which I hate the word normal, or when does it become excessive and not a response to our environment? I think the word extreme can be helpful in navigating anxiety. When it becomes a disorder, our responses to our internal and external stimuli are extreme. We have intense fear and worry which cannot be easily decreased with just recognizing nothing in our immediate environment is threatening. When anxiety is extreme our entire functioning is impacted: being around people can be exhausting; starting a task can cause complete debilitation; sleep is impacted; relationships are affected; work is affected; and our emotional well-being is in jeopardy.
For those around us, what does anxiety look like? It looks like a friend constantly cancelling plans because the idea of being with other people can sound exhausting. But then, cancelling the plans can cause more anxiety because we become so worried and create stories about the cancelling of plans the person hates us and we have lost the relationship. For our partners, we can come across as incredibly irritable because the thoughts and worries in our head prevent our ability to communicate effectively. Most people can become pretty annoyed with us because when we are worrying so much, we need constant validation about what we are worrying about is in fact, not reality. We avoid, but then when we actually do take the risk and speak up about what we are feeling, we second guess if we should have done it for so long it causes us to avoid again in the future.
Anxiety has been shamed and stigmatized, like most mental health disorders and symptoms are, as being something wrong with people and something they can and “should” control. Telling someone not to worry about something is about effective as telling an irate person to “just relax” or “clam down.” It is not helpful and when this emotion is shamed it creates even more anxiety for those struggling with it. What people with anxiety hear is, “Your emotion is making me uncomfortable, so you need to change it,” which only makes people more anxious because then we ruminate how much we are bothering others!
What can we do about it? There are actually several useful strategies, such as paced breathing and progressive muscle relaxation during heightened anxiety episodes. Keep in mind anxiety and worry are rooted in the emotion of fear, and fear motivates us to run or move. Thus, acting on our emotional urge, like exercising or going for a walk can be extremely beneficial. Therapeutic modalities, such as cognitive behavioral therapy and dialectical behavioral therapy have been shown to be incredibly effective. However, I would argue the most beneficial strategy for combatting anxiety is education. We need to educate ourselves how we experience anxiety in our bodies so we can feel it rather than stuff it; learn how to communicate what we are feeling so those close to us know when we are suffering; and talk about it. Shame causes us to stay quiet which increases our feeling of anxiety, and speaking out about our experience is the only anecdote to shame.