Anxiety
Anxiety is experienced by all people to a greater or lesser extent. It is a reaction to stress that may be external to the person, internal or things anticipated by the person. It affects behaviour and can affect the body. An alternative term that describes the experience of anxiety is worry. Events such as upcoming exams, being interviewed e.g. for a job, giving evidence in Court, meeting a partner’s family for the first time or having to cope with anything new are likely to cause anxiety. At a purely psychological level the person may find that their thoughts race and they have difficulty relaxing. At a physical level the person’s heart may race, the palms of their hand might become sweaty and they might have a sense of panic. By and large the psychological reactions are cognitive (i.e. to do with thought) and the bodily changes are physical.
Any bodily system can be affected by stress: the person’s stomach may react e.g. with a feeling of nausea or there may be changes in abdominal function perhaps in the form of pain, there may be difficulties breathing, skin conditions can develop, changes in kidney or bladder function can be noted, there may be changes in sensory capacity, in the ability to move or in any of the body’s innumerable other functions. Many people are unaware of the direct link between stress and physical changes that are experienced as ill health.
Some people are anxious by disposition. It is often found that one or both of their biological parents were worriers. Equally other blood relative e.g. grandparents, siblings, cousins and their own children include worriers. Adoptive relatives are not relevant in this regard. Separately from this people may be worried by specific events they encounter. This is situational anxiety and it is usually fairly short lived. The greatest anxiety occurs in those who are worried by disposition who encounter stressful situations. At a purely psychological level if a person has a score of 7 out of 10 for dispositional anxiety and a score of 8 out of 10 for situational anxiety their overall level of anxiety is not 7 + 8 = 15 but 7 x 8 = 56 i.e. there is an interaction between dispositional and situational anxiety that is far greater than the sum of its two parts.
Anxiety can wear people down and they will report this as feeling depressed. There is however an important difference between having depressive symptoms and having a depressive illness. The former is often a reflection of being highly anxious and the latter is a true illness. This is demonstrated by the fact that antidepressant medication is far less effective with problems of anxiety than with depression. Psychological treatment in the form of CBT (Cognitive Behavioural Therapy) for anxiety is of two types. Those who have physical anxiety benefit greatly from relaxation training, those with cognitive anxiety benefit from cognitive therapy in which the person may be asked to identify symptoms that characterise their anxiety. The relative difficulty that each of these symptoms causes is determined by the frequency of occurrence. The three most troublesome symptoms are recorded by the person on a daily basis for 2 weeks, the person is then asked to say “that’s because I’m anxious but I’m in control” each time one of the three key symptoms occurs and to carry on recording the daily frequency of occurrence of the key symptoms for a further two weeks. For the first two weeks the person generalises the skills he or she has acquired by applying the statement “that’s because I’m anxious but I’m in control” to all occurrences of anxiety.
A trial involving over 420 people found that 95% had a statistically significant increase in their level of control over their anxiety symptoms.
A certain level of anxiety is necessary for people to function at all. Too low a level and the person is not motivated, too high a level and the quality of the person’s performance deteriorates.
DJM
April 11
