What is anxiety?
Anxiety is a response that prepares us to flee or fight danger by producing stress hormones (cortisol, adrenaline). These hormones influence our bodies, emotions and attention, and behaviour.
The effect of anxiety on our body
- Heart rate and blood pressure increase, which can feel like a racing heart or a pounding sensation in the ears
- Breathing increases, which can cause hyperventilation and subsequent dizziness, and/or a sense of derealization, as if one is looking down at oneself
- Blood flow is directed away from the feet and hands and towards the large muscle groups, which can lead to tingling or numbness in the hands or feet (hence the term “cold feet”)
- Perspiration increases
- Muscle tension increases
- Nausea or other digestive disturbances can occur
The effect of anxiety on our emotions and attention
When anxious we become “threat sensitive”, alert to any sign of trouble. We can find it difficult to concentrate on anything else but the sense of threat and we may trivialize, discount or fail to notice information telling us things are fine. We may feel a sense of dread, doom, fear or just “on edge”. Often we can’t detect a specific sign of trouble, so we begin to wonder what we should be worried about. We may be quite irritable when anxious because we don’t want to be distracted.
The effect of anxiety on our behaviour
When anxious, we try to escape the situation, or at least the aspects of the situation that are causing us anxiety. For example, we might stay at a party but avoid talking to people we find intimidating, or go to a movie but be sure to sit on the aisle seat. We may avoid shaking hands, or we may be vigilant for any changes in our body symptoms (e.g., by checking our heart rate). We may avoid situations altogether (e.g., use the stairs rather than the elevator, avoid taking classes that require presentations, never use public bathrooms, avoid being the last one to leave the house, avoid leaving the house). If we cannot escape the situation, we may try to reduce anxiety by drinking alcohol or using drugs.
Some faces of anxiety
“Richard” is afraid of germs. He has elaborate cleaning routines for every room in the house and gets very upset when people don’t comply, even though the routines take hours. Richard’s family describes him as a neat freak.
“Marty” gets very anxious around people because he thinks he won’t measure up and they will make fun of him. He can’t bring himself to meet new people or speak up for himself. He has very few friends and has never had a romantic relationship even though he would like one. His family describes him as painfully shy.
“Fatimah” has panic attacks that come out of the blue and leave her terrified there is something wrong with her, even though numerous medical tests have detected nothing. She avoids lots of places now out of fear of having an attack and doing something embarrassing or not getting the help she needs.
“Ling” worries to the point that it makes her sick to her stomach. She can always spot what could go wrong and tries to plan against it, but the worries never stop. Ling has difficulty sleeping, is irritable, and can never relax. Her family describes her as a worrywart.