Demystifying & Understanding Anxiety: Symptoms, Causes, & Treatments

Contrary to what we may hear these days, anxiety is normal, useful, and even essential for survival. Everyone experiences anxiety from time to time. Anxiety alerts us to threats, protects us from danger, and helps us reach important goals. For example, it is normal to feel anxious when starting a new job, useful when deadlines are approaching, and essential when encountering a bear on a hike.

What is anxiety?

Anxiety is a feeling of concern, worry, or fear about something that is happening or could happen. A stressful situation at work can cause anxiety, as can a fight among friends or family. For many people, anxiety is a normal, temporary, and non-debilitating feeling. For others, the anxiety “feedback loop” runs amok and becomes a problem in and of itself.

Anxiety is not dangerous and is adaptive. The sensations we experience in an anxious situation are there to alert and activate our “fight-flight-freeze” response; our heart beats faster to pump blood to our muscles, so we have the energy to run away or fight off danger. Anxiety is abnormal when it becomes disruptive and life-altering, preventing you from moving forward at work or at home.

What are symptoms of anxiety?

• Emotions — nervousness, tension, “on edge.”
• Physical responses — stomach discomfort, nausea, headaches, chest pain, sore shoulders, dizziness, lightheadedness, feeling foggy or detached, hot or cold flashes, lump in the throat, numbness or tingling, rapid heart rate, rapid or shortness of breath, sweating, trembling. If four or more of these symptoms happen suddenly and intensely, you may be having a panic attack.
• Thoughts — worrisome thoughts about a current situation or future event.
• Behaviours — avoiding things, places, or social situations; seeking reassurance; over-relying on others; excessive fear of making mistakes.

What causes anxiety?

Anxiety is not fully understood. Traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Stress due to illness, stress buildup over time, certain personality types, other mental health disorders, drugs or alcohol, having blood relatives with an anxiety disorder, and inherited traits can all be factors.

Your anxiety may be linked to an underlying medical condition if you don’t have any blood relatives with an anxiety disorder, you didn’t have an anxiety disorder as a child or teen, or you have a sudden occurrence of anxiety that seems unrelated to life events. It’s always a great idea to check in with your family doctor.

How has our understanding of anxiety changed over time?

Greek and Latin physicians and philosophers distinguished anxiety from other types of negative affect and identified it as a medical disorder; they suggested techniques reminiscent of modern cognitive psychology. Between classical antiquity and the late 19th century, cases of anxiety were reported but were not separated from negative affect — they were just classified under different names.

Eventually, Sigmund Freud coined many of the terms used for various anxiety disorders in the DSM-I and DSM-II. The DSM-III introduced new disorders such as panic disorder, generalized anxiety disorder, and post-traumatic stress disorder.

With the DSM-5, we saw anxiety disorders grouped into three areas (anxiety, OCD, and trauma- and stressor-related disorders) based on shared features, and developmentally related disorders grouped within the same chapters.

How is anxiety currently treated?

Exercise & lifestyle changes

• Participate in activities that you enjoy and make you feel good about yourself
• Exercise is a powerful stress reducer — start slowly and gradually increase
• Avoid alcohol and recreational drugs
• Quit smoking and cut back on caffeine
• Use stress management and relaxation techniques like yoga and meditation
• Prioritize sleep; ask for help if you can’t
• Eat healthily — lots of vegetables, fruits, and whole grains
• Practice mindfulness

Counselling & therapy

Counselling is an effective treatment for anxiety disorders. It is directed towards a person’s specific anxieties and tailored to meet individual needs.

Cognitive Behavioural Therapy (CBT) is the most extensively researched form of psychotherapy for anxiety disorders, and is recommended as a first-line treatment in Canadian and international guidelines (Katzman et al., 2014; NICE CG113). Two methods often used together:

• Cognitive therapy focuses on demystifying, challenging, and neutralizing unhelpful or distorted thoughts.
• Exposure therapy focuses on gradually confronting the fears underlying an anxiety disorder. Often used along with relaxation exercises or imagery.

Medication

Often used alongside psychotherapy but not necessarily required. Does not cure anxiety but helps relieve symptoms. Most common: anti-anxiety drugs (benzodiazepines), antidepressants, and beta-blockers. Always consult your doctor before stopping medication — stopping abruptly can cause withdrawal symptoms.

When should you seek help for anxiety?

• When it becomes life-disrupting
• When it interferes with your daily activities
• When you feel powerless to influence it
• The sooner, the better

Anxiety is part of life

Trying to eliminate it entirely is almost impossible and inadvisable. Your therapist can help you identify coping strategies, resources, supports, and strengths to utilize in managing anxiety — and develop the confidence and skills to tolerate anxiety whenever it occurs and continue living your life.

If anxiety is something you’re navigating, read about our anxiety therapy or book a free 20-minute consult.