Anxiety Disorders
Anxiety is a normal and natural human emotion. Healthy levels of anxiety can serve as a form of protection and survival. Most individuals experience a normal amount of worry about important aspects of life such as relationships, performance, school, career, finances, health, and the future. Typically, these normal worries are not long-standing and do not cause a significant disruption to an individual’s emotional well-being and everyday functioning.
Anxiety disorders are different from the normal worry the average person may experience with everyday stressors. Anxiety disorders are characterized by excessive, irrational, and chronic worries that cause significant emotional distress and impact everyday functioning. Anxiety disorders can wax and wane throughout life and they tend to get worse during times of stress.
Signs of Problematic Anxiety:
Constant or persistent worry thoughts
Frequent somatic complaints: Headaches, stomachaches, unexplained physical complaints
Inability to concentrate
Irritability or moodiness
Behavioral outbursts
Refusal/shutdown behaviors
Avoiding situations
Asking many questions
Seeking frequent reassurance
Missing out on important life activities and events due to anxiety
Engaging in a high degree of pleasure or preferred activities and not participating in important life tasks or events
Core Components of Anxiety Disorders
There are several different anxiety disorders; however, there are relevant core components that cut across all anxiety disorders.
Intolerance of Uncertainty:
Life naturally requires us to live with uncertainty every day because we can never be 100% certain about anything. We tend to experience anxiety in areas of life where we seek certainty and predictability. Individuals with anxiety disorders tend to hold strong negative beliefs about the unknown and potential consequences.
Lower Risk Tolerance:
Life requires us every day to make decisions in which we assess risk and outcomes. Individuals with anxiety disorders are hypersensitive to risk and are less likely to take risks in life.
Lower Acceptance of Distress:
Humans are intended to feel the full range of emotions. Some emotions are pleasant and easier to experience, while other emotions can be more intense and uncomfortable to experience. Individuals with anxiety disorders are more sensitive to emotional discomfort and struggle with embracing unpleasant internal or emotional experiences. Individuals with anxiety disorders tend to try to change or get rid of unpleasant internal and emotional experiences which often is a main contributor to the vicious cycle of problematic anxiety.
Specific Anxiety Disorders:
What seems to differentiate each anxiety disorder is the specific content of the underlying area of intolerance of uncertainty and associated emotional and behavioral features.
Generalized Anxiety Disorder (GAD) is characterized by a general sense of uncertainty about a number of everyday life events with the intent of trying to minimize the likelihood of negative outcomes. These constant and excessive worries thoughts can appear obsessional with the “what ifs” of all future possibilities.
Social Anxiety Disorder (SAD) is characterized by a sense of uncertainty related to past, current, or future negative evaluation in social and performance situations. Individuals with social anxiety can also experience a fear of embarrassment, being the center of attention, humiliation, and criticism.
Panic Disorder is characterized by a sense of uncertainty related to the cause and consequences ofuncontrollable somatic sensations.
Separation Anxiety Disorder is characterized by a fear of being alone, abandoned, or something bad will happen when separated from an important caregiver.
Specific Phobia is characterized by a sense of uncertainty related to the unknown or anticipation of encountering a specific object or situations that causes unwanted distress.
Agoraphobia is characterized by a fear of experiencing unknown and uncomfortable emotional and physical sensations in public spaces.
Health Anxiety is characterized by the fear and expectation of having an unknown or unwanted health or medical condition.
Selective Mutism is characterized by the fear of negative evaluation and being the center of attention in addition to having a lower tolerance for embarrassment, humiliation, and criticism that results in inability to communicate in specific settings.
Anxiety-Avoidance Cycle
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Problematic anxiety is developed and maintained through the anxiety-avoidance cycle. Anxiety is elicited by internal and external triggers. Thoughts, emotions, memories, and physical sensations are common examples of internal triggers of anxiety, while anxiety triggers outside of the body and part of your environment are called external triggers, such as specific people, places, objects/items, or situations.
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Humans are biologically hardwired to avoid and alleviate distress so when anxiety is elicited in the body, it often can be experienced as an uncomfortable, unwanted, uncontrollable, and undesirable that creates a strong sense of urgency for immediate relief . Avoidance responses are any thoughts or actions that are taken with the intent to quickly decrease or escape feelings of anxiety and emotional distress.
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Initially, avoidance responses are highly effective and create quick and immediate relief from distress. This immediate sense of emotional relief creates an illusion of emotional control and certainty that makes it more likely that avoidance responses will be used in the future to respond to anxiety-provoking situations. However, the immediate relief from distress is only temporarily and the anxiety will inevitably come back stronger and more intense next time. Over time, these avoidance responses become less effective and there is a need to use avoidance responses more frequently in attempt to create the same level of relief. Also, when avoidance response become less effective it can set the stage for individuals to engage in more intense and severe avoidance responses in attempt to get instant emotional relief.
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In the long-term this pattern causes anxiety to get worse and results in a significant disruption to an individual’s emotional well-being and everyday functioning. Individuals who experience problematic anxiety often feel stuck in the anxiety-avoidance cycle and tend to make decisions and live their life in service of emotional relief rather than living the life they truly want.
Family Involvement in the Anxiety-Avoidance Cycle
The family system is often a primary source of support and comfort for many individuals, especially during times of stress. It is normal and healthy to provide support and care for a loved one when they are experiencing distress. However, sometimes well-intended family actions of support and accommodation unintentionally strengthens and grows anxiety. Family support and accommodation can take many different forms. When family members modify their own behaviors to help their loved one avoid or minimize distressing emotions they are unknowingly contributing to the anxiety-avoidance cycle. For instance, this might look like modifying family schedules or routines, answering your loved ones repeated anxious questions, taking on extra responsibilities, or not doing or going to meaningful or important activities. Initially, these actions provide immediate relief from distress for their loved one and they can seem very helpful, but the relief is only short-lived and the unwanted anxiety and emotional distress comes back stronger. As a result, a persistent pattern of avoidance responses tends to develop with a greater need and reliance on family members to provide relief from distress.
Many times, family members unknowingly and naturally get entangled with anxiety disorders and it can significantly impact their own quality of life as well. These actions of family accommodation do not mean that parents or family members are at fault or caused their loved one’s anxiety. It actually means that parents and families are an important part of the solution to helping their loved one overcome and break free from problematic anxiety.
Break Free with Anxiety Therapy in Doylestown, PA
With effective treatment you can reclaim your life from anxiety and emotional distress. Cognitive-behavioral treatments (CBT) and exposure-based behavioral therapies are scientifically proven treatments for anxiety disorders. There are several factors that contribute to treatment success for anxiety disorders. Working with a trusted professional and using treatment approaches that have been scientifically proven to work are important ones. Speak with a mental health professional at our center to learn more about your care options for breaking free from anxiety.