Chapter 1
Showing How Anxiety Affects Our Lives
In This Chapter
Growing by leaps and bounds: Anxiety’s proliferation
Paying the tab for anxiety
Understanding anxiety symptoms
Getting the help you need
Stroll down the street and about one in four of the people you walk by either has an anxiety disorder or at some point in their lives will experience one. Almost half of the people you encounter will struggle with anxiety to one degree or another, although they may not have a full-blown anxiety disorder. The rate of anxiety disorders has climbed for many decades, and no end is in sight.
The world watches in fear as disasters, terrorism, financial collapse, pandemics, crime and war threaten the security of home and family. Anxiety creates havoc in the home, destroys relationships, causes employees to lose time from work, and prevents people from living full, productive lives.
In this chapter, you find out how to recognise the symptoms of anxiety. We clarify the costs of anxiety — both personal and societal. We provide a brief overview of the treatments presented in greater detail in later chapters. You also get a glimpse of how to help if your child or someone else you care about has anxiety. If you worry too much or care for someone who has serious problems with anxiety, this chapter (and this book) is here to help!
Anxiety: Everybody’s Doing It
Anxiety involves feelings of uneasiness, worry, apprehension and/or fear, and it’s the most common of all the so-called mental disorders. In other words, you definitely aren’t alone if you have unwanted anxiety, and the numbers have grown over the years. At no time in history has anxiety tormented more people than it does today. Why?
Life has never been as complicated as it is now. The working week has grown longer rather than shorter and we’re all likely to work longer as the official retirement age increases — in Australia, for example, it’s scheduled to increase to 67 in the next ten years and to 70 in the decade following.
Broken and blended families create increased stresses to manage. Computer screens and television news bring the latest horrors into your living room in real time. Newspapers, blogs, tweets and magazines chronicle crime, war and corruption. Terrorism has crossed the globe and escalated to new heights. The media’s portrayal of these modern plagues includes full-colour images with unprecedented, graphic detail. Let’s face it, fear sells.
Unfortunately, as stressful and anxiety-arousing as the world is today, only a minority of those suffering from anxiety seek treatment. That’s a problem, because anxiety causes not only emotional pain and distress but also physical strain and even death, given that anxiety extracts a serious toll on the body and sometimes even contributes to suicide. Furthermore, anxiety costs society as a whole, to the tune of billions of dollars.
When people talk about what anxiety feels like, you may hear any or all of the following descriptions:
- When my panic attacks begin, I feel tightness in my chest. It’s as though I’m drowning or suffocating, and I begin to sweat; the fear is overwhelming. I feel like I’m going to die and I have to sit down or otherwise I’ll faint.
- I’ve always been painfully shy. I want friends, but I’m too embarrassed to call anyone. I guess I feel like anyone I call will think I’m not worth talking to.
- I wake with worry every day, even on the weekends. Ever since I lost my job, I worry all the time. Sometimes, when it’s really bad, I think about going to sleep and never waking up.
- Ever since my accident, I have nightmares and constant images racing through my mind about glass breaking, tires screeching and passengers screaming. I’m so jumpy and irritable that I can barely get through the day.
- I’m so afraid of flying that I can’t travel, even though I’d like to.
- I worry about germs and contamination so much that I wash my hands about 30 times a day — my hands are raw and bleeding. I just can’t stop.
As you can see, anxiety results in all sorts of thoughts, behaviours, and feelings. When your anxiety begins to interfere with day-to-day life, you need to find ways to put your fears and worries at ease.
Calculating the Costs of Anxiety
Anxiety costs. It costs the sufferer in emotional, physical and financial terms. But it doesn’t stop there. Anxiety also incurs a financial burden for everyone, and stress, worry and anxiety disrupt relationships, work and family.
What does anxiety cost you?
Obviously, if you have a problem with anxiety, you experience the cost of distressed, anxious feelings. Anxiety feels lousy. You don’t need to read a book to know that. But did you know that untreated anxiety increases costs in other ways as well? These costs include
- A physical toll: Higher blood pressure, tension headaches and gastrointestinal symptoms can affect your body. In fact, recent research found that certain types of chronic anxiety disorders change the makeup of your brain’s structures.
- A toll on your family: Parents with anxiety more often have anxious children. This is due in part to genetics, but it’s also because all children learn from observation. Anxious children can be so stressed that they can’t pay attention in school or function well in the playground.
- Fat!: Anxiety and stress increase the stress hormone known as cortisol. Cortisol causes fat storage in the abdominal area, thus increasing the risk of heart disease and stroke. Stress also leads to increased eating.
- More trips to the doctor: That’s because those with anxiety frequently experience worrying physical symptoms. In addition, anxious people often worry a great deal about their health.
- Relationship problems: People with anxiety frequently feel irritable. Sometimes, they withdraw emotionally or do the opposite and dependently cling to their partners.
- Avoidance: Those with anxiety disorders avoid anxiety-provoking situations, so they miss work more often than other people, usually in an effort to temporarily quell their distress.
Adding up the cost to society
Anxiety costs many billions of dollars worldwide. A US government report says that anxiety costs more than depression, schizophrenia or any other emotional problem. The annual tab is estimated at more than US$65 billion. The United Kingdom spent 32 billion pounds (approximately $58 billion in Australian dollars) on mental health care in 2002, a huge portion of which was spent on anxiety-related problems. In 2010, the Australian Bureau of Statistics estimated the annual cost of mental illness in Australia at A$20 billion. Even countries that spend little on mental health care incur substantial costs from anxiety disorders. These costs include
- Decreased productivity
- Health-care costs
- Medications
Decreased productivity is sometimes due to health problems made worse by anxiety. But the financial loss from downtime and health-care costs doesn’t include the dollars lost to substance abuse, which many of those with anxiety disorders turn to in order to deal with their anxiety. Thus, directly and indirectly, anxiety extracts a colossal toll on both the person who experiences it and society at large.
Recognising the Symptoms of Anxiety
You may not know if you suffer from anxiety or an anxiety disorder. That’s because anxiety involves a wide range of symptoms. Each person experiences a slightly different constellation of these symptoms. And your specific constellation determines what kind of anxiety disorder you may have. We discuss the various types of anxiety disorders in detail in Chapter 2.
For now, you should know that some signs of anxiety appear in the form of thoughts or beliefs. Other indications of anxiety manifest themselves in bodily sensations. Still other symptoms show up in various kinds of anxious behaviours. Some people experience anxiety signs in all three ways, while others only perceive their anxiety in one or two areas.
Thinking anxiously
People with anxiety generally think in ways that differ from the ways that other people think. You’re probably thinking anxiously if you experience
- Approval addiction: If you’re an approval addict, you worry a great deal about what other people think about you.
- Living in the future and predicting the worst: When you do this, you think about everything that lies ahead and assume the worst possible outcome.
- Magnification: People who magnify the importance of negative events usually feel more anxious than other people do.
- Perfectionism: If you’re a perfectionist, you assume that any mistake means total failure.
- Poor concentration: Anxious people routinely report that they struggle with focusing their thoughts. Short-term memory sometimes suffers as well.
- Racing thoughts: Thoughts zip through your mind in a stream of almost uncontrollable worry and concern.
See Chapters 5, 6 and 7 for information about anxious thinking.
Behaving anxiously
We have three words to describe anxious behaviour — avoidance, avoidance and avoidance. Anxious people inevitably attempt to stay away from the things that make them anxious. Whether it’s snakes, dogs, heights, crowds, freeways, parties, paying bills, reminders of bad times or public speaking, anxious people search for ways out.
In the short run, avoidance lowers anxiety. It makes you feel a little better. However, in the long run, avoidance actually maintains and heightens anxiety. We give you ways of dismantling avoidance in Chapter 8.
One of the most common and obvious examples of anxiety-induced avoidance is how people react to their phobias. Have you ever seen the response of a spider phobic when confronting one of these scary-looking creatures? Usually, they make a very hasty retreat.
Finding anxiety in your body
Almost all people with severe anxiety experience a range of physical effects. These sensations don’t simply occur in your head; they’re as real as this book you’re holding (or the device you’re reading this on). The responses to anxiety vary considerably from person to person and include
- Accelerated heartbeat
- A spike in blood pressure
- Dizziness
- Fatigue
- Gastrointestinal upset
- General aches and pains
- Muscle tension or spasms
- Sweating
The symptoms in the preceding list are simply the temporary effects that anxiety exerts on your body. Chronic anxiety left untreated poses serious risks to your health as well. We discuss the general health effects in greater detail in Chapter 2.
Seeking Help for Your Anxiety
As we say earlier in this chapter, most people simply choose to live with anxiety rather than seek help. Some people worry that treatment won’t work. Or they believe that the only effective treatment available is medication, and they hate the possibility of side effects. Others fret about the costs of getting help. And still others have concerns that tackling their anxiety would cause their fears to increase so much that they wouldn’t be able to stand it.
Stop adding worry to worry. You can significantly reduce your anxiety through a variety of interesting strategies. Many of these don’t have to cost a single cent. And if one doesn’t work, you can try another. Most people find that at least a couple of the approaches that we review work for them. The following sections provide an overview of treatment options and give you some guidance on what to do if your self-help efforts fall short.
Untreated anxiety may cause long-term health problems. It doesn’t make sense to avoid doing something about your anxiety.
Matching symptoms and therapies
Anxiety symptoms appear in three different spheres, as follows:
- Thinking symptoms: The thoughts that run through your mind
- Behaving symptoms: The things you do in response to anxiety
- Feeling symptoms: How your body reacts to anxiety
(Refer to the earlier section ‘Recognising the Symptoms of Anxiety’ for more details on these symptoms.)
Treatment corresponds to each of these three areas, as we discuss in the following three sections.
Thinking therapies
One of the most effective treatments for a wide range of emotional problems, known as cognitive therapy, deals with the way you think about, perceive and interpret everything that’s important to you, including
- Your views about yourself
- The events that happen to you in life
- Your future
When people feel unusually anxious and worried, they almost inevitably distort the way they think about these things. That distortion actually causes much of their anxiety.
In the following example, Lisa has both physical symptoms and cognitive symptoms of anxiety. Her therapist chooses a cognitive approach to help her reduce these symptoms.
Lisa, a first-year at university, gets physically ill before every exam. She throws up, has diarrhoea and her heart races. She fantasises that she will fail each and every test she takes and that eventually, the university will dismiss her. Yet, her lowest grade to date has been a credit.
The cognitive approach her therapist uses helps her capture the negative predictions and catastrophic outcomes that run through her mind. It then guides her to search for evidence about her true performance and a more realistic appraisal of the chances of her actually failing.
As simple as this approach sounds, hundreds of studies have found that it works well to reduce anxiety. Part II of this book describes various cognitive or thinking therapy techniques.
Behaving therapies
Another highly effective type of therapy is known as behaviour therapy. As the name suggests, this approach deals with actions you can take and behaviours you can incorporate to alleviate your anxiety. Some actions are fairly straightforward, like getting more exercise and sleep and managing your responsibilities. You can get good ideas on those actions in Chapter 10.
On the other hand, one type of action that targets anxiety and can also feel a little scary is exposure — breaking your fears down into small steps and facing them one at a time. We cover exposure in Chapter 8.
Some people, with the advice of their doctor, choose to take medications for their anxiety. If you’re considering that option, be sure to see Chapter 9 to help you make an informed decision.
Feeling therapies — soothing the inner storm
Anxiety sets off a storm of distressing physical symptoms, such as a racing heartbeat, upset stomach, muscle tension, sweating and dizziness. We have a variety of suggestions, including breathing and relaxation techniques, for helping quell this turmoil. You may choose to make changes in your lifestyle (see Chapter 10), give the relaxation strategies we cover in Chapters 11 and 12 a try, or employ mindfulness, an approach that teaches you to connect with present moment experiences (see Chapter 13).
Choosing where to start
We organise this book so you can start anywhere you want, but you may wonder whether one set of strategies would work better for you than another. Although we can’t predict with certainty what will work best for you, the following quiz provides a guide for helping you choose the approach that may feel most compatible for your initial efforts. On the other hand, if you just want to read the book from front to back, that’s fine, too.
In the following anxiety quiz, check all the items that apply to you. If you check off more items in one category than the others, you may consider starting with the part of this book that applies to it. For example, Chapters 5, 6 and 7 are designed especially for thinkers and present the thinking therapies, also known as cognitive therapy; Chapter 8 is aimed at doers and provides the essentials of behaviour therapy. The chapters in Part III focus on feelers who may profit most by starting with strategies for quelling troubling bodily sensations and feelings through relaxation, diet, exercise, meditation, better sleep habits and mindfulness. If you check an equal number of items in two or more categories, ask yourself which one seems most like you and start there.
Thinkers (see Chapters 5, 6 and 7)
___ I like to analyse problems.
___ I like to carefully consider pros and cons.
___ I enjoy dealing with facts.
___ I like to be logical.
___ I like to plan things in advance.
Doers (see Chapter 8)
___ If I have a problem, I take action right away.
___ I love getting things done.
___ I’m energetic.
___ I’m an active person.
___ I hate sitting still with nothing to do.
Feelers (see Part III)
___ I am always aware of every discomfort in my body.
___ I hate the feeling of anxiety.
___ I love to immerse myself in the arts.
___ Music speaks to me.
___ I love the feeling of a massage or a hot bath.
Finding the right help
We suppose it’s not too presumptuous to assume that because you’re reading this book, you or someone you know suffers from anxiety. And you’d probably like to tackle anxiety on your own. This is a self-help book, after all.
The good news is that self-help does work. A number of studies support the idea that people can deal with important, difficult problems without seeking the services of a professional. People clearly benefit from self-help. They get better and stay better.
Then again, sometimes self-help efforts fall short. Chapter 22 provides ten critical signs that indicate a likely need for professional help. See Chapter 4 for information about finding the right professional for you.
If you do need professional consultation, many qualified therapists will work with you on the ideas contained in this book. That’s because most mental health professionals will appreciate the comprehensive nature of the material and the fact that most of the strategies are based on well-proven methods. If research has yet to support the value of a particular approach, we take care to let you know that. We happen to think you’re much better off sticking with strategies known to work and avoiding those that don’t.
In Chapters 18, 19 and 20, we discuss how to help a child or an adult loved one who has anxiety. If you’re working with a friend or family member, you both may want to read Part V, and possibly more, of this book. Sometimes, friends and family can help those who are also working with a professional and making their own efforts.
Whichever sources, techniques or strategies you select, overcoming anxiety will be one of the most rewarding challenges that you ever undertake. The endeavour may scare you at first, and the going may start slowly and have its ups and downs. Try to persevere in working on strategic approaches to managing anxiety. Let your appraisals be realistic to reduce ‘false alarms’, or feeling like you’re not progressing quickly enough. Accept anxiety as part of your experience and tolerate its spikes — let them pass. Don’t run away from or avoid anxiety because that keeps you fearful. Prove to yourself that, by facing fear, your tolerance for anxiety and coping skills are bound to improve.