Ask An Adult: How Do I Know If My Worry Is Actually Anxiety?
The Debrief: Are my little worries actually way more serious?
Sweat, tears, a gnawing in your brain; we all know worrying. It walks along with us from the playground to the grave. But how do you know if your feeling about those looming deadlines, misplaced keys, family reunions and first dates is just everyday worrying or if you might have tipped over into something rather more serious?
We spoke to Dr Anne Marie O'Connor, Director and Clinical Psychologist and themindworks, private psychological practice in London, to ask how you can spot the difference between worrying and anxiety.
How do you differentiate between worrying and anxiety?
People worry. That’s fine. The main differentiation we have between the two is about functioning. Does it stop you doing something you want to do; having a conversation, visiting a place, going for a job, turning up at an event? If it interrupts your life or alters the way you do things, then it’s edging towards anxiety rather than just worry.
People often talk about having depression with anxiety. Can you suffer from both?
They often go hand in hand. Anxiety is a clinical term for fear, or threat. So, of course, being scared a lot of the time is obviously going to be very demoralising. It can crush both your confidence and your mood. If someone has an anxiety disorder their only respite from the anxious thinking and anxious process might be depression, because then your body and mind have time to recuperate, as unpleasant as that is. Then the anxiety picks up again.
Is anxiety more common among women?
In my experience it is under-reported in men. Women are more proactive when it comes to talking about the problem and seeking treatment. It is now completely acceptable to talk about anxiety, to ask your friends about it, to bring it up and recommend treatments.
What does anxiety feel like?
Anxiety can be a very physical experience. Your heart’s racing, you feel sick, dizzy, you’re restless and have lots of tension in your body. People can very often feel like a panic attack strikes from nowhere. That they weren’t even doing anything that made them feel nervous or agitated and then suddenly, bam!, this overwhelmingly daunting and physical experience took over. As a result, people can get scared of getting anxiety and that creates a problem because, in life, we do feel anxious sometimes.
Lots of people learn coping mechanisms to reduce their anxiety - is that helpful?
We call those safety-seeking behaviours. They’re done in a response to anxiety, which is something that makes you feel very threatened. Anxiety is our defence system being switched on. All of our oxygenated red blood cells are pumped to our limbs, ready to fight or flight, but if we’re just sitting on the tube then of course that’s completely unneccesary. Physiologically it’s no different to going to the gym and running on the treadmill. It’s just that it’s out of context, which makes it a very unpleasant sensation.
You might look out for exits or toilets, in case you need to escape. And that makes you feel temporarily reassured, so the anxiety goes down. But long term that behaviour reinforces or maintains the problem because next time you go out you’ll do the exact same thing. Treatment will include putting yourself in that situation, not using those safety-seeking behaviours and seeing what happens.
Let’s talk about treatment. What can people do to treat anxiety?
Cognitive Behavioural Therapy is the only evidence-based treatment for anxiety. Some people get good results from other things like hypnosis, but CBT and mindfulness are the only things I would recommend.
It’s collaborative work. You have to do homework. Like learning any other skill - like driving or the piano - you have to practice. If you only practice once a month you’ll learn, but it will take a lot longer. If you do 10 minutes a day you’ll get good at it really quickly.
It’s a two-pronged attack. You tackle the cognitive aspect: so what is it in your thinking that’s making you anxious when you walk into that restaurant? It’s usually something we call cognitive bias. Then there’s also the behavioural aspect: what are you doing, what safety-seeking behaviours are you using and then we make you do those differently? Those experiments in behaving differently will feed back into your thinking and make you realise that, actually, it’s not that daunting. With mild-to-moderate anxiety we might be talking as few as six sessions.
It is really treatable. We just need to understand it. Anxiety is what makes us human. We think about things, try to make sense of things, worry about things, try to minimise the chances of bad things happening again. We’re intelligent people so we’re motivated to try and work these things out. But the cost to us is often feeling anxious.
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