What is anxiety?

Anxiety can be thought of as a response to a perceived threat or potential danger. This can be specific to a person, object, or situation (e.g., anxiety about planes) or more general uncertainty about something that could happen down the line.

People often distinguish worry in anxiety and depressive rumination by its temporal direction. Depressive rumination is past-focused (e.g., “I could have done better in my exam today) whereas worry is future-focused (“I haven’t prepared enough for my exam next week).

Components of anxiety

Anxiety has three main components: a physical component, a cognitive component, and a behavioural component. These components are interlinked and can affect each other.

Physical component. The physical component is the physiological response, in which the sympathetic nervous system (network of nerves that puts our body in the ‘fight-or-flight’ response) prepares our body to handle threats. These are the sensations you might typically think of when you are anxious: your heart might racing, your body might be trembling, it may be difficult to breathe, etc. Once the perceived danger is gone, the parasympathetic nervous system kicks in to bring us back to baseline.

Cognitive component. When we are anxious, there is usually a thought that is automatically activated, which is associated with the situation. For example, in social anxiety disorder, the fear is negatively evaluation (i.e., other people thinking poorly of you). In a social situation, the thought that may pop up is “I’m going to look stupid in front of this person” or “I won’t know what to say and it’s going to be really embarrassing”.

Behavioural component. Our anxiety also leads to certain behaviours that try to reduce the anxiety. Many of these behaviours typically lead to short-term relief, but at the cost of maintaining the anxiety. A few examples include:

  • Avoidance
  • Overpreparation
  • Taking a friend along
  • Taking substances to relieve anxiety
Components of anxiety: thoughts, physical sensations, and behaviours
The three interrelated components of anxiety

Anxiety can be adaptive

Anxiety is different from an anxiety disorder. Anxiety is a perfectly normal experience, and everyone experiences anxiety to some degree. In moderate doses, anxiety can help us prepare for possible dangers and make sure that we stay safe. For example, if we did not have any anxiety about a test, we probably wouldn’t put in very much effort to prepare for it. Without anxiety, new mothers might be less attentive of their baby to ensure that their needs are being met. On the other hand, when anxiety is too high, it may impede us from engaging in goal-directed behaviours.  

When does anxiety become a problem?

Although anxiety in normal doses can be helpful, we move into the anxiety disorder category in some certain instances.

When anxiety becomes excessive. Anxiety disorders are typically excessive compared to the actual danger that the situation presents. For example, a person with generalized anxiety disorder may worry for several hours about being late to an appointment. Another example would be a person with social anxiety disorder choosing to not show up on the day of a presentation despite the presentation being worth 30% of their grade.

When anxiety is persistent or prolonged. Another quality of anxiety disorders is that they are more persistent or last longer than regular anxiety. For example, anxiety may be present most of the day and have been this way for the last several months.

When anxiety causes significant distress or is impairing daily functioning. The final quality I will talk about when anxiety becomes an anxiety disorder is when it begins to cause significant distress or impairs daily functioning. For example, when you need a friend around you to deal with a situation or you begin to avoid going to certain places because of the anxiety, then you may have an anxiety disorder.

Anxiety is helpful at taking tests.
Anxiety can be helpful when preparing for a test!
Photo by Ben Mullins on Unsplash

Types of Anxiety Disorder

  • Social Anxiety Disorder
  • Panic Disorder
  • Agoraphobia
  • Illness Anxiety Disorder
  • Generalized Anxiety Disorder
  • Specific Phobia

For more information on these disorders, see this post on six common anxiety disorders!

Evidence-Based Strategies to Manage Anxiety

The goal in therapy for anxiety is not to eliminate anxiety. In fact, I would not want to even if I could because anxiety can be helpful. The goal then is to reduce anxiety to the extent that it is no longer impairing your daily life and you are able to leverage anxiety in a way that supports you, rather than hinders. Below are a few evidence-based strategies to manage anxiety based on our thinking and behaviours. As you remember from the components of anxiety, we can intervene at the cognitive, behavioural, or physical level.

Strategies to target cognitions. Cognitive strategies challenge anxiety thoughts to bring a more balanced, realistic perspective. In doing so, we reduce our catastrophic worry thoughts, which can have a beneficial impact on our overall anxiety and emotions. Thought records can be a great way to evaluate our anxious thoughts to see if they are indeed true. Besides changing our thoughts, mindfulness exercises are helpful to change our relationship with our thoughts. By recognizing that a thought is simply a thought, the power of the thought weakens and we are less affected by it.

Strategies to target behaviours. Behaviours, such as avoidance, can lead to short-term relief but long-term anxiety. Therefore, evidence-based strategies such as behavioural experiments and exposures, are excellent options to confront our fears. Behavioural experiments allow us to act like curious scientists and systematically test whether a negative prediction is likely to be true. Moreover, it gives us the opportunity to see whether we can cope even if our worry thoughts end up being true. Exposures are a clinical technique that gradually puts us in a situation that we fear to increase our resilience to the feared object. For example, gradually exposing ourselves to spiders (if you have arachnophobia) to allow our brain to recognize that our fear is unsubstantiated.

Strategies to target physiological sensations. Relaxation strategies, such as breathing exercises and progressive muscle relaxation, put us in a state of low basal arousal. These techniques are naturally anxiety-reducing as they are behaviours that are incompatible with stress and are very compatible with a state of calmness. To learn more about different relaxation strategies, see this post on three relaxation techniques.

Summary

  • Anxiety can be adaptive in everyday life
  • There are three components of anxiety: behaviours, thoughts, physical sensations
  • Anxiety becomes anxiety disorders when it becomes excessive, distressing, and/or impairing
  • Evidence-based strategies to target each of the components of anxiety are presented

Best wishes,

P

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