I have always loved Pixar’s Toy Story films, not least because the toys capture so many fundamental personality types. Buzz is adventurous, optimistic; Woody is loyal, organised (a little controlling); Jessie is feisty and passionate; and Rex, the tyrannosaurus whom I relate to most, is sensitive, with a deep-set loathing of uncertainty. Sometimes I blame this personal tendency on my Taurean traits (we’re homebodies, we hate change), but really I can’t stand not knowing. A slew of possibilities will run through my mind, from the mildly inconvenient to downright catastrophic. On bad days, I’ll unravel completely and call my closest friends (okay, text) in a panic. And it seems I’m not alone.
Anxiety is on the rise, so much so that the Institute for Health Metrics and Evaluation reported in 2018 that 284 million of the global population now suffer from it, in one of its forms: panic disorder, obsessive compulsive disorder, generic anxiety disorder (GAD), social anxiety. This makes it one of the most prevalent mental health issues today. In the US alone, according to the Anxiety and Depression Association of America, 18 per cent of the population suffers from anxiety each year, yet only 36.9 per cent of those go on to receive treatment.
What is anxiety?
“Broadly speaking, anxiety disorder is when a person has so much anxiety that it prevents them from doing, or makes it extremely difficult for them to do, ordinary things that they would want to do,” says Dr David Carbonell, psychiatrist and author of bestselling self-help book, The Worry Trick. This manifests in various forms that can deeply affect day-to-day quality of life. It could be avoiding driving in certain circumstances, flying, socialising with groups for fear of awkward encounters—it is essentially where a normal activity causes undue stress and suffering.
“Anxiety is very similar to fear, only it’s fear cast to the future. You look to the horizon and anxiety is the ‘what if’s’, the uncertainty of what’s going to happen. Asking yourself constantly, Am I going to be ok?” explains Dr Ellen Hendriksen, author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety.
What are the triggers?
The key contributing factors to anxiety remain the same as decades ago: difficult relationships, unemployment, loneliness, exposure to trauma, conflict. However, our digital age has added its own slew of problems. Being connected 24 hours a day not only means exposure to news (good, bad, catastrophic), it also exposes us to the dangers of data hacking, trolling, systems crashing—the hurdles are endless. With the digital revolution comes a reduced need for personal interaction and as social media platforms thrive, there’s more of an emphasis on happiness based on metrics—how many followers, how many likes you get.
The evolution of technology further exacerbates the problem as it means we no longer have to leave our homes to carry out our day-to-day chores. Things that may have been perceived as stressful, but also deemed necessary, once forced us to face situations we can now comfortably avoid behind our screens. Why engage face to face, or even a phone call, when you can text? Why have a conversation with a colleague when you could chat online?
How do you get anxiety?
There are multiple factors that can contribute to anxiety, one being genetics. While an anxious predisposition can be inherited from your gene pool, major life changes also act as a catalyst— whether that’s leaving school or home for the first time, changing jobs, moving house, breaking up, having a child or any other uncertainty that comes with a shift in circumstance. It’s often at turning points like these that someone who has never suffered from anxiety before can develop it.
“It is, however,” explains Hendriksen, “built into nature, baked in and largely genetic. More often than not it is triggered by an event, usually a life event, particularly when there is a lot of uncertainty, or something happens to us, or we’re unsure of the outcome.”
Carbonell agrees: “There are genetic predispositions, more strongly in some families than others. I strongly believe that people are simply born with a likelihood of developing an anxiety disorder, and if they fall into this category, they have a season in which they bloom. For panic disorders, it’s somewhere between the ages of 18 and early thirties. Independence, adulthood—maybe all of these positive changes can suddenly become confronting.”
Is anxiety curable?
“People can enter into a long-term state of remission, which may continue for the rest of their lives. The word ‘cure’ has problems as it’s not really a disease,” explains Carbonell. “Some more extreme versions of anxiety can lead to this mentality, and a dependency on the mindset that you’re ‘cured’. Then the obsession will transmit to constantly reverting back to the mindset of I better check and see if my ‘cure’ is holding. That will be the undoing of it. The other thing about a ‘cure’ is that anxiety is an ordinary part of life, just a supercharged version of it.”
“Some anxiety is adaptive and frankly necessary,” adds Hendriksen. “It keeps us safe, keeps us from hurtling headlong into a situation. It forces us to stop and think. It’s our smoke detector. You wouldn’t want to turn it off.”
How can you manage anxiety?
Anxiety is vague, so a good strategy is to focus your thoughts in the form of a question. “You can argue with the what if’s if you specify theoretical situations, specify what your feared outcome is when your boss calls you into the office, etc. What is the worry exactly? It then becomes much easier to logic your way out of it,” explains Hendriksen.
- Specify your feared outcome. Eg: What if my boss fires me today?
- Turn the question into a statement. Eg: My boss will not fire me today.
- Ask has this ever happened before. Eg: Has my boss ever fired me before?
- What are the odds? Eg: Low.
- Anxiety also comes from believing you can’t cope. Make a plan for whatever you’re worried about. What are you doing about it? This takes away the uncertainty.
The core of both successful self-management and/or professional treatment of anxiety is exposure. Exposure therapy involves facing the situation that is causing you stress and anxiety. “We want it to be permissive. It’s important to take one step at a time. We don’t want exposure to be in a fighting, resisting, struggling kind of way, as that will bring up fight-or-flight reactions, triggering further stress,” says Carbonell. “Exposure therapy is not about fighting off the anxiety, it’s about staying in a situation long enough to be aware that it’s unpleasant. It’s about being able to hang out there and stay with it and see that it eventually subsides.”
Carbonell emphasises that coping doesn’t mean giving up on the things that cause the anxiety, whether that’s driving or presentations at work. Instead, it’s about staying exposed to it long enough to see that it won’t be catastrophic. “Ultimately, each time one avoids, one gets fooled into believing it’s harmful. The attitude of exposing yourself to the stressful situation can slowly reduce its status as something fearful.”
When it comes to mental health issues, meditation has proven efficacy. Researchers from Johns Hopkins University in Baltimore examined 47 trials that addressed the use of meditation to tackle the symptoms of anxiety. They showed considerable benefit to using meditation to quieten the anxious what if’s in the mind.
“A breathing technique is a good thing too,” adds Carbonell, “because people with panic disorders, in particular, tend to have bad breathing techniques. The chest gets tight and releases a whole lot of other symptoms, so finding a rhythmic breathing exercise can be a great comfort.”
Getting adequate sleep will keep the adrenals in check, meaning less cortisol in the system, meaning less incidents of fight-or-flight response. Ultimately it will keep you calmer if you are prone to anxiety, allowing for a greater resilience to things that may trigger an anxious episode.
“Exercise across the board, but particularly for anxiety disorders, is a good thing,” advises Carbonell. “Lots of people with anxiety disorders can be afraid of exercise because their heart rate picks up and their breathing gets out of control, but learning to exercise in a controlled way can have a great effect. It’s all a matter of proportion. The best use of exercise to get into a regular routine—three to five days a week, 30 to 40 minutes is helpful. What’s unhelpful is to get into the mindset of dependency, thinking Every time I have to do something challenging, I can go and work out hard for that hour. It’s not a shield, better to use it like a daily vitamin for its overall effects.”
Also read:
WHO officially recognises workplace burnout as a legitimate diagnosis
Alia Bhatt on anxiety: “Sometimes I feel like crying for no reason”
