Posted by Rachel Mallory

Given how common anxiety is, it’s pretty surprising that people tend to know so little about it when they first come in for treatment. Except that it really doesn’t seem to be discussed much, as far as I can tell. Stress – for sure, that gets talked about in the popular media. Stress tends to be seen as anxiety that’s a normal response to bad things happening. There are ways to deal with it, like exercise, or taking deep breaths, or prioritizing. Almost any popular magazine has frequent articles about this kind of thing.

Anxiety, on the other hand, is terrible, and mysterious, and inescapable. At least, that’s how my clients seem to perceive it, and it’s such a common view that it must come from our culture to some extent. It seems to be discussed even less than depression is, and that’s saying something.

So what is it? Anxiety is really fear, but fear without a clear trigger or solution. If a wild animal is chasing you, or a car looks like it will hit you, there is a clear source for the fear, and a clear solution – typically, run, or fight. So the body prepares for this with a massive adrenaline dump into the system. Your heart beats faster, your breathing speeds and shallows, your big muscles tense in readiness. All of the nonessential aspects of your physical self, like your extremities, your intestinal system, and, oddly, your brain, are shut down to some extent in order to fuel what’s really needed to have this huge burst of explosive action.

But what if there’s no car, no wild beast? What if the source of your fear is stress about work, or kids, or money? What if it’s a combination? What if it’s grief? Then all this preparation to fight or run is kind of irrelevant, and it doesn’t make sense, and you end up with odd thinking and bodily sensations that are horrible and frightening in and of themselves. Of course, you will frantically try to figure out what’s wrong. Maybe I’m having a heart attack, or a stroke. Maybe I’m going to go crazy. Maybe I’ll scream and embarrass myself… and the fear ratchets higher and higher and higher.

At its most extreme, anxiety can end in panic, and I often see clients with this issue. But worry is also very common, as is social anxiety. In the short term, anxiety is not harmful, although that is often difficult for people to believe. Having said that, anxiety symptoms need to be medically checked, because there are a number of possible physical causes, including heart concerns. However, that is the exception rather than the rule.

Ironically, anxiety is often the fastest and easiest of the psychological conditions to treat. (I do not include obsessive-compulsive disorder here, which is a more complex illness.) Education is a major aspect – if you know what is going on, it becomes much less frightening. Other than that, what helps anxiety? Well – look back at the recommendations for stress. Exercise. Deep breathing and other forms of relaxation. Prioritizing. Along with social support, and more specifically, identifying and challenging negative and erroneous thinking that leads to anxiety. Perfectionism is one frequent thinking pattern for those with anxiety, for example. Treatment may be as little as four to six sessions, depending on your particular concerns and how much you will work on your difficulties outside of sessions. It’s like driving lessons: the lessons matter a lot, but what is most important is all the practicing you do between meetings with your instructor.

For some people, medication is a helpful aspect of treatment, and I usually encourage people to discuss this with their doctors. Some antidepressants, for example, have good effects on anxiety and do not carry the risk of dependence and tolerance.

If you have anxiety, please seriously consider seeing a qualified psychologist or therapist, preferably one trained in cognitive-behavioural therapy. Hey, to quote Franklin D. Roosevelt – the only thing you have to fear is fear itself.