We all worry at some point, to some degree, about our friends and families, about finding a romantic partner or making it work with the one we have, about getting through school, about finding — or keeping — a job. We worry about our health, how we look, about our future, and our safety. And for most of us these worries come and go; it’s the natural, normal response to being a person in the world. We worry, we wonder and then we move on.
But for some of us the worries don’t seem to stop. They circle, and grow, and intrude. They’re unwelcome and unwanted but impossible to shake. If this sounds all too familiar, then you may be dealing with an anxiety disorder, and it’s time to get some help.
How do I know if it’s just anxiety, or an anxiety disorder?
The difference between normal worry and an anxiety disorder is the severity of the anxiety — how much time you spend being anxious and how much your anxiety impacts your daily life.
There’s a big difference between feeling stressed out after a fight with friend, or obsessing over the last thing you said to your Tinder or Bumble date, and the kind of pervasive, intense worry that’s caused by a disorder. Anxiety becomes cause for concern when it interferes with your ability to do the things you need to do, prompts you to avoid a lot of things that most people enjoy, keeps you from activities that used to be fun for you, or seems to come out of nowhere and won’t stop.
Signs your worries could be more than ordinary anxiety:
It’s unrealistic. You worry that every phone call might be someone telling you your parents have died, even though they’re healthy and safe at home.
It’s out of proportion. You spilled a drink on the host, or made a stupid offhand comment at a party, and you can’t stop thinking about it. Does everyone hate you? Why did you have to say that? Are your friends still talking about it?
It makes you overly self-conscious. You feel like everyone is looking at (and judging) you, so you hate to leave your apartment.
It’s unwanted and uncontrollable. You know that flying on airplanes isn’t actually dangerous, but you can’t stop panicking about your upcoming trip and obsessing on worst case scenarios.
Once it starts it doesn’t go away. You had a health scare three months ago that you’re still thinking about even though the doctor gave you a clean bill of health.
It makes you avoid things you once loved. You wave goodbye to your social life to stay at home alone and, if you do go out, you don’t have fun at events you used to love.
Kinds of anxiety
Not all anxiety disorders are the same, and different types of anxiety need different kinds of treatment. Understanding what you’re dealing with makes it easier to get the right kind of help, fast. Here are some of the most common:
· Social anxiety disorder: You’re self-conscious to the point of distraction. You feel so terrified of embarrassing yourself that routine interactions with other people become incredibly stressful. Going to parties or on dates is out of the question and even the most basic social situations cause distress. .
· Generalized anxiety disorder: You’re worried about everything, all the time, and with little reason. Will you fail out of school? Could you have cancer? Is your boyfriend sick of you? It seems random and you don’t have evidence to back up the worries, but you can’t talk yourself out of it.
· Obsessive-compulsive disorder: Your mind is filled with intrusive, stressful thoughts and it feels like the only way to alleviate the anxiety is by performing compulsive rituals like counting or washing your hands.
· Specific phobias: Excessive fear of specific things, like dogs or insects or vomiting.
· Panic disorder: This is what people mean when they talk about “panic attacks” or “anxiety attacks.” You experience sudden symptoms like shortness of breath, dizziness, nausea and sweating, which can feel like you’re having a heart attack. Some people feel an intense need to flee. These unpleasant symptoms can lead you to avoid situations similar to the one in which you had the attack (classes or parties, for example) or situations in which you wouldn’t be able to flee (ie, airplanes) for fear of having another attack.
· Illness anxiety disorder: You worry excessively about having or getting a serious illness, despite the fact that you’re either totally healthy, or overreact to very mild physical symptoms. A headache, for example, might make you convinced you’ve developed a brain tumor.
· Somatic symptom disorder: This is similar to illness anxiety disorder, but it usually follows a more specific course: You interpret physical symptoms that are fairly routine — headaches, stomachaches, nausea or fatigue — as signs of serious, life-threatening illness, to the point that your worries disrupt your life.
Long story short, anxiety comes in many (too many) different flavors, but the common theme with these disorders is that they disrupt your life, and make it more difficult, and more limited. You become someone who “doesn’t”: Doesn’t eat out, doesn’t go to parties, doesn’t go across bridges, doesn’t know how to fix what’s wrong.
Treatment for anxiety
Anxiety sucks, there’s no getting around that, but the good news is that if you are struggling you’re not alone and you have options. Anxiety disorders are among the most common mental health issues. They’re real and serious, and they’re also absolutely treatable.
The best treatment for anxiety disorders is a form of therapy called cognitive behavioral therapy, or CBT. CBT is also sometimes combined with medication like antidepressants. You might know some people who use medication alone to manage their anxiety. While medication can help reduce anxiety, more than 20 years of research has shown that CBT is the most effective treatment for reducing symptoms of severe anxiety. And unlike medication, which stops being effective when you stop taking it, CBT gives you the tools to continue to manage the anxiety yourself.
One of the most important techniques in CBT for anxiety is called exposure therapy. Exposure therapy is very different from traditional talk therapy, in which you and a therapist might explore the roots of the anxiety, in hopes of changing your behavior. The basic idea of exposure therapy is that you are exposed to the things that trigger your anxiety – in very small steps and in a safe setting with your therapist. As you become accustomed to each of your triggers, the anxiety begins fades and you start feeling like you are the one in control – not your anxiety.
If you are feeling discouraged or overwhelmed, remember that anxiety is a tricky, self-sustaining beast. It’s very good at making things feel insurmountable — which can make treatment seem impossible. But it doesn’t get the final say. You do. Help is available, and you deserve to feel better. And with a little time, support and the right treatment, you can, and you will.