Uncovering the Faces of Anxiety

Condition Report

Approximately three million Canadians have an anxiety disorder and approximately one in four will suffer from an anxiety disorder in their lifetime.(1)

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Recognized as one of the most common types of mental health disorders in Canada, anxiety disorders have a major impact on the lives of those affected. Having a better understanding of what anxiety disorders are, how they manifest, and techniques that can be used to manage anxiety, can help us support ourselves and others in minimizing anxiety symptoms.

Anxiety and Anxiety Disorders

Anxiety is a normal and temporary reaction to stressful situations or environments; whereas, anxiety disorders involve intense and prolonged reactions, which often have debilitating symptoms, including shortness of breath, heart palpitations, and irritability, that are misaligned with the reality of the situation or the associated risk.

Key differences:

  1. Stressor. A stressor is caused by an environmental or external stimulus that produces an anxiety reaction. Stressors may include writing an exam, preparing for an interview, or having an argument with a friend. Where individuals typically manage through, those with an anxiety disorder may experience continued uneasiness and tension, impacting their ability to move beyond the event and disrupting and influencing future behaviour.
  2. Intensity and length. Anxiety disorders often produce intense, excessive and lengthy emotional responses which are often disproportionate to the stressor. Anxiety is fleeting, whereas anxiety disorders are ongoing and difficult to overcome, often impacting your physical health. Physical symptoms may include headaches, dizziness and in some instances high blood pressure.
  3. Impairment. Anxiety disorders may impact basic life functions and many aspects of your day-to-day life. Avoidance is a common tactic used to prevent anxiety episodes. The desire is to prevent or eliminate environments where stressors may occur. This can cause isolation and withdrawal from daily activities for those who are using avoidance to manage their anxious feelings.

Causes of Anxiety Disorders

Researchers are learning that anxiety disorders can run in families, and have a biological basis, much like allergies. Anxiety disorders may develop from a complex set of risk factors, including genetics, personality, and life experience. Here are some theories on how anxiety disorders can develop:

  1. Medical. In some cases, medical issues may be a contributing factor (e.g. diabetes, heart disease, trauma). Although most anxiety disorders develop in childhood and adolescence, a medical cause is more likely to be a contributing factor later in life as people have a greater likelihood of developing medical health problems as they age.
  2. Genetics. While science has yet to identify an exact gene, it’s believed that genetics play a role in or at least increases the risk of developing an anxiety disorder. Chromosomal irregularities (missing, extra, or irregular portions of the chromosomal DNA), have been hypothesized to be the connection between genetics and anxiety disorders. Dr. Amy Przeworski of Case Western Reserve University in Cleveland has said “Individuals inherit a predisposition to being an anxious person, [and] about 30 to 40 percent of the variability is related to genetic factors.”(2)
  3. Psychological. There are several psychological theories on the causes of anxiety disorders, however each theory tends to only explain a portion of the diagnosis. Anxiety disorders can be attributed to interpersonal conflict, conditioned responses learned over time, or existence of dysfunctional thought patterns such as overestimating the level of danger in a given situation. Although these are only some of the psychological implications, depression and other mental health conditions may impact an individual’s likeliness to develop an anxiety disorder.(3)

There are multiple factors that could contribute to someone developing an anxiety disorder. With more research, we may be able to develop preventative exercises or measures limiting the number and prevalence of anxiety disorders.

Types of Anxiety Disorders

There are six major categories of anxiety disorders, each with separate and unique symptom profiles.

  1. General Anxiety Disorder (GAD). One out of every 20 individuals suffer from a GAD in Canada.4 Persons with GAD may experience chronic, excessive, and uncontrollable worry. Additional symptoms such as tension, fatigue, difficulty concentrating or falling sleeping are associated with GAD as well.
  2. Obsessive-Compulsive Disorder (OCD). Compulsions are repetitive, somewhat stereotypical behaviours (ex. hand-washing, skin-picking, rocking movements) or mental acts that the person performs in order to prevent or reduce their distress. Individuals may feel driven to perform the compulsive ritual even though they try to resist it.(5)
  3. Panic Disorder. Panic disorders are often marked by repeated fears that last for several minutes or longer. Often occurring unexpectedly in the absence of a situational threat, rapidly peaking in symptoms of panic, and often accompanied by a sense of imminent danger.(6)
  4. Phobic Disorder. One out of every 10 individuals suffer from a phobia in Canada.(7) The fear is often considered excessive because it is disproportionate to the level of danger associated with the situation. When an individual with a phobia is exposed to the fear stimulus, an immediate anxiety response is triggered that can sometimes grow into full-blown panic attacks.
  5. Post-Traumatic Stress Disorder (PTSD). One out of every 10 individuals in Canada will experience PTSD in their lifetime.8 PTSD develops after a person has experienced or witnessed a traumatic or terrifying event. It has lasting consequences of traumatic ordeals that cause intense fear, helplessness or horror. This could include responses to powerful one-time incidents or chronic/repetitive experiences.
  6. Social Anxiety Disorder. About eight percent of Canadians will experience social anxiety disorder in their lifetime.(9) People with social anxiety disorders experience nervousness and discomfort in formal and informal social settings. This can often lead individuals to become isolated, minimizing their contact and engagement with others.

How to Manage Symptoms of an Anxiety Disorder

Managing the symptoms of anxiety disorders is possible. Use the techniques below to minimize your occurrences.

  1. Connect with others. Loneliness and isolation set the stage for anxiety. By connecting with people who are supportive, caring, and sympathetic, you can decrease feelings of vulnerability (which can contribute to anxiety manifesting). Make it a point to regularly meet with friends or family, join a self-help or support group, or share your experience with a trusted loved one or counsellor.
  2. Practice relaxation techniques. Daily practice can help manage anxiety symptoms and increase relaxation, benefiting emotional well-being over time. Mindfulness meditation, progressive muscle relaxation techniques (controlling the state of muscular tension in your body), and doing deep breathing exercises, can all relieve feelings of anxiousness.
  3. Exercise regularly. Exercise is a natural stress and anxiety reliever. When exercising your body produces endorphins that combat fatigue and stress. Rhythmic activities that require moving both your arms and legs, such as walking, swimming, or dancing, are especially effective.
  4. Get enough sleep. Sleep is one of the most important activities in managing anxious thoughts and feelings. Those who struggle with anxiety often have difficulty getting to sleep. If you struggle with sleep, try meditation before bed to help clear your mind. Create the right environment for sleeping; not eating an hour before bed and keeping a consistent sleep schedule increases your quality of sleep.
  5. Be smart about caffeine, nicotine, and alcohol. If you struggle with anxiety, you may want to consider reducing your caffeine intake, or cutting it out completely. Caffeine has been shown to increase cortisol levels, which can lead to anxiousness.10 Nicotine, often thought to be a relaxant is actually a powerful stimulant that produces epinephrine (adrenaline) when inhaled. The production of adrenaline causes a spike in glucose levels which increase blood pressure, heart rate, and respiration, increasing the likelihood of anxiety manifesting.(11) Alcohol serves as both a stimulant and a depressant, making alcohol a key factor if you struggle with anxiety. When alcohol is consumed, your blood alcohol content (BAC) rises, causing mood and emotions to change; however as your BAC decreases, alcohol induced anxiety can manifest along with depression and fatigue.(12) When consuming caffeine, nicotine, or alcohol, realize these are key factors that directly affect your anxiety levels.
  6. Train your brain to stay calm. Worrying is a mental habit you can learn how to manage. Set aside dedicated time in your day to focus on difficult events or tasks. Write them down, assess the scenario and reflect upon how to approach or manage the situation. By challenging anxious thoughts and learning to accept uncertainty, you build resiliency which can reduce anxiety and fear.

Sources:

  1. Public Health Agency of Canada. (2015). Mood and Anxiety Disorders in Canada. Retrieved May 17, 2017, from https://www.canada.ca/content/dam/canada/health-ca...
  2. Waszczuk, M., Zavos, H., & Eley, T. (2013, June). Genetic and environmental influences on relationship between anxiety sensitivity and anxiety subscales in children. Retrieved May 17, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC38783...
  3. Tracy, N. (2016, June). What Causes Anxiety Disorders to Develop? - Anxiety Disorders - Anxiety Panic. Retrieved May 17, 2017, from https://www.healthyplace.com/anxiety-panic/anxiety...
  4. Canadian Psychological Association. (2014, December). “Psychology Works” Fact Sheet:Generalized Anxiety Disorder. Retrieved May 17, 2017, from http://www.cpa.ca/docs/File/Publications/FactSheet...
  5. Canadian Psychological Association. (2009, January). “Psychology Works” Fact Sheet: Obsessive Compulsive Disorder. Retrieved May 17, 2017, from http://www.cpa.ca/docs/File/Publications/FactSheet...
  6. 6 Canadian Psychological Association. (2009, May). “Psychology Works” Fact Sheet: Panic Disorder. Retrieved May 17, 2017, from http://www.cpa.ca/docs/File/Publications/FactSheet...
  7. Canadian Psychological Association. (2015, January). “Psychology Works” Fact Sheet: Phobias. Retrieved May 17, 2017, from http://www.cpa.ca/docs/File/Publications/FactSheet...
  8. News, CBC. (2008, September 18). Almost 1 in 10 Canadians has post-traumatic stress at some point: study. Retrieved May 17, 2017, from http://www.cbc.ca/news/technology/almost-1-in-10-c...
  9. CMHA. (n.d.). Mental Health. Retrieved May 17, 2017, from https://www.cmha.bc.ca/documents/social-anxiety-di...
  10. Veleber, D. M., Templer, D. I., & California School of Professional Psychology - Fresno. (1984, September). Effects of Caffeine on Anxiety and Depression. Retrieved May 17, 2017, from https://pdfs.semanticscholar.org/f29a/18c89b6f6d46...
  11. Psychology Today. (2017, April 17). Nicotine. Retrieved May 17, 2017, from https://www.psychologytoday.com/conditions/nicotin...
  12. Wolitzky-Taylor, K., Brown, L. A., Roy-Byrne, P., Sherbourne, C., Stein, M. B., Sullivan, G., Craske, M.G. (2015). The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care. Journal of Anxiety Disorders, 30, 88–93. http://doi.org/10.1016/j.janxdis.2014.12.011