Feeling anxious?

I often get asked the difference between feelings of anxiety or an anxiety disorder. The diagnostic statistical manual (DSM), aka the bible in the world of mental health, classifies symptoms into various disorders. The DSM is a large book which lists the different mental health disorders thus making it easier for mental health professionals to communicate with one another ("so and so has bipolar" or "A. has schizophrenia", etc).

Honestly, not all disorders are the same because we are working with unique individuals with characteristics, temperaments, personalities, unique histories, etc. Social workers take on a bio-psycho-social model which stands for biology, psychology and social, viewing all aspects of a clients life and not just the standard bio-psycho medical model that is our DSM.... BUT that is for another post so let's get back to anxiety. In my practice, I look more at the individual sitting in front of me and less on their labeled disorder.I love this quote:  'Ask not what disease the person has, but rather what person the disease has'-William Osler

What is anxiety?
We have all felt stress or anxiety at one point in our lives. Whether we are preparing for a big exam and feeling overwhelmed about how we will cram in all the information or feel our heart beating very fast, palm sweaty right before public speaking. Stress is a normal, biological response to an outside (external) challenge. Stress activates our "flight or fight" response by way of our sympathetic nervous system. Without feeling stress (or fear) we wouldn't know to run when a large grizzly bear is about to attack us or pay attention to serious problem that requires problem solving skills and a resolution.

I will get into the neurochemical mechanisms in a future blog post.

As I mentioned above, we have all felt stress. If anxiety is a normal function of our human existence, when does it become "a problem?" The answer is when the symptoms become excessive, debilitating and therefore prevent day to day functioning. While anticipating getting a root canal may bring some feelings of anxiety, having panic attacks when you sit in the car is excessive. Another example is feeling nervous for your first day of work vs having insomnia for months because you experience paralyzing fear when confronted with any social situation so you either avoid leaving your house or need to self medicate.

Anxiety disorders often are caused by dysfunctional thought pattern which influences maladaptive behavior. Often times, individuals with anxiety disorders begin avoiding situations, people, places which makes them anxious which in turn makes the anxiety worst.

Dysfunctional thoughts aka distorted thinking, commonly seen in individuals with anxiety are All or Nothing thinking ("if I don't do this perfectly, then I failed, have to be perfect"), Emotional reasoning ("my feelings are facts so therefore if I am feeling hurt then you have betrayed me" or "I am beginning to feel anxious sitting on this train therefore I must be in danger"), Should statements ("everyone should be nice to me", "I should be rich, married, loved by everyone around me").

.Click here for more information about cognitive behavioral therapy and here. More to come!

The outcome is excellent with cognitive behavioral therapy (CBT) treatment. In a nutshell, CBT teaches recognition of thought patterns and changes behaviors/thoughts which makes the anxiety worst. CBT also helps establish day to day tools and valuable problem solving skills to manage stress.