Understanding Anxiety & Panic

Anxiety is a natural emotion experienced by every single person.  It is different from fear in that it is future oriented versus related to immediate and eminent danger.  Anxiety is a way for the individual to prepare for a real or perceived future danger.  Anxiety is not bad in and of itself and in many cases is a productive, driving force.  It can vary tremendously in severity, from mild uneasiness to extreme terror and panic, and can vary in frequency from occasional distress to seemingly constant unease.  When anxiety is experienced as very intense or very frequent it can interfere with an individual's functioning.  Hence, understanding anxiety, reducing its frequency and/or intensity, and learning how to better deal with stress as well as with anxiety become very important.

There are three major components to anxiety:

• Physiological arousal is associated with different physical sensations or feelings, e.g., increased heart rate, changes in digestion, and shallow breathing.
• The cognitive component includes thoughts or self-statements, beliefs, interpretations, expectations and visual imagery.  Cognitive components are often related to fear of loss of control, lack of prediction, no outlets for frustration, and a real or perceived chronic threat.
• Overt behavior includes avoidance, escape, and disruption of performance.

These three components are frequently related.

For example:  A thought may bring about physical arousal and may interfere with behavior, such as thinking that you might get into an accident, causing palpitations of the heart and hyperventilating. To stop this feeling you decide not to get in the car and the physical sensation stops.

Physical sensations may be misinterpreted as signs of anxiety and result in increased fear of negative consequences. This could include anything from being seen as foolish to fearing you might die, causing a change to overt behavior.

The overt behavior is usually two types, approach or avoidance.  Anxiety is a self-protective mechanism that is very beneficial, however when a person develops a chronic self-focus and avoidance, the individual does not learn how to cope with an anxiety provoking situation productively, and does not learn that their fears may be unrealistic.

Treatment for anxiety disorders consists of exposure to the situation with a focus on the thoughts associated with the fears, along with methods, such as relaxation techniques, to control the physiological response.  In addressing the thoughts, feelings and behaviors related to the anxiety an individual learns that they do have control, feel more competent, and are less likely to rely on avoidance strategies.

Dr. Nicholas Martino is a licensed psychologist at Life Management Associates.