Anxiety is one of the most common negative human emotions and is felt in response to a potentially harmful experience. It functions to alert us to the possibility of danger so that we can prepare accordingly and hence protect ourselves from the perceived threat (Mclean & Woody, 2001). It thus acts as a mechanism for safety and survival.
Fear and Anxiety are different
Anxiety is not the same as fear; even though both have similar manifestation. Generally speaking, we feel fear when we know that the threat is real. On the other hand we feel anxiety, when we believe that there might be a threat and then worry as a result (Stein & Walker, 2002). For example, when one comes
across a dog, one may feel fear. On the other hand, if one is walking and constantly worries that a rabid dog might attack, then this would be anxiety.
Is anxiety beneficial?
Both fear and anxiety can be effective as far as security is concerned, but the latter has no other function but to prepare, in case the threat actually occurs. If there is no real threat and one just constantly worries about the possibility, then it just becomes a hindrance. The consequence being that it limits one’s ability to function properly in any given situation.
Is anxiety abnormal?
Anxiety itself is not abnormal and everyone feels it occasionally. It may be due to a stressful life event e.g. going for a job interview. Anxiety may even help us to plan our lives accordingly. Without it, we might postpone a lot of important tasks. For example, we regularly pay our electricity bills because we worry
that if we do not, we may get fined or our electricity might be cut off. A person who does not worry about paying bills may suffer such consequences. Another example is anxiety because of an upcoming exam. A student who does not feel any anxiety at all may not get motivated to study at all.
Therefore, worrying can be beneficial to us. On the other hand if we start feeling anxious to a level which exceeds the possible threat, the reaction to it will be equally out of proportion. If such anxiety leads to difficulty at work, home or in relationships, then it becomes necessary to learn how to overcome it.
What causes anxiety?
The feeling one describes as “anxiety” can differ from person to person. The intensity of the experience and where or how it manifests also varies. Furthermore, anxiety may even have multiple causes. The cause may be medical e.g. in Phaeochromocytoma (Longmore et al., 2004), a symptom of a
psychiatric illness e.g. Schizophrenia (Lewis et al., 2009) or purely psychological e.g. due to a traumatic event in the past.
Anxiety may have its roots in a number of related or unrelated factors. DiTomasso & Gosch (2002) divide the possible factors into three categories. Some factors may predispose an individual to anxiety; some contribute to triggering it; while others to maintaining it.
A) PREDISPOSING FACTORS:
Genetics:
An individual suffering from anxiety may have a genetic predisposition to it i.e. someone in the family may also suffer from anxiety. Studies like Merikangas et al. (1999) show that
children of parents who had anxiety related disorders have a higher incidence of social phobia compared to children of parents who had no anxiety (Kearney, 2005). Studies like Fyer et al. (1993) show that children who have a relative with Social Anxiety Disorder have a three times higher chance of developing the same disorder later in life than those without such family
history (Hofmann & Otto, 2008).
Medical causes:
Another reason for anxiety is acute or chronic medical illness. Some medical conditions e.g. Grave’s disease (an autoimmune disease of the thyroid gland), has anxiety as one of the symptoms (Longmore et al., 2004). Furthermore, an already diagnosed illness may also be playing a role in the anxiety. So, if someone is feeling anxiety consistently, it should be ensured that a doctor has ruled out such causes. This is important as a serious medical condition may get masked with sedatives or antianxiety medication.
History of trauma:
The individual suffering from anxiety may have suffered a trauma in the past. According to Starcevic (2005), trauma can cause an anxiety related disorder to develop in those individuals who are already predisposed to it. It could be a trauma related to social situations or otherwise. Examples of the former could be a rejection from the opposite sex or embarrassment while giving a presentation at work. Examples of the later could be a mugging or a sexual abuse. Alternatively having witnessed or heard about such an event from someone else may also lead to anxiety about the same occurring to self.
Parental attitudes:
The predisposition to anxiety may develop due to factors related to childhood development. Faravelli et al. (2001) point out that clients with social phobia tend to have parents who are “rejecting, overprotective, and lacking in emotional warmth”. Such individuals may grow up doubting their own abilities and become dependent on others.
For instance someone belonging to a strict religious and cultural background might contribute to lack of confidence in communication with the opposite sex. A combination of these factors may result in a lack of experience and skills to cope with the stresses of social life with resultant anxiety.
Cognitive factors:
One common reason of anxiety is because of defective thoughts and beliefs. Most common thinking error is of overestimating an experience and catastrophizing it (Kase & Ledley, 2007). Such individuals believe that in a given situation, the worst is highly likely to happen and it will have detrimental consequences.
In the social context for example, an anxious person may think that they will make mistakes and will be criticised or judged by people as a result. They become conscious of their inability to cope with situations and ruminate when they do make mistakes (Kearney, 2005; Faravelli et al., 2001).
Psychological conditions:
In some psychological conditions (mental disorders) like PTSD, Anorexia and Body Dysmorphic disorders, etc. the individual may feel anxiety along with other symptoms of that condition.
B) TRIGGERING FACTORS:
Anxiety is often triggered when the individual has undergone or is going through a stressful experience (DiTomasso & Gosch, 2002). The sufferer could have gone through a life-changing experience like death of a relative, divorce, financial loss, change in residence, job promotion with added responsibilities and long commutes, lack of sleep, etc.
This stress could also be due to medical reasons. Anxiety could both be a part of the illness or due to its presence. Some medications e.g. Theophylline and Salbutmaol have anxiety as one of their side effects (Longmore et al., 2004).
At work, facing discrimination, bullying or have cultural or language barriers which may also contribute to anxiety.
Increased consumption of caffeine and alcohol, substance abuse and nicotine withdrawal may also trigger anxiety (Root, 2000).
C) MAINTAINING FACTORS:
The anxiety is maintained when either the triggering factors remain intact or when the individual starts to avoid the situation which is causing the anxiety (Wolfe, 2005). Avoidance helps to reduce anxiety, but at the same time keeps the individual from realizing that the feared situation is unlikely to happen and
also from learning and developing the skills to deal with it (Leahy et al., 2005).
Thus, the individual does not act to change what is causing the anxiety, nor learns how to cope with the problem and hence the anxiety continues.
CONCLUSION
While this article does not offer an exhaustive list of causes of anxiety, it however aims to explain that while there are factors which may predispose or trigger anxiety; it is the maintaining factors which cause long-term anxiety. Therefore, looking into and changing the factors which are maintaining the anxiety might be a good first step towards overcoming it.
References:
DiTomasso, R. A. & Gosch, E. A. (eds.) (2002) Anxiety disorders: a practitioner’s guide to comparative treatments. New York, Springer Publishing Company.
Faravelli, C., Zucchi, T., Perone, A., Salmoria R. & Viviani, B. (2001) Social phobia. In: Griez, E. J. L., Faravelli, C., Nutt D. & Zohar, D. (eds.) Anxiety disorders: an introduction to clinical management and research. Chichester, John Wiley & Sons, pp. 137-155.
Hofmann, S. G. & Otto, M. W. (2008) Cognitive behavioral therapy for social anxiety disorder: evidence-based and disorder-specific treatment techniques. New York, Routledge.
Kase, L. & Ledley, D. R. (2007) The Wiley concise guides to mental health: anxiety disorders. New Jersey, John Wiley & Sons.
Kearney, C. A. (2005) Social anxiety and social phobia in youth.
characteristics, assessment, and psychological treatment. New York, Springer.
Leahy, R. L. McGinn, L. K., Busch, F. N. & Milrod, B. L. (2005) Anxiety disorders. In: Gabbard, G. O., Beck, J. S. & Holmes, J. (eds.) Oxford textbook of psychotherapy. Oxford, Oxford University Press, pp. 137-161.
Longmore, M., Wilkinson, I. B. & Rajagopalan, S. R. (eds.) (2004) Oxford handbook of clinical medicine. 6th edition. Oxford, Oxford University Press.
McLean, P. D. & Woody, S. R. (eds) (2001) Anxiety disorders in adults: an evidence-based approach to psychological treatment. New York, Oxford University Press.
Starcevic, V. (2005) Anxiety disorders in adults: a clinical guide. USA, Oxford University Press.
Stein, B. M. & Walker, J. R. (2002) Triumph over shyness: conquering shyness and social anxiety. New York, McGraw-Hill.
Wolfe, B. E. (2005) Understanding and treating anxiety disorders: an integrative approach to healing the wounded self. Washington, American Psychological Association.
