We all have anxiety now and then when we’re faced with taking a risk, getting evaluated at work or on a test, public speaking, or making an important decision. But some people suffer from anxiety on a regular, even daily basis.
Anxiety is typically characterized by obsessive worry. We ruminate with apprehension about a future threat. Unlike with fear, the threat may not even be imminent. Unpredictability and powerlessness add to anxiety. Our bodies are designed to respond to fear by fighting or fleeing, but when you can neither escape nor control a situation, anxiety results. Interspersed with imaginings about how we’d like things to be, we project our hopes and fears into the future — even when there’s no evidence that they will occur.
Anxiety disorders affect nearly one in five adults in the United States. Women tend to ruminate more than men and are more than twice as likely as men to get an anxiety disorder. Anxiety disorders include generalized anxiety disorder, panic attacks, and social anxiety. They don’t go away and can get worse over time. The anxiety can interfere with daily activities. Other illnesses, such as post-traumatic stress disorder and obsessive-compulsive disorder also have symptoms of agitation, hypervigilance, and anxiety.
Anxiety can cause an inability to concentrate and may affect restful sleep. Physical symptoms can include any increased heart rate, shortness of breath, dry mouth restlessness, muscle tension, numbness or tingling in hands or feet, perspiration, nausea or diarrhea, and dizziness. Some people who are chronically anxious develop TMJ, teeth clenching, rashes, digestive disorders, and other health problems.
Shame is a common cause of anxiety, particularly for codependents. It’s called shame anxiety, and is the fear of experiencing shame in the future. Usually these fears involve being judged, rejected, disliked or unloved, making mistakes, looking foolish, or failing. They also fear experiencing their feelings and experience chronic anxiety instead. They fear taking risks and others’ reactions, especially anger. Intimacy feels risky and produces anxiety that their unworthiness will be exposed and that they’ll be hurt, judged, or worse, rejected. These feelings of insecurity and ‘toxic” shame originate in childhood and lead to self-consciousness. Toxic shame exaggerates normal anxiety and affects your feelings and actions. Your mind can spin into obsessions contemplating dreaded outcomes. Instead of responding to reality, you might react to your skewed thoughts and sabotage your job or relationships.
Shame anxiety affects our self-esteem. We worry about what we say, how well we perform, and how we’re perceived by others. It can make us very sensitive to real or imagined criticism from ourselves or others. Shame anxiety may manifest as social phobia, or in symptoms of codependency, such as controlling behavior, people-pleasing, perfectionism, fear of abandonment, or obsessions about another person or addiction.
Economic insecurity and shyness are risk factors for anxiety, but more importantly, if we’ve suffered emotional abandonment in the past, particularly in childhood, we can have anxiety about experiencing it in the future. We worry others are judging us or we’re upset with us. If we have an emotionally or physically abusive partner, we’re liable to be “walking on eggshells,” anxious about displeasing him or her. This reaction is typical when living with a practicing addict, narcissist, or someone bipolar or with a borderline disorder. It’s also common among children of addicts or those who grew up in a dysfunctional family where emotional abuse, including control or criticism, was common. When we live in such an environment for years, we may not realize we’re anxious. The state of hypervigilance becomes so constant that we can take it for granted. Anxiety and accompanying depression are characteristic of codependents.
The most effective treatment is cognitive-behavioral-therapy (“CBT”), combined with learning self-soothing skills. CBT involves identifying, challenging, and neutralizing negative thinking that increases anxiety. Support groups are also helpful. Learning to calm yourself with meditation, mindfulness, and other stress-management generate long term benefits. Anti-depressants and anti-anxiety drugs can be used, but it’s far better to retrain your mind and use nonmedical approaches, except temporarily or in the most extreme cases.
Darlene Lancer, MFT – Stress Counseling, Stress Management, Anxiety Counseling, and Anxiety Treatment in Santa Monica, Los Angeles, and Culver City, CA, California
©Darlene Lancer 2016