Anxiety – Phobias and Disorders

Anxiety vs Stress

At the outset we need to clarify what is Anxiety and what is Stress. These two terms can sometimes be used to mean or identify a situation where the coping mechanism is under threat. One may hear a person say “I am stressed” or “I cannot cope” or “I am anxious about …” perhaps even “I am feeling overwhelmed”.

Anxiety and stress however, are quite different. Both Stress and Anxiety can be managed with Cognitive Behavioural Therapy (CBT).


Anxiety and Stress Defined

Anxiety – is a person’s specific reaction to an INTERNAL source and does not subside even after a concern has passed. These can escalate into anxiety disorders. Occasional anxiety is common, but chronic feelings of worry, fear or dread are NOT common, and need to be addressed. Anxiety is a treatable and recoverable condition.

Stress – is a response from an EXTERNAL source and subsides once the situation has been resolved. It is a nonspecific response, but varies in degrees as it is about the context and perception of the situation by the individual. Stress is a treatable and recoverable condition.

We all experience Anxiety at various levels and times as it is part of our Autonomic Nervous System (ANS) response – It’s our fight or flight response – an innate human quality for self-preservation. When this happens our brains release chemicals of Adrenaline and Cortisol to assist the body to react to the perceived or real threat.

When the adrenaline courses through our body, we can experience some very real physical responses as well as psychological and emotional responses.

With Thanks to Alina Grubnyak – Unsplash

Sustained high levels of Anxiety will affect our Physical bodies as well as our mental health. It is therefore important for us to manage our levels of anxiety for our own well-being.

Anxiety Cycle

The exact cause of anxiety disorders is unknown, but anxiety disorders, like other forms of mental illness, are not the result of personal weakness, a character flaw, or poor upbringing. Anxiety disorders may be caused by environmental factors, medical factors, genetics, brain chemistry, substance abuse, or a combination of these.

The cycle of anxiety works as follows:

An individual will feel a sense of worry or threat. As a result, their attention span narrows and they become highly attuned to their environment. Believing that they are at risk of harm, they begin “scanning” places (and people) in an attempt to locate the source of the perceived danger. At this stage, the individual is consumed by their thoughts. They then engage in avoidance or safety behaviours, which may yield short-term relief.

However, over the long term, they will experience more worry, more distress about the fact that their avoidance behaviours are having a negative impact on their life and more physical symptoms of anxiety. The individual may well become depressed. Sometimes, avoidance is not obvious – it may be harder to spot, a behaviour known as “subtle avoidance”. Classic avoidance behaviour entails eliminating all exposure to a feared situation.

“Although they may not consciously realise it at first, those suffering from anxiety disorders assume, on some level, that their anxiety is keeping them safe. This is a core belief that must be identified, challenged and replaced with Empowering Beliefs and Thoughts.”

Anxiety – Phobias

Phobias are chronic, exaggerated and excessive fears or anxieties about a specific situation or object that are considered to be markedly disproportional to the actual threat involved. The feared object or situation almost always provokes an immediate fear response or anxiety reaction. These situations in most instances are not dangerous per say.

The result of the fear or anxiety leads to a number of dysfunctional behaviors aimed at avoiding the situation or object in question. Patients who are diagnosed with simple phobias generally do not demonstrate fearfulness as long as they can avoid coming into contact with, or thinking about, their phobic situations.

With Thanks to Priscilla Du Preez – Unsplash

Sometimes, a person with a phobia will experience anxiety as a result of merely contemplating the source of their fear. This phenomenon is referred to as “anticipatory anxiety”. When they are confronted by the source of their fear, a person with a phobia will experience physical and psychological symptoms of anxiety, including those associated with panic attacks.

Of course, there are a number of different phobias recognized, the majority of which actually represent potentially threatening situations or objects, such as snakes, spiders, flying, being in enclosed spaces.

“When they are confronted by the source of their fear, a person with a phobia will experience physical and psychological symptoms of anxiety, including those associated with panic attacks.”

GAD – General Anxiety Disorder

GAD is a disorder that is considered to be chronic and represents excessive fear or anxiety or apprehension, about many different types of events. Individuals who experience chronic, compelling, and pervasive anxieties maintain beliefs that make them prone to interpret numerous situations as posing risk and threat.

It is a general, long-lasting worry and anxiety about everyday life, about anything and everything. People with GAD imagine the worst happening (and worry about all the possible worst case scenarios). They believe future events are almost always negative, and they won’t be able to cope ‘when’ these things ‘do’ happen.

“The mind and body are linked. Tension in the mind can give rise to tension in the body, but tension in the body can also promote worry. This is because the brain takes cues from the physical body when generating an emotion.”

However, as in all anxiety, we tend to over-estimate the danger, and under-estimate our ability to cope. People with GAD can display the inability to relax and it is often seen in highly anxious individuals and a lack of concentration. People with GAD are often considered to be worrywarts or neurotic in that they just seem to worry about everything and are anxious about everything.

Example of these situations may include Constant:

  • Restlessness or feeling on edge
  • Difficulties with concentrating or with attention
  • Feeling fatigued or fatiguing very easily
  • Experiencing muscle tension
  • Expressions of irritability or restlessness
  • Experiencing problems with sleeping
With Thanks to Priscilla Du Preez – Unsplash

SAD – Social Anxiety Disorder

Social anxiety disorder is characterized by having an excessive anxiety or fear concerning at least one social situation where the person will be scrutinized by other people. These situations can include things like being with unfamiliar people for the first time, being watched when one is eating, and, of course, actually performing in front of others, such as speaking in public.

Individuals with social anxiety disorder most often feel that they will be humiliated as a result of these interactions and will typically avoid these situations. If forced to perform, they will generally do so under extreme duress. They so fear failing or messing up their chances to win the support, approval, acceptance, and praise of others that they either isolate themselves or reveal their anxieties by acting awkwardly, thereby causing embarrassment and fulfilling their negative prophecies.

Anxiety – Panic Disorder – Attacks

Panic attacks are extreme and intense periods of anxiety or fear that affect both the individual’s physical functioning (e.g., pounding heart, sweating, trembling, sensations of choking or being unable to breathe, extreme nausea, dizziness, chills, chest pains, etc.) and emotional functioning (e.g., feeling as if one is going crazy, feeling as if one is detached from reality, the sensation that one is detached from one’s own body, fear of losing control, or fear of dying). Panic and Anxiety Checklist

” It is the tending to make catastrophic interpretations about a wide range of physical sensations and mental states, that they may experience, resulting in hyper-vigilance to and dread of normal changes, that take place in the body and mind.”

The number of individuals who experience occasional panic attacks, or anxiety attacks as many call them, is actually relatively high. Most people do not develop panic disorder as a result of experiencing these brief periods of extreme anxiety. Individuals who have repeated panic attacks and attempt to cope with them in a dysfunctional manner are diagnosed with this disorder.

It is important to mention that a number of different physical and mental conditions can be associated with panic attacks. Individuals experiencing repeated panic attacks should have a full physical evaluation as they may be a sign of an endocrine issue (e.g., thyroid condition), cardiovascular problem, or some other serious medical problem. If an individual is experiencing panic attacks that can be associated with a specific physical disorder, such as a heart condition, the physical condition should be addressed

With thanks to Brett Jordan – Unsplash

Anxiety – Agoraphobia

Agoraphobia is a condition that was previously most often associated with the development of a panic disorder, however, it has become a standalone diagnosis. It consists of a fear or extreme anxiety about being in two or more different situations where one believes that they cannot escape or no help is available.

These situations include being:

  • In open spaces
  • In a crowd
  • Outside of one’s home alone
  • In some form of public transportation
  • In some enclosed place, including stores, theaters, etc.

” They may may refuse to venture outside of a very restricted “safe zone” which sometimes entails remaining completely housebound.”

Anxiety – Separation Anxiety Disorder

Separation anxiety disorder occurs when someone displays fear or anxiety that is considered to be inappropriate for being separated from a person (excessive given their age and level of cognitive/emotional development)

These episodes of an appropriate fear or anxiety are typically displayed by a consistent presentation that includes four or more of the following recurrent episodes:

  • Excessive distress when either being separated from the person or when they anticipate being separated from the person or from their home,
  • Excessive worry about losing major figures to whom they are attached,
  • Excessive worry about some event that will lead to separation from the person or home
  • Refusing to leave the home or the person (e.g., a teacher at school) due to the fear of being separated,
  • Refusing to sleep away from the person or place, being fearful of being left alone,
  • Complaining of being ill when they perceive that they will be separated from the person,
  • Having nightmares about separation.

Often, the person experiences symptoms that are very similar to symptoms of a panic attack when either thinking about or being in the situation.

With thanks to Loius Hansel – Unsplash

Anxiety Disorders and Phobias – Treatable and Recoverable

Anxiety Disorders and Phobias are treatable using prescribed medication, (from your GP) or by taking Cognitive Behavioural Therapy – CBT – sessions with a Psychotherapist or using Self-Help guidance and Support groups.

The main pathway to recovery is the challenging and re-framing of the persons Limiting belief system, Unhelpful thoughts and replacing them with positive and empowering thoughts and beliefs. See Managing your Thoughts to better understand the process.

Get In Touch

If you are experiencing Anxiety or Stress it is important for you to get help. We are here for you to help and support you. For more information or to book a CBT session please contact us, and select from the drop down box the appropriate option.