What is Anxiety?
Symptoms and Psychological Treatment of Anxiety
Very few psychological problems cause more distress than anxiety. Often, the symptoms develop over time and the individual may
not be aware of the anxiety as an ongoing problem. Anxiety causes a range of psychological as well as physical symptoms.
These can vary between individuals, however, psychological symptoms often include:
- excessive worries
- exclusive focus on one particular topic
- lack of concentration
- social withdrawal
- avoidance of locations or individuals
- disturbances to memory and attention
- negative thinking ("There is no easy way out")
In addition, physical symptoms are possible including
- feeling hot
- feeling unsteady
- heart pounding or racing
- feeling dizzy
- hands trembling
- difficulty in breathing
- a feeling of choking
- hot and cold sweats
Not everybody experiences all of these symptoms and they may change over time. Individuals with phobias (fear of a specific object or situation) may feel anxious when approaching the particular object or situation. Examples of specific phobias are
- a fear of certain animals
- concerns about a particular medical procedure (e.g. an injection)
- a fear of flying (e.g. air travel)
- being uncomfortable in open places
- being uncomfortable in narrow/enclosed locations
- a fear of acceleration (e.g. in an elevator)
- a fear of public places
Individuals with social anxiety (or phobia) often avoid social groups and situations as well as meeting new people. It is important to distinguish social anxiety from neuro-developmental disorders such as Autism Spectrum Disorder (ASD), including Aspergers, and social (pragmatic) communication disorder. These neuro-developmental disorders make social communication difficult or may delay the devlopment of social skills.
Anxiety disorders are common in children (and adults), with prevalence estimates ranging from 5% to 25% in different countries. Anxiety disorders often co-occur with mood disorders and can result in depression or other mental health problems such as substance use. Early onset anxiety disorders (13 years or younger) may follow a chronic course and, hence, an early diagnosis is important.
Cognitive-behavioural models of anxiety disorders suggest that negative automatic thoughts play a significant role. Hence, Cognitive Behavioural Therapy (CBT) strategies have been developed, which include cognitive restructuring, coping self-talk, in vivo exposure, modelling and relaxation training. The effectiveness of CBT can be further enhanced through the addition of family therapy. The authors report that negative automatic thoughts and anxiety control (the feeling to be in control of symptoms) make unique contributions to treatment outcome. The influence of both automatic thoughts and anxiety control appeared to differ across various types of anxiety disorders.
What are the Psychological Treatment Options?
CBT is long established as a method of choice for anxiety and depression in children. Negative automatic thoughts play a role in symptoms of anxiety disorder. The individual may make false or immature predictions about what can happen in the absence of care-givers or partners. Alternatively, the individual may rehearse in his or her mind what might happen to attachment figures during periods of absence, which could lead to an indefinite separation. The individual may also “catastrophise”, that is, interpret minor events in the absence of parents or partners as very negative and, as a result, experience intense fear.
How does Cognitive Behavioural Therapy work? CBT addresses distorted and unhelpful patterns of thinking that result in anxiety. Based on the assumption that negative thoughts result in negative emotions and that well-adapted positive thoughts result in positive emotions, CBT tries to replace cognitive distortions (unhelpful thinking styles) with well-adjusted thinking patterns. Core elements of CBT are:
- Cognitive restructuring: Identifying negative thoughts and replacing these by positive thinking styles.
- Modelling: Practicing successful behaviour for critical situations; plus
- Relaxation training: This may include calming (breathing) techniques and progressive muscle relaxation. These can be adjusted for young children.
Autogenic Training is an evidence-based relaxation technique that involves self-suggestions and the concentration of bodily perceptions. Autogenic training is not recommended for individuals with severe mental health issues. If you have any health issues, you should consult with a medical professional prior to beginning autogenic training. If you feel any discomfort during or after autogenic training, please discontinue and consult a health professional.
Listen here to the first two exercises of Autogenic Training. Do not listen to the recordings while driving or operating heavy machinery. This is not a replacement for medical or psychological attention.