Anxiety is a biological and psychological response to a perceived threat in our environment. It is the body’s internal alarm system that is meant to help us focus our attention on the source of danger and do one of three things to resume safety: fight, flee, or freeze. A common misconception about anxiety is that it is bad and we should do whatever we can to get rid of it. The truth is, all of us experience anxiety at some point or another, and not all anxiety is bad. For example, it is normal to feel anxious about an upcoming test, exam, big project, or presentation at school or work; after all, there’s a lot on the line in all these examples. Mild anxiety can help us hone our focus, set and achieve goals, and perform at our best. For example, anxiety might motivate you to skip a social event to meet an important deadline. Too much anxiety, however, can negatively affect our performance or get in the way of doing important things and achieving some of our most desired goals. If you are experiencing frequent and difficult to manage anxiety that interferes with your ability to do normal things, like socialize, go to school or work, get things done on time, and pursue your goals, you may have an anxiety disorder.
There are several different types of anxiety disorders that are all a little bit different. For example, Social Anxiety Disorder produces worries about how one is viewed by others and may lead people to avoid social situations or speaking with people they do not know well. Comparatively, Obsessive-Compulsive Disorder (OCD) can plague people with unwanted, intrusive thoughts that make them do certain things to get rid of the thoughts and associated distress, like washing your hands in a very specific way after having an intrusive thought about germs and contamination. Despite these differences, all anxiety disorders have a few common elements:
- Frequent and difficult to manage worries.
- Feelings of nervousness, fearfulness, or being on edge.
- Physiological changes in the body, which could include increased heart rate, rapid breathing, sweating, physical shaking, and having an upset stomach, to name a few.
- Behavioural changes meant to eliminate or reduce worry and nervousness, which could include avoidance or escape from anxiety-provoking situations, double checking, and excessive reassurance seeking, to name a few.
Here are some common types of anxiety disorders and brief descriptions to help you understand their subtle differences.
Social anxiety disorder (also known as social phobia): is characterized by significant fear and avoidance of social situations where one may be judged, evaluated, or otherwise scrutinized by others. Some examples can include fear of social interaction (e.g. making small talk, initiating a conversation), being observed (e.g. while eating, trying on clothes in a store), and performing in front of others (e.g. giving a presentation in class or at work).
Illness anxiety disorder: is characterized by a preoccupation and significant fear of having or acquiring a serious illness. These fears can sometimes lead to excessive health-related behaviours, such as checking one’s pulse or blood pressure repeatedly throughout the day, making lots of visits to your family doctor, and google searching normal physiological experiences, like heartburn, stomach aches, and constipation.
Obsessive-compulsive disorder: is a condition that causes one to experience obsessions and/or compulsions. An obsession is recurrent and intrusive thought, image, or impulse that causes significant distress. There are many different kinds of obsessions, but some common ones include intrusive thoughts about contamination, harming oneself or someone else, making mistakes, numbers, “rightness” or orderliness, and blasphemous thoughts. Compulsions, by comparison, refer to repetitive behaviours that a person feels driven to perform in response to obsessive thoughts as a means of trying to prevent some sort of a feared outcome. For example, people with obsessions about making mistakes may find themselves driven to double or even triple check things like emails, text messages, or their work to a degree that may get in the way of getting things done in a timely manner or at all.
Separation anxiety disorder: is characterized by excessive fear and anxiety about leaving home and/or being separated from important loved ones, such as parents or other family members. It can also include extreme worries about harm befalling loved ones when we are not with them. These fears often cause people to stay close to their loved ones at all costs and may lead to flat out avoidance of different situations (e.g. avoidance of school, work, sleepovers, etc.).
Specific phobia: is characterized by extreme fear and avoidance of specific objects or situations. There are several types of phobias and some of the most common ones include fear of animals (e.g. dogs), environments (e.g. heights, storms), blood and/or needles, and situations (e.g. flying, riding an elevator).
Generalized anxiety disorder: is defined by excessive, frequent, and difficult to manage worry about a variety of things (e.g. finances, health, socializing, school or work, one’s future, etc.). This worry is often accompanied by frequent feelings of nervousness, irritability, difficulty concentrating, and sleep problems.
Panic disorder: is characterized by significant fear and worry of having recurrent and unexpected panic attacks. This worry often leads to changes in behaviour that attempt to reduce the frequency of panic attacks, such as avoiding exercise because it increases one’s heart rate, which is a symptom of a panic attack. Panic attacks are surges of fear and uncomfortable sensations that come on quickly, peak rapidly (i.e. within 10-15 minutes), and then resolve.
Agoraphobia: refers to intense fear and anxiety that is triggered by different types of situations, which can include using public transportation, being in open spaces (e.g. parking lot, public park), being in enclosed spaces (e.g. movie theaters, shopping malls), standing in line, being in crowds, or being outside of one’s home. People with agoraphobia often try to avoid the feared situation because of fear of experiencing symptoms of panic, embarrassing oneself, or the belief that they would not be able to access help, if needed.
Selective mutism: is characterized by a consistent failure to speak to specific people and/or speak in certain social situations where speaking is required or necessary, despite speaking normally in other situations. For example, some children with selective mutism may refuse to speak at school or in the presence of adults while speaking normally to their close friends and family.
Anxiety Canada is a great resource with lots of information about the various types of anxiety disorders that exist, treatments, and self-help tools to better manage your symptoms. They have interesting videos and audio files related to anxiety.
Canadian Mental Health Association (CMHA) is another great, free resource with helpful information about anxiety and how to effectively manage it.
BounceBack Ontario is a free resource open to Ontario residents over the age of 15 years that is funded by the Canadian Mental Health Association. They offer up to six free sessions of telephone coaching as well as self-guided videos, educational materials, and skill booklets that help people better manage mild symptoms of anxiety.
Readings, Tools, Apps
MindShift CBT is a program with smart phone apps that use scientifically-proven tools from Cognitive Behavioural Therapy (CBT) to help you learn how to better manage and overcome your anxiety. MindShift CBT also offers some online CBT groups.
Calm is a mindfulness based smartphone app that helps you learn how to relax and incorporate mindfulness into your daily practices. Mindfulness is another scientifically-proven strategy that helps people learn to be present, relax, and detach from upsetting thoughts and feelings.
Headspace is a mindfulness based program that offers both a smartphone app as well as instructional videos on Netflix. You can download the app wherever you get your apps, such as the iTune or Google Play Store. Headspace has also teamed up with Netflix and created three mini-series that you might be interested in checking out; headspace: Guide to Meditation, headspace: Guide to Sleep, headspace: Unwind Your Mind.
Books for Adults
Full Catastrophe Living by Jon Kabat-Zinn
The Anxiety & Phobia Workbook by Edmund Bourne
The Relaxation and Stress Reduction Workbook by Martha Davis, Elizabeth Robbins Eshelam, and Matthew McKay
Unwinding Anxiety by Judson Brewer
Mind Over Mood by Dennis Greenberger, Christine Padesky, and Aaron Beck
Books for Children and Adolescents
The Whatifs by Emily Kilgore
The Don’t Worry Book by Todd Parr
Ruby Finds a Worry by Tom Percival
Wilma Jean the Worry Machine by Julia Cook
The Worry Workbook for Kids by Muniya Khanna and Deborah Roth Ledley
The Anxiety Workbook for Kids by Robin Atler and Crystal Clarke
The Self-Regulation Workbook for Kids by Jenna Berman
The Relaxation and Stress Reduction Workbook for Kids by Lawrence Shapiro and Robin Sprague
The Anxiety Workbook for Teens by Lisa Schab
The Teen Girl’s Anxiety Survival Guide by Lucie Hemmen
Rewire Your Anxious Brain for Teens by Debra Kissen, Ashley Kendall, Michelle Lozano and Micah Ioffe
The Perfectionism Workbook for Teens by Ann Marie Dobosz