We all get anxious, right? Just like we all get sad. This is why anxiety is probably just as misunderstood as depression, and the two often go hand-in-hand. The thing is, anxiety in an anxiety disorder doesn’t really behave the way plain old anxiety does, and that’s why there’s not as much sensitivity about it as one would hope.
Deviant, disabling, and distressing are the three criteria that psychologists use to define a disorder. If it’s significantly deviant from what’s “normal”, if it causes problems for every day life, and if it is distressing, either to the afflicted or the afflicted’s close associates (y’know, like family), it’s a disorder.
That said, yes. Some mental disorders for some specific people are not book disorders. Maybe you have all the symptoms of some dissociative disorder (deviant), but you cope well enough it doesn’t affect your every day life, and maybe you don’t find your detachment from yourself distressing. Technically speaking, you don’t actually have a disorder. But let’s be honest; most disorders are distressing for the afflicted.
So that brings me to anxiety, panic, and nervousness.
When we talked about the first two in one of my classes, my professor handed out a surprise quiz on the reading and said she could tell we weren’t doing the reading beforehand (mostly true) and this would now count for 15% of our grade. Imagine the emotions I had, not having done the reading, having no idea what the flip any of the questions were even talking about. About five minutes into the quiz, there was suddenly a blaring whistle that got our adrenaline pumping.
This is the difference between anxiety and panic: anxiety is that worried feeling you get as something difficult approaches, is demanded of you; an alertness that might help you perform on the task that is worrying. This is, of course, for both tasks in the near and distant future. Panic is an instigation of the fight-or-flight response. Obviously these are both important functions. Anxiety can help us take a task very seriously, and prepare better for it. Panic can help us survive! But what if you couldn’t turn off the anxiety, or if you responded with panic to the wrong stimulus? (I’ll give you a hint: just that, by itself, is deviance. You could probably see where the other two quickly follow.)
Stop: clarification, I am going to say ‘anxiety’ when I’m talking about the disorder, and ‘nervousness’ when I’m talking about natural emotions we all feel. Yes, I know those two are not necessarily the same thing, and yes, anxiety is an emotion that is not a disorder. Like I said, I’m doing that for clarity purposes.
When you get nervous, usually it’s over something really important to you. You have a presentation coming up, a test, a date with that girl/boy you really like, it’s your first time making the first step to accomplish that dream you’ve always had. You might be severely nervous about it and far in advance. You reach the performance, test, date, whatever. You go through it. Maybe you’re nervous the whole time. Then it’s over. And I don’t mean, just the test – you have the results now. You know if the agent’s taking you on. If the girl/boy wants a second date. It’s completely over, whatever was making you nervous. Nervousness is gone.
When you have anxiety, usually it’s over everything. Walking your kid to school? Anxious (what if we get hit by a car? What if there’s a shooting at the school today? Am I even a good mother/father for walking my kid to school? Shouldn’t I be doing more to help in his/her education?). Trying to find the bathroom in a mall? Anxious (What if there isn’t one here? What if I can’t find it in time and I embarrass myself in front of everyone?). Doing taxes – when you are, say, middle class and it’s just annoying and it’s not like you’re going to have any financial problems if you don’t get a big return? Still anxious about that return. And then the event is over, completely over – and you’re still anxious about it, how it could have gone instead, anxious about how bad it could have been if it had been worse. And while you’re worrying about the past, there’s some new trial – if asking the employee at the grocery store where they keep the ketchup is a trial – to make you anxious for the present and probably something else, like that perfectly normal doctor’s check-up (y’know, the yearly check-up where he always tells you what good health you’re in) in a few weeks to make you anxious for the future.
Actually, because I feel my grasp on anxiety is more tenuous than on other disorders, let me send you to another blog post about someone who actually has suffered from anxiety long-term.
You know what? Have another.
Advice people give when you find yourself nervous include things like, “Just don’t think about it. It’s going to be okay”, “imagine people in their underwear/other silly thing”, “It’s not the end of the world if you fail/you can’t be any more not [published] than you already are so you don’t lose anything by [submitting your manuscript to an agent] if they say no”. People will offer to help prepare for the problem or be moral support. This is usually great at alleviating nervousness. Well, sometimes, anyway.
None of this really works terribly well with anxiety. Because it’s a disorder. It doesn’t work the same way. Imagine you have two hoses spraying water uncontrollably, one connected to a nozzle on a house, one inexplicably springing from the ground. Yes, the problems look identical – crazy water – but if you give suggestions for how to shut the nozzle off to the person with the ground hose, it’s not going to help them, no matter how effective it is for the house hose guy. It’s not that your advice isn’t good – it’s that there’s no way to shut off the water.
As for moral support – let’s say, that’s trying to hold the hose down. That will probably work equally well, although eventually the hose hose is going to be turned off and the moral support can get up and move on. The ground hose is never going to be turned off. You will be trying to hold that wiggly piece of…rubber? Isn’t that what hoses are made of? forever. And all the while, you’ll be thinking, “Why do you even HAVE a ground hose?”
And why, indeed, are you even so anxious about crossing the food court to the water fountain? Why are you so anxious about being able to get your grandkid’s ID card for the first day of school? It’s not a big deal, there is plenty of time to find the office where they issue IDs. I mean, school doesn’t even start until Monday. We literally have all week to get that ID. Why are you so anxious? Why do you even have a ground hose?
So how do you solve anxiety? Drugs and therapy. You, the friend, parent, child, grandchild, roommate, partner, etc. – you can’t fix the anxiety. “What? I can’t fix it? That’s so hopeless!” No, it’s okay to be able to not fix things. It is, I promise. We’re so tetchy about the way we feel that we think it’s horrible to be anything but happy and okay and if someone’s not, we need to fix it, fast. It’s okay. Let the people who know what they’re doing try to fix the problem. There’s something more important you can do. Patience, compassion, understanding. Because the only thing worse than having a problem is having others make you feel badly for having a problem. If you find it too exhausting to morally support your anxious friend (or whatever) all the time, then just show patience. Don’t push them, and don’t become irritated with their anxiety.
Although if you’re curious, some therapeutic techniques include things like meditation, breathing techniques, and even dunking one’s face in cold water to which the body has a natural response to slow down the heart. But, uh, let’s not try to administer therapy to our friends and families unless we’re trained and licensed therapists, eh?
Now, panic attacks, the disorder form of panic. Let me give you a scenario. You’re in the grocery store, comparing brands of peanut butter (or walking home from an easy day at school or lounging at a park with your dog) when all of a sudden, there’s heat flaring through you. There’s a slight terror you feel, and your muscles seem to be pinched. Your heart is beating terribly fast. You look around but no one else seems to be noticing. You are having a stroke, or a heart attack! Except you’re not. Your body just initiated the fight-or-flight reaction for no flippin’ reason whatsoever. And seriously – most people having a panic attack will think they’re suddenly dying, or having a heart attack. It’s a truly terrifying experience – if any of you have had a moment where you were truly panicking, try to imagine that, but with no context.
We talk about agoraphobia like it’s any other phobia – people afraid of open spaces. Most agoraphobic folks aren’t so much afraid of open spaces as they are afraid of having a panic attack while in some place where they can’t get help fast, or where they’re not safe. So what that means is that if you have a friend who suffers from panic attacks, the best thing you can do for them is get them to a safe place. A safe place could be anything – it’s probably a place where no one else is. You cannot stop the panic attack. Do not try to ‘fix’ the panic attack. Do not try to calm the person down the same way you’d try to calm other people down. Just don’t do it. You’ll make it worse. Like I said, just get them somewhere where they can have their panic attack in peace, somewhere safe.
(Hey, you know in Iron Man 3 when Robert Down…Tony Stark was having PTSD (which is, subsequently, another anxiety disorder) and panic attacks? That was actually a pretty great movie adaptation, in my opinion.)
Speaking of PTSD – that one deserves its own post but, unfortunately, I will not be talking about it. I said I feel least confident in my knowledge of anxiety disorders – the exception to that is OCD, and the exceptional example of that is PTSD. People who actually have PTSD will probably want to throw rocks at me if I wrote about it. PTSD might be a great disorder to give your villain/hero/whatever character, so if you’re thinking about it, here’s what you might do to research it: Look up the actual diagnosis in the DSM. Look up soldier’s accounts of their PTSD. And look up research on the disorder, especially case studies.
So, recap: nervousness is good for helping us prepare and perform. Anxiety over everything that cannot be shut off is bad, and totally out of the control of the person enduring it. Please show patience. Panic is good for survival. Panic with no real trigger is bad and WAY out of the control of the person suffering it. Like a heart attack would be. Get them somewhere safe and wait. PTSD is not something I feel confident in posting about so don’t ask.
Please stop treating anxiety disorders like some sort of weakness of character or frailty of mind. That’s not it.