Situational Anxiety

Situational Anxiety

What amount of anxiety is normal?

To a certain extent, panic is a natural phenomenon. It has developed from the natural “fight or flight” instinct we all have ingrained in us, which is medically known as an acute stress response. The fight or flight response is triggered when the body and mind are alerted to a potential threat, which in the days when we were cavemen this response was actually useful, and would have been triggered when something like a predator was looking like it was going to attack us. Below are some of the symptoms of the fight or flight response, and why they are useful:

• Rapid heart rate and breathing, to pump more blood around the body and by extension, more oxygen too
• Dilation of certain blood vessels, such as to the legs, to increase the effectiveness of a getaway and allowing you to run faster
• Constriction of other blood vessels to unimportant parts of the body, such as the stomach, so the focus is on where it’s needed the most
• Sweating, to cool your body down
• Narrowed vision, so you are not distracted by the wider image and can focus on the predator and your getaway
• Needing to use the toilet, which was originally useful as it makes the body lighter, so you have less weight to carry when you’re running
• The release of chemicals such as noradrenaline to heighten your sense and temporarily increase your physical strength

In the context of the age old fight or flight instinct, these responses make sense. However the problem nowadays is that we are rarely under this kind of strain. If you were in a situation such as a house fire or a natural disaster, this heightened strength, ability to flee and focussed awareness might allow you to escape marginally quicker, but the chances of this happening are pretty low. Instead, in modern environments, this reaction is unleashed in situations where it isn’t really necessary, and certainly isn’t crucial to our survival. It’s because of this chain reaction (brain identifies fear > chemicals are released > body goes into fight or flight mode) that we get so panicked before going into scary situations such as going on roller coasters, into job interviews, or on first dates.

If you suffer from anxiety, it is likely that you experience this feeling over all kinds of issues, most of which the general population would not find particularly scary, or even think twice about doing. These can include situations such as going to the corner shop to buy milk or walking through a town centre.

Types of anxiety

There are several different types of anxiety which have their own uniquenesses:

• Generalised Anxiety Disorder (GAD). This is the most common type of anxiety, and as the name suggests, is general. There is no one specific cause of trigger of the anxiety, and can be provoked by circumstances or thoughts that would have little to no significance in most people’s daily lives.
• Specific phobias. Around 5-12% of people worldwide experience specific phobias, major ones being heights, water and blood. The anxiety reaction is triggered when a person encounters their phobia.
• Panic disorder. This is where a certain situation, thought process or trigger leads to a panic attack which can last up to a few hours. Panic attacks are characterised by nausea, shaking, difficulty breathing, confusion and dizziness. The best way to cope with panic disorder is by trying to identify your triggers and avoiding them where possible, though this is often difficult to do.
• Social anxiety disorder. This type of anxiety is characterised by fear and anxiety related to social situations. This is not specific to typically scary events such as public speaking or job interviews, but can surround all social events, even what may seem to be relatively innocuous ones such as a meal with friends or going to the cinema. Selective mutism is a variant of social anxiety and means the sufferer cannot speak in situations they find overwhelming.
• Separation anxiety disorder. This is a natural and common phenomenon among children (do you remember your first day of school?) but usually fades as they get older. The anxiety can be triggered by the separation from a specific person or place to which they have strong attachment.

There are two other illness that were once classified as anxiety disorders and are now not, or are only classified in some manuals. These are OCD and PTSD. The first of these, obsessive compulsive disorder, is an illness which causes the sufferer to have certain obsessions or compulsions which they cannot control, and if they are deviated from, will cause intense anxiety. The second of these, post traumatic stress disorder, is caused by exposure to an extreme and traumatic situation, such as combat, rape, or even an extreme car crash. Flashbacks, anxiety hypervigilance are all symptoms of PTSD.

What’s the difference between Generalised Anxiety Disorder and Situational Anxiety?

Situational anxiety is not classified as an illness in itself, but it has specific features that the wider condition, generalised anxiety disorder, does not have. The most important thing to remember about situational anxiety is in the name: it is panic based upon a specific situation. General anxiety disorder can interrupt all aspects of life, from impairing your ability to make phone calls, to worrying endlessly that all your friends and family hate you, to paranoia that consumes your life and impairs your ability to function as most people do. On the other hand, situational anxiety is only caused by specific situations. These can be small things such as standing in tightly packed spaces, or huge life events such as moving house or getting married.

What’s the difference between Situational Anxiety and normal nerves?

The key difference between situational anxiety and your normal amount of nerves is the trigger of it, and the proportion of it. A lot of people would feel a bit uncomfortable in a tightly packed lift and probably want to get out as soon as they reasonably could, but few would find it so horrendous that it would cause them to feel ill, start shaking and sweating and loose their concentration. Likewise, most people feel nerves on their wedding day, but (unless you are not sure you’re getting married to the right person) most don’t find it panic inducing to the extent where it is debilitating. The main thing to remember about anxiety is that the fear is grossly disproportionate to the threat.

What are the symptoms of anxiety?

The situations of anxiety vary person to person and can depend of the severity of the attack. They can include, but are not limited to:

• Nervousness
• Nausea
• Fatigue / exhaustion but combined with difficulty sleeping
• Tension
• Swearing
• Chest pains
• Headaches
• Irritability

What causes anxiety?

There are many different factors which can cause anxiety. These include:

• Drug and alcohol abuse. Although anxiety can be bad whilst the drug has its effect on you, it can get even worse when you stop taking it and anxiety can be a huge withdrawal symptom. Some psychiatric medications can also have the side effect of anxiety. Nicotine and caffeine can be just as bad for your mental health.
• Childhood experiences such as being bullied, excluded or abused. Childhood abuse can lead to longstanding mental illnesses.
• Other mental health illnesses. If you are suffering from an illness such as depression, anxiety often accompanies it.
• Living with stress, pain or having recently experienced intense grief.
• Genetics. There is evidence to suggest that if one of your family members experiences situational anxiety disorder, you are more likely to as well.

What treatments are available?

You should speak to your doctor if your anxiety has an effect on your life which limits your ability to live life fully, for example you find yourself constantly on edge as a precaution, even when not in a situation that gives you anxiety, or you find yourself significantly altering how you live your life to avoid your situational triggers, or it begins to affect your work and relationships. When you speak to your doctor about the problems you are facing, they will be able to help you manage your anxiety. Although, especially for people with situational anxiety, making an appointment to speak to your doctor about something so personal may feel like the most difficult thing in the world, but it is important to remember that they are there to help you, and will be very sympathetic and understating of your condition. You might find it beneficial to bring a friend along with you for moral and emotional support. There are various treatments for situational anxiety, some which may be more suitable for you than others:

• Avoiding your triggers. This comes with the problem that you may not always be able to predict your triggers and it may limit your lifestyle, but it is a good place to start, as not all medication or counselling works quickly.
• CBT, cognitive behavioural therapy. This is a type of therapy that encourages you to examine your thought processes and change them. This means you can work with your therapist to remove the fear you associate with certain situations, so you don’t need to worry about avoiding your triggers.
• Speaking with a counsellor. This is slightly different from CBT, as it just involves you speaking about your fears and discussing them with an experienced professional, who can help you come to terms with your problems and find ways to resolve them.
• Support groups. This is where you meet with people suffering from the same problems as you, and work through your issues together, guided by a trained professional. This can help to remind you that you’re not alone, and allow you to get tips from people in the same position as you as to how you can better cope with your situational anxiety.
• Mindfulness and applied relaxation. These are techniques which can help strengthen the mind to battle negative thoughts and patterns. You can also condition yourself to relax on command to a word, so if you are in a situation that begins to trigger your anxiety, you can more easily calm down as, like a muscle, it is trained and well rehearsed from memory.
• Medications. There are many different types of medications you may be offered, and due to their side effects you should not experiment with any yourself without your doctor’s advice and prescription. If one type of medication doesn’t work for you, they may recommend another, but bear in mind they can take several weeks to have an effect, and in the first few weeks the body will be adjusting to the new chemicals, which may mean things get temporarily worse before they get better.

From Doctor-4-U, you can buy a medication called Propranolol, a type of beta blocker, to help ease your anxiety. Beta blockers can be taken for all kinds of health issues, such as high blood pressure, migraines and angina. They work by slowly the heart beat down and making it beat with less force, so if you begin to panic, the symptoms will be slower and you will feel more relaxed. Not everyone can take Propranolol, though, for example if you already have low blood pressure, it could be very dangerous for you to lower it even further with this medication.

If you have situational anxiety, going to the doctor to get help make seem like one of the most difficult things in the world, but take someone with you and remember your doctor will be very understanding, and you’ll have begun the road to recovery.