In recent years, the stigma behind discussing anxiety and other mental illnesses has lifted quite a bit. Sure there is room for improvement, but I can’t tell you how much I see anxiety being talked about on social media and in “real life” exchanges. However, I have also noticed that, despite the increase in discussion around anxiety as an issue, there is still a lot of confusion about what anxiety actually means.

What is anxiety, really?

Is it just the sense of feeling stressed? Is it when you worry about school? Is it the same thing as a panic attack? Additionally people are very curious about where it comes from in the first place. That’s what I want to cover in this post. I’d like to do my best to define anxiety and break down some of the biology behind it in straightforward terms that you don’t need a Ph.D. to understand.

This post is adapted from my bestselling book, Hardcore Self Help: F**k Anxiety, available on Amazon!

An audio version of this post can be found below for your convenience.

What is Anxiety?

So let’s start at the top. What the heck is anxiety? Well the guide that us psychologists (in the USA) use to diagnose psychological disorders, called the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V), makes the following distinction:

Fear is the emotional response to a real or perceived imminent threat, whereas anxiety is the anticipation of a future threat.

I think this is a great explanation and distinction. When you are out in the world and someone threatens you with violence, your body goes through a physiological response (that we will talk more about) to prepare your for action. This fear reaction serves a very clear evolutionary purpose to keep you safe.

Now with anxiety, we have a similar reaction, but the most important distinction is that it is not in response to a real threat like the fear reaction. For instance, you might be at work and start to worry about whether you are going to be able to work fast enough to meet your really important deadline. This may cause your body to tense up. You might breathe more rapidly, have trouble concentrating, and find that your heart is pounding. Sounds very much like the normal reaction when faced with a dangerous situation, but in this case, you are not actually in any danger. Instead, you are anticipating a situation that might occur. Your body is not in any physical danger, but your worries trigger the same physical sensations as if you were in danger. There is nothing dangerous about speaking in public, but that doesn’t stop your body from making you feel like you are about to have a heart attack.

Types of Anxiety

Now, anxiety is a bit different for everyone. In general, I find that people tend to fall into three camps: physically driven, cognitively driven, or both.

Physically driven anxiety affects people mainly in their body. They may not think about their stresses or worries excessively, but their body shows all the telltale signs of anxiety such as:

• Rapid heartbeat
• Sweating
• Shortness of breath
• Trembling
• Nausea
• Numbness or tingling
• Chills or hot flashes
• Feeling detached from body

A panic attack is when you have several of these intense physical symptoms that come on abruptly, along with an feeling of strong fear or impending doom. A panic attack typically peaks within a few minutes and then your body begins to regulate and come back to a normal state. Not all people with anxiety get panic attacks. They are just the most clear expression of physiological anxiety. You can definitely have 2 or 3 of these symptoms without having a full blown panic attack, in which you are debilitated and unable to successfully operate in your life.

On the other side of the coin, you have people with cognitively driven anxiety. By that I mean that their anxiety is largely caused by their thoughts. This is where that anticipation comes in. People who have cognitively driven anxiety often feel a sense of impending doom due to anticipation of something bad. If depression is fueled by regrets from the past, anxiety is driven by worries about the future. It’s super common for someone with anxiety to constantly be wondering “what if?”. What if I get in a car accident? What will happen to my kids? What if I can’t finish this project? What if I get rejected when I go to ask her out? What if a bomb goes off in this movie theater? These worries are sometimes rooted in reality, but often spiral out and become unreasonable.

Another key characteristic is that the worries are often about things that are not in the person’s control. Therefore they have this psychological turmoil and tension caused by their worries AND they don’t feel like they have any way to do something about it, which can lead to some serious agitation and frustration. There is often this sense that something is always unresolved and you can’t quite rest your mind.

This is very tough stuff. Everyone experiences some anxiety at some point in their life. It’s normal to experience a temporary state of anxiety when you have a huge exam coming up or the day of your wedding.

Anxiety is both an emotion and a class of disorders, so it can be confusing. By that I mean that you can feel anxiety without “having anxiety”. Usually when we say that someone “has anxiety” we are implying that they live with some sort of anxiety disorder.

Anxiety disorders are a consistent pattern of particular anxiety symptoms that cause a person impairment in their daily life. For instance, panic disorder is one anxiety disorder in which someone has recurrent panic attacks and has an extreme fear of future attacks. A specific phobia is an intense anxiety reaction to one particular stimulus such as blood or snakes. There are quite a few anxiety disorders that I won’t get into here, but the point is there is a big difference between the occasionally anxious moment and a persistent anxiety disorder that would need to be diagnosed by a professional. I talk a lot more about the different types of anxiety disorders in my book if you are curious to learn more.

What Causes Anxiety?

Now that you have a general understanding of what anxiety looks like, we should talk a bit about where the heck it comes from in the first place. I’m going to get a bit into the biology behind anxiety here, so hold on to your hats. I’ll try to keep it as straightforward as possible.

 

Let’s start by talking about your nervous system. The nervous system is basically the network of nerve cells that transmit signals all around your body. It is broken up into the central nervous system (CNS), which contains your brain and spinal cord and the peripheral nervous system (PNS), which contains the nerves that connect the CNS to all the other parts of your body. In discussing anxiety, we are most interested in a portion of the PNS called the autonomic nervous system (ANS). As the name suggests, the ANS helps to manage the automatic functions in your body. It governs the things that are mostly unconscious such as heart rate, digestion, pupil response, sexual arousal, and respiratory rate.

With me so far? Nervous system = central + peripheral. We are focusing on part of the peripheral called the autonomic nervous system. Autonomic = automatic. Got it?

Let’s go a little deeper. The autonomic nervous system has two halves to it: the sympathetic nervous system and the parasympathetic nervous system. This is where we really hone in on where anxiety comes from within your physiology. Remember that fear reaction that we described at the beginning of this post? That’s the job of the sympathetic nervous system. The sympathetic nervous system is often called the “fight or flight” system. This is something that evolved to keep humans alive. When you are out in the plains as a caveman and there is a rustling bush, you need to quickly tell whether it’s a predator or prey and then instantly snap into action to either hunt it down or to run your buns off to avoid being eaten yourself. In modern times, this is the reaction that helps you to jump out of the way when a car runs a red light and flies into the crosswalk.

The fight or flight response first begins within a part of your brain called the amygdala. The amygdala’s job is to simply provide that first basic warning that danger is imminent. There is not complex thinking going on in the amygdala, it’s basically just the warning siren of your brain. That warning siren then kicks your hypothalamus into action. The hypothalamus is basically the middle man between the warning siren of the amygdala and the other parts of your brain that secrete hormones to kick you into action. Think of the hypothalamus as the safety director at a factory. When the the amygdala throws the switch and sets off the siren, the hypothalamus says “Alright, chumps. It’s go time. Adrenal gland, I need you to push out a bunch of adrenaline to get our butts moving faster. Pituitary? We need some cortisol in here. Alright, people. Look a live! Go, go, go!!” …okay that was super cheesy, but I hope you get the point. There is a whole cascade of things that happen in your brain that you really don’t need to know in excruciating detail. Just understand that when you are faced with danger, the sympathetic nervous system has your back and prepares your body to respond. 

When that fight or flight response, prompted by the sympathetic nervous system happens without an actual danger in your environment, that’s when you have those physical symptoms of anxiety. It’s essentially a fight or flight response that is prompted by your own thoughts, worries, or a non-threatening situation. The primary medications that are used in the treatment of anxiety disorders are called selective serotonin reuptake inhibitors (SSRIs). These increase the amount of serotonin (a communication chemical called a neurotransmitter) available in your brain. Without going into too much detail, this basically decreases the activation of the amygdala (warning siren) and other areas of the brain involved in the anxiety response.

Interestingly, the sympathetic nervous system that causes your fight or flight response also has a counterpart called the parasympathetic nervous system. Whereas the sympathetic nervous system is the “fight or flight” system, the parasympathetic  is the “rest and digest” system. It basically undoes the effects of the stress reaction. It lowers your heart rate, reduces muscle tension, and initiates the relaxation response. This parasympathetic reaction can be turned on through the process of deep breathing, which is why breathing exercises are so popular as coping tools for anxiety.

How Do I Get Rid Of Anxiety?

By now you should have a pretty good idea about what anxiety is and where it comes from within your body. Let’s talk briefly about how you can deal with it. As I mentioned, deep breathing is a vital tool in combating the physical symptoms of anxiety.

Here are several tools that I have on my website to help you with this process:

 

There is also the other side of the equation to deal with. It isn’t always the physical symptoms of anxiety that cause you the most problems. Sometimes it is the thinking patterns. As humans, we often engage in unhelpful thinking patterns such as “black and white” thinking or when we attempt to “mind read” and assume we know people’s private motivations behind their behaviors. Modifying these unhelpful thoughts is the basis behind cognitive behavioral therapy and is something that I focus on extensively in my book, which you can find here.

Thank you for spending this time with me and learning a bit more about anxiety. I have many other resources related to anxiety on my blog and podcast, so please have a look around! I sincerely hope this was helpful to you.

Here is an audio version of this post, What is Anxiety, for your convenience.

What to learn more about how to battle that beast called anxiety?