A person feels anxious on most days, worrying about lots of different things, for a period of six months or more.
Most people feel anxious and worried from time to time, especially when faced with stressful situations like taking an exam, speaking in public, playing competitive sport or going for a job interview. This sort of anxiety can make you feel alert and focused, helping you get things done faster or perform at your best.
People with GAD, however, feel anxious and worried most of the time, not just in specific stressful situations, and these worries are intense, persistent and interfere with their normal lives. Their worries relate to several aspect of everyday life, including work, health, family and/or financial issues, rather than just one issue. Even minor things such as household chores or being late for an appointment can become the focus of anxiety, leading to uncontrollable worries and a feeling that something terrible will happen.
People with GAD may have related disorders, most commonly depression, social phobia, or other anxiety conditions. They may also misuse alcohol or drugs and may experience a range of physical health problems such as headaches or bowel complaints.
Social Anxiety Disorder
A person has an intense fear of being criticised, embarrassed or humiliated, even in everyday situations, such as speaking publicly, eating in public, being assertive at work or making small talk.
It's perfectly normal to feel nervous in social situations where we might come under the attention of others, whether they're strangers or people we know. Attending a formal function, giving a speech at a wedding, doing a presentation to work colleagues are likely to cause nervousness and anxiety, both in the lead-up and during the event.
However, for people with social anxiety disorder (sometimes known as social phobia), performing in front of others and social situations can lead to intense anxiety. They may fear being judged, criticised, laughed at or humiliated in front of others, even in the most ordinary, everyday situations. For example, the prospect of eating in front of others at a restaurant can be daunting for some people with social phobia.
Social anxiety may occur in the lead up to or during in:
performance situations (such as having to give a speech or being watched while doing something at work)
situations involving social interaction (such as having a meal with friends, or making small talk)
Social anxiety can also be specific; where people fear a specific situation or a few situations related to a specific fear (such as being assertive at work or with their friends).
Common symptoms of social anxiety disorder include physical symptoms and psychological symptoms.
The physical symptoms that can be particularly distressing for people with social phobia include:
blushing or stammering when trying to speak
nausea or diarrhoea
These physical symptoms often cause further anxiety as the person fears others will notice – even though these signs are usually barely noticeable to those around them.
People with social anxiety also worry excessively that they will do or say the wrong thing and that something terrible will happen as a result.
People with social anxiety try to avoid situations where they fear acting in a way that's humiliating or embarrassing. If avoidance isn't possible, they endure the situation but can become extremely anxious and distressed and may try to leave the situation as soon as they can. This can have a serious negative effect on their personal relationships, professional lives and ability to go about their daily routine.
A diagnosis of social anxiety disorder is based on having the typical symptoms, which cause significant distress or impairment of day-to-day functioning, and the symptoms are persistent for at least six months.
Managing Anxiety during COVID-19
Anxiety is more than just feeling stressed or worried. While stress and anxious feelings are a common response to a situation where we feel under pressure, they usually pass once the stressful situation is over, or ‘stressor’ is removed. There are many ways to help manage anxiety and the sooner people with anxiety engage with support, the more likely they are to regain stability and develop an effective management plan.
Everyone feels anxious from time to time. When anxious feelings don't go away, happen without any particular reason or make it hard to cope with daily life, it may be the sign of an anxiety condition.
In this time of uncertainty, due to the COVID-19 epidemic, many people are more likely to experience a sense of ongoing worry or anxiety.
The difference between worrying and actual anxiety is usually the way we feel in our mind and body. Worrying can certainly be part of anxiety, but not necessarily. We can worry about many things, for example, our safety, finances, health and our future. However, anxiety is a deeper, full sensory experience, which can be quite debilitating and impact our ability to function well, maintain healthy relationships and engage with friends or the community.
During this time of insecurity with the pandemic, many of us may find ourselves worrying more than usual. Worries may typically be around health safety, finances, job security, attending school, education, family, along with increased relationship and parenting issues. However, the threat of serious illness or loss of life due to COVID-19 is a major cause of anxiety for many people right now.
What this pause in real time has brought us is the opportunity, whether we want to or not, to focus on those things which are often just under the surface, or even buried pretty deeply, as we have more time on our hands and are isolating with, or without, others. Financial pressure and domestic violence are two of the leading causes of divorce, so it’s no wonder relationships are feeling the heat right now.
Personal, relationship, career and family issues can be ignored, swept under the carpet and avoided fairly well when we are busy. Most of us are usually very busy these days, often wishing for more time-out to enjoy the good things in life. Ideally, though, we would also have the freedom to move about as we choose. This time of isolation and social distancing, where we find ourselves cloistered with others 24/7 or unable to be with loved ones, is likely to be putting a huge strain on even the best of dynamics. So, here we are, our wish for more time being granted, however, the restrictions we have experienced have not necessarily allowed us to enjoy the free time we have had at hand.
During this COVID-19 situation, those who are more inclined to significantly worry, become anxious or already have an anxiety disorder diagnosis, will likely find such a health crisis particularly challenging. You could expect to see a heightened state of anxiety with an increase in symptoms and coping behaviours. However, there are many healthy and effective ways to manage stress and anxiety which you may find useful for you and your family, including children, who are experiencing greater levels of stress, worry and/or anxiety at this time.
Essentially, anxiety is one outcome of our fight and fight response caused by an emotional trigger or “threat”. COVID-19 in of itself is a huge, real threat to our life. For some, it will cause greater anxiety than others. Many people have an innate sense of being safe in the world, no matter what. This doesn’t necessarily mean they’re irresponsible, avoidant or in denial, simply, they have a greater trust in the world being a safe place and they’re somewhat confident they’ll remain safe within it.
For others, two things are possible:
They normally feel safe in the world, however, the impact of COVID-19 on individuals around the world is overwhelming. Or
They’re already coping with other issues causing anxiety and the severity of COVID-19 adds to an already anxious predisposition, or overload.
How each person responds to the threat of COVID-19 on the safety of themselves and their loved ones, indeed, their care for others around the world, depends on those points above. As such, it’s important to understand your own levels of anxiety and why you feel the way you do. In addition, understanding and accepting others may not be responding in the same way you are, respecting they’re anxiety levels and coping strategies may be different to yours. That one person’s expression, or lack thereof, isn’t right or wrong, just different.
Being caring to others during this time, appreciating everyone is handling their reaction to COVID-19 in their own way, internally and/or externally. We have seen this in action with the frenzy of toilet paper supplies. Some people think it’s completely understandable to want to stock up and others think it’s totally unnecessary, especially when the panic buying causes a shortage for others.
Reducing anxiety is key to managing our emotions and behaviours. There are many ways in which we can support ourselves in balancing our mind, body and soul to create more internal calm and external harmony. These include:
Identifying underlying or existing stressors
Identifying the full impact of COVID-19 on your stress levels
Seeking talking therapy, counselling, to help with the above and alleviate them
Mindfulness to bring awareness back to your core, so you can regain some control over your emotions and behaviours. Cognitive Behavioural Therapy (CBT) is helpful with this.
Meditation is also helpful with mindfulness
Playing music, singing and dancing, exercise
Developing an anxiety attack grounding checklist. Keep it somewhere easy to access for you and others to help you with. Some points might be:
Breathing - regain control of slow deep breathing, returning to normal
Tapping your fingers on your body to bring your mind back into your physical body, saying something like, I’m safe/it’s safe to be in my body
Observing items around you – the chair, the pot plant, the table, etc
Listen to the sounds of things around you – hear the cars, birds, talking
Have a drink of water and/or cup of calming herbal tea – not caffeine as it is a stimulant
Chat to a friend/loved one or call someone/support line
Have a walk
Be kind and supportive of yourself, as your body has just released a huge amount of cortisol and needs to rebalance your biochemistry now
Clearly, the best things we can do for ourselves is take the proper precautions to stay safe. Engage with others as often as possible to keep mental health in check and get the right help and support as soon as you feel you’re not coping. This will ensure you’re looking after yourself and loved ones, enabling you to return to a new sense of normal as soon as possible.