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Anxiety Symptoms That Many People Overlook

Anxiety Symptoms That Many People Overlook

“Anxious” is a word with two faces. Sometimes it means eager excitement. “I’m anxious to see you!” we say, as we get off the phone with a friend who’s coming to visit. The other side of “anxious” is a bit darker: “I’m anxious about that test,” we say, when we’re worried about the results. We call the second meaning “anxiety,” and most of us experience it from time to time.

In common usage, both meanings of “anxious” describe our responses to fleeting, time-limited events. But anxiety can also have a much more powerful grip on many of us. Without the right kind of attention, it can rule our lives.

I’m a psychotherapist in private practice north of Boston, Massachusetts, and I’ve worked with many clients who have anxiety. In this, the first of two articles on a psychotherapist’s views on anxiety, I’ll describe what anxiety is and how you can tell whether you or someone close to you is suffering from it. In Part II, I’ll go into its causes and treatments, as well as the best ways to help heal from anxiety disorders.

Anxiety is more common than people think

More people in the United States have anxiety disorders than any other mental illness. Anxiety affects more than 40 million adult Americans and about one in eight children. Some experts put the estimate much higher, because many people don’t know they have anxiety, are diagnosed incorrectly, or don’t seek help for it.

In my psychotherapy practice, nearly all my clients have some form of anxiety. Sometimes it’s the main reason they came to therapy, and sometimes it’s an underlying issue that shows up after we’ve handled the immediate reason they came for help.

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Only about one-third of people who have anxiety disorders seek treatment.

Many anxious people know they have anxiety, but many more do not. They think catastrophizing, expecting the worst, worrying about what people think of them, or staying up late at night worrying about just about everything is normal.

It feels normal because that’s what they’ve been used to most of their lives – but it doesn’t have to be. Most people with an anxiety disorder can overcome it with treatment, support, and self-help strategies.

The difference between feeling worried and having anxiety

An anxiety disorder is different from feeling worried or being afraid. Worries about new or uncertain situations are normal, and feeling afraid in potentially dangerous situations is not only normal, but can sometimes save your life. Worrying about how you will perform on an exam might motivate you to study harder. Worrying about an erratic driver in front of you might help you drive more defensively. Feeling fearful about driving on a winding road in a storm might get you to wait for safer weather conditions.

Also, not everybody who worries a lot has an anxiety disorder. You might feel anxious because of too much work, too much stress, too little sleep, too much coffee, or low blood sugar.

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The biggest distinction between normal worry or fear and anxiety disorders is that anxiety disorders involve some form of chronic anxiety, and the anxiety interferes with normal functioning.

7 specific anxiety disorders

There are several kinds of anxiety disorders, and they each look and feel different from one another. One person might have intense panic, another might avoid social situations, another might be unreasonably frightened by dogs, and someone else might worry about nearly everything.

All anxiety disorders share a persistent fear or worry in situations where most people would not be afraid. Specific anxiety disorders have other, specific symptoms.

1. Social Phobia

People with social phobias are afraid of embarrassment or judgement in social situations and may blush, feel tongue-tied, go blank, have rapid heart rate, or show other signs of anxiety in those situations. They will avoid social situations whenever possible.

2. Special Phobias

People with special phobias might be unreasonably afraid of animals such as dogs or spiders, natural events like storms or lightning, heights, open spaces, enclosed spaces, and other parts of the normal world. They may go to extremes to avoid these things.

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3. Generalized Anxiety Disorder

Symptoms of Generalized Anxiety Disorder (GAD) can include feeling nervous most of the time, a sense of impending doom, feeling helpless, rapid breathing, increased heart rate, sweating, trembling, a queasy feeling, and tension in the neck, shoulders, or both.

4. Acute Stress Disorder and Post-Traumatic Stress Disorder (PTSD)

Both of these anxiety disorders sometimes occur after people have witnessed or experienced a physical threat. Symptoms include disturbing memories, flashbacks of the event, trouble sleeping or concentrating, and feeling either tense or numb. Acute Stress Disorder symptoms begin within a month of the traumatic event, while PTSD symptoms typically begin later. Symptoms can last for many years without treatment.

5. Panic Disorder

People with panic disorder have unexpected, severe anxiety attacks during which they are afraid they might die, pass out, or that they are suffocating. They often avoid places where panic attacks occur, which can lead to agoraphobia.

6. Hypochondria

People with hypochondria (now called Illness Anxiety Disorder) worry about having illnesses they probably don’t have. They catastrophize minor or imagined symptoms into a worst-case scenario. For example, they may be convinced that a headache means they have a fatal brain tumor.

7. Obsessive-Compulsive Disorder (OCD)

Sufferers may check obsessively, count when counting is unnecessary, and in general do ritualized behaviors. They feel unbearably anxious if they do not perform these rituals.

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The most common anxiety disorders, in approximately this order, are: Social Phobia, Specific Phobias, Generalized Anxiety Disorder, Acute and Post-Traumatic Stress Disorders, Panic Disorder, Hypochondria, and Obsessive-Compulsive Disorder

In my practice, I most often encounter Generalized Anxiety Disorder and PTSD, though I have also had many clients with Panic Disorder, Hypochondria, Social Anxiety Disorder, and Obsessive-Compulsive Disorder. Sometimes, people come in with more than one anxiety disorder. Hypochondria and Generalized Anxiety Disorder, for example, often show up in the same person, as do Social Anxiety Disorder and perfectionism which, though not an “official” anxiety disorder, contributes greatly to most forms of anxiety.

Signs of anxiety disorders

If you identify with any of the following symptoms, you might be dealing with an anxiety disorder.

  • You’re almost always worried or on edge.
  • You have irrational fears that you just can’t shake.
  • You’re often afraid that bad things will happen if you don’t do things in a particular way.
  • You avoid everyday situations or activities because they make you anxious.
  • You have sudden, unpredictable attacks of heart-pounding panic.
  • You almost always expect the worst.
  • You have trouble getting to sleep or staying asleep.
  • Your muscles almost always feel tense.
  • You often feel overwhelmed.
  • You expect more from yourself than most people do
  • You tend to focus on your health and personal problems more than other things in your life.
  • Your anxiety interferes with work, school, or family life.
  • You have one or more of the following physical symptoms: pounding heart, sweating when you’re not exercising or in a warm place, headaches, frequent upset stomach or diarrhea, dizziness, shortness of breath, shaking or trembling.

Some anxiety disorders are harder to spot

In my experience with psychotherapy clients, PTSD is usually the most difficult to spot because its symptoms don’t always cleanly match the standard definition. PTSD can look like depression, several other forms of anxiety disorder, ADHD, or a combination of mental illnesses.

An example: I once worked with a client who seemed to cycle through several anxiety disorders within a few months. She first displayed typical signs of panic disorder, and we quickly worked through them. But then OCD symptoms appeared. Again, we worked through them in what seemed like record time. Irrational fears and intrusive, disturbing thoughts soon followed.

It was a few months before we understood that what she was actually suffering from was the aftermath of childhood trauma. She had what I now think of as free-floating anxiety – a form of anxiety that unconsciously attaches itself to other anxiety syndromes. A clue to understanding how to help her was that she had majored in psychology and knew about various mental illnesses. Her half-remembered knowledge of common anxiety disorders gave her free-floating anxiety a place to focus. Working through the trauma helped her resolve all her anxiety symptoms.

Stay tuned!

In this article, we’ve looked at how worrying and fear are different from anxiety disorders and have identified the main symptoms of common anxiety disorders. In Part II of this two-part series, we’ll go into the causes of anxiety disorders, their treatments, and some self-help practices people with anxiety disorders and their loved ones can do.

More by this author

David J. Bookbinder, LMHC

Psychotherapist, writer, and photographer north of Boston, MA.

Anxiety Symptoms That Many People Overlook The Best Anxiety Treatment I’d Recommend as a Psychotherapist

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Last Updated on May 7, 2019

How to Detect a Wolf in Sheep’s Clothing

How to Detect a Wolf in Sheep’s Clothing

Work in any competitive field long enough, and you’re bound to run into a wolf in sheep’s clothing. It’s a powerful image. A shepherd watches over his flock to protect them from harm. He’d chase away any predator that tried to make its way into the flock. A clever wolf wearing the skin of a sheep as a disguise can sneak by the vigilant shepherd and get into the herd undetected.

The story isn’t just a colorful description–it’s a warning to all of us to beware the wolf in sheep’s clothing. They may seem innocent, but they have ulterior motives. They’ll use different tactics to camouflage their intentions.

The person who is kind to you, but undercuts you when you aren’t around is a wolf in disguise. A wolf in sheep’s clothing might pick your brain for ideas and then pass them off as their own to get a promotion. They’re always looking out for themselves at the expense of everyone around them.

Wearing a Disguise Has Its Advantages

People don’t go out of their way to manipulate others unless they’re getting something out of it. Hiding their intentions gives wolves the chance to manipulate other people to advance their own agenda. They know that what they’re trying to do wouldn’t be popular, or it might cause struggle if they presented themselves honestly.

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    They’ll be able to do what they want with less interference if they put on an act. By the time people figure out their true motives, the wolf has what it wants.

    Signs That Someone Is a Wolf in Disguise

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        1. They live to take power instead of empowering others. A wolf uses people as stepping stones to get the things that they want. They don’t care what happens to anyone else.[1] A wolf at work might make you look bad during a presentation to make themselves look amazing in front of the boss.
        2. Wolves seem sweet on the outside, but they’ll show you their teeth. If wolves revealed their true identity, people wouldn’t associate with them. They develop a friendly or kind persona, but they can’t keep up the act 24/7. Eventually, they’ll reveal their aggressive tendencies. A wealthy person who likes to break the law may make sizable charitable donations to convince people that they are kind and thoughtful. These donations largely keep them out of trouble, but if someone calls them out, they destroy that person’s reputation to stifle the criticism.
        3. They manipulate through emotions to get what they want. Wolves know that they can get ahead by appealing to your emotions. They find out what you want and need, and they give you just enough to keep you quiet and compliant. Imagine that your boss is a wolf in sheep’s clothing, and you want to ask for a vacation. She might try to play on your guilt and feelings of insecurity to get you to skip vacation or take fewer days off.
        4. A wolf will charm you first. Wolves are experts at manipulating the people around them. They appear interested in whatever you’re doing, and you’ll get the impression that they care. After they get you where they want you, they do just enough to keep you on the hook. This is the coworker who may start out being your friend, but they end up dumping responsibility onto you. When they see that you are growing frustrated, they’ll surprise you with something to charm you some more. Then, they’ll continue to do whatever they want.
        5. Their stories are full of holes.  Calling a wolf out is the surest way to make them squirm. When this person tries to come up with a story, it won’t make much sense because they are improvising.[2] The classic example of this is the significant other that you suspect has cheated on you. When you ask them why they came home so late, they’ll either become upset with you, or they’ll make up a weak explanation.

        How to Spot a Wolf

          Know What’s Real So You Can Spot the Phony

          Do some homework so that you have as much of the story as possible before you work with them. Research how they respond in certain situations, or give them hypothetical problems to see how they respond.

          A job applicant might tell you that she’s always positive and thinks of herself as a team-player. That’s what every employer wants to hear. During the interview you ask applicants to work in groups to solve a problem to see how they handle the situation. The applicant “positive team-player” is bossy and negative. You’ve spotted the wolf.

          A wolf will tell you something that ultimately benefits them. Gather evidence that proves or disproves their position, and see what happens. Chances are, when you choose the side that supports their agenda, they’ll act like your best friend. If you disagree, they’ll become aggressive.

          Spotting a potential wolf–especially if you are one of the sheep–can present you with some challenges. If your gut tells you that a wolf is lurking among all the other sheep, pay attention, and make sure you take the next step.

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          Ask Questions, the More the Better

          There’s nothing wrong with asking questions to uncover the truth. The safety of everyone in your group is at risk. Since wolves often make up stories, you may be able to call them out when their tales lack details.

          When they state an opinion, ask “Why do you think that?” or “How do you know it’s like that?” They’ll have trouble coming up with enough information to pull off the lie.

          Since wolves are always pretending to be something they aren’t, they don’t usually have a clearly thought-out reason for what they say. In a debate, they won’t understand the root of an issue.

          They may also tell you what they think you want to hear, but when pressed for more information, they won’t have anything to add. Their knowledge is superficial. No matter how much you try to encourage discussion, they will not be able to carry on a conversation about the subject.

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          Wolves Are Everywhere

          As much as we want to believe that everyone has the best intentions, it isn’t always the case. Some people only do things to benefit themselves, and they don’t care who they hurt in the process.

          Wolves in sheep’s clothing can be found in almost every setting. You can’t get rid of them, but if you can spot them, you can avoid falling into their traps.

          Reference

          [1] Association of Biblical Counselors: Three Ways to Spot a Wolf in Sheep’s Clothing
          [2] Power of Positivity: Beware of a wolf in sheep’s clothing

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