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Is it Anxiety or anxiety?

The ‘A’ word get’s bandied about a LOT nowadays. I can’t imagine for a moment that my parents generation talked in terms of anyone being ‘anxious’ and growing up in the 1970’s it also wasn’t yet a familiar term. In today’s world though, I challenge you to spend more than five minutes in the popular media, Social or not before you come across the statement that someone or other is ‘suffering from Anxiety’. And following a world pandemic that forced people into many situations that they would otherwise flee from, many of us are experiencing what we may describe as Anxiety on a new or epic scale.

Now don’t misunderstand me: I’m a therapist dealing with more Anxiety cases than any other kind of issue. So I don’t lack understanding and I certainly am not lacking in empathy. My beef is the mislabelling of what might be called ordinary or situational anxiety (let’s call that anxiety with a small ‘a’) and an Anxiety Disorder, which most definitely is deserving of capital letters. So how do you know the difference between the two?

The shortest explanation I can give you is that a Disorder brings with it ‘dis-order’. Someone feeling anxious about an upcoming exam, having some sleepless nights and maybe a few tears, then still turning up on exam day is not suffering from Anxiety. They are responding to a real and current or upcoming situation with an understandable level of concern. Some people have more of a tendency to worry and so concern morphs into worry and then from worry to rumination (going over and over something in your head). It’s not pleasant, but it doesn’t last forever and it’s the kind of concern that often leads us towards the things that help - like studying a little harder.

And it’s always been useful… back in our ancestors day, being concerned about being eaten by a bear when they were actually bears around, was a helpful state of mind to be in, simply because it made you take care! Someone with an Anxiety Disorder is unlikely to be filled with fear and dread about just one thing (the upcoming exams), they are likely to add this situation into a huge landscape of things that also appear to them as threatening or catastrophic. And the fear generated by the “what if?” thinking around these things will lead to dis-order… they may drop out of school to avoid the exams, they may turn to drugs, alcohol or self-harm to try and numb their feelings… they don’t just turn up on the day and do their best to get on with it. Because when you’re dealing with a ‘dis-order’ standard rational thinking just doesn’t land....ever.

Here are two other aspects that can be helpful in making a distinction between an Anxiety Disorder and plain everyday anxious feelings, concerns or worries?

One way is to check if the thing you’re worried about is in personal context: that it has some kind of relation to your current life. So being concerned that you might have a car crash when you’ve already experienced one makes some kind of sense. On the other hand, panicking about the thought of being in one when you never have, nor is there any reason why you are specifically and currently at risk, is just the kind of constructed harmful ‘what if’ thought that is typical of Anxiety. You may see the 'dis-order' in a reluctance to leave the house for fear of being in a car accident,. So anxious feelings are lower case 'a' and an Anxiety Disorder has the capital 'A'.

The investment of lengthy time stressing over and over things that logically are so unlikely to happen can be an indicator that you're in Anxiety territory. But you'd still be looking for the dis-order that comes from such rumination.

When I was doing a daily commute to London, maybe once a week or so I’d be at the edge of a crowded tube platform and one of two thoughts would jump into my head: either “what if this crowd surged forward and I fell into the path of this train?” or an even more macabre one “what if I jumped onto the rails right now?”. Someone with an Anxiety Disorder may use those random thoughts to create an internal story about being suicidal (at worst) or at best, develop such a fear that they refused to take the tube (that dis-order thing again). As it was, I told my internal narrator to shut up and not entertain such unhelpful thoughts. They came back every now and then, as random thoughts do.

Managing random thoughts is 100% normal, but It’s surprising how many people I meet who have no concept of having to manage their own thoughts and having let them ‘run free’, wonder why they feel so down!

If you sense some of your thoughts and feelings are irrational and yet it doesn’t feel like you can control them, and they are also leading you into dis-order in your life, I’d like to recommend a little book that I often share with my clients. It’s called Stop Thinking, Start Living by Richard Carlson. You’ll find it on Amazon. And if you need some in-person support, I'm available to work with clients in a number of ways.

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