Through experience at one time or another we are all familiar with uncomfortable tension and worry. This is anxiety and, in itself, is a normal and functional dimension of our mental lives. It keeps us alert and therefore safe in potentially threatening or dangerous situations. It helps us take evasive action when needed. It is a potent cue for learning so that we know what to avoid in future. It is therefore necessarily “wired in” to us.
Like any dimension of our psychological make-up we are each born with different levels of loading to experience anxiety, some of us being more “wired up” than others. In addition difficult experiences in our early lives and how we were helped learn to deal with them can lead to this level of amplification being turned further higher or lower.
The result is that some people can come to experience much higher levels of anxiety than others in relatively ordinary situations. This can be fairly generalized or sometimes focussed on only a few aspects of our lives. It can sometimes manifest as sudden peaks, often referred to as “panic attacks”. Because these heightened levels of anxiety are very unpleasant and indeed exhausting, we find ways to lessen them. Avoidance is a common strategy, sometimes resulting in agoraphobia, i.e. markedly restricting our lives to environments which feel safe. Alcohol or drug use can be another strategy. Depression can arise out of feelings of restriction and despair.
The specific manifestations of excessive anxiety result in what psychiatrists classify as different types of anxiety disorders. Their particular manifestations are unique in each person as is their pattern of adaptation and the life situation in which they find themselves. It is important to develop a thorough understanding of this for each individual patient.
Anxiety disorders can be effectively treated symptomatically with a variety of different medications. When anxiety is debilitating this is often the best approach to enabling a person to get going again. In the long run anxiety disorders are best dealt with by helping the patient to learn strategies to manage their own anxiety, though medication can often play a role here too.