What Exactly Is Anxiety?

When someone tells you that they are struggling with anxiety, it is not uncommon to assume you know what they mean.

It might be tempting to think that the person who is high-functioning has a deeper faith the the person who struggles more intensely. But that is not necessarily so. Someone who struggles more intensely with anxiety may actually have a more robust faith than the person whose struggle is less. The Scriptures remind us again and again that the weak know their need of God’s grace while the “strong” may be falsely self-confident and self-reliant.

 

What is worry? In the first blog we discussed the experience of worry and in the second we addressed the multi-layered potential shaping influences that impact the degree to which we may struggle with anxiety. But what exactly is anxiety/worry? How do you begin to define it?

Let’s begin with the advent of modern psychology and psychiatry. A great deal of empirical research has been done over the past century. While these disciplines are quite young in many ways, they have proven to generate a wealth of observable data. When Christians stop and listen to the research, they are able to wisely engage rather than dismiss it out of hand. The following definition is an excerpt taken from the DSM Psychiatry Online Website:

Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Obviously, these two states overlap, but they also differ, with fear more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors, and anxiety more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors. Sometimes the level of fear or anxiety is reduced by pervasive avoidance behaviors. Panic attacks feature prominently within the anxiety disorders as a particular type of fear response. Panic attacks are not limited to anxiety disorders but rather can be seen in other mental disorders as well.

Here is a list of classifications of worry that can be found in the most current version of the Diagnostic and Statistical Manual of Mental Disorders V (DSM V). Where possible, screening questions from Allen Frances’ book, Essentials of Psychiatric Diagnosis, are included in italics:

  • Separation Anxiety Disorder: Is your child inordinately scared of separations?
  • Selective Mutism: the voluntary refusal to speak (typically occurring outside the home or immediate family).
  • Specific Phobia: Do you have a particular fear that causes you special trouble, like flying, heights, closed places, animals, seeing blood, or getting an injection?
  • Social Anxiety Disorder (Social Phobia): Do you frequently avoid social situations because you are afraid of doing something stupid or looking silly?
  • Panic Disorder: Have you ever had a panic attack?
  • Panic Attack Specifier: A panic attack associated with a certain trigger (social anxiety, etc.).
  • Agoraphobia: Are there many things you’re afraid to do and many places you’re afraid to go?
  • Generalized Anxiety Disorder: Are you a ‘worry-wart,’ unnecessarily anxious all the time about a lot of different things?
  • Substance/Medication-Induced Anxiety Disorder: Have you had a lot of anxiety symptoms associated with using drugs, drinking alcohol or coffee, taking medication, or withdrawing from drugs or medication?
  • Anxiety Disorder Due to Another Medical Condition: Have you had symptoms of anxiety in association with a medical condition, like and overactive thyroid?
  • Obsessive-Compulsive Disorder: Do you ever have weird thoughts that you can’t get out of your mind? Are there rituals you can’t resist doing over and over and over and over again?
  • Post-traumatic Stress Disorder: Have you experienced a traumatic event that keeps haunting you in terrible memories, flashbacks, or nightmares?

Below is a helpful chart that compares “normal” anxiety and “abnormal” anxiety.

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