What is anxiety?
In her 2008 book, A Brief History of Anxiety, author Patricia Pearson describes anxiety as a fear that is “unbearably vivid, yet insanely abstract.” Simply put, anxiety is worrying about something that is yet to happen.
Remember the tight clench of your stomach before your Maths paper? The knot would ease after the exam, but resume before the next paper. By the end of the exams your anxiety would have vanished, only to reappear later at the time of the results. But as a mental disorder, anxiety never leaves.
The term that doctors use for the most common kind of anxiety disorder is called Generalised Anxiety Disorder. GAD is marked by excessive worry in several areas of life — work, relationships, finance — even when there is little cause for concern.
Then there are specific forms of anxiety. Social anxiety is the irrational fear and avoidance of social gatherings, born out of concern that others may view you negatively. Separation anxiety disorder is, as the name suggests, a fear of separation from the comfort of your home, or parents.
And then there is the anxiety that is masked by other issues like depression, Obsessive Compulsive behaviour, and Post Traumatic Stress Disorder (PTSD).
Dr Kersi Chavda, past president of the Bombay Psychiatric Society, says that more often than not, people approach a doctor only after they’ve had a panic attack — where they have anxiety so acutely that they blanked out, broke into a cold sweat or had palpitations.
When anxiety wears a mask
In the case of Obsessive Compulsive Disorder, recurrent, irrational fears are assuaged to a degree when the person engages in a repetitive behaviour. PTSD develops in the wake of a terrifying event, which results in feelings of extreme helplessness, horror and fear. Anxiety is couched in the sense of numbness, dissociation and hyper-vigilance when the person re-experiences that fear. While it is easier to diagnose OCD, PTSD takes time to diagnose, because symptoms take time to show up. Meanwhile, research on this condition, which was known as shell shock during World War I, still continues. The distinction between simple and complex PTSD, for instance, was only made in the 1990s.
In these cases, anxiety is intrinsically linked to the condition, so it isn’t treated separately, but as part of a larger issue. Further, people who have been diagnosed with a chronic, life-threatening ailment are also susceptible to anxiety. Often, hospitals recommend psychiatric sessions for such patients.
“There are gradations of anxiety,” says Chavda. “There is good stress, which makes a person productive, and there is bad stress, or distress, that causes trouble. There are more than 100 neurotransmitters in the body. One develops a condition depending on which neurotransmitter is affected.”