Posted by: Admin | May 1, 2009

Anxiety or Fear?

In today’s climate of uncertainty, it is normal to feel unstable about our jobs, kids, the education system, credit scores, global warming, stimulus plan… the list continues. I believe that as our lives get busier, our tendency to “worry” increases.  Excessive worry can lead to an inability to function in daily life. Similar to terms like depression and bipolar, anxiety has become a part of our daily language to communicate a feeling state.

But how do we discriminate between anxiety, which can be debilitating, and fear, which is something we share with animals? DSM-IV-TR, today’s bible of psychiatry, lists the diagnostic features of General Anxiety Disorder (GAD) as the following:

“Excessive anxiety and worry (apprehensive expectation), occurring more days than not for a period of at least 6 months, about a number of events or activities. The anxiety and worry are accompanied by at least three additional symptoms from a list that includes restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and disturbed sleep”.

The National Institute of Mental Health reports that 19 million adults in the US suffer from one form of anxiety or another. Sleep disorders or early awakening, depression, tension, muscle aches, and fatigue can all accompany chronic anxiety. I would guess that with the current state of national economy, this number is on the rise.

I have been in both states of fear and anxiety quite often in my life. For many years, I didn’t understand the difference and used these words synonymously. But I’ve recently learned that there is a major difference between the two. Anxiety has the basic experience of paralysis. I’ve experienced it as a constant feeling of being in quicksand, unable to move or breath, just a feeling of dread in the pit of my stomach. Fear has a different sensation, for it’s the impulse that moves me into action. Fear accompanies a fight-or-flight state, a basic instinct of survival, experienced physically as an increased heart rate, sweating palms, muscle tightness and a rush of adrenaline which makes me feel like running faster than a cougar.

Anxiety or Fear?

Anxiety or Fear?

This differentiation is quite significant, for one is created by not facing reality, and the other by facing the truth. Although there may be a biological basis to anxiety disorders, the feeling of dread and angst is often created by our inability to face our fears. Let’s say I’m terrified of snakes, and hiking with a friend. Because I don’t want to seem afraid, I pretend to be enjoying the trip. Meanwhile, the little voice in the back of my head tells me to ‘be careful’, ‘there could be a snake anywhere’. My muscles become stiff, stomach cramps, I feel nauseous, face turns white and I suddenly become unable to breath, and there is no snake in sight. Am I experiencing a fear of snakes, or my fear of being afraid?

What if I had accepted my fear, did some research about possibility of snakes in that particular trail, talked to my friend and came up with a solution? Perhaps we’d choose another trail or a different activity. Would I still experience anxiety, or just fear?

About a year ago I was experiencing medical complications. Coincidentally, or not, I was also in an unfulfilling career, working for a company that didn’t respect me as an individual. I was living in constant fear of the unknown: test results, side effects of treatment, losing my job, keeping the job and losing my soul, financial insecurity, worrying my family, etc. One would say these were all legitimate reactions to a difficult time in my life, and perhaps not a psychological disorder. During one of my weekly doctor visits, I broke down and began to cry, unable to breathe and felt completely powerless over my life. The well-intentioned doctor offered me a prescription for anti-anxiety medication to ‘take the edge off’. I looked at her in disbelief, refused the script and realized I had better get used to being with my own pain since others around me did not seem to have that capacity.

My point is that fear is a normal reaction to everyday life, one that moves us into making the right choices for our individual paths. Anxiety steps in when we fail to face the hard truths about ourselves – when we are unwilling to face our shadows. Our fears are the most powerful when not acknowledged and often manifest as phobias, panic attacks and disorders.

What I’ve learned from that experience is that each time I don’t face my own truth and wait for another to give me the answers I have within, I fall into a state of paralysis and panic. Do I need to be medicated or hospitalized? Perhaps. Or maybe just trust my own intuition.

What is your story? Do you have a fear that’s waiting to be acknowledged?

By Rashin D’Angelo, Ph.D. (cand)

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