At first this might seem like a basic question, but for those of us who have difficulty identifying feelings, it's a legitimate question. Personally, for a long time I thought I was just stressed out. Turns out, I was actually anxious. I couldn't sleep, had racing thoughts, was afraid that anything could and would happen and of course I felt the classic, sense of impending doom, that comes along with anxiety. Anxiety can sometimes feel like it comes out of nowhere.
I'm sure you (like I did myself) Googled "signs of anxiety" or "why am I anxious"- and kept going in circles. So let's break down the classic features of anxiety and maybe that will help mitigate some confusion. Anxiety, as many other mental health issues, presents with both physical and emotional symptoms.
First, racing thoughts. Well, maybe, like many, you don't even realize they are racing thoughts. Maybe sometimes you are okay and other times IT WON'T SHUT UP. For example, when you are trying to do your dishes. You might find yourself off in some land where you lost your home, your kids are doing drugs, or someone got into a car accident.
Racing thoughts bolster a second feature- Impending doom. All of the above scenarios are doom scenarios (if you would call them that?? I dono- they suck though). Doom is also described in this context as an emotion. Fear of something out of control or awful happening.
As a result of all these imaginary pressures, your sleep begins to suffer. The racing thoughts follow you to bed. While you try to sleep you are in preparation for imaginary events. As a result you lay awake curating possible solutions to each scenario.
Poor concentration can be a result of anxiety as well. Sometimes poor concentration is solely misplaced onto Attention Deficit Disorder. Anxiety and depression cause an inability to focus. And who in the universe can manage these symptoms without problems with concentration? Can't read a book, watch a show, eat dinner, go for a walk, nor hold a conversation because you are too anxious to focus. Our minds instead focused on whatever the anxious fixation is, we ruminate.
The icing on the cake- irritability. When your state of being is primarily anxious, thoughts and physical states intrude and leave you with very little patience. When we spend all night problem solving or putting the final details on an event and something doesn't go according to THE PLAN our day flips on its head. It's over small things too, any hiccup in the day, no matter how little, can throw your whole mood off.
So now that we have most of the emotional symptoms clarified let's talk about the physical symptoms- poor sleep, appetite changes, fatigue and tension.
An often obvious one is tension, I think every single human feels tension. I don't know who doesn't. Tension, then, begets restlessness. You are unable to sit still, mind racing, have to keep moving, fidgeting, wringing your hands, biting your nails. Or you could be paralyzed, unable to think. Restlessness, also impacts sleep. Appetite is also inevitably going to suffer as well.
Finally, after you have spent all your energy living anxiously, you are bound to be fatigued. How is someone supposed to operate under these conditions?! Well, I think it's pretty safe to say that it's really hard- and for most people anxiety is a combination of learned and biological influences that create it.
Overall, this is a list of symptoms that may not apply to everyone, and the other thing to consider is the severity of the anxiety. For some people it is intermittent, for others, daily. To understand whether it is a disorder - we have to think of it in terms of how much it impacts our lives. Do other people notice that you are on edge? How much sleep do you lose? How is your concentration, does it interfere with work or home life? Does it make you clam up, unable to say what's happening for fear people will think you are unhinged?
So what's the solution? Well, there are lots of self help books are out there on how to change your thinking to improve anxiety, or on bodily regulation to assist in emotional regulation. But the most important thing is to slow down. Take a deep breath. Let's look at solutions.
DSM - V Criteria for Generalized Anxiety Disorder
Here is the recipe (diagnostic criteria) for Generalized Anxiety Disorder:
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one item required in children.
1. Restlessness, feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
F. The disturbance is not better explained by another medical disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia]
Samantha Yerks, MSW LICSW LADC
Photo by Sincerely Media on Unsplash
There are several forms of depression and symptoms may vary from person to person. Some people find it hard to believe that they have depression because they "aren't sad", but depression doesn't always equate with sadness. Some common symptoms of depression are trouble sleeping/ sleeping too much, pessimism, irritability, change in appetite (weight loss or gain), distance from relationships, little enjoyment in usually pleasant activities, lethargic/ tired, troubles with concentration, feeling excessive guilt or hopelessness. Some people with depression have suicidal thoughts, if this is happening to someone you love, or yourself please seek help immediately. Follow this link to be connected to crisis resources.
I have found as a therapist that most depression symptoms usually arise from either an organic medical condition, or are embedded in historical issues. For some people, shame (feeling like a bad person) is a major source of their depression. They often say negative things to themselves like, 'I'm a bad person', 'I'll never be good enough', 'No one loves me' and so on. Usually these messages stem from relationships we have had in formative years, trauma, or even from being bullied in school. Medical conditions can also cause symptoms of depression. For instance, most of us in Minnesota are at risk for low vitamin D, and this can be a source of lethargy, irritability, inability to manage emotions and flat out sadness. I always suggest before beginning any kind of mental health treatment, that a person go visit their primary doctor to have their labs done, that way if there are any nutritional deficiencies this can be treated at the same time.
Talking about the treatment of depression is complex. There are many schools of thought and all have value and importance in the treatment of any mental health disorder. From psychoanalytic thought, to cognitive behavioral therapy, everyone responds differently and no one person is going to need the exact same approach. I have personally found that approaching issues from a historical perspective (looking at parent-child relationships, developmental relationships or issues) are a good place to start. From there emotional identification and expression, challenging negative thinking and finding internal resources that foster continued personal growth and success are some of the basics in finding improvement.
Samantha Yerks, MSW LICSW LADC
Photo by Tengyart on Unsplash