Anxiety, in its many forms, is something that many of us struggle with. In fact, according to a recent report, over 3 million Canadian adults have reported experiencing some kind of mood or anxiety disorder.
There is also plenty to learn and understand about anxiety – it’s not a catch-all phrase, after all; there are many different types of anxiety disorders, including Generalized Anxiety Disorder, Social Anxiety Disorder, and Panic Disorder. They may differ in terms of the signs and symptoms they present, but each can affect your quality of life. Here, we explore how GAD, SAD, and Panic Disorder can differ from one another.
Generalized Anxiety Disorder
It’s perfectly normal to worry from time to time, but when that worry feels like it’s taking over your life, it’s referred to as Generalized Anxiety Disorder (GAD).
Imagine that everything begins to give you cause for concern – you worry constantly about your work, your family, your health, money, the news, your future, and everything else in between. With GAD, worrying is so pervasive because it’s very difficult for someone to limit or stop the worrying that they do; it feels out of control.
Some of the worrying can seem minor by comparison (“What if I buy this muffin and I don’t like the taste of it?” “What if we are late?” “What if I have trouble finding parking?”). More often, however, GAD worrying is escalated internally, where one worry gets cognitively ‘chained’ to another (“What if I’m late for work… and then my boss gets angry with me… and then I get fired… and I can’t find another job… and I end up homeless…”). The result is that people with GAD are constantly predicting a “disaster”. Because they are always catastrophizing, they feel anxious, nervous, tense or “on edge”.
With GAD, people tend to worry about things that they care about bit are not completely in our control, like finances and relationships and the health and safety of loved ones(“What if my sister gets hit by a car while bicycling?”), or themselves (“I have a headache; what if I have brain cancer?”).
At the heart of GAD, is an intolerance of uncertainty; worrying may help us believe that we have some degree of ‘control’ over a situation. Often, this can mean that we actively avoid situations that will increase uncertainty and cause us additional worry (social events, new work opportunities, etc.).
It is also common for people with GAD to experience physical symptoms related to excessive worrying. These may include a racing heart, stomach pains, excessive sweating, irritability, sleep problems, fatigue, and muscle pain in the neck and shoulders.
Social Anxiety Disorder
Most people experience at least a little fear and anxiety in some social and performance situations. Most people would be at least a little anxious if they had to give a presentation to an auditorium full of 200 people or on a first date. Most of us care about what other people think and can relate to wondering if we’ve made a good impression, but when these concerns become overwhelming, and we feel increasingly anxious or nervous, it may relate to Social Anxiety Disorder (SAD). You can think of it as being painfully shy or self-conscious.
As one of the most common anxiety disorders, the central worries in SAD are about being judged, embarrassed, humiliated or offending other people in social and performance situations.
We may think of SAD as affecting our thoughts, feelings and behaviours in social situations (imagine being invited to a party where you don’t know many people), but it can also happen in any kind of performance situation or situation in which we may be observed such as public speaking, eating in front of others, performing a song, or even using the bathroom. Many situations are a combination of interacting with strangers and being observed including meeting new people, dating, ordering food, lining up at the grocery store, or going on a job interview.
People who struggle with SAD spend a lot of time worrying about what other people are thinking of them (“What if people think I’m dumb?”), while also excessively focusing on their internal experience (their own anxious thoughts and feelings) in social situations and not what is happening externally (the conversation with the other person).
These problems also manifest physically, with symptoms up to and including panic in social and performance situations including racing heart, shortness of breath, shaking, nausea, dry mouth, dizziness, and sweating amongst other symptoms.
Most people experience symptoms panic at some point in their lives in response to a scary situation. At least one third of people will experience a panic attack at some point in their life, usually at a time of extreme stress or distress. Signs and symptoms of a panic attack include – a racing heart, shortness of breath, sweating, chills, trembling, chest pains, and dizziness. Symptoms of panic typically peak within around ten minutes before the symptoms begin to lessen in intensity although people can feel “bad” or “weird” for much longer. Panic attacks feel terrible.
When repeated unexpected panic attacks become more problematic, they may indicate a Panic Disorder.
When you have Panic Disorder, you have experienced repeated unexpected panic attacks that are hard to predict; in turn, you have become worried that there is something terribly wrong with you, that you will have more panic attacks, that the panic attacks will get worse and worse, that one day you will have an attack that won’t end and it will cause you to lose control, do something embarrassing or even die.
Panic develops into Panic Disorder when people experience and increased frequency of panic attacks, become constantly worried and preoccupied about having another attack and start to avoid situations, thoughts and feelings that they associate with panic attacks including open and enclosed spaces, going to the grocery store, public transportation, being a passenger in a car, going out or being at home alone, socializing, physical activity, and specific foods and beverages.
GAD, SAD and PD are conditions that can cause severe distress and interfere with people’s ability to live their daily lives. However, knowledge is power and by understanding these conditions we can better understand how to help ourselves and the people that we care about.
If you or someone you care about is struggling with anxiety or panic, Cognitive Behavioural Therapy (CBT) is effective treatment. CBT is a way to understand how your thoughts, feelings, and behaviour are related; and it can help you gain the perspective you need to be able to untangle your thoughts and feelings, and move forward.
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