Anxiety, Fear, Panic, and Phobias
I’ve heard it said that you know when you’re a problem drinker when your drinking causes you problems, whether of the emotional, legal, financial, or several other varieties.
Similarly, I think anxiety, fears, panic, and phobias are problems only when they cause you problems.
Let me unpack that a bit.
Phobias are considered to be a type of anxiety disorder or panic disorder. For example, social anxiety is sometimes defined as social phobia. Everyone has anxieties. Many people have at least one phobia. And most people can avoid these triggers with little or no effect on their daily lives. There are habits they can cultivate to avoid the things that make them anxious or phobic.
For instance, someone with acrophobia, a fear of high places, isn’t usually incapacitated by a stepladder, and can fairly easily avoid standing on cliff edges, rotating top-floor restaurants, and hotel rooms over the first or second floor. (When the anxiety/phobia extends to fear of flying, or aerophobia, the person can limit or eliminate air travel from their lives, usually without much difficulty.)
Crippling phobias, however, are generally classed as mental illnesses. My panic around bees (apiphobia) does not rise to that level; I would call it an anxiety reaction or a panic attack, not a phobia. It usually only manifests as bodily stiffening, tremors, and immobility, and pleas for anyone in the area to shoo away the offending insect. (I once took a beekeeping class to try to get over my phobia. Big mistake. Didn’t work.)
Agoraphobia (fear of unfamiliar environments or ones where you feel out of control), however, can be socially and psychologically crippling. The Mayo Clinic says that agoraphobia “can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.” (Technology has made these constrictions less onerous, what with doorstep delivery and Skype.)
Anxieties as a symptom of mental illness are harder to define. While some anxieties have triggers, others simply don’t. “Free-floating” anxiety comes on unexpectedly, like the depressions and manias of bipolar disorder. This doesn’t mean that the anxiety isn’t real. It certainly is. It just means that the anxiety has no identifiable cause such as high places or bees. It is simply (or not so simply) a panic attack, which the Cleveland Clinic says is “sudden, unreasonable feelings of fear and anxiety that cause physical symptoms like a racing heart, fast breathing, and sweating. Some people become so fearful of these attacks that they develop panic disorder, a type of anxiety disorder.” They add, “Every year, up to 11% of Americans experience a panic attack. Approximately 2% to 3% of them go on to develop panic disorder.”
Sometimes I have anxiety that is attributable to triggers, such as financial difficulties, which are relatively easy for other people to understand. Who wouldn’t be anxious when the bank account is dry and a bill is due?
Other times, free-floating anxiety or panic simply descends on me, with nothing that triggers it. It’s an awful feeling, like waiting for the other shoe to drop when there has been no first shoe. Like a cloud hovering around me with the potential for lightning bolts at any time.
The thing is, I don’t know how to get rid of my anxieties, fears, or phobias. There are desensitization procedures that are supposed to work by getting one used to the trigger gradually. (I think that was my idea behind taking the beekeeping class. One of them, anyway.) There are antianxiety medications, including antidepressants and benzos, designed to take the edge off, if not remove the anxiety. (I take antianxiety medications. I’m still afraid of bees. Not that it affects my daily life much, but I’m never likely to visit that island off Croatia that’s covered with lavender.) For phobias, Cognitive Behavioral Therapy (CBT), as well as exposure therapy, has been recommended. This is usually a short-term procedure, according to the Mayo Clinic. But I have an aversion to CBT.
Still, despite my therapy and medications, I have to live with my anxiety and phobias. I’ve probably not reached the point where the anxiety causes me severe problems, like bankruptcy, though I have been known to overdraw my checking account on occasion and run my credit card up too high. These, of course, are signals that I may have a problem or am beginning to have one. It’s something to explore with my therapist, anyway. Maybe she can suggest ways I can deal with my anxieties before they turn into more significant problems.