Anxiety is such a common human experience; it would be difficult to find someone who has not experienced it at some point in their lives. Whether in its subtle form of mild worry or as an overwhelming sense of dread, it seems to exist as an intrinsic part of the human condition. A lot of people experience anxiety not as a single phenomenon, but as multi-faceted with different dimensions. It is no surprise that in psychotherapy, many books and approaches have been dedicated to the topic. As it is too broad a topic to cover in one blog post, I hope to cover multiple aspects of anxiety in future. This post will focus on covering some ground in understanding anxiety and some common types.
Understanding Anxiety
Anxiety, in its simplest form, is an individual’s natural response to perceived threats. Most modern definitions align with the British Association for Counselling and Psychotherapy (BACP) description that anxiety is "a feeling of worry or fear that is a normal response to a range of different situations". It is often accompanied by physiological symptoms such as restlessness, increased heart rate, rapid breathing, with a sense of impending danger or panic. Understanding anxiety across different dimensions of human experience can help people gain valuable insight into why it manifests and how it may be addressed.
On a biological level, anxiety can be linked to imbalances in neurotransmitters such as serotonin and dopamine. Genetic predispositions may also play a role — studies have shown that anxiety disorders can run in families. Additionally, an overactive amygdala (the brain’s fear center) can contribute to heightened anxiety responses. Hormonal imbalances, chronic stress, poor diet, and lack of sleep can also exacerbate or trigger anxiety.
Psychologically, trauma - both acute and complex, can imprint deeply on the psyche, creating patterns of fear and hypervigilance. The role of shame – with a perceived sense of separation and lack of self-worth - is also getting more recognition as an overlooked factor that can provoke anxiety about being rejected. Anxiety often follows maladaptive thought patterns. Cognitive distortions, such as catastrophising lead some of us to expect the worst to happen, or overgeneralising takes place where there is an assumption that one failure means total failure.
Anxiety does not arise on its own. Our cultural and social environments play significant roles in shaping our experience of it. Society can place a high value on achievement, productivity, and ‘success’, creating immense pressure on individuals. There are those who live with a sense of uncertainty and fear amplified from consuming the constant barrage of information from media, particularly fear-inducing news cycles. In addition, to some, social isolation, systemic oppression, and the breakdown of community support systems contribute to feelings of insecurity and anxiety.
Many spiritual traditions point to anxiety as a form of existential suffering. On an existential level, anxiety can emerge from a disconnection with one’s purpose, or a sense of meaning. In this context, anxiety is not simply a response to external circumstances, but an expression of the spiritual void or sense of alienation.
Some Common Types of Anxiety
While anxiety manifests differently for different people, there are some types that share common characteristics. Here are some of the most prevalent forms:
Generalized Anxiety Disorder (GAD): GAD is characterised by chronic, excessive worry about a wide range of everyday issues — from health, work, and relationships to finances. The individual often feels as though they are in a state of constant apprehension, even when there is no immediate danger.
Social Anxiety: Here, the anxiety is tied to social interactions or situations where the individual fears being judged, embarrassed, or humiliated. Social anxiety can interfere with everyday activities, such as attending social gatherings, or even one-on-one interactions with others.
Panic Attacks: This involves sudden, intense bursts of fear, which can feel overwhelming and physically debilitating. Symptoms include rapid heartbeat, shortness of breath, chest pain, and dizziness, often leading individuals to feel like they're losing control or experiencing a heart attack.
Post-Traumatic Stress Disorder (PTSD): PTSD is a form of anxiety that occurs after experiencing / witnessing a traumatic event, or prolonged / repetitive exposures to a series of distressing circumstances. Event-specific PTSD is often marked by flashbacks, nightmares, hypervigilance, and a sense of detachment from the present moment, all driven by an underlying anxiety related to the past trauma.
Phobias: These involve intense, irrational fears related to specific objects or situations, such as heights, flying, or animals. The anxiety experienced is disproportionate to the actual threat posed by the phobia.
Anxiety does not have to be a symptom to be eradicated. We can attend to our body, reshape our perspectives, engage with community, and connect to the spiritual dimensions of life – which could lead to reduction of its emotional intensity, or enable us to live in contentment with it. In my psychotherapy practice, efforts are made to address anxiety beyond symptom management to utilising it as an opportunity for gaining insight and transformation.