For something so common, anxiety is still massively misunderstood. There are myths and misconceptions about everything from what anxiety disorders look and feel like to what actually helps to treat these illnesses and navigate anxiety.
Even though anxiety disorders are difficult, they’re one of the most treatable disorders. Yet only a third of people seek treatment, said Kevin Chapman, Ph.D., a psychologist who specializes in evidence-based treatment for anxiety and related disorders in adults and adolescents at his private practice in Louisville, K.Y. That’s because “Most individuals with anxiety disorders manage their anxiety through avoidance behaviours.”
In fact, many of Regine Galanti’s clients don’t even use the word “anxiety” to describe their concerns. Galanti, Ph.D., is the director of Long Island Behavioral Psychology, where she specializes in using evidence-based treatments for anxiety and related disorders in children, teens and adults.
Rather, her clients talk about everything they don’t do, she said: They don’t drive or attend get-togethers with more than a few people. They avoid public speaking.
Avoidance may provide temporary relief. But it also “maintains the anxiety long term and creates a vicious cycle of further avoidance,” Chapman said. Thankfully, you don’t need to go to therapy for years to feel better.
Cognitive-behavioral therapy (CBT) is a powerful treatment that typically ranges from 8 to 17 sessions for panic disorder, agoraphobia, social anxiety disorder, phobias, GAD, PTSD, and OCD, Chapman said. For a spider phobia, a single prolonged session—several hours-long—can even effect positive change.
Anxiety goes beyond anxious thoughts.
Anxiety is very visceral. As Galanti explained, when something sparks our anxiety, our bodies go into “panic mode,” triggering a cascade of reactions: your heart beats faster, your breath accelerates, your muscles stiffen, your head aches, and it feels like your stomach is doing somersaults.
These physical reactions lead to more anxious thoughts, which leads to stronger reactions.
Galanti gave this example: “My breathing quickens when I see [a] spider, which makes me think, ‘Oh wow, that spider must be really dangerous,’ which makes my heart beat even faster, which is just proof that the spider is dangerous. So the system is self-perpetuating.”
Similarly, Galanti wants readers to know that this visceral reaction makes it difficult to use rational thinking to reduce anxiety.
“Most people with anxiety know they’re being irrational, but it doesn’t help because in the moment, fear takes over.” In the moment, fear convinces us that we’re having a heart attack. As Galanti’s clients tell her, “it feels so real.” In the moment, fear convinces us that we’re going to throw up during our talk.
This is why the best strategy is to gradually, systematically and repeatedly face our fears (as part of exposure therapy).
Many people use substances to cope with anxiety—and it’s not a laughing matter.
Humour can be a great tool for dealing with anxiety—and really anything. But it becomes unhelpful when destructive habits are regularly glorified. For example, as therapist Zoë Kahn, LCSW, pointed out, almost every post on @mytherapistsays (which has 3.2 million followers) normalizes blackout drinking to deal with social anxiety.
“The memes are funny because they ring true to many young people’s experience of social expectations and romanticized desires to be popular or instafamous,” said Kahn, a licensed clinical social worker in private practice, primarily seeing clients on the Eastside of Los Angeles.
“As a former staff therapist at several drug and alcohol treatment programs in Los Angeles, I can say that somewhere between 50 to 75 percent of clients began using drugs and alcohol at an early age to self-medicate for varying anxiety disorders [such as] social anxiety disorder, panic disorder or anxiety related to trauma.”
Again, turning to substances to avoid experiencing anxiety (or to dampen your inhibitions) only exacerbates that anxiety. It sends “the message that anxiety is dangerous and that you need to do something to make it go away,” Galanti said. It also sends the message that you can’t cope with certain situations unless you’re drinking or using drugs. Which only deepens self-doubt and ramps up those dangerous habits. But you can tolerate difficult situations (and the discomfort) and thrive—seeking therapy is a transformational way to do that.
Scarlet, founder of Superhero Therapy, which incorporates superheroes and comic book and science fiction characters into evidence-based therapies, wants everyone to know that “it takes a great hero to face a dragon on a daily basis.”
“Like Frodo in ‘Lord of the Rings,’ like Harry Potter, like Wonder Woman, people with anxiety didn’t choose the things that happen to them.” But you have “the knowledge and the wisdom to understand others who may be going through the same experience. Your anxiety is your origin story; the rest of your heroic quest is up to you.”
Anxiety can be successfully treated in a timely fashion!