3 Exploring anxiety part 1

The OpenLearn course Understanding depression and anxiety [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] provides a useful starting point to some of the issues that we will discuss over the next three sessions. Specifically, the relationship between stressful life events and emotional disorders, the main features of the physiological response to stress and the role of genetic and environmental factors, which we will briefly review here.

It is often the case that those developing anxiety or depression have experienced significant stress during childhood or adolescence as well as in their adult life, and recurring episodes are triggered by stressful life events (e.g. the loss of a loved one, unemployment, divorce, poverty and discrimination). Some personal traits considered to be ‘anxiety-prone’, can exacerbate the experience and increase the likelihood of developing an anxiety disorder. One of the most potent factors predicting anxiety in later life is early traumatic experiences including physical abuse as well as emotional neglect or mistreatment. Childhood abuse is a strong predictor for post-traumatic stress disorder and depression in later adult life.

There are cognitive styles (ways of thinking) that may predispose an individual to stress and to the development of anxiety or depression. People use different ‘coping strategies’ to manage stressful situations. An important element is the perception of ‘control’ over the situation – a person can feel frustrated and anxious if they feel they have no control over a situation or do not achieve the outcome they anticipate. This form of helplessness or hopelessness resembles that of subordinate or ‘defeated’ status in social mammals where a hierarchical social structure prevails. Challenging or re-framing the appraisal of a situation is an important strategy used by psychotherapists to help people with emotional disorders. Personality traits and temperament (so-called ‘trait anxiety’) are also known to be associated with mood and anxiety disorders – neuroticism predisposes to anxiety, whereas an easy-going and optimistic temperament may help a person cope more effectively with stressors. There is evidence to suggest that genetic inheritance can contribute to temperament. There is a tendency for emotional disorders to run in families, and anxiety can also frequently co-exist with other psychiatric conditions (including obsessive-compulsive disorder). The prevailing view is that a combination of (predisposing) genetic factors can make it more likely that a person will be vulnerable to environmental factors such as stressful events and to developing emotional disorders including anxiety and depression. Alternatively, the ‘transmission’ of emotional disorders is also thought to pass from parent to child in some instances as a form of learned behaviour in which a child models or mimics the behaviour of the parent. You can read more on the topics of temperament, heritability, ‘trait’ anxiety and the role of stress in the related OpenLearn courses Emotions and emotional disorders and Understanding depression and anxiety.

It has been argued that we now live in a society where people in general are experiencing heightened levels of anxiety primarily in response to rapid technological and social change. Advances in both technology and communication − the internet, mobile technologies and social media − have given us more immediacy in our daily interactions with others and greater awareness of local, national and global events. Social pressures can dictate how we respond, putting us on the spot. We have access to ‘live’ information, moment by moment as events occur, and are constantly bombarded by news stories in the media that are filled with warnings, dire predictions and uncertainties about the future. It can be difficult to ‘switch-off’.

As a society, we are more and more concerned with our safety and with 'risk', even though most of us are safer than ever, statistically speaking. The consequences of catastrophic events such as outbreaks of disease, nuclear accidents, war and conflict and outcomes of political upheaval and instability throughout the world are difficult to predict. So much so, that in industrialised (and typically Western) societies 'risk' and 'danger' have become synonymous and strongly associated with the possibility of negative outcomes. Risk is less often viewed in terms of balancing good with adverse outcomes. The OpenLearn course Challenging ideas in mental health discusses this further, exploring the meaning of risk in the context of mental health.

It is perhaps not surprising therefore that societal views as well as cultural influences have a strong impact in shaping our emotional states. Constant uncertainties over the future, and perceived risks can be viewed as a threat or danger to our safety and wellbeing and to those closest to us, keeping us at a higher state of vigilance, and further heightening our ‘baseline’ levels of anxiety. But what does it actually feel like to experience anxiety? Can anxiety be helpful to us in any way? How can anxiety disorders be diagnosed? We will explore these and other questions next.