Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained. — Arthur Somers Roche


Anxiety is an emotion characterized by the feelings of worry, nervousness, or tension.Anxiety refers to multiple mental and physiological phenomena, including a person’s conscious state of worry over an unexpected future event or apprehension of an actual situation.

Although unpleasant, occasional sessions of anxiety are natural and sometimes even productive: By signaling that something isn’t quite right, anxiety can help people both escape danger and make major changes in one’s life.
However, chronic anxiety that is persistent, irrational and exhausting could have a significant impact on the overall quality of your life. When anxiety begins to interfere with our ability to function in daily life, work, school, and in our personal relationships, then it marks the onset of an anxiety disorder.
Anxiety disorders are distinct from usual nervousness or distress symptoms, which includes extreme anxiety or panic. Anxiety disorders are the most prominent amongst all mental disorders and affects nearly 30 percent of adults at some point in their lives. According to the
National Institute of Mental Health, anxiety disorders affect 40 million adults in the United States, that’s 18.1% of the population every year.


An anxiety condition isn’t developed or caused by a single factor but a culmination of factors. The various factors predisposing to anxiety include –

Biological factors
Growing evidence exists that biological factors have a significant contribution to anxiety disorders. Several disorders, including generalized anxiety disorder, panic disorders, phobias, and OCD, tend to run in families.; pointing to a genetic basis for these disorders.

Personality factors

People with certain personality traits are more likely to have anxiety than others. These traits are planted in childhood itself. children with
temperamental traits of shyness, timidness,moral rigidness or behavioral inhibition have higher chances of developing anxiety during childhood, adolescence or as adults. Sometimes these traits may become too serious and may amount to anxiety disorder.

External factors

Exposure to stressful and negative life or events in early childhood or adulthood is a major contributor to anxiety disorders.

Common triggers include:
Stress from personal relationships like marriage. Work stress, stress at school , financial predicament or distress loved ones can trigger your
anxiety too.
If you have endured highly stressful events at early stages of your life; like violence, sexual abuse, loss of a loved one etc. then you are more
likely to have anxiety later in life. It could take the form of post-traumatic stress disorder (PTSD). That’s when you relive stressful events in dreams or obsessive memories. When this happens, you might start to sweat. Your heart might race, too.

Physical health conditions

Chronic physical illness can also contribute to anxiety conditions or impact on the treatment of either the anxiety or the physical illness itself. Common chronic conditions associated with anxiety include:

● diabetes
● asthma
● heart diseases
● Thyroid problems

Some physical conditions can mimic anxiety conditions, like an overactive thyroid. A physical health examination is helpful in the evaluation of a possible anxiety disorder.

Other mental health conditions
While some people may experience an anxiety condition on its own, others may experience multiple anxiety conditions, or other mental health conditions. Depression and anxiety conditions often occur together. It’s when a feeling of depression stays around long enough and starts affecting your daily life. If your doctor tells you that you have depression, you’re also more likely to develop an anxiety disorder. Substance use people who experience anxiety are most likely to misuse alcohol and other drugs. In some cases, this may lead to people developing a substance use problem along with their anxiety condition. Alcohol and substance use can aggravate anxiety conditions particularly as the effects of the substance wear off. The misuse itself might cause shame, embarrassment, personal problems, and other issues that lead to anxiety.


Individuals suffering from anxiety may endure common feelings of restlessness and irrational fear. People with this disorder are just plain worriers. Their worries can prevail in all domains of life, from social situations and family dynamics to physical health and professional commitments. People may also irrationally believe that the worst-case scenario is inevitable.
Some other notable symptoms include –

● Uncontrollable, obsessive thinking
● Repeated thoughts or “flashbacks” of traumatic events
● Excessive sweating or numbness in the hands or feet
● Chest pain or Heart Palpitations
● Dry mouth, Nausea, Dizziness
● Feeling tense, edgy or tired
● Having trouble concentrating
● Dulled senses
● Muscle aches
● Difficulty controlling feelings of worry
● Having sleep problems, such as insomnia

Types of anxiety disorders

Anxiety disorders manifest in different ways and are diagnostically distinct. Generalized anxiety disorder. It is a disorder in which a person has feelings of dread and impending doom along with physical symptoms of stress which may last 6 months or more. It involves persistent and excessive worry that interferes with daily activities. These feelings of anxiety have no particular source that can be pinpointed, nor
can the person control the feelings even if an effort is made to do so. They worry excessively about various things such as money, personal
relationships, job responsibilities as well as things which no one else would see as a reason to worry. They have muscle aches, they experience sleeping problems, and they are often irritable – all signs of stress.

Panic Disorder

A panic attack refers to the sudden onset of extreme panic accompanied by physical symptoms such as a racing heart, rapid breathing, a sensation of being out of one’s body; dulled hearing and vision, sweating and dry mouth. Panic attacks are so intense that many people think that they are having a heart attack. Psychologically, the person having a panic attack is in a state of terror, thinking that this is it; death is happening, and many people feel a need to escape. The attack happens without any warning and quite suddenly. It is only when panic attacks occur repeatedly and cause persistent worry or changes in behavior that they become a panic disorder.

Specific Phobias

A specific phobia is a type of anxiety disorder that amounts to an unreasonableor irrational fear related to contact with some object or specific situations. For example, a fear of dogs, fear of being in enclosed spaces (claustrophobia), fear of dental work (odontophobia), fear of heights(acrophobia) etc. The level of fear is disproportionate to the situation and can instigate the person to go to great lengths to avoid what they fear. Avoidance of the feared object or situation only strengthens the phobia. The fear is so intense that the idea of facing the actual phobia can lead to a panic attack or severe anxiety.

Social anxiety disorder

Social anxiety disorder involves a fear of interacting with others or being in social situations. It is one of the most common phobias that people experience. People with social phobia experience crippling anxiety and excessive self-consciousness in everyday social situations. They are afraid of being evaluated in some negative way by others, so they tend to avoid situations that could lead to something embarrassing or humiliating. Common types of social phobia are stage fright, fear of public speaking or even the fear of meeting new people.


It is the fear of being in a place or situation from which escape may be difficult or impossible if something could go wrong. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. Furthermore , anxiety is present in more than one situation. Some of the common areas where people feel anxiety include –

○ Using public transportation like a bus
○ Being in open spaces like a bridge
○ Being in enclosed places like a grocery store
○ Standing in line or being in a crowd like at a concert
○ Being out of the home alone

A severe case of agoraphobia can make a person’s home a prison, leaving the person trapped inside unable to go to work, shop or engage in any kind of activity that requires going outside.

Obsessive-Compulsive Disorder (OCD)

Sometimes people get a thought running through their head that just won’t go away like when a song gets stuck in one’s mind. If that particular thought causes a lot of anxiety, it could become the basis of OCD. It is a disorder in which intruding thoughts(obsessions, such as the fear that there are germs on one’s hands) occur frequently and are followed by some repetitive, ritualistic behaviour or mental acts (compulsions, such as repeated hand washing). The distress caused by the failure or inability to successfully complete the compulsion is a defining feature of OCD.

Post traumatic stress disorder (PTSD)

It is an anxiety disorder that can develop following a traumatic or life-threatening event. Some examples of traumatic events are being in a war, the unexpected death of a loved one, being raped, assaulted, in a plane crash or a natural disaster. It is normal and expected to respond to trauma with “shock” or acute stress, however, if dealt with and worked through, over time these symptoms gradually lift. For example, the trauma, stress and anxiety experienced by people after the 9/11 attack. when experiencing PTSD, you remain in a state of mental shock and symptoms worsen over time. While suffering from PTSD you can experience significant problems at home, work, or other important spheres of your life.

How to discover the need for counselling

While there are several forms of anxiety disorders, evidence shows that most are guided by common mechanisms that underlie them. People with anxiety problems seem to get confused by their thoughts quickly and they seem to have especially adverse responses to certain unpleasant feelings and circumstances. People also seek to deal with these adverse reactions by minimizing situations or interactions that can make them anxious. Unfortunately, avoidance can backfire and actually feed the anxiety. Psychologists are qualified to treat anxiety problems, and to provide safer, more efficient approaches to cope with the issue. Counselors use psychotherapy or talk therapy with the clients to relieve fear. Psychotherapy is directed at the particular anxieties of an individual and is personalized to suit the needs of the client.
A type of psychotherapy known as cognitive behavioral therapy (CBT) is particularly beneficial in the treatment of anxiety disorders. Via CBT, counselors help patients understand how to recognize and control causes that lead to their anxiety.
Via the cognitive aspect of counseling, patients understand how their thoughts and emotions lead to their symptoms of anxiety.
With a therapeutic aspect, patients learn strategies to eliminate unhealthy behaviours associated with anxiety disorders. Specifically, patients are advised to participate in behaviors and circumstances that induce distress (such as public speaking or sitting in a confined space) and discover that their expected consequences (such as losing their composure or experiencing a heart attack) are unlikely.

Therapeutic route ( what would be discussed in the counselling sessions)

Psychotherapy is a collaborative process in which counsellors and patients collaborate closely to recognize common problems, and establish practical strategies and methods to overcome distress. Patients may continue to use their learning techniques outside of therapy to handle discomfort in conditions that may render them anxious. However, psychologists won’t pressure people into these situations until they are confident that they have the skills to successfully overcome their fears. In addition to CBT, psychologists also use various other approaches to address anxiety disorders.Community psychotherapy, which usually includes a variety of individuals with anxiety problems, may be successful both in managing distress and in providing support to the patients. Family psychotherapy may help family members appreciate their loved one’s distress effectively and help them find strategies to interact that doesn’t exacerbate their nervous behavior.

Takeaway from the session

Anxiety disorders are very much treatable and counselors have a plethora of tools to lessen your anxiety. The majority of patients who suffer from anxiety are able to reduce or eliminate symptoms after a few months of psychotherapy, and many patients notice progress after just a few sessions. Psychologists are professionally qualified and can customize a recovery program to suit the specific requirements of each individual.


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