41. Types of Anxiety: Part 1
If you were to see a counselor to help you with your anxiety and planned to bill insurance, your counselor would have to diagnose you with some kind of mental health condition. Since you came to them for help with anxiety, they’d likely diagnose you with some kind of anxiety disorder. In my opinion, there are positives and negatives to this requirement. The positive side is that it can really help give language to the things you’ve been feeling. You can realize you’re not alone in your struggles, that this is a real condition, your counselor is trained and familiar with it, and you can begin to better understand yourself and recognize your patterns. The negative side is that, once someone receives a diagnosis of an anxiety disorder, they might use that diagnosis as a label for themselves. They might feel stigmatized or feel like there’s something wrong with them. They might even use it as a crutch of some sort, saying they can’t do certain things because of their anxiety.
Before I get into diagnoses, I’ll say that I believe anxiety generally takes two different forms: situational and chronic. Situational anxiety is a normal human response to a temporary time of transition or challenge. It’s something that we all experience from time to time. You might be going through a season of caring for an ailing parent, or dealing with your kids’ challenges at school, or moving or changing jobs or welcoming a new family member. During that time, you feel more on edge than usual. You might be extra tired, irritable, worried. You might seek out counseling to help get you through the tough season. But once that season has ended and the challenging situation is no longer present, you go back to “normal.” Or, the challenging situation continues to be present, but you adjust and learn to cope and no longer feel on edge.
Chronic anxiety, as the name implies, persists over a long period of time even when no obvious stressor is present. When you are chronically anxious, you often aren’t even aware that you are anxious because it’s become such a normal part of your life. You might feel tired most of the time, have difficulty slowing down even when you’re exhausted, feel guilty for taking breaks, constantly go along with others’ wishes even if they don’t match your own, struggle with ongoing headaches, digestive issues, sleep issues, or other chronic health issues, or have this persistent feeling that something bad is going to happen.
So, how does one develop chronic anxiety? And can situational anxiety turn into chronic anxiety?
If you grew up in a stressful environment and did not have the resources you needed to understand your feelings and cope, it’s likely that you might feel chronically anxious. If you grew up not knowing when your next meal would happen, or if you’d have a bed to sleep in, or whether Mom or Dad were going to be drunk tonight or even come home at all, or if your parents fought often, you likely chronically lived on edge anticipating the next stressful event. If you had a parent who struggled with illness, mental health issues, stress from their job or interpersonal issues, or if you had a sibling with a lot of needs that took attention away from you, you likely experienced chronic stress and had to deal with your feelings on your own. If you felt like you had to be a certain way and achieve certain goals to earn your parents’ approval, you likely experienced chronic stress not knowing if you’d receive the love and validation you needed.
If you grew up experiencing chronic stress but had someone in your life who was very attentive, helped you understand and cope with your feelings, gave you comfort and validation, and helped you feel like you weren’t responsible for managing alone, then you may not struggle with anxiety as much as the person who felt alone during childhood. Experiences that are the most traumatic are often the ones where we feel like no one is there for us, or like we’re stuck or trapped. If you grew up feeling like a burden to your parents or like you couldn’t go to them for comfort, then you likely didn’t have the resourcing you needed to help you manage your stress in a helpful way.
Some stress is a good thing, of course, and a necessary part of being human. But the stress we experience should ideally be proportional to our developmental level. If you grew up feeling responsible for things that a typical child shouldn’t yet feel responsible for - for example, handling your feelings on your own because your caregiver wasn’t emotionally available, or feeling responsible to make things easier on your parents by being extra good instead of leaning on them for support - your young mind was trying to process and carry burdens it wasn’t yet equipped to handle. Because you were resilient, you found a way to manage, but not without consequences. I’ll get into that more as I continue this series.
If you received the proper resourcing as a child to manage your stress, you’ll be more naturally equipped to handle challenges as an adult. You’ll understand that, when a challenging situation arises, certain other responsibilities may have to be let go for the season so you can devote your energy to managing the challenge. You’ll understand that it’s okay and necessary to ask for help sometimes. You’ll have compassion for yourself during situational stresses because you have perspective that this is hard and you’re doing the best you can.
Situational anxiety could become chronic anxiety without the necessary resources and support to adequately process the situation and move on. For example, a person in the military or a survivor of a violent crime may develop PTSD even if they did not have a history of trauma prior to the incident. However, research shows that people with a history of trauma are more likely to develop ongoing PTSD symptoms than people who grew up in supportive environments. This is because people who grew up in supportive environments are given the resources to believe in their ability to cope with challenges and know they’re not carrying it all alone. Meanwhile, people who grew up already feeling a sense of being alone and unsupported, had nervous systems that were so used to being activated that their natural resources had been being depleted their entire lives. Therefore, when a traumatic or stressful event happens in adulthood, a person already stretched to their limit is more likely to experience severe consequences and have a harder time bouncing back, than someone who had generally had a stable and supportive upbringing. However, no one is destined for a lifetime of PTSD or chronic anxiety. There are ways that even the most debilitating of cases can be helped. Nothing I write is a substitute for seeking out your own therapy, of course, but I hope that I can at least offer some perspective and hope.
It’s also important to realize that the notion of a “supportive environment” is completely subjective. A person might have grown up with all of the physical resources in the world but without an emotionally present parent figure. This has potential to leave the person feeling a gaping sense of loneliness due to their basic human need of emotional connection being neglected. Meanwhile, another person may have grown up with very few material possessions, but had very emotionally involved and nurturing parents. So, please don’t make assumptions about someone’s experiences of their upbringing just because it looked a certain way to you.
Next post, I’ll talk more about some different types of anxiety diagnoses that exist.
