Got anxiety? At what point does anxiety become a disorder? | NevadaAppeal.com

Got anxiety? At what point does anxiety become a disorder?

Barry Barmann, Ph.D.
LVN News Service

Anxiety is a good thing! Yes, you read that last sentence correctly. Anxiety is good for everyone … in the right dosage.

If anxiety came in a pill format, I would recommend that all of us make it part of our daily vitamin routine, just so long as it is taken at the correct dosage. We need anxiety in our lives because it serves an important purpose.

I know some of you reading are saying, “I thought Dr. Barmann was considered to be an expert in the treatment of anxiety disorders, and here he is advocating that we invite anxiety into our lives. I don’t get it.”

I don’t blame you for thinking that way, but I’m accustomed to teaching patients a set of skills directed at “thinking about how they think,” followed by learning how to shift their perspective toward a new strategy for changing the relationship they have with their own anxiety.

Think about the last three important challenges you needed to encounter in your life, tasks that you wanted very badly to be successful at achieving.

Maybe it was a very important job interview, a major exam you needed to pass for some type of professional licensure requirement, or maybe even a first date with someone you very much wanted to have a relationship with.

Did you experience a certain degree of anxiety associated with meeting each of these challenges? I feel extremely confident that your answer is “yes” to all three.

In other words, we need a moderate degree of anxious arousal in order to enhance our performance levels when needing to succeed.

This fact has been empirically validated in the psychological literature by two researchers, Robert Yerkes and John Dodson. They went on to name their findings, surprisingly, the “Yerkes-Dodson law” — obviously not modest researchers when publishing their study.

They also found that performance enhancement has its limits. When levels of anxious physical and mental arousal become too high (which will vary across individuals), behavioral performance deteriorates.

As I mentioned above, although a moderate amount of anxiety can be helpful to us, high levels of arousal will result in declines in behavioral performance.

The issue then becomes — at what point does productive anxiety evolve into an anxiety disorder, which affects approximately 8 million American children and adults?

In fact, 83 percent of cases seen by general practitioners in the field of medicine are anxiety-related in nature.

The answer to this question concerns itself with six primary factors: Frequency, Duration, Intensity, Interference, Pervasiveness, and Avoidance:

Frequency: How often do you feel a high level of anxious arousal that results in an impaired ability to concentrate and negatively affects your performance? A person with a diagnosis of Generalized Anxiety Disorder would say, “I worry all the time, every day, since I was a kid.”

Duration: How long does your anxiety last, on any given day — just a little, or throughout most of the day? Again, a chronic worrier would answer that question by stating, “from the minute I wake up, until I go to bed.”

Intensity: Is your anxiety causing you problems with your health such as chronic headaches, fatigue, sleep disturbance, stomach upset, etc.? An individual with Panic Disorder will state that their anxiety attacks are so severe, they are afraid to leave their own home.

Interference: Does your anxiety slow down or prevent you from taking part in daily activities, or new activities you would like to engage in? A person with Obsessive-Compulsive Disorder might say that the rituals they perform in response to their obsessions are interfering with job performance.

Pervasiveness: Is the anxiety you are experiencing occurring in several different settings such as home, work, school, social functions, etc.? An individual with Social Anxiety would most likely state that his or her anxious arousal occurs nearly anywhere outside the home.

Avoidance: Are you avoiding engaging in certain activities as a result of your anxiety? Although a person suffering from any diagnostic category related to anxiety disorders would answer “yes,” consider someone who is phobic of dogs (cynophobia).

So therefore, don’t expect this last person to be spending his or her free time having lunch at the Village Green — although that is exactly what he or she needs to do!

Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California and is co-executive director of the Center for Anxiety & Chronic Worry, with offices in Incline Village. He may be reached for comment at barry@behaveanalysis.com; visit anxietytreatment inclinevillage.com to learn more.