Understanding and Managing Anxiety

What is Anxiety?

Anxiety is a natural emotion that every individual experiences from time to time, usually defined by distress, worry, and anxiety. Anxiety is a response of the body and mind to the various difficulties and uncertainties of life. However, when anxiety becomes persistent and seriously affects a person’s daily life and functionality, it is considered a problem.

Anxiety disorders are among the most common mental health problems. According to the World Health Organization, one in every 13 people suffers from an anxiety disorder. Anxiety can manifest itself not only through thoughts and feelings, but also through physical (somatic) symptoms.

Major Types of Anxiety

Generalized Anxiety Disorder: The person constantly feels anxious and restless. They tend to think about the worst-case scenarios and have difficulty controlling these feelings. There are concerns about various areas of life, not limited to a certain area.

  1. Symptoms: Constant anxiety, muscle tension, sleep problems.

Social Anxiety: An intense fear of performing in social situations and in front of others. Fear of being ridiculed, judged, or humiliated is prominent.

  1. Symptoms: Difficulty speaking in public, intense embarrassment in social situations, shyness in meeting new people.

Panic Disorder: Panic attacks occur suddenly and cause symptoms such as shaking, heart palpitations, dizziness. The person experiences feelings such as fear of death and fainting.

  1. Symptoms: Sudden intense fear, rapid heartbeat, sweating, shaking.

Phobias: A state of intense and irrational fear of certain objects or situations. Knowing that the fear is irrational does not provide relief.

Causes of Anxiety

According to CBT, there are two main causes of anxiety:

Perceptions: Perceiving events as worse than they are. A person’s exaggerated evaluation of situations and events can cause anxiety.

Belief in One’s Ability to Cope: Lack of belief in one’s ability to cope with events can increase anxiety. When a person thinks that they will not be able to cope with the challenges they will face, the level of anxiety increases.

Symptoms of Anxiety

Our mindset consists of three main elements:

Automatic Thoughts: These are thoughts that suddenly appear in the face of events and we are usually not even aware of them. For example, the thought, “I failed again.”

Intermediate Beliefs: Assumptions or rules about ourselves, other people, and the world that guide automatic thoughts. For example, a belief such as “Achieving success is inevitable.”

Core Beliefs: Deeper-rooted and often unconscious beliefs. Basic beliefs about ourselves, other people, and the outside world, such as “I am inadequate” or “I am worthless.”

Cognitive Distortions

Cognitive distortions are errors in thinking that cause people to perceive events and situations incorrectly. These can cause a person to misjudge reality and distort their emotional responses.

  1. Black-and-White Thinking: The tendency to evaluate events as either all good or all bad.
    • Example: “If I don’t do the project perfectly, I am a total failure.”
  2. Catastrophizing: Seeing possible outcomes as worse than they are and focusing on the worst-case scenario.
    • Example: “If I get a low grade on the exam, my life will be miserable and I will not be able to find a job.”
  3. Generalizing: Making broad generalizations based on a single event.
    • Example: “A friend didn’t help me, so no one will help me.”
  4. Should-Thoughts: Creating rigid expectations and obligations for ourselves or others.
    • Example: “I must always be perfect. Otherwise, people will not like me.”
  5. What-If Thinking: Constantly thinking about negative scenarios and imagining worst-case scenarios.
    • Example: “What if I make a bad impression at this job interview? I might not be able to find a job and I’ll be in financial trouble.”
  6. Ignoring the Negative: Downplaying or ignoring positive developments.
    • Example: “I did well on this project, but it was just luck. I’m still not good enough.”
  7. Fortune telling: Predicting and making predictions about future events without evidence.
    • Example: “I am sick and have a fever. I definitely have a serious illness, and if the doctors don’t recognize it, it will get worse.”
  8. Emotional Inference: Drawing conclusions about facts based on the emotions we feel.
    • Example: “I feel uneasy inside, so something bad is bound to happen.”

Emotion-Thought-Behavior Model and Struggling with Anxiety

Emotion-thought-behavior is a whole. They all affect and trigger each other. A negative thought can trigger a negative emotion and behavior. This makes the situation more difficult. Sometimes our behaviors cause the thing we fear to happen to us. For example, the fear of failure can lead to self-sabotaging behaviors. For this reason, a person can have attention problems, avoid working, surrender to their anxiety and as a result, experience what they fear. They actually fail and confirm their anxiety.

In this way, there is a system that feeds on each other. Therefore, according to the CBT approach, in order to combat anxiety, we must approach the situation with the help of this system.

  1. Identify the emotion: How do you feel in this situation, what emotions do you experience? Notice emotions such as anxiety, fear, sadness, shame, anger. Write these emotions down.
  1. Notice your thoughts: Identify the automatic thoughts that appear in your mind when you are experiencing anxiety. Think about what thoughts are going through your mind and take notes.
  1. Question: Evaluate how accurate and logical these thoughts are. You can use cognitive distortions to identify irrational and inaccurate thoughts in your thoughts. Are these thoughts helping you or making you feel worse?
  1. Change: Replace false and harmful thoughts with more realistic and positive thoughts. Develop alternative thoughts.
  1. Watch your behavior: You should also watch the other element of the model, your behavior. What happens to your behavior when you are anxious? Does it help you or does it make you more anxious? For example, if you end up avoiding studying for a test that you are anxious about, then that behavior is not helping you because it is in service of your anxiety.
  1. Develop alternative behaviors: If you have identified behaviors that are not helping you and that are harming you, think about what you can do instead, how you can change them, and what will help you, and take notes of possible changes.
  1. Implement and evaluate: Implement your new behaviors and thinking changes and evaluate their impact. Continuously review these processes and make necessary adjustments.

The Cognitive Behavioral Therapy (CBT) approach offers an effective method for managing anxiety. With this model, you can understand your emotions, thoughts, and behaviors and better manage anxiety. Getting anxiety under control can improve both your mental and physical health and help you live a more fulfilling life.