My Anxiety Handbook. Bridie Gallagher

      Anxious behaviours

      The most common behaviour that we see when people are anxious is that they avoid the thing that they think is making them anxious. They might even avoid places where they think it is more likely that they will feel anxious or where they think the trigger (the cause or source) for the anxiety might be. If we feel that we can’t get away from the trigger for our anxiety, we might raise our voices and/or become more animated, or, otherwise, we might become extremely quiet and still. We can go back to the evolution of anxiety and the flight, fight, freeze responses to understand these behaviours. The problem with avoidance as our “go to” behaviour when we are anxious is that we never get to test out whether we really needed to be anxious about that situation in the first place or whether we can cope when things do get difficult. For example, a teacher asks you a question in class, not a particularly difficult question, but because you weren’t paying full attention, your mind goes blank. You feel everyone waiting and looking at you, so you start to feel very self-conscious; you flush red, your palms are sweating, and your heart is beating out of your chest. After a few seconds (that feels like much longer) the teacher moves on to one of your classmates who answers the question correctly. Following this experience, just the thought of a teacher asking you a question makes you feel anxious and your heart beat faster. You start to do small things to become less visible in class, for example not making eye contact with your teachers, so that no one picks you in class. You stop volunteering answers entirely. In the short term, this makes you feel safer (“Phew, no teachers picked me today”) but, in the long term, you are less involved in the class, you stop getting positive feedback from your teachers and you lose opportunities to learn that you can answer questions and even cope with awkward silences. If you continue to avoid answering questions in class and feel like you just cannot do it, then this story about you being “incapable” becomes a “fact” and you have a really big problem.

      What is great about anxiety?

      You might think this is a very silly section of the chapter, especially if anxiety is currently making your life miserable. However, it is important to remember that anxiety is useful and we wouldn’t want to be without it. We developed flight, fight and freeze for a very good reason and although we now have more complex worries and things to be scared of, we still need our anxiety to make our lives work.

      Imagine if parents didn’t feel anxious about their new baby? Dads might not bother to baby-proof the house, mums might not bother to check that the car seats are attached properly. None of these things work out very well for the baby.

      Worrying about exams might be stressful, but is it worse than not worrying about exams? If we didn’t have any anxiety about the future, then we would probably just sit and eat ice-cream rather than revising. After all, which is more fun and pleasant?

      In this book, we do not aim to rid you of anxiety. This might sound like a blissful idea, but we really think that your anxiety is an important and useful part of your life. It might just need some understanding, and maybe some taming, to make sure it is helping more than it is causing you problems.

      What is an anxiety disorder?

      There’s a lot more discussion and information about “mental health disorders” around now. This can sound a bit scary! When we talk about “anxiety disorders”, all it really means is when anxiety starts to interfere with school, friendships and your daily activities. It also means that your anxiety has been around for longer than a few days or even weeks, but has stuck around for months.

      There are some disagreements between psychologists and other mental health professionals about diagnosis and the use of the word “disorder”. Some people think that it’s a useful, non-blaming way to help people to understand the way feelings and behaviours can become problematic; others think it makes people feel that there is something wrong with them for being distressed. One of the main arguments against using the word “disorder” is that suffering and distress are part of being human, so why do we treat it like illness?

      We (the people writing this book) think the most important thing to remember is that anxiety is normal, but that we should not ignore distress. It is really important that you don’t try to “manage” anxiety like an illness if there is a clear cause. Often feeling anxious is your body and brain’s way of telling you that there is something wrong in your environment and that you, or the adults around you, need to make a change. For example, if someone is hurting or humiliating you and this is making you feel anxious, you should not work on the anxiety but on the cause instead. We know that it can feel really scary telling someone about what is happening because you are worried that they won’t believe you, or might blame you for what is happening. This is rarely the case. We can assure you that letting a trusted adult know (whether this is a parent, teacher or someone else that you feel safe with) means that they can help to make it stop, support you or give you advice about what to do next. If someone is hurting you and you don’t feel that there is anyone you can talk to about it, there are organisations that you can contact who can help and advise you (see Useful Information section at the end of the book).

      In Chapter 11 we say a bit more about how to tell someone you are feeling anxious.

      Who gets a diagnosis of anxiety disorder?

      Sometimes the term “anxiety disorder” is written down by a professional and then it becomes something that you “have”. It’s OK to question professionals about how they have come to these decisions. Other times you might be told exactly what is happening and go through a structured process of answering lots of questions about your anxiety and how it affects your life. A diagnosis should only be given if anxiety has been around for a number of months and causes significant problems at home and school, and/or in your social life. The impact of anxiety should be assessed from your perspective and from the perspective of those who know you best such as parents and teachers.

      Diagnoses are often used to help the professionals decide on the best way to help you with the problem and to begin to develop a shared understanding.

      Formulation is another way of understanding anxiety. The difference from diagnosis is that it uses a story about your fears, worries or behaviours instead of a label. A story means that it is more personal to you and includes your needs and strengths. Formulation also thinks about how past experiences may have impacted upon the anxiety that you feel now, and the ways that you cope with it (see Chapter 2 for more information about where anxiety comes from). Formulation aims to identify what is keeping your anxiety going so you can take steps to get back on track. The Anxiety Survival Plan in Chapter 13 should get you started on making your own formulation.

      Will problem anxiety go away on its own?

      We know that about 1 in 20 young people will experience anxiety so severe that it could be considered a “disorder”. We also know that most of them will recover and no longer suffer from anxiety that causes them severe problems by the time they reach adulthood. So, you could just hope that you get through a tough time and it goes away because for most people it does. However, we also know that most adults who suffer with severe anxiety started to struggle with anxiety when they were a child or adolescent. We think it’s really helpful if young people develop an understanding of anxiety early in their life and find the coping skills and strategies for managing anxiety that suit them. If you master these skills now, then you are ready for anything! You can read about young people who have suffered with anxiety and found their way through it in Chapter 12. We also know that at some point it becomes a significant problem for about 1 in 10 adults. Your understanding and skills will mean that you are well equipped both for everyday stresses and if life throws something really stressful at you.

      How does this book help with anxiety?

      In this book, we aim to provide you with information and young people’s stories that will help you to better understand your anxiety and where it might come from, and to explain a number of different approaches and strategies to help you to feel more in