Fear is an emotional response to an external situation. Being in the presence of a charging grizzly bear would certainly evoke fear within us. Anxiety is that similar feeling except the bear is internal and most often unrecognized.

Anxiety is the feeling when the integrity of the self has been threatened.

We all experience anxiety at different times and different situations; but when anxiety is constant, overwhelming and interferes with our ability to sleep and generally function, we may be developing an anxiety disorder. These include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, specific phobias and generalized anxiety disorder.

The causes are many – the expectation of shame and humiliation from an overly harsh and critical parent; various psychic conflicts such as the need to succeed and the fear of failure or success; the conflict between the need for independence and autonomy and the fear of abandonment; and a narcissistic fear of not making a perfect impression or performance. As we go through life we will have experiences that can be profoundly anxiety provoking – natural disasters, man–made disasters and of course the consequences of war.

Everything we think and do has its origin at the unconscious level, and the unconscious is the warehouse for our history including the frightening, painful, difficult emotions of early and mid–development; therefore anxiety disorders are caused by ‘something’ at the unconscious level, most often related to something we experienced in childhood.

Infancy and early childhood are critical times for the development of self in a realistic world – a task where none of us totally succeed, meaning we all come out of our childhood with some sort of neurosis or personality problem.

Anxiety and depression often co-exist, and their relationship is complex. Sometimes anxiety is unconsciously converted into a form of depression, and depression can be converted into a form of anxiety. More often than not they appear together. To understand and ‘manage’ these feelings requires effort, energy, commitment and discipline.

I emphasize the word ‘manage’ as these are feelings that cannot be eliminated from our lives. There will be experiences that depress us, and there will be experiences that make us anxious. To resolve issues of anxiety and depression we must look at the complete history of our lives as each of us is the totality of our experience. Our symptoms are a lifetime in their formation. There are NOquick fixes or pills that cure.

Life always includes experiences of neglect, threat, uncertainty, conflict, and the inevitable knowledge that each of us will die. Our defenses work overtime to avoid the awareness and profound impact of such inevitability. Anxiety is a part of our lives, an experience none of us can avoid.

We are an over–medicated, desensitized, angry and frightened species on the run from a source of pain that can never be escaped – ourselves. The Xanax, Valium, Ambien cocktails are an option only when we seek to become numb to our own internal lives,emotionally dead before we die.

Life is an anxiety producing experience. The human task is to learn to live with anxiety through awareness and disciplined use of self-management skills. Thus the need for psychotherapy.

Symptoms of Anxiety

• a heightened fear of what people think of you
• afraid of being trapped in a place with no exits
• constant feeling of being overwhelmed
• fear of being in public
• fear of dying
• fear of losing control
• fear of impending doom
• fear of making mistakes or making a fool of yourself to others
• fear of passing out
• fear of losing your mind
• fears about irrational things, objects, circumstances or situations
• heightened self-awareness or self-consciousness
• need to sit near exits
• difficulty concentrating, short-term memory loss
• difficulty thinking, speaking, forming thoughts, following conversations
• repetitive thinking or incessant ‘mind chatter’
• always feeling angry, lack of patience
• feeling under pressure all the time
• dry mouth
• difficulty falling or staying asleep