Anxiety

toc The dictionary defines anxiety as "a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome." As they often can be, this dictionary definition is rather limiting. Anxiety is a normal feeling that virtually everyone experiences from time to time, but "anxiety" is also a catch-all term for a type of psychiatric disorder that is often characterized by the chronic //feeling// of anxiety. It is important to distinguish between feeling anxious, and having a legitimate psychiatric disorder. Regardless of whether one is merely feeling anxiety, or suffering from a diagnosed disorder, these are phenomena that can be greatly exacerbated through the trials of college. Students in their first year of college experience many foreign concepts and experiences, and the stress of this new environment can lead them to encounter the problem of anxiety in new ways. Anxiety (the feeling, and its many disorders) can often get in the way of productivity, which is why college students have a very tangible reason to find ways to deal with this problem - anxiety can get in the way of a thriving academic and social life. The purpose of this wiki is to explore the origins of anxiety, how anxiety affects college students, and most importantly, delve into ways that people (specifically college students) can prevent and cope with anxiety and its related disorders.

=Why Did I Choose This Topic?= This topic is especially important to me because it is one that has touched my life in the past in many ways. Anxiety is prevalent in my family, and I was at one point diagnosed with an anxiety disorder. Additionally, throughout high school and my first semester of college here at Coe, I have witnessed the effects of anxiety on many people around me, and it is evident that anxiety can have drastic effects on people's daily lives. It is hard to explain an anxiety disorder to someone who has never experienced one, so that is one reason I think this topic is important for my wiki. Additionally, I have experienced firsthand how stressful the first year of college can be, and as such, such stressors can have a great deal of impact on causing anxiety, and making it harder to deal with anxiety disorders.

=What is Anxiety?= Anxiety is a feeling that is virtually universal. Everyone at some time or another feels uneasy, fearful, or worried about events of the future that are uncertain. When someone experiences anxiety, he or she could have experiences that are both mental (rumination and fear, for example) and physical (such as shaking, pacing, or difficulty breathing). Physical symptoms are more likely to be observed when someone has a full-on panic attack.

If everyone experiences anxiety at some point or another, then what constitutes an //anxiety disorder//? As it is often difficult to label abnormality in general, the line between normal anxiety and an actual disorder is often a difficult line to discuss, and the line is often blurred further by the unique experiences of college. However, Ciccarelli and White (2013) explain that anxiety becomes a disorder when the anxiety is either excessive, or unrealistic. That is to say, if someone worries "too much" about something, or worries about something they shouldn't worry about they have an anxiety disorder.

Click here to view the Hamilton Anxiety Rating Scale, and measure the severity of your anxiety.

=Types of Anxiety Disorders= Anxiety disorders are separated into several different specific conditions that fit under the umbrella of "anxiety." These conditions include:
 * generalized anxiety disorder, in which people experience chronic feelings of dread not necessarily associated with any apparent cause
 * phobias, in which people have irrational fear of a specific object or social interaction
 * panic disorder, which is characterized by severe symptoms of physical stress that come on with no warning
 * obsessive-compulsive disorder, in which people experience obsessions (pervasive thoughts) and compulsions (repeated behaviors)
 * stress disorders, in which exposure to a specific stressor results in symptoms of severe anxiety

=Treatment of Anxiety Disorders= According to the Anxiety and Depression Association of America (ADAA), anxiety disorders are treated by medical professionals in a variety of ways. The methods of treatment include therapy, medications, and more and more commonly, alternative or complementary treatments. These different methods are often integrated, or used in combination with each other in order to meet the exact needs of the client. The most common and well established form of therapy is known as cognitive-behavioral therapy (CBT) and involves the attempt to change the patterns of thinking in a patient. This method is useful in treating patients with anxiety because it demands that the patient be involved in their recovery, and thus the patient obtains a sense of control, which I would argue is important in treating a condition in which one has fear of the uncertain.

Medication is also often a probable option for patients being treated for anxiety. For those with a diagnosed anxiety disorder, medication is often used to alter the chemistry of the brain in order to improve balance. For example, a class of drugs called selective serotonin reuptake inhibitors (SSRIs), block a certain neurotransmitter (serotonin) from being used by certain cells of the brain so that it is readily available, improving mood and reducing symptoms of anxiety. There are other medications affect the levels of other neurotransmitters, while another class of drugs called benzodiazepines, "promote relaxation and reduce muscular tension." By combating the physical symptoms of anxiety, this class of drugs is often a valuable short-term treatment of anxiety disorders. The important thing to remember about medications is that they take time to work, so patience - and focusing on therapy - are key. The most progressive category of anxiety therapy is complementary, or alternative, treatment. These treatments exist outside the sphere of conventional psychology, and include yoga, acupuncture, and the consumption of a South Pacific plant called kava. These treatments have some evidence to suggest they are effective treatments, but some scientific research also points to skepticism, such as a 2010 study by Kimberly Zoberi that suggested that kava is not effective in treating anxiety. Clearly, the effectiveness of alternative treatments is not yet fully understood.

=Why Do We Feel Anxiety?= There are many different explanations for why anxiety is felt by humans. The different schools of thought within psychology have many different interpretations of why we feel anxious. For example, those who prescribe to the psychodynamic model might believe that anxiety is a kind of signal that repressed thoughts are trying to surface. Behaviorists might believe that feelings of anxiety are actually developed through classical conditioning, and cognitive psychologists would obviously associate excessive or unrealistic anxiety (disorderly anxiety) as a result of flawed thinking. There is also a growing amount of evidence that may suggest that biological factors are mostly at play in terms of anxiety disorders. For example, imbalances of the neurotransmitter serotonin in the brain might be something that causes us to feel uneasy or unhappy, which in turn contributes to anxiety. This could also explain why individuals with depression (caused by brain chemistry) are often also afflicted with anxiety disorders. The link is one that is important to consider.

It has been suggested that anxiety, which is often believed to be unique to humans, stems virtually entirely from the fact that we fear the future, the unknown (Diamond, 2010). Because are brains are so developed, and we are able to focus so much on what will happen weeks, months, even decades, from now, it makes sense that this would cause us to worry about what we cannot control. Because humans can comprehend the world - and its unpredictability - so well, we naturally feel unease about it. As stated earlier, when anxiety becomes excessive or unrealistic, it challenges our ability to function, and becomes a full-fledged mental disorder.

=Anxiety and College Students: An Overview= Anxiety is a topic that, without question, relates to college students. As I've explained earlier, college students encounter many unique situations that can be triggers for anxiety. These include academic stresses, extracurricular activities, the social anxiety surrounding friendships, and the adaptation to a new environment. Anxiety is a pivotal part of every college student's life, and the individual facets of anxiety as it relates to college could be listed innumerably. In the next three sections, however, I have chosen specific ways in which college students encounter stress:
 * 1) The relationship between anxiety and perfectionism, as the desire to achieve perfection in social and academic situations is a prevalent issue
 * 2) The relationship between acculturative stress and anxiety, as the need to adapt to a new culture is a stressor that can lead to severe anxiety
 * 3) The phenomenon of social anxiety, and more specifically how it relates to college students' consumption of alcohol

=Anxiety and Perfectionism= Perfectionism, or the refusal to accept any end result that is short of perfection, is a factor that can have a tremendous impact on anxiety, especially in the case of college students. This also relates to "all-or-nothing thinking," a psychological phenomenon that Ciccarelli and White (2013) define as "the tendency to believe that one's performance must be perfect or the result will be a total failure." This definition is virtually a pathologization of perfectionism. If one has tendencies toward perfectionism, it is understandable why such a person would struggle with anxiety: true perfection is, of course, unattainable. Furthermore, perfectionists' goal is not only unrealistic, it is rigid, that is to say, the only end result that is acceptable is absolute perfection. Since the feeling of anxiety stems from unease about the uncertain, it makes sense that perfectionists would be at risk for anxiety, as they are constantly unsure of whether they will reach their one goal. College students could encounter perfectionism in many ways, through their desire to be perfect in academic endeavors, as well as to achieve social perfection (many friends and flawless social life).

One study has shown that aspects of perfectionism are associated with high levels of anxiety (Kawamura, Hunt, Frost, & DiBartolo, 2001). This study displayed strong positive correlations between three anxiety factors (obsessive-compulsive disorder, social anxiety, and PTSD) and perfectionism. It is important to note that this study did not actually identify perfectionism as a predictor for anxiety, but the study did show that the two are most definitely linked. In fact, the types of anxiety that would one most find associated with college students (trait anxiety, worry, and social anxiety) seemed to be developed and maintained by perfectionist tendencies, while these tendencies did not have an effect on the development of "harm-based" anxiety disorders, such as OCD and PTSD. This might suggest a relationship of causality between more generalized anxiety and perfectionism.

Another study (Flett, Hewitt, Endler, & Tassone, 1994) found that "socially prescribed perfectionism was indeed associated with higher levels of state anxiety." It is interesting to note that neither of these two studies discussing anxiety and perfectionism found any substantial difference between men and women in terms of a relationship between the two phenomena (Kawamura et. al., 2001; Flett et. al., 1994) and this illustrates that anxiety can be a universal problem for perfectionists in college.

=Acculturative Stress= The concept of acculturative stress is often applied to individuals who cross cultural boundaries in terms of national identity, but I believe that it also applies to college students. While most students attend college in their native national culture, they still experience a huge cultural shift when they make the jump from high school to a university. Just about everything is different - new environment, new living space, new people, new classes, etc. The level of culture shock is different for each person; for example, I attended the same school district in southwest Washington state for 13 years, and therefore my adjustment may have been more drastic than someone who grew up in Cedar Rapids. However, virtually all college students experience some sort of cultural change, and all of these can have an impact on developing anxiety. Certain features of acculturative stress include:
 * **Integration**, in which a person maintains their identity with the old culture but also tries to blend in with the new. This could contribute to anxiety because it offers some element of the unknown: how does one balance the two?
 * **Assimilation**, in which the person completely gives up their old identity and accepts a role in the new culture. This could lead to anxiety because it creates an element of the unknown: how will people back home react?
 * **Separation**, in which a person rejects the new culture and attempts to remain in the old one. This could lead to social anxiety because when someone refuses to participate fully in college life, it can make social situations difficult.
 * **Marginalization**, in which a person neither retains their old identity or accepts a new one. This definitely contributes to anxiety because the person's entire //identity// is in question, everything about them is unknown.

=Social Anxiety and Alcohol Consumption= =media type="custom" key="24592990"= Social anxiety, according to Katz (2012), is "anxiety...in which a person has an excessive and unreasonable fear of social situations." Many people feel slightly uneasy about entering social situations, especially new ones, and college life (especially for new students) presents many opportunities for new social situations. Meeting new people, making new friends, and doing new things can lead to social anxiety that for many, often leads to levels of disorder. In the above video, a college student discusses his experiences with social anxiety. While he discusses his high school experiences, the vivid description of social situations as very frightening ideas is an example of what social anxiety feels like.

As stated earlier, college students are prime targets for social anxiety because of all the new experiences they encounter. Research has shown that young adults are likely to use alcohol as a coping mechanism, because it is believed by many that consuming alcohol enhances social situations, helps avoid "peer rejection," and reduces effects of anxiety (Blumenthal, Leen-Feldner, Frala, Badour, & Ham, 2010). Regardless of whether alcohol is actually successful in achieving these objectives, it is a somewhat problematic notion that socially anxious young people might use alcohol as a coping mechanism. Research promotes this idea as well, as it is shown that there is a positive correlation between social anxiety-related drinking motives, and problematic alcohol use (Blumenthal et. al., 2010). One could argue that it is important for college students to find ways to manage anxiety, because if those with social anxiety are more likely to drink problematically, they could be at higher risk for developing alcoholism as well.

=Coping with Anxiety= It is evident that anxiety is a prevalent problem for college students in many ways. As with any issue, however, it is important to ask the question: So what? Well, anxiety can have a tremendous negative impact on college students and their ability to function, in so many facets of their lives. This means that it is important that college students - whether they are afflicted with an anxiety disorder, or just feeling normal anxiety - find ways to cope with anxiety and deal with anxiety issues to make their situation better.

One study, (Ng, Ang, & Ho, 2012) which dealt with subjects slightly younger than college students, found that one of the most effective ways to combat anxiety was positive thinking. Positive thinking can have a lot to do with a person's "self-talk" (Mayo, 2011). Self-talk refers to the constant inner monologue that runs through a person's head throughout the day, and this monologue obviously adopts a certain character. In some people, self-talk is more negative than positive, and vice versa. It is thought that one can make a conscious effort to change their self-talk, and people stand to benefit from this: people who engage in positive self-talk (and other methods of positive thinking) experience more health benefits, on average. One theory of why positive thinking is beneficial to mental health is that it allows us to be more adaptive and flexible, and therefore more likely to handle stress effectively. The effective management of stress is evidently a factor that may contribute to reducing levels of anxiety.

In addition to the power of positive thinking, one sure-fire way for college students to assure that they are making an effort to manage anxiety, is seeking help (Ng et. al., 2012). On many college campuses, resources for dealing with stress and mental health abound. When students make connections, they can find ways to adequately deal with the enormous amount of anxiety that comes their way. Seeing a mental health professional, in order to determine if one has a mental health disorder, can be a valuable way to assess a situation and determine a course of action.

=Conclusions= After considering all of the research, it is evident to me that anxiety is a near-universal issue facing college students, and it is one that must be dealt with. At the individual level, I believe that students should do their best to remain positive, take stress head-on, and maintain a positive attitude. When anxiety does become too much to handle, it is //always// a good idea for a student to reach out. One thing that I think must change is that mental health issues become less taboo of a topic in our culture - after all, everyone experiences anxiety at some point or another. On a broader level, I believe college administrators should make solid efforts to provide resources for those afflicted with anxiety to manage their issues. This issue is so significant because of its sweeping impact, and because of the crippling effect it can have on students' ability to be productive.

=References= Anxiety and Depression Association of America. (2010). //Treatment//. Retrieved from http://www.adaa.org/finding-help/treatment

Blumenthal, H., Leen-Feldner, E.W., Frala, J.L., Badour, C.L., & Ham, L.S. (2010). Social anxiety and motives for alcohol use among adolescents. //Psychology of Addictive Behaviors, 24//. Retrieved from http://crlinweb3.coe.edu:2117/ehost/detail?sid=51689bb2-3b5f-4b49-8d16-849b56eac512%40sessionmgr4003&vid=6&hid=4102&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=pdh&AN=2010-19026-019

Ciccarelli, S.K., & White, J.N. (2013). //Psychology: An exploration// (2nd ed.). Upper Saddle River, NJ: Pearson.

Diamond, S.A. (2010). //Essential secrets of psychotherapy: Why we worry (and what we can do about it).// Retrieved from http://www.psychologytoday.com/blog/evil-deeds/201011/essential-secrets-psychotherapy-why-we-worry-and-what-we-can-do-about-it

Flett, G.L., Hewitt, P.L., Endler, N.S., & Tassone, C. (1994). Perfectionism and components of state and trait anxiety. //Current Psychology, 13//. Retrieved from http://crlinweb3.coe.edu:2117/ehost/pdfviewer/pdfviewer?sid=0fa64994-d74e-499d-b148-06734903e0ba%40sessionmgr4001&vid=1&hid=4102

Katz, M. (2012). //Social anxiety disorder//. Retrieved from http://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder

Kawamura, K.Y., Hunt, S.L., Frost, R.O., & DiBartolo, P.M. (2001). Perfectionism, anxiety, and depression: Are the relationships independent? //Cognitive Therapy & Research, 25//. Retrieved from http://crlinweb3.coe.edu:2117/ehost/pdfviewer/pdfviewer?sid=7c84dfc5-045d-484a-ac73-2bb3b4ba22c9%40sessionmgr4002&vid=5&hid=4102

Mayo Clinic staff. (2011). //Positive thinking: Reduce stress by eliminating negative self-talk//. Retrieved from http://www.mayoclinic.com/health/positive-thinking/SR00009

Medical News Today. (2010). //Doctor warns against St. John's wort for anxiety//. Retrieved from http://www.medicalnewstoday.com/releases/184631.php

Ng, R., Ang, R.P., & Ho, R.M. (2012). Coping with anxiety, depression, anger, and aggression: The mediational role of resilience in adolescents. //Child & Youth Care Forum, 41//. Retrieved from http://crlinweb3.coe.edu:2117/ehost/pdfviewer/pdfviewer?sid=226fcb02-117b-42a3-88c7-1e23b3334d40%40sessionmgr4002&vid=1&hid=4210