COVID has just had a name change from pandemic to endemic. According to Webster’s online dictionary, “the word pandemic refers to an epidemic that has gone international: the disease, once localized in scope, now starts to appear in other countries and even on other continents, typically infecting a large number of people in a short amount of time. A pandemic often has significant economic and social ramifications due to its global impact. If a disease lingers for a long time as an epidemic or a pandemic, it may eventually become endemic to an area. The word endemic describes a disease that persists at a consistent level within a region with fairly predictable rates of infection and spread, making it easier to prevent future outbreaks.”
Anxiety is ready for a name change as well.
I noticed a ten-year-old boy in the self-serve breakfast bar, wringing his hands and nervously glancing about while we were both waiting for our waffles to cook. It wasn’t clear if he was wondering where his father was, how long it was going to take to get his waffle or something else.
When watching the Olympic Games in Paris I was captivated by some of the athletes’ kissing charms on their necklaces or performing a series of rituals before the starting signal. The charm kissing and ritualistic physical movements looked like a combination of superstitious behavior and a meditative practice of getting their body ready for what was about to happen next.
During an evaluation of a felon in the prison interview room I was distracted by the shaking of the table we were seated at together while he bounced his leg up and down when talking about his first-degree murder charge.
This type of psychomotor agitation is not uncommon for me to see with defendants under a lot of duress while imprisoned. The American Psychological Association Dictionary of Psychology suggests that physical agitation like this is “restless physical activity arising from mental tension or disturbance. It includes pacing, hand wringing, and pulling or rubbing clothing and other objects and is a common symptom of both major depressive episodes and manic episodes.”
Another recent example of an unexpected non-verbal communication I witnessed was while I was consulting on a military court martial trial. My observation antenna went up when I saw what the defense attorney would routinely do while cross examining witnesses about their testimony regarding his accused sexual predator client. The defense attorney would non-verbally punctuate his questions by holding his chin in his hand and leaning his head to one side whenever he wasn’t getting the witness to agree with his line of questioning.
Just a heads up, this column is meant to provide an overview of anxiety, exploring its definitions, differences across generations and genders, and evolutionary aspects.
Anxiety, superstitious behavior, psychomotor agitation, and non-verbal tells.
Each of the body movements, the wringing of the hands, touching or moving while waiting for the starting gun, rapid leg shifting and body signals or “tells” by the defense attorney struck me as to how we communicate incredible amounts of information while never saying a word.
Don’t get me wrong, not all facial tics (rapid movements of the face, eyes or cheek muscles), psychomotor agitation (leg shaking), and innocuous tells like those of the defense attorney mentioned above are due to anxiety. Some of these behaviors can be due to a plethora of reasons. Without knowing the person’s background your observation is only a guess.
The reason for what may pass as a symptom of anxiety can be caused by genetics, a side effect of medication (similar to tardive dyskinesia which the APA Dictionary of Psychology defines as “tremor, so-called choreoathetoid movements and spasticity of muscle groups, particularly orofacial muscles and muscles in the extremities”) an underlying mental illness or the byproduct of unconscious thoughts that the person hasn’t been able to control and are outside of their consciousness.
Fear is situational, while anxiety is anticipatory
Fear is situational, while anxiety is anticipatory. For example, fear of a barking dog vs. anxiety about walking past a house with a dog. Anxiety can be part of other conditions like post traumatic stress. When a person has been traumatized by an event (think car accident), a person can have anticipatory anxiety (thoughts) about riding in a car because that’s where their trauma occurred.
Anxious body movements are easily observed but not easily interpreted. What do you do when anxious? Bite your fingernails? Tap your leg? Hold your forearms?
Anxiety as defined by the APA Dictionary of Psychology is an emotion characterized by apprehension and symptoms of tension. Muscles become tense, breathing is faster, and the heart beats more rapidly.
The APA goes on to say that anxiety may be distinguished from fear both conceptually and physiologically. An article on Anxiety from the APA website includes that “anxiety is considered a future-oriented, long-acting response broadly focused on a diffuse threat, whereas fear is an appropriate, present-oriented, and short-lived response to a clearly identifiable and specific threat.”
Response to anxiety is in our DNA
Anxiety has an evolutionary benefit. It helped us survive! When we sensed threat, an unexpected noise in the brush or the roar of an animal we had an immediate fear response. Our bodies reacted by shutting down some bodily systems (like digestion) which enabled our circulatory system to redirect our blood flow to our heart while simultaneously causing the excitation of other systems (shallow breathing and dilation of our pupils) so we could prepare to fight or flee.
Epictetus said, “Man is not worried by real problems so much as by his imagined anxieties about real problems.”
Unfortunately for us, our bodies haven’t adapted all that well to the 21st century challenges and now we readily get unnecessarily anxious and engage our flight or flee physiological state when a calmer approach would serve us just as well.
31% of adults will experience an anxiety disorder
According to the National Institute of Health, 31.1% of US adults will experience an anxiety disorder at some point in their lives. The Diagnostic and Statistical Manual published by the APA defines 3 different types of anxiety disorders 1. Generalized or persistent and excessive worries about finances, identity crisis, interpersonal relations and social media influence (more about that momentarily). 2. Panic disorder (unexpected panic attacks) and 3. Social Anxiety Disorder or the intense fear of social situations.
Jonathan Haidt’s new book, “The Anxious Generation,” which is about Generation Z, is particularly worrisome. He highlights how Gen Z has had a “required childhood resulting in an epidemic of mental illness.” He goes on to say a collection of four foundational harms: social deprivation, sleep deprivation, attention fragmentation and addiction (to social media) has caused untold harm and made an anxious generation.
In a January 2021 interview with National Institute of Mental Health, Krystal Lewis, Ph.D., said in reaction to questions about how adolescents react to stressors in their lives said it’s important that “once you’re aware of the anxiety, you can do certain things to disrupt the worrying and the anxious feelings that you experience. This means you can challenge anxious or irrational thoughts by reframing your worries. So, you have a deadline, and you’re stressed about it. Instead of saying to yourself, ‘I should have already done this…’ say, ‘I’m doing the best that I can.’ No one is perfect. Sometimes things might be late right now, and that’s okay.”
Corrie Ten Boom, a famous Dutch watchmaker, said, “Worrying is carrying tomorrow’s load with today’s strength — carrying two days at once. It is moving into tomorrow ahead of time. Worrying doesn’t empty tomorrow of its sorrow, it empties today of its strength.”
Which gender experiences a greater portion of anxiety in their lives?
There is a gender difference in acquiring anxiousness. In their National Center for Biotechnology 2011 article. Carmen P. McLean, Anu Asnaani, Brett T. Litz et. al. found gender differences in anxiety disorders and that “women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence.
No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extent also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men.”
All is not lost. Anxiety and other physical manifestations that are disruptive and interfere with your everyday experience are manageable.
Jonanthan Haidt and Krystal Lewis both mentioned a call to action. For children facing undue pressure Haidt suggests “voluntary coordination e.g. no smartphone until eighth grade, social norms, technological solutions and laws that protect the innocent.” Lewis suggests employing calming or relaxation techniques.
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Questions? Suggestions? Send me an email at psychology@americanisraelite.com. Be well. See you here next month.
