In a time when we’re collectively dealing with heightened levels of stress and anxiety — how can you tell when it’s something more serious? 

By Kylie Gilbert
Sep 01, 2020 @ 10:00 am
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Millennials are oft-referred to in the media as the anxious generation. Some argue it's a product of growing up with social media, but ironically, it's also social media that's made talking about the mental illness, and naming it as such, feel less taboo. Dakota Johnson, Kylie Jenner, Camila Cabello, Lili Reinhart are just a few of the many stars who have publicly shared their struggles with anxiety; even fashion influencers have gotten on board. It's become so normalized, we've even created new subcategories of it, like "election anxiety," and, more recently, "eco-anxiety," the extremely 2020 condition triggered by climate change and natural disasters.

And then coronavirus anxiety hit. According to a recent survey from the CDC, 25% of adults reported experiencing symptoms of anxiety disorder in the U.S. from April to June — three times the reported rates from the same period in 2019. The troubling numbers are confirmed by Census Bureau data from the end of May that found 30 percent of Americans showed symptoms of generalized anxiety disorder.

“Without a doubt, I am seeing heightened levels of clinical anxiety — I’ve been busier than I’ve ever been. People that have been functioning fairly well have found that the pandemic has put them over the edge,” New York City-based psychologist Ben Michaelis, Ph.D tells InStyle

Coronavirus created the “perfect storm” for anxiety to thrive — “like waves that keep hitting the shore with no chance to recover,” says Amanda Spray, Ph.D., clinical associate professor in the department of psychiatry at NYU Grossman School of Medicine. And we're still dealing with it, now in the form of re-entry anxiety — the result of the massive uncertainty we feel as the country re-opens and shuts down again.

The bright side: Everywhere we look, we're being reassured that we're all in this together (even Michelle Obama struggles with her mental health!); that anxiety is incredibly normal and to be expected. (And it is.) The problem: In this universally stressful time, it's becoming harder for some to tell what's natural — or sometimes even, helpful — anxiety, and what may actually be an anxiety disorder, the most common mental illness in the U.S.

If you feel like your anxiety is becoming uncontrollable and getting in the way of your life — and Instagram therapy or meditation apps just aren't doing the trick — here's where to start and how to get help.

Here's what 'healthy' anxiety looks like.

First thing's first: Anxiety isn’t inherently a bad thing. As human beings, we’re hardwired to respond to stress as a means of self-protection in potentially dangerous or unfamiliar situations.

“A certain level of anxiety throughout this pandemic is adaptive and fairly normal — we have anxiety for a reason. We are fearful when we see a bear, or when a car is approaching and we need to step out of the street. That fear response is a good thing. It keeps us safe,” explains Dr. Spray.

“For a lot of people, that’s being activated right now for good reason. We have a very real threat out there and we should be concerned,” she says.

This anxiety can manifest in physical symptoms, too — like sweaty palms, shortness of breath, and a pounding heartbeat. “Our nervous system is set up to recognize a threat and pour blood into our heart, lungs, and muscles in preparation to fight or flight,” explains Elisha Goldstein, Ph.D., creator of the 21 Day Program to Naturally Relieving Anxiety.

So, if you feel these less-than-pleasant symptoms say, while putting your mask on before leaving home, know that it's a good thing, Dr. Spray says. "It's our body preparing us," Dr. Spray says.

So, what are the signs of an anxiety disorder?

Some anxiety can actually be a good thing if you’re experiencing it temporarily, which is how our body's stress-response system is designed to operate. “When we need to take a step back and evaluate is when the anxiety becomes overwhelming and a misfire in a way — when we’re telling ourselves we need to be fearful when there’s no actual threat there,” Dr. Spray explains.

There are two official criteria for generalized anxiety disorder (GAD), per the American Psychiatric Association: the fear or anxiety must be out of proportion to the situation and it must hinder your ability to function normally or cause some interference in your life. Or, as Dr. Goldstein puts it to his patients: “Nothing is a problem unless it’s a problem.”

Dr. Goldstein suggests asking yourself the following questions if you’re feeling concerned that your anxiety is abnormal: Is it causing you to not be able to get a single thing accomplished in your job? Is it causing you to fight with your partner or lash out at your kids? Is it preventing you from doing even doing an online yoga class or other activities you enjoyed before? Is it getting in the way of your sleep?

While each person may experience anxiety slightly differently, per the National Institute of Mental Health (NIMH), symptoms of GAD include the following:

  • Feeling restless, wound-up, or on-edge
  • Being easily fatigued
  • Having difficulty concentrating; mind going blank
  • Being irritable
  • Having muscle tension
  • Difficulty controlling feelings of worry
  • Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep.

Uncontrollable worry in "multiple domains" is another chief sign of an anxiety disorder and a clue that it may be time to get outside help, the experts we spoke to said.

“Humans are really good at dealing with one major stressor — what we’re not good at is when we have multiple simultaneous stressors, which is what’s happening now. For example, dealing with the unknown of the virus and job loss, the virus and the illness of a relative, or the virus and a break-up,” says Dr. Michaelis. “Multiple stressors are sending people over the edge into more of a clinically anxious or depressed place.”

There are several types of anxiety disorders, including panic disorder and social anxiety disorder.

Although the most common anxiety disorder is GAD, affecting 6.8 million adults, there are several different types to know about, including panic disorder, social anxiety disorder, and various phobia-related disorders.

People with panic disorder have recurrent unexpected panic attacks, or sudden periods of intense fear, that are often triggered by a feared object or situation. A panic attack can also bring on intense physical symptoms like heart palpitations, sensations of choking, and feelings of impending doom.

Social anxiety disorder (previously called social phobia) refers to the fear of social or performance situations — as Zendaya described in her September InStyle cover interview. More than just shyness, people with social anxiety disorder are extremely worried about being judged by others and often avoid social situations as a result.

There are also several types of phobias that cause people to have an intense fear or anxiety about specific objects or situations, such as flying, heights, spiders, or needles.

Anxiety disorders are incredibly common — and affect women more than men.

Although they can feel isolating, anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, per the Anxiety and Depression Association of America (ADAA). An estimated 30% of U.S. adults experience any anxiety disorder at some time in their lives, according to the NIMH.

Unsurprisingly, whether or not you end up in this 30% depends on both genetics as well as environmental factors, says Dr. Goldstein. A family history of anxiety or other mental illnesses, exposure to stressful or traumatic life events (such as sexual assault, or the loss of a loved one due to COVID), or working in certain high-stress job fields can all contribute to your risk of developing an anxiety disorder.

Plus, women are twice as likely to be affected as men, according to the ADAA. This is likely due to many factors — in general, men seek health services less than women, but societal pressures are most likely at play too, especially for women of childbearing age, Dr. Spray explains. “In our society, there is pressure on women to do it all and have it all.”

These are the most common treatment options for anxiety that can help you find relief.

While the stigma around mental health issues (or seeking therapy) is getting better, experts agree there's room for improvement. Case in point: Only 37% of those suffering from an anxiety disorder receive treatment, according to the ADAA, despite the fact that treatment actually helps most people with anxiety disorders lead happy and productive lives.

Anxiety disorders are generally treated with therapy, medication, or a combination of both, according to the NIMH. One common form of talk therapy used for anxiety disorders is cognitive behavior therapy (CBT), a goal-oriented approach in which a psychotherapist will help you become aware of inaccurate or negative thinking so you can respond more effectively to challenging or stressful situations, according to the Mayo Clinic.

“We know that CBT face-to-face works — and we are learning about in what other forms it can work. Studies show that it is effective over video, which is a big relief during a pandemic, and it’s also being translated into apps, like COVID Coach. These apps aren’t a replacement for in-person treatment, but they can be great adjunctively, or as an intro to how CBT works,” explains Dr. Spray.

Anti-anxiety medication or antidepressants are also common treatment options. “While medication is often overprescribed, it can be supportive for many people to help them engage in the practices of self-care they need to come back into balance,” Dr. Goldstein says.

Self-care is also huge when it comes to managing anxiety.

In addition to seeing a professional, “There are really simple things you can do every day even during this time to feel a greater sense of grounding, relief, personal control of your mind and life,” Dr. Goldstein says.

Some of those self-care practices include yoga, meditation (Dr. Spray recommends apps like Headspace and Calm), and eating well — as well as curbing activities that amplify your nervous system.

For example: How you take in information about coronavirus. “The news is a form of diet; it’s something you’re ingesting. As a responsible citizen, it may feel like you need to know what’s going on at all times, but you need to be careful about how the information comes at you — news alerts can cause distress,” says Dr. Michaelis. Limiting alcohol and drugs, which can make depression and anxiety worse over time, can also have a measurable impact on your anxiety, he adds.

Bottom line: “If you’re experiencing more anxiety lately, know that it’s not your fault and you aren’t alone in this,” Dr. Goldstein says. “In fact, you can come out of this with greater strength and presence than you had before.”

If you’re experiencing anxiety and/or depression and are in need of crisis support, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).