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Why We Need to Stop Treating All Types of Anxiety Like They're the Same

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Anxiety is often seen as a collective ball. An all-encompassing state of being you either have or don’t have.

But in reality, there are various forms of anxiety one could struggle with (and they are not all optimally treated by the same therapeutic approaches as the other).

Let’s start with what’s commonly known as generalized anxiety disorder (GAD). GAD is the most common form of anxiety where people feel psychologically, mentally, emotionally and/or physiologically anxious (from mild to severe). It can be difficult to calm your thoughts, there may be incessant worries, rigidities, avoidances, rumination and physically feeling like it’s difficult to sit still. It can cause hyperventilation, or a sensation you are carrying more energy than your body can handle and you are not sure how to get rid of it.

Another type of anxiety is separation anxiety. This particular form of anxiety actually can reach into other types of anxiety. For example, I’ve found that many people who experience separation anxiety can experience GAD as well, but it is not one and the same. Or interestingly, I have observed in my work that many people who struggle with a fear of flying actually can also struggle with separation anxiety. This isn’t 100% across the board, but it’s enough to notice the trend. People often experience separation anxiety without fully realizing that’s what it is. I’ve also found that while separation anxiety generally originates developmentally early in childhood, it can be further exacerbated into adulthood by continuous exposure to parents and caretakers with narcissistic behaviors growing up.

With parent(s) who are narcissistic, it can become difficult to feel a fully empowered sense of self. Instead, growing up you can often be treated as an extension of the parent with narcissistic behaviors. When parents tell you there is one way to live life, and that their way is the way life “is done,” they’re essentially raising you to be little versions of themselves. They control your upbringing and life in their vision of it, rather than allowing you to shape your own. Self-actualization can become scary because the unconscious feeling is that without this parent, you can’t exist as a separate self. You often learn to need them to guide you and can’t fully trust your own judgment in decision-making. It can be very complicated to detach from parents who are narcissistic when you feel helpless to guide yourself. I’ve found this form of separation anxiety is often experienced the most in adulthood with co-dependent intimate relationships and a difficulty individuating, relying on a heavy dependency on the parents (or the partner as a stand-in for the parent). As painful as these relationships can be at times, they can still be quite difficult to detach from or create effective boundaries with.

Then there is also anxiety related to intimacy. This is another one that impacts people in creating relationships and friendships, but they may not realize that’s what the problem is. Anxiety with intimacy can happen for an array of reasons, but I’ve found it’s generally linked to a greater fear of being hurt, left or abandoned, shamed or being vulnerable and sitting with a lack of emotional control in the relationship. This can create a dynamic of being an arm’s distance in relationships. You may feel like you want to be closer and experience the intimacy, but whenever those opportunities present themselves, the safer route is taken to hold back. The reaction is generally unconscious and you likely may not even be aware you’re doing it in the moment. This can lead to feeling less fulfilled in relationships and friendships, or also finding it difficult to commit in a relationship.

The above are just some short explanations of some common anxieties. They are each quite complicated in nature and tend to take much more than a paragraph to fully understand. Other anxieties can include anxiety related to sex, social anxiety, test-taking anxiety, dating or relationship anxiety, anxiety or fear of conflict or confrontation, commitment anxiety, fear of ending up destitute or being fired, fear of flying, fear of being alone and others. These anxieties can all exist in their own right, and can develop from different places for each person.

In my practice, I specialize in working with the many faces of anxiety. It’s possible to struggle with just one or more than one type of anxiety at a time. GAD is often present alongside of other anxieties, but this actually isn’t always the case. And just because someone struggles with GAD doesn’t necessarily mean they struggle in the other areas too. What’s notable here is that while the term “anxiety” is often used as a catch-all for a collection of symptoms; in reality, the various types of anxieties do not all originate from the same place or impact the same life situations, even if they can result in some similar forms of physiological and emotional experiences at times (and they can also result in very different symptoms and responses as well).

It sometimes can take a bit of exploration and reflection to understand where a deeper form of anxiety is coming from. It’s not necessary to figure it all out by yourself, and it’s important to take the necessary time to understand the particular form of anxiety you are struggling with. People often come to me describing previous anxiety therapies they have had, only to find that they were being treated as if their anxiety was GAD simply because the manifesting symptoms were similar to those seen with GAD. When treating one form of anxiety as if it’s another, it’s more likely the anxiety will either return or keep recurring.

Getty image by wildpixel

Originally published: December 20, 2019
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