Written by Heather Ballingham ACMHC
Right now, it seems as though anxiety is one of the most common symptoms of people coming to my office; and most of the time, they don’t even realize they’re experiencing anxiety. The interesting thing is, our body creates anxiety because it is trying to make us feel safe.
Years ago, I worked in an Addiction Recovery clinic. (I never, ever wanted to work with addicts. Ever.) I loved it. I learned more about people and families than I could imagine. In my office, it was not just about the addiction; it was about what causes anxiety and what is happening around you that makes you feel anxious. One night at that clinic, I was working on treatment plans. I remember this so clearly. I had 23 to do, and I was on #11… making progress, right? I was putting in diagnosis codes and a basic plan to start with. I realized as I was putting in codes, that I had typed in F41.1 Generalized Anxiety Disorder (GAD) in just about every treatment plan. I went back into other files and realized that I had basically diagnosed everyone with anxiety. That’s when I realized that most addicts are experiencing anxiety.
What are the symptoms a person must be experiencing to be diagnosed with anxiety? Let’s get technical:
F41.1 is a billable ICD code used to specify a diagnosis of generalized anxiety disorder. A 'billable code' is detailed enough to be used to specify a medical diagnosis.
Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry, that is, apprehensive expectation about events or activities. This excessive worry often interferes with daily functioning, as individuals with GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friendship problems, interpersonal relationship problems, or work difficulties. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, excessive stomach acid buildup, stomach pain, vomiting, diarrhea, bouts of breathing difficulty, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, rashes, and inability to fully control the anxiety (ICD-10). These symptoms must be consistent and ongoing, persisting at least six months, for a formal diagnosis of GAD.
If you didn’t read all that I don’t blame you, but it is quite fascinating. We may all be experiencing some symptoms of generalized anxiety disorder.
So, why did I diagnose everyone with F41.1, GAD? Typically, addicts will have anxiety because people become anxious when they do not get what they are looking for, need, or believe they need. Anxiety occurs when you feel out of control - and you need to have control. As an addict the control they feel they need would be their drug of choice/addiction.
WHAT DOES ANXIETY DO OR FEEL LIKE?
Anxiety can ruin peacefulness in your world right now, and the fear of it coming can be debilitating for some people. Anxiety is different from fear, but it will have a fear component. Fear is the strongest, most driving emotion in how we navigate our world. When experiencing fear, one can be mistrusting and afraid of rejection, abandonment or betrayal, death, or dying.
Anticipatory Anxiety refers to the “what ifs” we all seem to experience. When this occurs, we need to question ourselves. “Is this happening right now? Am I anticipating something might happen and I color it with my fear crayon? Am I truly anxious because of something happening right now?”
Although anxiety frequently has similar symptoms, it can be a different experience for everyone. When we take time to explore our own experiences with anxiety, we can recognize physical feelings within our body. This can be helpful in that we can more quickly recognize symptoms of anxiety as they come. Some physical feelings reported to me are:
Butterflies in my stomach
Tightness of muscles
Clenched jaw
Fidgeting with anything, such as tapping a pen, bouncing my leg, my fingers feel weird – I may bite them, pull at them, crack my knuckles, and so on
Move toes around in shoes or wiggle them.
There are many symptoms, so take the time to discover how your body reacts to anxiety.
When we are experiencing anxiety, it is important to ask ourselves questions regarding our feelings. For example, what am I feeling? What am I thinking? Is this a real issue?
Anxiety affects the limbic system, this is why our hands, fingers and toes feel it.
WHAT CREATES ANXIETY?
A variety of different things cause anxiety. Here are a few:
Heredity & Genetics: You are 3-5x more likely to have anxiety if a first degree relative has anxiety (father, mother, siblings). That means it is hard wired in us. I often hear clients say, “I’m anxious just like my mom was and/or is.”
Personality Traits: Perfectionist, Type A personality, Red personality, I like things just so, Black and White thinking. Fast moving – feeling you always need to be doing something. When feelings of losing control occur, you may feel the need to gain control over anything and everything that you possibly can.
Fear: what if things don’t go the way we need them to (precursor).
Conditioning: How were we parented? How did our parents react to things? How are we taught to respond to stimuli in the world? For example, if someone in your family spills milk at the dinner table, did your parents laugh and tell you to grab a paper towel. Or did a parent freak out or yell and announce dinner is now over and everyone had to stop right then and clean everything!
Environmental Concerns: Abuse of any kind, or naturally fearful of things due to what is happening around you.
Substances: Drugs, Alcohol, Prescription Drugs, Over the counter medication.
Non-Substances: Video Games, Pornography, Phones, Spending money.
Hormones: An adolescent going through puberty, PMS, Menopause. It isn’t that your world is scary, just that you are hormonally off inside. Men watch out, you have wacky hormones too.
Auto-Immune Disorders: Thyroid disease, Diabetes, Lupus, Celiac Disease.
Autism
Learning Disabilities
We all know someone with anxiety, we have all experienced moments of anxiety. Be kind to yourself, be kind to others. Remember, everyone is battling a battle you don’t know about.