Anxiety: The ins and outs

A big test or a playoff game can have emotions running high, and between the nerves and sweaty palms, it’s easy to get overwhelmed. Although anxiety is a normal response to a high-stakes or otherwise stressful situation, if it starts to occur even without these outside influences or if it negatively impacts your day-to-day life, it may be time to seek help.

What is normal anxiety?

Anxiety is a normal response to life situations and is actually an evolutionarily useful trait that was passed down from our ancestors. When we perceive a threat, the nervous system releases hormones that can make us feel uneasy or unsafe, cuing the fight-or-flight response. This was particularly useful for early humans who heard a rustle in the bushes and thought it was a predator—compared with those who just assumed it was the wind. The former survived to have decedents that include us, while the latter got eaten.

In the modern world, we can experience anxiety in our day-to-day lives too, but ours is more likely to manifest as stress around doing our taxes or a big project for work or school—rather than being hunted by a wild animal. Also, anxiety is a part of our personalities, more so for some than for others. So our body’s response to outside anxiety can also also be determined by how much anxiety is already embedded in our DNA.

“Anxiety can be broken down into ‘state’ and ‘trait’ anxiety,” said Brian Holland, PhD, MSN, RN, assistant dean for undergraduate studies and assistant professor at the Texas A&M College of Nursing. “State anxiety typically comes from outside influences, while trait anxiety can be seen as how much anxiety someone experiences as part of their personality.”

Of course, these components of anxiety two interact. If someone who is a typically anxious individual (think of Piglet from Winnie the Pooh) is dealing with stress of final exams, then that person’s anxiety levels may be higher than if James Bond was dealing with those same exams. For the average anxious person, experiencing high amounts of anxiety during social situations or activities where your performance is measured is very common. Exams, presentations at work and first dates are all instances that can increase someone’s state anxiety.

And although anxiety can be a normal response, there is a point where it becomes problematic.

“Anxiety will rise when people perceive a threat or are uneasy and there are a lot of things in everyday life that can cause these,” Holland said. “Everyone experiences these types of anxiety, but some people may need additional help from a professional if their anxiety levels get too high.”

When is anxiety a problem?

Anxiety can present with cognitive symptoms—such as fear, racing thoughts and poor concentration—or with somatic symptoms—such as sweaty palms, abnormal heartbeat or trembling. It may be difficult to decipher the exact moment when anxiety becomes too much, but there are some things to consider.

“If these symptoms are frequently interfering with day-to-day activities, then it’s a problem,” Holland said. “Having an open dialogue with your health care provider about your symptoms and potential causes for your anxiety levels can help you develop a plan to deal with these issues.”

According to the Anxiety and Depression Association of America (ADAA), there are many different ways anxiety can present in a person. In fact, diagnosable anxiety and anxiety-related disorders can include post-traumatic stress disorder (PTSD), social anxiety disorders, generalized anxiety disorder (GAD) and phobias. Treatment for these conditions may typically include cognitive behavioral therapy and medication.

Although it may be uncomfortable to talk about anxieties, if they interfere with daily life, it’s important to see a health care provider for diagnosis and treatment.

Anxiety and performance go together

When dealing with circumstances that can raise your state anxiety, such as a test or presentation, there is no magic remedy. However, Holland was part of a team that conducted a study to try to help  nursing students deal with anxiety before patient care simulations.

“Our study assigned music for the students to listen to before patient care simulations.,” Holland said. “What we saw was that the students’ instructor evaluated performance and self-efficacy improved and their anxiety decreased.”

Dealing with performance anxiety can be a tricky situation. Basically, too little or too much anxiety can hinder learning and performance, so the objective is to find that zone that offers the best level of anxiety that will create an atmosphere that promotes confidence.

For example, imagine a basketball player during a big game. If the crowd is roaring and the game is in overtime, the arousal levels could be too high for a player to optimally perform. However, the converse is true as well: The same player could find it difficult to perform at his or her highest potential when playing in a scrimmage in an empty gym. Optimal arousal could help with confidence and productivity and allow the participant to perform most efficiently.

“The goal is to use the arousal to help find maximum performance without overdoing it,” Holland said. “More complex tasks will require lower levels of arousal, but the optimal performance window may be smaller.”

Dealing with anxiety

There are many different ways to lower anxiety levels, and although music may have worked for the nursing students in Holland’s study, there are other ways to lower your anxiety in the moment.

“Music is a good way to help reduce your anxiety in stressful situations, but it may not work for everyone,” Holland said. “Deep breathing or meditation before an anxiety-inducing situation could help you manage that anxiety and achieve optimal performance.”

Even when you’re not in a stressful situation, there are lifestyle changes that could be done to lower the ceiling of your overall anxiety.

“Exercise is always a good way to lower your anxiety levels,” Holland said. “Also make sure that you’re living a healthy lifestyle by getting enough sleep, eating a healthy diet and having your social needs met. These are all ways that can help reduce your anxiety, but remember that professional help is also available if you need it.”