Tony Stark, the genius narcissist and billionaire scientist, suffers from severe insomnia. When he manages to fall asleep, he experiences nightmares in which scenes from his battle against the Chitauri, the extraterrestrial race that was invading the Earth months earlier, are recreated in extremely vivid manner (vivid dreams). Picture it: the Avengers are fighting against an army from space coming through an interdimensional portal. The fate of the earth hangs in the balance. Iron Man heads towards the interdimensional portal with an atomic missile on his back. Right after guiding the atomic missile to its target, the high-tech suit malfunctions, and he falls unconscious.
At a restaurant, Tony suddenly starts sweating profusely (diaphoresis), feeling like he’s losing control. He becomes uncomfortable amidst the crowd (agoraphobia), and an extreme and irrational fear overtakes him (panic attack). The anxiety is unbearable. An imminent sense of death prompts him to leave the restaurant desperately, heading for his suit. Once inside his technological armour, and with the use of artificial intelligence (JARVIS), he is diagnosed with a severe generalised anxiety attack. Tony Stark is officially diagnosed with post-traumatic stress disorder and anxiety.
Anxiety is a part of our daily life, and it can affect us in different ways and at almost any age. The difference from stress is that the latter is caused by external factors (such as financial or work-related issues) and is usually manageable. Anxiety, on the other hand, doesn’t have a specific triggering component. Moreover, anxiety can persist, unlike stress, even when the triggering cause is no longer present.
Anxiety can severely interfere with people’s lives. Confronting one’s fears can be difficult, and it’s very easy to think that one might lose control, exacerbating anxiety symptoms. However, the first and most important thing to recognise is that anxiety is normal and part of our biology. Anxiety keeps us alert; this increases the production and release of adrenaline to accelerate our heartbeat and increase oxygen levels in our body to prepare it for fight or flight (the fight or flight response). This state of alertness and the rush of adrenaline coursing through our veins were highly beneficial for our ancestors, helping them respond to situations of imminent danger. Unfortunately, this response can be triggered when it is not needed, and stress can be spiralled out of our control. The feeling of anxiety can generate a wide variety of physical, psychological, and behavioural symptoms (see table below).
Anxiety can manifest in the form of various disorders: obsessive-compulsive disorder, panic attacks, post-traumatic stress disorder, and phobias. Obsessive-compulsive disorder is characterised by obsessions (intrusive and repetitive thoughts resulting in irrational fear) and compulsions (intense desire to perform an action in response to fears generated by obsessions); for example, some obsessions include excessive worry about death or illnesses, undesirable sexual thoughts, or fears of causing harm to others.
Post-traumatic stress disorder is an anxiety disorder that can develop after exposure to a traumatic event that could cause death or severe harm. The traumatic event can be due to direct or indirect exposure to the event. People with post-traumatic stress disorder can experience vivid memories, panic attacks, and increased alertness—remember Iron Man? The most well-known example is military personnel who have been in war zones.
Panic attacks can occur independently or be part of other forms of anxiety. People experiencing panic attacks can be fine one minute and experience excessive fear without apparent cause the next. This triggers physical symptoms like increased heart rate, nausea and other gastrointestinal problems, or psychological thoughts and experiences that can be terrifying.
Phobias, on the other hand, involve an intense and irrational, pathological fear of people, things, or situations.
There’s no single treatment or method to control anxiety. Like many things in life, it’s a personal long-term commitment to begin the path to recovery, understanding that feeling better and learning how to manage anxiety takes time and patience. Known treatments so far are medical therapy and/or cognitive-behavioural therapy (both with scientific evidence). Other anxiety management methods include self-help (books, groups, etc., with little to no evidence) or mindfulness (still lacking clear evidence). It seems clear that the accumulation of stress can trigger spontaneous anxiety and panic episodes with no obvious cause, hence the emphasis on proper stress management.
Some recommended activities to manage stress include:
- Spending time outdoors and walking.
- Reducing coffee consumption.
- Putting your needs first. This doesn’t mean being selfish; it’s dedicating time and effort to self-care; for example, exercising, eating healthily, or getting enough sleep.
- Seeking help. This is easier said than done, but it’s immensely helpful for managing anxiety. Find someone you trust or support groups with people facing similar issues.
Anxiety is a universal experience that we all have encountered at some point in our lives. Anxiety is a symptom, not a diagnosis, that may be related to other psychological conditions such as depression. Recognising it in time to manage it or seeking specialised help is crucial. Some people are anxious all the time but can somehow control their nervousness. Others don’t show nervousness or aren’t affected in the same way as others. In fact, anxiety becomes problematic when a person feels that nervousness is spiralling out of control, becoming more frequent, and the intensity can’t be tolerated. Finally, remember that while anxiety can be a chronic condition, it’s highly treatable, and there are enormous possibilities for those who suffer from it to improve with medical and psychological treatments. Don’t suffer in SILENCE, not even Iron Man did.
| Physical symptoms | Psychological symptoms | Behavioural symptoms |
|---|---|---|
| Increased heart rate | Feeling like losing control | Avoidance (evading situations that trigger anxiety, although this is only a temporary solution) |
| Muscle tension | Sense of impending death or having a heart attack | |
| Dizziness or nausea | Feeling like others are observing your anxiety | |
| Difficulty breathing | Feeling detached from reality (depersonalisation) | |
| Headache | Desiring to run away or escape the situation | |
| Feeling of suffocation | Feeling nervous | |
| Dry mouth | ||
| Tight chest |
