Though more than 40 million people in the U.S. have anxiety disorder, it’s still a condition that’s easily misunderstood. That may be because, as the National Alliance on Mental Illness points out, most people experience anxiety from time to time. Life is stressful, and it’s normal to get anxious about a big event or when there’s a lot going on. But anxiety disorder is complex, and understanding what it’s all about can ensure more people get help. These are five common myths—and the truth about what’s really going on with anxiety.
Myth #1: Anxiety is all in your head
The truth: Anxiety causes very real physical, if often silent, responses that may include shaking, chest pain, heart palpitations, nausea, and light-headedness, says Karen Surowiec, Psy.D., a psychologist with the Manhattan Psychology Group. That’s because fears and worries cause the body’s fight-or-flight response to kick in, releasing hormones that make your muscles tense and your heartbeat and breath quicken. The brain and the gut share a connection too, which is why feeling nervous can upset your stomach and an upset stomach can make you feel nervous. One study found that 44% of people with irritable bowel syndrome (IBS) had anxiety compared with just 8% without IBS. All of which means that even if the fears you have aren’t likely to come true, they could be causing a very real physical reaction.
Myth #2: Anxiety is simply worrying too much
The truth: Worry is a part of anxiety, but it’s not the whole ball game. Regular worries tend to be tied to specific, realistic fears—losing a job, your child being bullied, missing a flight. Anxiety, meanwhile, may not be based on rational fears and creates extreme emotional distress that can be felt in your body. Some anxiety is good, but when it gets in the way of everyday functioning, it may be diagnosed as a disorder, says Aaron Telnes, a psychologist with the College of Alberta Psychologists. Sometimes the fear is not specific—or it continues even after what you were worried about is over. For example, it’s common to be nervous before a review with your boss, but fixating after the fact on something you said or on the outcome can be debilitating and may involve a sense of doom, hyperventilating, sweating, and trouble concentrating or sleeping. If anxiety has been interfering with how well you function at school, work, or home for weeks or months, it’s time to seek out therapy, Telnes says.
Myth #3: You should avoid situations that make you anxious
The truth: Though it’s a natural reaction, avoidance may make your anxiety worse, says anxiety expert Haley Neidich, L.C.S.W. “Anxiety will insist on being felt,” she says, and hiding from it can have secondary effects. Not speaking up in relationships, procrastinating, and avoiding social interactions or bills all have serious consequences,” she says. In fact, a common treatment for anxiety is the opposite of avoidance: exposure therapy. This works by helping people approach their fears in a safe environment, says Telnes—and, by doing so, learn that they can handle them. Sometimes the exposure is gradual, using virtual reality in the safety of a therapist’s office (for example, taking a simulated flight to overcome a fear of flying) or out in the “real” world. Also part of it is learning ways to cope, such as acknowledging anxiety: “Saying to yourself, ‘Yup, I’m anxious; I feel it in my chest; I feel like I’m losing it’ sounds simple, but it can reduce your symptoms immediately, and it puts you in a place of problem-solving rather than denying reality,” Neidich says.
Myth #4: Social anxiety is the same as shyness
The truth: Shyness is more of a personality trait, whereas social anxiety is a disorder—and while shyness can be uncomfortable, social anxiety disorder (SAD) can be debilitating. With shyness, you might find it tough to talk to people you don’t know or to be the center of attention. When you have SAD, you fear being watched, judged, or humiliated and may dread or avoid social situations for months. It’s easy to see how SAD can make it hard to function: Someone with SAD may worry that a cashier will ask them a question they can’t answer and thus avoid food shopping altogether, for example. And while nervousness related to shyness can cause physical symptoms—sweaty palms, jittery hands—people with SAD may have additional heightened fear responses such as body stiffness and feeling their minds “go blank,” according to the National Institute of Mental Health. Fortunately, research shows that people with SAD who are treated with cognitive-behavioral therapy (CBT) can have a recovery rate of nearly 70%.
Myth #5: You can just snap out of it
The truth: Just as someone can’t “snap out of” cancer or diabetes, the same is true for anxiety. “That mentality is rooted in mental health stigma and denialism of mental health disorders as real medical issues,” says Neidich. While it is sometimes healthy to temporarily set anxious feelings aside to get through a challenging situation, denying or suppressing anxiety isn’t a long-term plan—doing so can result in outcomes such as substance abuse, chronic health conditions, dysfunctional relationships, and insomnia, she says. “If you want to feel better, you’re going to have to acknowledge your anxiety, feel your feelings, and learn coping mechanisms,” adds Neidich. Those can include stress-reduction techniques such as exercise; journaling; relaxation exercises like deep breathing, meditation, and yoga; and CBT, which can help you challenge your reactions and fears and find healthier, more positive ways to address them, she says.
Kate Rockwood is a freelance writer based in New York.