“Social anxiety is a made up disorder, used by psychiatrists to push unnecessary medications…,” I heard the TV say one night, “…It’s just anxiety. It’s just shyness”. I was in the kitchen doing dishes at the time. Dropping my rags, I ran to the living room to see the source of the comment. Someone left Youtube running and it ended up on an anti-psychiatry documentary.
“Everyone has anxiety, there is no such thing as social anxiety disorder,” I heard them say again. Anger filled me to the core. How dare they, I thought. The people who say that are the people who do not have it.
It’s not just anxiety to people who have the disorder.
Growing up I had a condition called amblyopia where one eye was weaker than the other. I was bullied relentlessly throughout elementary school because of my condition. My parents never thought it was that big of a deal – I just had to “learn to be confident and get over it”.
Along with being bullied, my condition caused severe physiological and emotional distress. Crippling headaches and eye strain plagued me day and night. I became hypersensitive and anxious very quickly.
Over time I learned how to never look someone directly in the eye. For class photos I would turn my head slightly so that not even the cameraman would notice. I stopped initiating conversation with friends and stopped living in the external world. Instead, I fell deep into my own internal world where I felt safer.
Over the course of years my anxiety ballooned into a very real social anxiety disorder. Even though my condition as an adult improved and was not even noticeable, the effects of what I went through as a child stuck like glue.
What happens to us as children can physiologically alter our brain.
Studies show that childhood trauma decreases the amount of white matter in the brain. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307045/.
Further studies have shown that those who experienced childhood abuse or neglect had thinner myelin coating in a large part of nerve fibers. The researchers determined that in these cases, the cells responsible for the maintenance and production of myelin (oligodendrocytes), were impacted on a molecular level.
Abnormally thick axons were also found in the brains of those exposed to childhood abuse. They theorized that these alterations negatively influenced the anterior cingulate cortex connectivity.
This area of the brain is implicated in emotional processing and cognitive function. Afflicted areas in this study included the amygdala and the nucleus accumbens.
The result of the study was the determination that childhood trauma disrupts connectivity in areas of the brain responsible for emotional processing and cognitive function.
“Just get over it,” can’t work if the brain is physiologically altered.
The stigmatizing of those with mental illness reminds me of my amblyopia as a child. Even though it was a condition I was born with, I was viewed in a negative light by those around me.
For whatever reason, it is often thought that those with mental illness can simply “just get over it”. A lot of this might relate to the fact that everyone experiences some level of fear, shyness and sadness. To those without the disorder, it’s “just anxiety”.
Anxiety is of no importance to a healthy person, because relief is relatively easy to achieve.
Free and widespread use of the labels “anxiety” or “depression” in reference to normal or healthy emotional responses is part of the problem. If someone is nervous for a presentation at work, they may assume they have an anxiety disorder. If someone experiences a normal range of sadness related to a particular situation that is easily managed, they may say they have depression.
Those with healthy emotional ranges claiming to have true disorders of the brain may offer insight on how to get better. Their heart is in the right place, but they fail to recognize the harm this can cause.
Treatment for anxiety disorders is not a straightforward or simple process. That being said, the expectation on those who have it to “just get over it,” is high. Some even go so far as to say the disorder is not even real.
When we start comparing the effectiveness of treatment on people with the disorder to those without, the line becomes blurred. It warps the definition of anxiety disorder by applying it to normal emotional responses to situations.
“Well, I have anxiety and I choose to not let it get to me”.
A predominant belief regarding anxiety disorders is that the person afflicted somehow chooses to have it. This relates to the idea that if a person isn’t getting better, it’s due to a lack of will.
This idea of “choice” is applied to most mental health conditions. In comparison, when someone breaks their leg, no one will imply that they chose to break it. When someone has a physical health condition, we know by default that it is out of their immediate control. Therefore, how can we possibly expect them to cure it by sheer will?
What “just anxiety” means to a person with an anxiety disorder:
- Monthly, weekly or even daily panic attacks.
- TMJ and bruxism.
- Tension headaches and migraines.
- Inner restlessness and agitation.
- Chronic fatigue.
- Loss of appetite or eating too much/weight issues.
- Derealization, depersonalization and dissociation symptoms.
- Loss of connection to family and friends.
- Loss of job opportunities or experiences.
- Loss of functioning completely in some cases.
- Inner ear issues.
- Acid reflux and GERD.
- Irritable bowl syndrome.
- Visual problems.
- Other mental health conditions such as depression.
- Hypersensitivity and a sensitized nervous system.
We have to stop telling people “it’s just anxiety”.
An anxiety disorder is not the same as situational worry in a healthy subject. Treatment for periodic anxiety not classified as a disorder will differ significantly from treatment for an anxiety disorder.
Having an anxiety disorder is a very real physiological ailment effecting ones mind, body and spirit. Treatment not only includes prolonged psychotherapy, but a multitude of factors that will take time and patience.
One can only hope that the day will come when we stop romanticizing anxiety and applying it to all situations that involve healthy fear response patterns. Only then will more people decide to reach out for help with their condition. We can end the stigma by understanding that mental health conditions are real, and should be treated as such.
For more information about anxiety disorders, see https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/anxiety-disorders.
See “250 labels used to stigmatize people with mental illness,” on NCBI by visiting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1925070/.