Fact Checking the False Narrative of Anxiety
Lydia Kraszewski, LPC.
Anxiety, Explained
I cannot tell you the number of times in my life (dating back to when I was in kindergarten) that this tricky thing referred to as anxiety has created an entire story in my brain, which caused me immense amounts of distress and fear-based thinking. If this sounds familiar to you, you probably know that nine out of ten times, the story that anxiety recites to us is nowhere near being accurate. Throughout my life, anxiety has disabled me from being present and has created barriers to mindfulness as well as formulating thoughts from a place of logic. I have come to learn that I am not the only one who experiences this, which is both comforting and disheartening, because if you know the challenges that come along with having anxiety, you know how hard it can be. Anxiety will tell you, “Your life is over”, “You’re going to fail”, “This person is mad at you”, and “You ruined everything,” amongst many other mean and untrue mental scripts. The World Health Organization (WHO) asserts that anxiety disorders are:
- The WORLD’S most common mental health disorder
- More prevalent in women than men (that’s not to say men can’t experience anxiety)
- Likely to present in childhood or the teenage years
- Effectively treated with a combination of medication and/or mental health counseling
- Said to affect 4% of the population, or approximately 301 million people in the world, and are only continuing to increase (mind you, these statistics are from 2019)
All of this to say, there is a 1/5 (20%) chance that whoever is reading this currently struggles with anxiety, and a 1/3 chance (31%) that at some point in life– they will, if not right now. It’s obviously important to have conversations surrounding anxiety, seeing as it is a complete day-ruiner and relevant to so many of us.
Understanding the Biopsychosocial Model of Anxiety
I will do my best not to bore you with the origin of anxiety, but to really debunk its internalized myths, it’s useful to understand its roots. First off, the term “biopsychosocial” means a combination of biological factors (our genetic makeup and our brain chemistry), psychological predispositions (sensitivity to mental health disorders), and our environments. On top of this– substance use, a history of trauma, subjective life stressors, bullying, cultural norms, systemic affiliations, and social separation are also all potential causes for anxiety. Anxiety is not “one size fits all”, meaning people can experience anxiety in different ways, for different reasons, and at different times in their lives.
The Diagnostic and Statistical Manual (DSM) includes multiple variations of anxiety disorders in which individuals may present with. These include Generalized Anxiety disorder, Panic disorder, Agoraphobia, Specific Phobias, Social Anxiety disorder, and Selective Mutism. Generalized Anxiety disorder (GAD) is the most commonly recognized, but surprisingly not the most prevalent. According to the National Institute of Mental Health (NIMH), 5.7% of adults in the U.S are likely to experience it in their lifetime– while roughly 12.5% experience specific phobias and 12.1% experience social anxiety. To spare you from having to read the criteria for each individual anxiety disorder, we can just quickly go over the DSM-5-TR qualifiers for GAD.
- Excessive worry and anxiety occurring more days than not, for at least 6 months, surrounding various events or activities
- Difficulty controlling the worry
- Associated with three or more of the following symptoms:
- Restlessness/feeling keyed up or on edge
- Fatigue
- Difficulties concentrating
- Irritability
- Muscle tension
- Sleep disturbances
- The anxiety causes clinically significant distress– meaning it negatively impacts occupational, interpersonal, and other important areas of functioning
- The anxiety is not a result of substance use, medication, or other possible medical conditions
- Other mental health disorders have been ruled out for proper diagnosis
Alright, phew! Now we can move on with a better understanding of how anxiety can show up in our lives and affect us daily.
Anxiety Equals Fear
Someone in the clinical mental health field told me that when we say “anxiety”, what we’re really talking about is fear; I was shocked hearing that, realizing it took me over a year as a therapist to identify what was really going on behind anxiety. Anxiety is a psychological and physiological response to either real or perceived threat; it is our body’s way of telling us something is wrong– or even, that we are in danger. I personally think it is easier to dismiss my anxiety and pretend it does not exist, versus allowing myself the space to actually feel it. The ironic thing is, time and time again, this avoidance only makes the anxiety/fear/panic worse. Anxiety is UNCOMFORTABLE, and resisting it, in my experience, only leads to feeling more consumed by it than I did in the first place. To make the process of experiencing excessive worry a little more palatable, try separating yourself from your anxiety, observing it from a curious space, and listening to the message it is attempting to tell you. At this point, its attempted communication may become clearer, and sitting with it may become less paralyzing.
Have you ever noticed how anxiety is most always about something that COULD happen rather than something that is based on cold, hard facts? That’s because our minds and nervous systems have been triggered in some sense and have created a fear-based scenario as a result. This likely leads to changes in our behavior, mood, expression, thought process, cognition, and insight.
Quick Case Study
Morgan was diagnosed with Generalized Anxiety Disorder when she was in college and has been taking medication to subside the symptoms for the last six years. Although she has made a lot of progress managing her symptoms and discovering useful tools, she notices being more sensitive to it during times of stress (triggering events, feeling a lack of control, dealing with the unknown). Morgan and one of her friends are going shopping for outfits for their friend Tracy’s wedding. Morgan and her ex-boyfriend, Tim, broke up a few months ago, and the wedding will be the first time she thinks she will run into him since, seeing as the bride is a mutual friend.
As she is trying to pick out a dress, she starts to become overwhelmed and notices her breathing becoming dysregulated, her hands starting to shake, her thoughts speeding up, and being unable to concentrate on what her friend is talking about. Morgan is aware she struggles with anxiety, but at the moment, her awareness cannot compete with the racing thoughts and physical sensations she is now experiencing.
Morgan’s Anxiety Brain Right Now
“I hate all these dresses; I shouldn’t even go, I’m going to look stupid in front of Tim. What if he’s bringing a date and I’m wearing an ugly dress? What if he’s engaged and this is how I find out? I did see he posted a picture on Instagram with a girl in the background– that must be his new girlfriend. Maybe they are going to announce their engagement at the wedding. I’m going to look like such an idiot. I need to call Tracy and tell her I can’t come. She’s going to hate me, and then I won’t be invited to her baby shower. How do I tell her?”
Reality
Here’s the thing: Tracy is not pregnant and is not planning on having a baby shower anytime soon. Morgan has no confirmation that her ex will be attending the wedding or that he has a new girlfriend. Morgan has no clue who the girl was in the picture with him, and no reason to think they are engaged, let alone dating. There is absolutely zero evidence to give legitimacy to any of Morgan’s fears, yet they feel debilitating and extremely real.
Anxiety tells us that something bad is going to happen and persists through excessive worry, which our brain tells us will help better prepare for the anticipated danger ahead. Rather than looking at anxiety as a defining trait of who we are, we can view it through the lens of being a protective part that is trying to help us.
Imagine your anxiety as something that exists outside of who you actually are as a person. Put a name to it and imagine it like an object or a figure that you can have an open dialogue with. If able to take a step back, a conversation can be created with the anxiety, which has the ability to create an understanding of the job it is trying to perform. Also, think about it– if we’re able to swap out our judgment for this part with compassion and consideration, there’s a likely chance it won’t feel as heavy and scary.
If you take the above example of Morgan and the wedding, you can read between the lines and see that the dialogue in her head was actually trying to help her. Now, what exactly was it helping her do? The narrative was trying to alert Morgan to the potential of getting hurt and having to suffer any pain. Morgan’s anxious thoughts were a way of keeping her on guard for the worst-case scenario; they were activated because Morgan feared the unknown, and the cognitive response provided a false sense of control.
Hidden Meaning
Now that we know our anxiety is meant to protect us, here are some helpful reminders to gently challenge racing and distorted thoughts (which are not based in reality).
Thought: I am not in control, and it is scary.
Reframe: The anxious part of me is seeking answers and is trying to help me find them.
Thought: People are going to judge me.
Reframe: I have no evidence to support this claim, and it is anxiety telling me I do.
Thought: I am going to get fired.
Reframe: I really care about and value my job, and that is the source of this fear.
Summary and Takeaway
While all that information may feel like a lot at first, it all makes sense when you view it through a clear and curious lens. Our anxiety can tell us stories which are based in zero reality, come with no evidence and have the potential to drive extreme behavior. If you are able to successfully separate who you are from the anxious part of you, there is a good chance that anxiety’s voice will not be so loud anymore.
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Arlington, VA: American Psychiatric Publishing.
Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361/
Mental illness. (2022). National Institute of Mental Health (NIMH).
World Health Organization: WHO. (2023, September 27). Anxiety disorders.