Interestingly, it is usually not until the condition worsens and causes dysfunction that the person takes stock in how bad things have become. Many people have said to me “I didn’t realize how much anxiety affected my life until it got really bad.” “Really bad” could mean losing a job, failing a class, or the inability to drive a car. It is different for everyone. In any case, recognizing that things have gotten “really bad” often occurs later in life when the person is able to compare their level of anxiety with others.
Angela stated that she talked with friends who said they have experienced bouts of anxiety in their lives, but nothing to the extent where they were unable to get themselves out of bed or drive themselves to work. At first, Angela was surprised. She assumed other people had similar bouts with anxiety and strangely thought it was normal to some extent. Looking back, she could logically see that it was not and was glad she finally sought out treatment.
Patients often come into my office thinking that their experience with anxiety is “normal.” In fact, when asked about anxiety, many answer that it is minimal even when observably it is not. Like Angela, they are surprised to find out that others do not share their level of anxiety. These individuals have gotten used to feeling this way even though it is not something they like or desire. In turn, they develop coping mechanisms to deal with their distress. Some of these coping mechanisms may be positive and some negative. If the coping mechanisms are negative, this may be seen as the problem rather than the anxiety. This is particularly important to explore with a professional so that the right problem is being treated.
For example, Angela revealed that one of her coping mechanisms is drinking. She does not believe she has a problem with drinking, but does admit that she uses it often as a way to deal with her anxiety. This coping mechanism developed in college and is still present. If she has a very stressful day or she is anxious in a certain situation, she likes to relax with a glass of wine. This immediately calms her down. One of the reasons Angela may not have realized her level of high anxiety is because she was self-medicating. Perhaps without this coping mechanism she would have sought treatment for her anxiety disorder earlier in her life.
If she developed a problem with alcohol, an unknowing therapist would treat her alcohol problem without treating her anxiety at the same time. Obviously, an alcohol problem would require alcohol treatment, but without the treatment of anxiety, which caused the alcohol abuse in the first place, the distress would remain. Alcohol abuse is just one example; however, there are many others such as self-injury, eating disorders, clinical depression, etc. A full assessment in these cases is always a good idea to get to the bottom of what the problem is and then to treat it properly. Most importantly, remember that there is hope and treatment is available.
