General Nerves Vs. Clinical Anxiety and How to Tell the Difference.
There is a surge in reported cases of anxiety both locally and worldwide. The World Health Organization reported 301 million people in the world were living with anxiety conditions in 2021, a figure that is likely to have increased since.[i]
The rise of mental health influencers and online wellness coaches has made mental health resources more accessible. The good news is that awareness of mental health is on the rise. With the stigma around mental illness decreasing, people are more open to discussing their challenges and seeking help. This can lead to earlier treatment before things get worse and more supportive environments.
However, the challenge lies in distinguishing between anxiety that requires professional support and situational nerves to be expected as part of the everyday healthy spectrum of emotions. Increased awareness seems like a double-edged sword, driving risk of overinterpretation of healthy emotions and over-self-diagnosing. This can in turn lead to genuine mental health conditions not being taken as seriously.
Spreading false information may be counterintuitive to the benefits of normalising mental health conversations.
So, how can we distinguish between situational nerves and clinical anxiety that requires professional intervention? Understanding this distinction is crucial in getting the proper support at the right time.
Anxiety as a Trending Topic vs. a Clinical Condition
If you’ve observed signs of poor wellbeing in your colleagues or kaimahi (employees), it’s essential to know how to understand and support them, including identifying when a mental health concern might be present.
But doesn’t it seem like everyone experiences anxiety these days?
In recent years, the term “anxiety” has become part of our general lexicon. It’s a trending topic in both social media discussions and workplace conversations.
We frequently use “anxiety” in everyday conversations to describe a wide range of feelings, from everyday stress to severe unwellness. How often have you said or heard someone say, “Oh, I’m so anxious trying to pick an outfit!” “I have so much anxiety about these exams!” or “I get anxiety every time I fly even though I know it’s safe”?
This widespread use of the term might lead to the trivialisation of clinical anxiety, often causing us to label our normal feelings with psychiatric terminology. So, let’s look into the difference between clinical anxiety, which refers to a mental health condition that might need treatment and specific accommodations, and general nervousness, which can be expected as part of everyday life.
Understanding Anxiety: Clinical Conditions vs. General Nerves
Clinical anxiety is characterised by persistent and excessive worry, uneasiness, or discomfort in response to a perceived threat. Often this leads a person to avoid certain situations.
To meet the diagnostic threshold for a clinical mental health condition, this excessive worry, or related distress and avoidance, must significantly interfere with a person’s functioning. This could include a person’s ability to manage at work, at home, and/or in their social life. Alternatively, a person may appear on the outside to be functioning well but be seriously distressed and exhausted from “pushing through” and keeping up appearances.
Clinical anxiety is an umbrella term used to capture anxiety-related disorders. These are specific conditions, each with clear diagnostic criteria, that need to be determined by a mental health professional. Some common anxiety conditions include:
- Specific phobias – where a person develops an exaggerated fear response to something specific, such as fear of public speaking, dogs, or flying, and often will go to great lengths to avoid it.
- Panic Disorder – where a person has a debilitating fear of having a panic attack. Situation they believe they might have a panic attack will be avoided, or endured with great distress.
- Generalised Anxiety Disorder (GAD) – where a person experiences persistent feelings of tension and worry, and can feel overrun by concerns about several aspects of life, such as finances, health, work, and so on.
- Social Anxiety Disorder – where a person experiences heightened fear of social situations, especially how they might appear to others, and will avoid social interactions or make a lot of effort to reduce the risk of embarrassing themself.
Like physical health conditions, most cases of mental unwellness are mind but anxiety conditions can be mild, moderate or severe. However, don’t mistake mild unwellness for healthy … think back to how unwell you felt the last time you had the flu!
While it is completely natural to feel nervous or worried in specific situations such as going to a doctor, speaking in front of a crowd, or taking a crucial exam, anxiety disorders involve excessive fear or worry that interferes with daily life.
If you have a clinical anxiety condition, you may experience physical signs, like sleep problems, aches, muscle tension, fatigue, and increased heart rate, as well as emotional and cognitive signs like a constant feeling of dread, difficulty concentrating, restlessness, and irritability.
On the other hand, general nervousness can be an expected and temporary reaction to specific situations. This is especially true when stress is involved! Imagine giving an important presentation at work or getting ready for an essential job interview. Feeling restless or spending a sleepless night beforehand is natural. But, your sweaty palms, racing heart, and butterflies in your stomach will eventually subside once your presentation or job interview is over. In fact, the pressure you feel in these situations is a natural and adaptive stress response to energise and improve your performance. Unlike clinical anxiety disorders, these feelings are typically brief and don’t significantly disrupt our daily activities, at least for long.
How Many People Experience Anxiety?
Clinical anxiety conditions affect approximately 1 in 4 Kiwis at some stage in their lives.[ii]
Often, the first onset of difficulties occurs in late childhood or early adolescence.
The causes of anxiety disorders are not fully known. Still, factors like genetics[iii], environmental stressors[iv], brain changes[v], and negative thinking patterns[vi] are all known to contribute.
Avoidance and Its Role in Aggravating Anxiety
If certain situations trigger feelings of nervousness, you may want to avoid these situations to reduce the discomfort they trigger. Avoiding certain situations may help you feel less upset, worried, and afraid, reducing your anxiety. Unfortunately, despite this short-term relief, avoidance often actually reinforces and intensifies the fear response in the long run. When you eventually have to deal with the avoided situation, the experience can be highly overwhelming, spiralling into or aggravating clinical anxiety. In short, avoidance commonly creates a vicious cycle where the more you avoid, the more anxious you become about facing the situation in future. Psychological treatments for anxiety conditions often target this avoidance cycle.
How Is Anxiety Diagnosed?
In Aotearoa New Zealand, anxiety is diagnosed by a healthcare professional such as GP, clinical psychologist, or psychiatrist. Diagnostic criteria, like the DSM-5, are used as part of a comprehensive evaluation to assess symptoms and to tailor treatment plans. Treatment may include psychological treatment, medication, and other support services.
How Is Anxiety Treated?
Evidence-based treatments are available that are effective for specific anxiety conditions. Once an accurate diagnosis has been clarified, there are best practice treatment guidelines that should be followed, along with your preferences being taken into account.
For medication options, your GP is usually the best place to start. If you require more specialist support, a psychiatrist is usually the best next step.
For psychological treatments, as a first point of call depending on the severity of the anxiety condition, you may be referred to free self-guided courses by Just A Thought. These are available for several anxiety conditions and are based on evidence-based psychological approaches.
MindMatters Clinic also offers clinical psychologist experts trained in the diagnosis and psychological treatment of anxiety conditions. Other psychological treatment providers can be located by searching the New Zealand College of Clinical Psychologists database. Some other mental health professionals, such as counsellors and other types of psychologists, may be trained in evidence-based treatments but it pays to ask first and check their recommendations against best practice guidelines to ensure you are making an informed choice.
Understanding and Supporting Anxiety in the Modern Workplace
About 35% of Kiwis say they have worked with someone experiencing mental distress.[vii] How can organisations understand and support their employees, ensuring they provide the right kind of help and accommodations when needed without falling into the trap of overinterpretation?
No one should suffer in silence. It’s not about ending a discussion about mental health; awareness is essential. But we must be more thoughtful about approaching the subject openly and not unnecessarily label feelings with clinical terms. See our article for practical tips on approaching mental health kōrero (conversations) at work.
New Zealand’s legal and ethical considerations require organisations to accommodate employees with clinical anxiety, offering reasonable adjustments like modified schedules or remote work options to support their needs.[viii] Here’s what you can do to support your employees’ wellness:
- Set the inclusive tone: Have your leaders and managers openly discuss mental health issues and offer support, empowering others to share their experiences without fear of judgment.
- Raise awareness: An informed community better supports individuals with anxiety. Educate the workforce through training programs and workshops on mental health awareness, such as those run by MindMatters Clinic. This equips line managers and kaimahi (employees) with the tools and knowledge to support themselves, their loved ones, their colleagues, and the customers or clients they work with.
- Promote a culture of inclusion, support and understanding: Encourage open conversations about anxiety conditions to help break the stigma surrounding mental ill health. Implement strategies and policies that encourage mental wellbeing, such as flexible work arrangements and mental health days, while remaining within the reasonable limits of what you, as an employer, can offer.
- Encourage employees to seek support: Be ready to direct the employee to other appropriate support services such as employee assistance programmes, mental health resources, or clinical experts such as MindMatters Clinic.
Conclusion
It seems like anxiety has been everywhere lately, becoming a trending topic. While rising mental health awareness is undoubtedly beneficial, it is also crucial to distinguish between natural nerves and mental health conditions, like anxiety disorders, that can require professional support.
By being mindful of how we speak about and address the full mental health spectrum, we can ensure clinical anxiety concerns are identified and addressed, without trivialising or over-diagnosing everyday emotions which inevitably include with some distress at times.
References:
https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
https://anxiety.org.nz/resources/how-to-make-a-difference-in-the-mental-health-of-new-zealanders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573560/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3297659/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684250/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899011/
https://www.hpa.org.nz/sites/default/files/Mental_Health_Aotearoa_Insight_2020.pdf
https://mentalhealth.org.nz/resources/download/1189/qle4m7xadwlp2ibk