Anxiety: From Helpful to Harmful

Dr. Nitasha Puri, MD

Generalized anxiety is one of the most common problems experienced by South Asians in Canada. Although anxiety is a normal response that our body experiences to help us avoid danger, at times it can become out of control and start to cause problems when there is no real threat.  The first step in managing problematic anxiety is to recognize it, then seek professional help. And there is every reason to be hopeful: anxiety is very treatable.

Jas sits in traffic, heading back to Surrey after a long workday. His mind starts to wander. I hope that Naina is doing okay at home with the baby. What if I’m not a dutiful father and can’t provide for the family? What if Dad gets sick again and needs to go to the hospital? I don’t think we can afford one more thing. Man, I feel like such a failure. I’m starting to shake; especially because this traffic is making me late for that dinner party at Masi’s house. I’m so nervous about talking to everyone at that party. I can’t take this anymore — I just want to go and have a drink.

WHAT IS ANXIETY?

Anxiety is a normal adaptive response that happens when a person perceives a threat to their way of being. It can help us deal with real danger (for example, to run away from a bear) or to perform at our best (for example, when giving a big presentation).

When you experience anxiety, your “fight-flight-freeze” response is triggered. Chemicals are released in your brain and body that help you get rid of the threat (“fight”), run away from the threat (“flight”), or take no action until the threat passes (“freeze”). This prepares your body to work to its maximum potential to keep you safe. Some people have a body chemistry that initiates the anxiety response stronger than others.

Normally, anxiety is short-lived, and an action can be taken to avoid danger or let go of the thoughts that create a perceived threat. However, at times, some people have an anxiety response that is in overdrive – the fight-flight-freeze response cannot be deactivated, even when there is no immediate risk or danger. This is when anxiety becomes a problem.

Sneha swipes her transit Compass Card through the reader. As she heads through the gates and moves to sit on the SkyTrain, her head is flooded with thoughts. How long ‘til I get home? I’m feeling so nervous here in this train, around all these people. Ew. There are so many germs on this pole. Where is my hand sanitizer? I must rub it in my hands ten times. Count – 1, 2, 3, 4…will it work? I don’t know. I feel like I’m going to have a heart attack…I just need to breathe and calm down.

WHAT ARE THE SYMPTOMS OF ANXIETY?

When someone is experiencing anxiety, they often have some of the following symptoms:

  • Experiencing a great sense of fear or panic due to a particular thought or interaction
  • Racing mind, full of  ‘what if’ or worries
  • Catastrophic thinking, imagining the worst that can happen even with minimal risk
  • Self-doubt and guilt
  • Difficulty breathing or shortness of breath
  • Racing heart and heart palpitations, chest tightness
  • Tremors
  • Sweatiness
  • Numbness or tingling
  • Trouble sleeping
  • Dizziness
  • Nausea or vomiting
  • Rapid speech
  • Inability to calm down or sit still

Some people try to manage these feelings in unhealthy ways by avoiding triggers for fear/anxiety, or by using substances like alcohol to numb the intensity of the stress.

At times, people don’t recognize they are anxious because the symptoms can feel like other conditions. Some even go to their family doctor to address ‘stomach issues’ or ‘chest pain’ without realizing that they may be experiencing anxiety.  Many people think they are simply ‘worrying’ about something. However, when there are ongoing physical and mental symptoms such as those described above, it is likely that the experience has gone beyond worrying about one particular issue or event.

WHEN DOES ANXIETY BECOME A PROBLEM?

Anxiety can become a problem when your body constantly reacts as if there is a danger when there is no actual threat. In today’s complex world, our minds can often create judgments and perceptions of risk without having all the information necessary to confirm a threat. It’s like having an overly sensitive smoke alarm system in your body. A smoke alarm can help protect us when there is a fire but, when a smoke alarm is too sensitive and goes off when there isn’t a fire, it can be disruptive, scary and sometimes even exhausting.

Although we are describing general anxiety in this article, there are many specific types that people experience. More information can be found on the websites fraserhealth.ca/mental health or anxietybc.com

Amrit kneads the atta and makes it into small balls. It’s almost dinner time, and soon the kids will come downstairs from their rooms, demanding something to eat. She rolls the rotis and begins to worry. I hope Harpreet is doing her homework. She has been looking so stressed lately with schoolwork. Is she happy? Is she healthy? I hope I didn’t do anything wrong. I’m such a bad mother. Oof, my stomach feels so off all of a sudden. I feel dizzy, sweaty and shaky. Should I call the family doctor?

Approximately 10 to 20 percent of adults in Canada, including South Asians, experience anxiety that is in overdrive and not well managed. Although we do not want to get rid of the natural alarm system because it protects us from danger, we want to be able to manage it in healthy ways so that it works correctly for us. There is every reason to be hopeful that you can recognize and respond comfortably to anxiety: if it is in overdrive, this can be treated.

HOW CAN YOU TREAT AND MANAGE ANXIETY?

To Sneha, Jas, and Amrit, some family members might say: “Have strong willpower and be happy!” Although this is coming from a place of love, it does not help them understand their anxiety and seek support or treatment to help manage it. It is important for people who are experiencing distress due to anxiety to be aware of their experiences and know when to seek professional help. With the right treatment, people with anxiety feel better. Whereas some people require medication to calm down their alarm system, others will benefit from therapy, and most people will find some improvement with meditation and mindfulness. Healthy diet, exercise, and good stress management techniques can also help with managing anxiety. Most importantly, self-awareness and recognition of anxiety is needed to treat it. Empowering oneself with information and support from family and friends is the first step to managing the distress that comes with anxiety.

WHERE TO GET HELP?

Start with a visit to the family doctor if you are experiencing any symptoms of anxiety daily for two weeks or more. You may also want to reach out to organizations and resources such as:

  • South Asian Mental Health Association (SAMHAA) – samhaa.org
  • anxietyBC.com
  • fraserhealth.ca/mental health for more information on mental health and addiction issues, plus contact information to seek support through your local Mental Health Centre.

Together, we can improve our mental, physical and spiritual well-being.

Dr. Nitasha Puri is a family doctor whose practice is mainly focused on addiction and mental health. She is the medical lead at the Roshni Clinic in Fraser Health, which provides support for South Asian people with alcohol addiction, located at Jim Pattison Outpatient Care and Surgery Centre.