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The common and not-so-common symptoms of anxiety across our lifespan

Who hasn’t felt that knot of fear, worry, or anxiety at some point in their life? Anxiety is a normal reaction to stress and is closely linked with fear. Fear is our response to immediate danger, whilst anxiety kicks in when we’re dealing with uncertain threats.


Think of anxiety as part of our built-in threat detection system, centred in a region of our brain called the Amygdala. This tiny but powerful structure is like our brain's alarm bell, sounding the alarm for fight or flight when it senses danger. When the alarm is triggered, it sets off a chain reaction involving the hypothalamus, which then activates our body's stress response. That's when we start feeling those familiar physical symptoms like a racing heart, sweaty palms, and heightened blood pressure - all signs that our body is gearing up for action. For instance, imagine strolling through a park and suddenly spotting a tiger. Your brain instantly recognises the danger and signals the amygdala to prepare for escape. This saves your life as you run from the tiger. Thankfully, our rational brain, controlled by the prefrontal cortex, often steps in to reassure us that we're safe - for example; if the tiger was in a cage, our prefrontal cortex steps in and says “Hey, the tiger is in a cage, and you are at the zoo, it’s safe” - and calms down the amygdala.


However, in the case of anxiety, our prefrontal cortex often forgets to step in to reassure us that we are safe. Instead, it leads us to fret endlessly about the future and our safety. When this response becomes overwhelming and persistent, it can interfere with our daily lives, impacting things like school and work. The good news is that our brains are incredibly adaptable. We can actually rewire neural pathways (known as neuroplasticity), toning down the exaggerated anxiety response over time. Essentially, it's like recalibrating an overactive threat detection system.


The experience of anxiety isn’t always as obvious as we might think. There are the typical signs and symptoms, which are more familiar and obvious - racing thoughts, sweaty palms, etc. However, anxiety can manifest in subtle ways that we might not immediately associate with anxiety. 


Let's dive into what common and not-so-common symptoms of anxiety can look like for children, teens, and adults. 



Children 


Imagine your child gearing up for an award ceremony where they are required to go up on stage to receive an award. The typical symptoms of anxiety may include physical symptoms like racing heart, and sweaty palms.  Your child may have anxious thoughts reflecting their fear of embarrassment or humiliation - their inner dialogue filled with “what if's” “what if I trip on stage?” “What if everyone laughs at me?". These types of symptoms seem to be more commonly recognised. 


But anxiety manifests in more subtle ways that might not immediately stand out - withdrawing or avoiding the event, reluctance to join similar events in the future. They may become irritable, struggle to focus, feel tired, have difficulty eating, or find it hard to sleep before the award ceremony. And then there’s the urge for continual reassurance. To help calm their anxiety, your kid may seek reassurance by asking lots of questions or the same question over and over, seeking confirmation that everything will be okay. “Are you sure I won’t trip over?” “Are you sure?” - it's an attempt to calm the fear and uncertainty that comes with anxiety.


Headaches and stomach aches are another nuance of anxiety in kids - they might not realise these are physical manifestations of their anxiety. And, behaviourally, they may become more rigid, prone to tantrums or anger when faced with changes to their routine. The unpredictability of change can create a sense of danger, as what they thought was going to happen is no longer the case. 


Anxiety in children is complex, with both obvious and subtle signs - so it’s important to look out for the not-so-obvious cues that something is not right. 



Adolescence 


When it comes to teenagers, they are pros at hiding/masking their emotions. However, there are subtle/nuanced signs of anxiety in teenagers that may not be as commonly recognised - things like avoidance, irritability, outbursts, and an “I don't care” attitude - can all be signs of anxiety in teens that aren’t typically associated with anxiety. 


A “ don’t care” attitude is where your teen might avoid tasks or responsibilities, and it may serve as a protective mechanism against the fear of judgment or failure. What is often underlying a “don't care” attitude is perfectionism and fearing failure, usually in areas like school or sports. It can be tough to spot because teens often hide or deny their true feelings, or maybe they just struggle to express themselves. What you might see as laziness or a lack of motivation could be the iceberg of significant anxiety about school or other aspects of their lives. The fear of failure or not meeting expectations, especially with academic pressure, can lead to what we see as avoidance behaviours or a “don't care” attitude. Some internal thoughts could be “If I don’t care/put little effort into the assignment, I don’t risk the vulnerability of not doing good enough, not achieving a good mark,  therefore I am not judged for not doing good enough” - all of which can be thoughts stemming from anxiety. 


Dissociation or emotional numbness can also be symptoms of anxiety related to a 'don't care’ attitude - which may arise from conflicts at home like divorce or general household tension. For example, they may be experiencing anxious thoughts hearing parents argue, worrying that they may be getting divorced, and so on - this may become overwhelming that their brain shuts down in a protective response to keep them safe when their nervous system is overloaded (freeze response) - it can seem as though they don’t care or are aloof - but really they are protecting themselves by disconnecting from intense emotions as a coping mechanism in response to overwhelming stress or conflicts. 


Self-doubt is another nuanced aspect of anxiety, causing teens to avoid activities they once enjoyed, like a hobby or sport. As they enter their teen years, there is a certain pressure to do well and achieve, rather than doing an activity for pure enjoyment or fun.  They may lose interest or enthusiasm for hobbies or activities they once enjoyed due to pressure to perform or meet expectations. 


Comparison and social anxiety in teenagers include comparing themselves to peers and worrying about their appearance or how they are perceived by others. 



Adults 


As with children and adolescents, the experience of anxiety in adults varies from person to person.  And similarly, there are a range of nuanced symptoms that often go beyond the typical signs. Anxiety is downright exhausting - it takes a big load on our nervous system and body - the body uses all of its energy to survive, to keep us safe. 


Brain fog and cognitive decline is a symptom of anxiety - this might look like difficulty concentrating, processing information, or remembering things - it’s an overall feeling of mental haziness rather than mental sharpness. Due to this struggle with comprehending and synthesising information appropriately, individuals may have difficulty with decision-making and problem-solving. “Decision paralysis” is the term for over-analysing a situation and feeling extremely overwhelmed with information that a decision seems impossible to make. Individuals who experience anxiety are often termed “overthinkers”, and this translates into overthinking decisions as well. 


Procrastination is another nuanced symptom of anxiety-related perfectionism, as individuals fear not meeting high standards or being judged for imperfect work. When this perfectionism anxiety becomes all too overwhelming, procrastination kicks in - and can look like laziness or seeming unmotivated on the outside. But really, the feelings are so overwhelming and debilitating that it puts the individual into avoidance/ freeze mode. This cycle of avoidance only exacerbates feelings of anxiety and self-doubt. 


The tendency to ruminate on past conversations or overanalyze social interactions is another common yet nuanced manifestation of anxiety in adults. This can lead to a cycle of overthinking and self-doubt, where minor social cues or interactions become the focus of intense scrutiny or worry. Imagine you’re in a work meeting, and as you leave, you find yourself replaying the conversations in your mind. You question whether your comments may have been misinterpreted or perceived as rude by your colleagues. This tendency to ruminate reflects a hyper-awareness of social interactions and heightened sensitivity. You might ruminate on a question you asked in a meeting, wondering if you sounded stupid, or if you may have unintentionally offended someone - this self-consciousness and insecurity stems from the worry about how you are perceived by others, which can stem from anxiety. 


This form of ruminating on the past tends to focus on the negative experiences. People who experience anxiety often have distorted evaluations of themselves which can in turn lead to decreased self-esteem. Socially, anxiety can lead to behaviours such as over-explaining or justifying decisions in an attempt to seek validation and avoid criticism. Anxious thoughts can also prompt individuals to engage in excessive rumination and scenario-building in their minds, creating elaborate stories or predicting conversations that haven't happened yet. This tendency towards overthinking can result in feeling voiceless, as anxiety erodes confidence and makes it difficult to assert oneself or express opinions.


Additionally, anxiety can compromise the immune system - and nuanced symptoms may be individuals getting ill more frequently, or experiencing headaches or digestive issues. Some other physical behaviours like nail biting and tongue/lip biting can also be manifestations of anxiety. They essentially provide a temporary outlet for nervous energy. Tense shoulders/tension in the upper back and shoulders can also be a sign of anxiety, as well as shortness of breath/taking gasps of air. Additionally, anxiety can manifest as heightened sensitivity to sensory stimuli and individuals may be easy to startle or “jumpy” in response to unexpected sounds or movements. 


So, when we talk about anxiety, it's essential to recognise these nuances, shedding light on the diverse ways it can impact us that may not often be spoken about.

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