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Running Head: BRINGING AWARENESS TO ANXIETY 1

Bringing Awareness Toward Anxiety to End Stigmas

Alexandria Hernandez

University of Texas at El Paso


BRINGING AWARENESS TOWARDS ANXIETY 2

Abstract

Anxiety is known as being one of the leading causes to depression, which then leads to the

alarming epidemic of suicide and self-harm. However, while everyone focuses on depression it is

important to focus on anxiety as well, being that there are many stigmas surrounding it ,

including treatment, relationships, and discourse about it. This literature review will focus on and

inform the reader about treatment options, maintaining relationships while having anxiety and

being able to comfortably talk about anxiety.


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Bringing Awareness Toward Anxiety to End Stigmas

Anxiety stigmas such as medication, discussing mental illness and maintaining

relationship all arise from the lack of awareness and education on the matter. These stigmas lead

to the building of barriers between one's health, relationships (romantic and platonic) and

comfortable discourse. Anxiety is a widespread and everyday obstacle many persons face,

however the lack of awareness leads to stigmas within discourse, relationships and treatment.

A stigma is a “mark of disgrace associated with a particular circumstance, quality, or

person.” In association with anxiety, the stigmas which will be discussed will be the “disgrace”

or fear that follows the lack of knowledge concerning anxiety. Not only has anxiety been

saturated through casual discourse, it is constantly used in a negative connotation. The casual use

of the word “anxiety,” can most commonly be found intertwined with discourse about

depression, suicide, mental institutes, mental breakdowns, and inconsolable emotions. Another

issue being, that conversation regarding anxiety comes from those unknowledgeable of the true

symptoms of the mental illness, either leading them to use the term loosely and as a joke or in a

disturbed alarming context. This abuse of discourse then masks the real time stigmas and issues

that come along with not being knowledgeable in regards of anxiety. Although having and

having any sort of relation with someone who has anxiety may be difficult, there are aspects that

may be acknowledged and overcome easier through being properly educated. Issues such as

treatment/management of anxiety have become a toppling stigma which often time gets ignored

or pushed aside due to negative connotation. Other issues such as being in relationship while

struggling with anxiety or r being able to openly and comfortably bring up the conversation of

this mental illness continue to add to the fear, which veers away effective help. In order to find
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effective questions that must be answered in early awareness regarding anxiety, this review will

dive into the following questions first: 1. How is anxiety being discussed? How can the

conversation of anxiety be less taboo? 2. How does having anxiety effect relationships? 3. What

are approaches that could be taken to assist one living with anxiety?

However, before approaching these questions, it is critical that anxiety is defined so it is

understood what is being discussed throughout this research and literature review. Anxiety, as

defined by Kimberly Holland, comes in spectrum where one side of the spectrum is “the body’s

natural response to stress” and the opposite side of the spectrum is when the symptoms are

extreme, frequent and long term. In this instance that one finds themselves on this end of the

spectrum they would be known to have Anxiety Disorder. When dealing with anxiety disorder,

intense feeling of fear is constantly with someone, which may bring them to a halt in life, and

according to Holland, will get worse if left untreated. Anxiety, then, is the “key part of several

different disorders,” those disorders being: panic disorder, phobia, social anxiety disorder,

obsessive-compulsive disorder, separation anxiety disorder, post-traumatic disorder and post-

traumatic stress disorder. Symptoms for those with anxiety disorder, in reference to Holland, are

“feeling out of control,” which may lead to an increased heart rate, rapid breathing, panic attacks,

“painful thoughts and memories that you can’t control,” and constantly feeling fearful and

worried. Other symptoms, which were gathered through surveys of El Paso residents, were

tightening of the chest, uncontrollable crying and sad emotion and inability to concentrate on

anything else other than their worries. A common occurrence for those who experience the

symptoms of anxiety disorder is an anxiety attack, an anxiety attack is a “feeling of

overwhelming apprehension, worry, distress, or fear.” An anxiety attack is known to bring the

feeling of faint or dizziness, shortness of breath, sweating, chills, distress and restlessness
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(Holland, 2018). With this, the remainder of the research and literature review will focus on

stigmas revolving around anxiety symptoms, those of stress induced anxiety and those of anxiety

disorder, which are due to lack of knowledge and awareness.

Living with Anxiety (Treatment, medication and other approaches)

A concerning stigma is those afraid and hesitant to receive treatment to help control and

maintain their anxiety symptoms. It has become evident through surveys conducted that many

believe the only approach to treating anxiety is through medication. One answered received

through this survey included a fearful nineteen-year-old expressing that she has heard that being

medicated for anxiety is “known for stripping one of their personality.” However, other answers

had been relatively similar to that of the teenager. They had all been in the relativity of “putting

you to sleep,” and bringing a “numb” sensation. A small portion of answers had mentioned a

different approach of treatment, these answers briefly mentioned the use of marijuana, CBD and

sleep. There had been approximately, fifteen surveys which had been left blank or answered that

they were unaware of any forms of treatment or control for anxiety when asked. It is also worth

mentioning that those whose answers did mention medication, that no brands, names, or specifics

had been included in any survey, only the terms “medication,” “pills,” or “prescription drugs,”

had been used. Through this survey it had been evident that medication had been the most

commonly known form of treatment and had been viewed and discussed in a negative light.

Medication is a form a treatment, there is a wide variety of medications that may be

prescribed to a patient if they choose to accept. It is important to note that anxiety disorder is not

curable, however, treatment such as medications makes the symptoms more manageable which

helps patients go on with their day to day life. Medications include Benzodiazepines, Buspirone,

Antidepressants, SSRIs, Tricyclics, MAOIs and Beta-Blockers. Benzodiazepines are “sedatives


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that can help relax your muscles and calm your mind. (Healthline, 2016),”so they are usually

used to treat panic, social and general anxiety disorder and are used for only short term due to

symptoms such as drowsiness, lack of balance and issues with memory. However, medication

such as Buspirone is used for both short-term anxiety and chronic longer termed anxiety, and it

known to help regulate your mood; side effects include dizziness, headaches and nausea.

Antidepressants are prescribed to anxiety patients because they are known to work by “affecting

neurotransmitters,” which help treat symptoms (Healthline, 2016). A type of antidepressant used

to treat anxiety is SSRIs, selective serotonin reuptake inhibitors, which increase levels of

serotonin, affecting mood, appetite, sexual desire, sleep and memory all which are known to be

lost while dealing with anxiety; side effects include, nausea, dry mouth, dizziness, drowsiness,

diarrhea, muscle weakness and sexual dysfunction. Tricyclics are similar to SSRIs, however

cannot be used to treat obsessive-compulsive disorder, but in general is an older medication that

is now rarely used; side effects include dizziness, drowsiness, lack of energy, dry mouth, nausea,

constipation, blurred vision, and weight gain. MAOIs are commonly used to treat panic disorder

and social phobias, because it is an antidepressant it will work with your neurotransmitters to

regulate your mood, however, like SSRIs, MAOIs are an older medication which come with

many side effects. Lastly, beta-blockers are used mainly for the “physical symptoms of anxiety,”

which is useful for those who suffer with social anxiety disorder, allowing them to manage

symptoms and overcome social events they find themselves distressed in. It is evident that taking

medication to treat anxiety does come with risks and side effects, just as any medication would,

however, through research none are “known for stripping one of their personality.” It is crucial

that you express to your doctor not only your symptoms but also your concerns and stigmas
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about medication, they will be sure to prescribe a medication best suited for you and within your

comfort.

Medication, however, still may not be the route that some prefer to take. Luckily there are

numerous natural, non-medicinal approaches anxiety patients may take. With that, it is still

strongly suggested to speak to a doctor or professional to hear options and be guided toward the

best option for their symptoms, because even the natural approaches work for certain symptoms.

Non-medicinal approaches range anywhere from psychotherapy, meditation and exercise

to avoiding caffeine and taking natural supplements. Psychotherapy will require a person

speaking with a therapist or psychologist, which may help implement strategies and certain tools

to control anxiety on your own. Many patients choose to see a therapist because they say this is

an approach where they feel like they have control over, those who see therapists frequently have

learned how to apply the skills they were taught to subdue the symptoms on their own.

Meditation is another natural approach that patients find themselves enjoying and being able to

personally implement. The practice of meditation and mindfulness has helped those with social

anxiety and phobias by “improving social competence and interpersonal connectedness,”

allowing one to reach in to their own mind and calm themselves in that moment (Koszycki, D.,

Thake, J., Mavounza, C., Daoust, J., Taljaard, M., & Bradwejn, J., 2016). Exercise is a universal

approach not only used to overcome some symptoms of anxiety but also stress, fatigue and other

negative aspects, because during exercise the body will release endorphines which regulates

moods and tends to make someone happier or relaxed. There has also been plenty of research

and success found in taking natural supplement, this approach is similar to taking medication but

preferred since they are natural. Some natural supplements being passion flower, kava and

valarian root all which have been found to reduce and subdue anxiety symptoms. For example,
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valarian root is known for “sedative-

hypnotic effects,” and passion flower is

“marketed as a treatment for sleep

disorders, nervous tension, and anxiety

(Kinrys, G., Coleman, E., & Rothstein, E.

2009).” Discussing with a professional

will open plenty more opportunites in

finding alternative and natural rememdies

best suited for specific symptoms.

Maintaining Relationships While

Having Anxiety

When one does not have anxiety or has never come across someone with it, the lack of

awareness and education of anxiety is often overlooked. And for those living with anxiety, are

constantly working toward cope with their own symptoms and feelings, building relationships

(platonic or romantic), is difficult and may feel as a job almost. The early awareness of not only

defining anxiety or talking about in a negative concise matter but rather what the symptoms are

and even the practices which make a “close to normal life” possible will allow even those who

don’t suffer from anxiety disorder to be aware of the mentality and break the mental barrier

between each other. In the survey conducted, one of the questions included asked “Do you

believe you would be able to notice if a loved one has anxiety disorder?” In which the results had

been majority negative, which then brings up the next issue is, if anxious tendencies do arise

where does the blame and understanding lean towards?


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A symptom of anxiety disorder that is often overlooked or not spoken about, is anxious

attachment. Because anxiety is a constant mental battle, a symptom such as attachment is not

brought to light until someone is put into a situation where they are working or plunging into a

relationship whether it be with a friend, family member or new romantic partner. Anxious

attachment “involves hypervigilance to perceived threats such as abandonment; worry-related

cognitions with a focus on interpersonal and social domains; and the constant seeking of

attention and care from others when such threats are present (Roccaforte,Cinzia, 2017).” In other

words, the anxiety will brew a mental threat on the relationship that may not exist, so will tell the

person to seek reassurance and attention in order to shut out these anxious feelings and

symptoms. Experiencing anxious attachment is difficult for both parties because the anxious one

is constantly living with negative cognitions which then leads to negative reactions. As for the

other party, the one without anxiety, is not given a fair chance in the relationship because

regardless of them never giving a reason to have a negative view upon them, the anxious

tendencies has already casted that cloud above them.

However, just as the discussion of medication and having the loophole of natural

approaches, there is a way to overcome and subdue the negative effects of anxious attachment

and have a comfortable and healthy relationship. There is the approach of talking to a

professional, and whilst stating symptoms also mentioning the overcast of worry in the

relationship. Possibility of medication or lifestyle change may be the answer to treating the cloud

of fear and worry. There is also the approach of therapy, it may be helpful to have a clinician

explain why these feelings are arising and will help one better understand themselves and better

relate to others which will be useful in implementing into relationship building.


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It is important to understand anxiety, the symptoms and thought process is causes if you

are not one who has anxiety but especially if you do suffer from it yourself. Anxiety disorder is a

constant mental battle, so when seeing negative results such as a failing or troublesome

relationship it is easy for the worry and fear to be turned to one's self, in the sense of self-blame,

which is extremely unhealthy especially with the sensitivity of someone with anxiety disorder.

Although anxious attachment is just one of the obstacles that may arise within a relationship, due

to anxiety, it is a prime example of not only being aware that a partner or friend is dealing with

anxiety disorder, but to also be aware of what comes with it and how to approach it together and

in a healthy way.

Talking About Anxiety

Along with being aware and educated on the topic of anxiety disorders, it is crucial to

break the barrier which holds us back from talking about it. Beginning the discussion revolving

around mental illness early will not only implement easy discussion later, but open doors to

reaching out for help and justify the feelings of those who feel alone while dealing with anxiety.

Early discussion will burn the bridge between someone with anxiety disorder and treatment,

medical professionals, relationships, family, friends and the rest of the world which is usually

difficult to attain due to the constant symptoms of anxiety.

Luckily, anxiety has been brought to light through mental illness awareness platforms

such as newsletters, webpages (I.e. anxiety.com) and celebrity mental illness advocates.

Newsletters and webpages, although easily accessible, are not as commonly found or saturated

through our everyday lives. In other words, it is less common to come across or scroll past a

newsletter or webpage in our everyday lives. However, we find ourselves scrolling past pop

culture content without even having the intent to take part in it. So, the likely hood to come
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across 800,000 people kill themselves every year. What can we do? Is high because pop-star

Lady Gaga took part in this article. Simply having her name associated with information such as

“One in four of us will have to deal with a mental health condition at some point in our lives, and

if we’re not directly affected, someone we care for is likely to be (Lady, G., Adhanom, T.,

2018),” will make its way to a much bigger audience who may not even be in search of

information, which is extremely helpful. If this trend continues, and the audience allows

themselves to implement this trend of openly speaking in mental illness in the same way they

implement other trends they inherit from pop-culture, the discussion will always be open.

Conclusion

In conclusion, this research and literature review has found and analyzed that with proper

education and discussion, plenty of barriers are easy to overcome. All stigmas discussed are

interrelated, discusssion will break the barrier in relationships and the barrier in receiving

treatment. Receiving treatment will help treat symptoms which will allow everyday life

relationships and discourse more approachable. While overcoming relationship barriers may help

one realize that treatment is a good option and that discourse is crucial. And with that, they are

all interconnected with early education, when mental illness awareness is brought up at an early

age, it allows other to feel more confident in overcoming these stigmas if they ever do arise

whether they have anxiety disorder or not. This analysis was completed in the hopes to cover and

elaborate on information that is commonly misread or ignored which survey takers had noted

caused their stigmas.

References

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others with social anxiety disorder: A comparison to depression and general mental
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illness stigma. American Journk al of Orthopsychiatry, 85(2), 131-138.

doi:10.1037/ort0000046

Kinrys, G., Coleman, E., & Rothstein, E. (2009). Natural remedies for anxiety disorders:

Potential use and clinical applications. Depression & Anxiety (1091-4269), 26(3), 259-

265. doi:10.1002/da.20460

Koszycki, D., Thake, J., Mavounza, C., Daoust, J., Taljaard, M., & Bradwejn, J. (2016).

Preliminary investigation of a mindfulness-based intervention for social anxiety disorder

that integrates compassion meditation and mindful exposure. Journal of Alternative &

Complementary Medicine, 22(5), 363-374. doi:10.1089/acm.2015.0108

Lakhan, S. E., & Vieira, K. F. (2010). Nutritional and herbal supplements for anxiety and

anxiety-related disorders: Systematic review. Nutrition Journal, 9, 42-55.

doi:10.1186/1475-2891-9-42

Olfson, M., & Guardino, M. (2000). Barriers to the treatment of social anxiety. American Journal

of Psychiatry, 157(4), 521. Retrieved from http://0-

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Pimentel, D. (2003). Sustainability of meat-based and plant-based diets and the environment.

Stevenson-Hinde, J., Curley, J. P., Chicot, R., & Johannsson, C. (2018). Anxiety within families:

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Stress Anxiety Research Society. $$Q Stress Anxiety Research Society. (1992). Anxiety, Stress,

and Coping.

Anxiety.org. (2015). What is mental health stigma and how can you overcome it?

Gaga, L., & Adhanom, T. (2018). 800,000 people kill themselves every year. what can we do?

Roccaforte, C. (2017). The negative effects of anxious attatchment on intimate relationships and

how to overcome them.

Holland, K. (2018). Everything you need to know about anxiety. Retrieved September/19, 2018,

from https://www.healthline.com/health/anxiety;

Healthline Editorial Team, & Cochrane PharmD, Z. (2016). Drugs to treat anxiety

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