There’s No Such Thing as Generalized Anxiety: Only an Overwhelming Accumulation of Unresolved Anxieties
March 15, 2023
Anxiety is a signal, not a biological disorder
We have an idea of anxiety as this amorphous thing, which culminates in the most commonly diagnosed mental disorder, Generalized Anxiety Disorder. This idea likely grows out of a wish that anxiety was a biological disorder, a malfunction of the nervous system that is correctible just like a malfunction of the endocrine system. But, it’s not. There’s no such thing as “generalized anxiety,” but an accumulation of piled-up anxieties that are so abundant they become overwhelming and impossible to distinguish.
Anxiety is many things, but it is most usefully understood as a signal. When a signal is present like when an alarm goes off, we typically attempt to understand the meaning or purpose behind that signal. Similarly, if someone who doesn’t typically have a ton of anxiety wakes up on a Tuesday morning feeling anxious, they likely would ask themselves a series of questions: Did something happen yesterday that I’m worried about? Am I more nervous about this meeting at work? Am I scared? These are an attempt to identify what the anxiety is signaling.
When anxiety is present most of the time, we quit relating to it as a signal
Relating to anxiety as a signal tends to stop when the frequency of anxiety is present a lot or most of the time. This is likely an expression of feeling overwhelmed by the thought that so much could be wrong. Since our body is telling us there is just so much that needs emotional attention, we desperately look for another explanation.
A fire alarm is a helpful metaphor here. Imagine hearing a fire alarm on your block. If you hear an alarm, you likely would run outside towards the alarm to investigate, look for smoke and other signs of fire, and call the fire department for help. Imagine, then, another scenario in which several alarms are blaring from different homes on the block. You might hypothesize that there is some sort of malfunction afoot and yet, it would nonetheless be essential to investigate whether those alarms are, in fact, telling you there is a fire (or a lot of fires).
So too with anxiety. It is tempting to believe that a ton of anxiety is a malfunction of the signaling system. What follows from this belief is a treatment that relates to anxiety as that troublesome malfunction—as the problem. The construction of the diagnosis Generalized Anxiety Disorder frames anxiety in just this way. The diagnosis takes away from understanding anxiety as evidence that something (or several somethings) is wrong and instead, relates to the anxiety itself as wrong. This influences a treatment of symptoms geared towards reducing the body’s tendency to fire so much anxiety such as medication, cognitive behavioral reframing, or both.
But, what if truly nothing is wrong?
The obvious question that follows is: “I feel anxious, really anxious, but I’ve looked around and I can’t place it. Everything is fine. I don’t have an object for my anxiety. What if nothing is wrong and I’m just an anxious person?”
If this is the case, you may come to understand that you’re guarded from feeling that underlying reason (or reasons), hiding from it because it’s so scary. Secondly, that object of anxiety may be in the distant past. Anxiety is historical. You can be scared, worried, stressed, nervous, or otherwise lit up with anxiety (signal) from a significant, scary, uncomfortable, unsafe, and perhaps traumatic experience from long ago that, most importantly, was never brought to resolve.
When you have an accumulation of those experiences that have never been brought to resolve, they pile up. You may get better and better at managing the accumulation and better and better at ignoring the signal. You, then, find yourself with so many anxieties about so many things both past and present, known but mostly unknown. And with the anxieties that linger for decades, it’s likely those signals were from a time when you didn’t have a fire department to call.
If anxiety is a signal coming from somewhere, how do we treat it?
For starters, intense anxiety sucks. It’s often debilitating and requires symptom relief. There are medications that can help, as well as strategies, from cognitive reframing to breathing techniques, that can make it more manageable. Relief from pain and discomfort is a good thing, but it’s also a bad long-term plan to simply relieve that anxiety without investigating what the signal is saying.
Why? If what’s underneath the signal isn’t fully addressed, it’s likely that signal will come back or the underlying problem will find its way to a new kind of signal. This may lead to a new symptom developing and you’ll find yourself chasing symptoms. Instead, locating the origins of the anxiety can bring tremendous relief.
This method is, in some ways, quite primitive. When a child is scared, we offer them comfort, listen to their fears, and navigate ways to make a situation safer so they can internalize a feeling of safety. Then, they are no longer scared. What makes this difficult for adults who have not had those needs met in certain scary experiences is that we have some challenging detective work to do to find the origin of fear. But, when that origin is found and given attention, the signal is no longer needed, just like when the fire alarm no longer needs to go off after the smoke clears (a much better solution than unplugging the alarm).
