Expat Mental Health: Anxiety - Part 1

Everyone experiences feelings of anxiety from time to time. Anxiety is a normal human reaction to fear-provoking situations. In fact, we're evolutionarily wired to feel a certain degree of anxiety in response to fear.

Think of the "flight-or-fight" response you probably learned about in school. The "fight-or-flight" response is a reaction that, as the name implies, prepares you to stand and face your stressor or attacker - the "fight" response, or to run and flee - the "flight" response. This response promotes the release of chemical messengers like adrenaline, noradrenaline and cortisol - chemicals that prepare your body to take action.

While this reaction had a real, practical benefit to our caveman ancestors, it's not always a necessary reaction to situations we encounter in modern times.

Yet many people - in fact, as many as 18% of adults, according to statistics provided by the National Alliance on Mental Illness - suffer from persistent, uncontrollable feelings of anxiety - leading to anxiety disorders such as generalised anxiety disorder, obsessive-compulsive disorder (OCD), social phobia and other phobias, panic disorder and even post-traumatic stress disorder (PTSD).

As expats, we're faced with a number of "new" and sometimes, fear-provoking situations that can promote or exacerbate feelings of anxiety.

And if you're naturally anxious or shy, it can be particularly difficult to handle certain situations - like practicing your Dutch, meeting new people, interacting in what might seem like "unusual" social situations, adapting to new customs, looking for a job or even simply being away from familiar surroundings, family and friends and trying to fit in to a new culture.

Anxiety & Risk factors

Almost everyone will experience some level of anxiety when confronted with these situations.

How you handle these feelings of anxiety depends on a number of factors - some of which you simply cannot influence. These factors include:
› Medical factors such as illness, drug or alcohol abuse
› A history of trauma
› Genetic predisposition to anxiety disorders
› Withdrawal from certain medications
› Being female women are more frequently diagnosed with anxiety disorders, although whether this is a biological trait or the fact that women are more likely to seek help - and therefore more frequently diagnosed - is unclear.
› Stress
› Personality type
Certain personality types, such as introverts or those with the "highly sensitive" trait are naturally more affected by changes in environment and other external (and internal) circumstances.

Signs & Symptoms

It's important to keep in mind that experiencing feelings of anxiety doesn't necessarily mean that you have an anxiety disorder.

In order to be diagnosed with an anxiety disorder, your feelings must be persistent, pervasive and significantly interfere with your overall well-being and affect your ability to function in everyday life.

But you should be aware of symptoms that can indicate the presence of an anxiety disorder. These symptoms include:

› Physical changes

Decreased appetite, insomnia, trembling, heart palpitations or a racing heart - especially in specific circumstances, dizziness, dry mouth, feeling like you need to escape, nausea, abdominal pain or discomfort, muscle tension or unexplainable body aches and pains.

› Mental or cognitive changes

Being hypersensitive to criticism, feeling like everyone is watching or judging you - even if you're in an objectively "benign" situation, or feeling as though you're under attack - even if there's no apparent danger or stressor.

› Behavioural changes

- Avoiding certain situations. For example, you might decide not to try to speak Dutch with the grocery store clerk at all for fear of looking "stupid" or being judged.
- Ritualistic behaviours or obsessive thought patterns, which can indicate the presence of OCD.
- Extreme anxiety in social situations, which can indicate social phobia.
- Avoiding going out in public altogether, which can be a sign of agoraphobia.

Next in the series
› Expat Mental Health: Anxiety - Part 2 (Seeking Help & Self-help techniques)