You might have noticed that sometimes I capitalize the word “anxiety,” and sometimes I don’t. Am I just being sloppy, or is there a reason for it?
There is a reason, and a very simple one. I reserve the capitalized letter for diagnosable Anxiety Disorders, and use the lower-case letter for everything else. I use the little “a” for butterflies in the stomach, and the big “A” for Godzilla’s buddy Mothra flapping around in your belly!
In the English language there is only one word to take care of both the “normal” sense and the psychiatric sense of the feeling of anxiety. This is one of those instances — ”depression” is another — where we could use a different word to name one of those senses. Instead, we are left with one word to describe two very different states of mind.
This ambiguity is confusing for the public, and is the source of untold misery to the millions of Anxiety Disorder sufferers. One of the bedrock principles for this blog is to help you better understand the difference between anxiety and Anxiety. This post introduces you to my way of thinking about these terms and the reasons behind it.
Anxiety Disorders and anxiety lie along a continuum
Imagine a continuum from no anxiety to being overwhelmed
Anxiety exists along a continuum. Imagine a line, with one end being completely free of anxiety, and the other end being completely overwhelmed by it. We exist daily somewhere along that continuum.
The transient daily worries and anxieties that plague human existence are usually far at one end. They are with us only a short time, and go away when the situation causing them goes away. For example:
Ted’s anxiety over the report’s deadline was palpable. That means he had a feeling of nervousness, worry or unease about this one report. It may have led to a sleepless night and a bit of nail-biting, but it was not a lingering condition. He was anxious, but since his symptoms passed with the deadline, he likely does not have Anxiety with the big “A.”
For others, these same anxieties take up root in the psyche, flourish, and reproduce. These people’s experience of Anxiety is much further along the continuum than what is “normal,” because these Anxieties will not go away.
Sally’s anxiety over deadlines cause her to throw up at the thought of one, and she lives in dread of the next one. This says that she is anxious over deadlines in general, of whatever type, and that just thinking about deadlines makes her physically ill. Sally’s anxiety is characterized by a state of excessive uneasiness and apprehension about any and every deadline, real or imagined. Her throwing up suggests some sort of Anxiety disorder with a big “A.”
One word for “anxiety” leads to confusion and suffering
Having only one word exaggerates the “normal” definition
In English, we have only one word to work with for the same feeling that can be benign and even helpful at one end of the continuum, and extremely destructive to lives at the other end.
This having only one word tends to exaggerate the “normal” anxiety and minimize the abnormal, or mentally disordered, Anxiety.
The general public, using the word “anxiety” to describe the physical and mental symptoms it feels when stressed, thinks that all anxiety is a temporary state. And it is true that it’s a passing unpleasantness in eighty percent of the population. However, the public does not “get” that anxiety becomes permanent in that other twenty percent.
The complaints of an Anxiety Disorder sufferer are likely to seem silly, self-indulgent and irrational to others. In fact, Anxiety sufferers often feel the same way about themselves. The same word “anxious” that is used to describe Auntie Maude’s being a worrier is the only word available to describe your having a Panic Attack in an elevator.
This misunderstanding and amplification of a term used to describe a diagnosable mental disorder into one found in daily life is so common that it even has a name of its own: clinomorphism. For example, the term “obsessive-compulsive” is often used in casual speech to describe behavior that may be picky or pedantic, but it is not even close to the diagnostic criteria for Obsessive-Compulsive behavior.
There have been effective campaigns to educate the public about mental health issues, particularly depression. But accurate public knowledge of Anxiety Disorder is practically nil. This leaves both the “normals” and the sufferers in a great black hole of ignorance and causes unnecessary suffering.
What you can do about it
Be clear in your speech about the Anxiety Disorders
First of all, you can be clear when you speak with others — and to yourself — about anxiety and Anxiety Disorder. It’s a bit clunky, but I always try to use the term “Anxiety Disorder” rather than just “Anxiety” when referring to the mental illness.
You can educate your family and friends about the difference between normal anxiety and the Anxiety Disorders. Only by publicly acknowledging your Anxiety Disorder and helping others to understand that you are not some sort of monster can you hope to get their empathy and trust.
And finally, you can join the National Alliance on Mental Illness (NAMI) and Mental Health America in their campaigns to break the stigma of mental illness. There are local chapters everywhere.
Eliminating the stigma attached to mental illness and Anxiety Disorder in particular is something you and I are obligated to work toward. It’s not enough to suffer in silence, to allow others (and yourself) to think you weak-willed and unable to “just get a grip.” All of us must do our part to make Anxiety Disorder as much a recognized a part of the human experience as physical maladies such as diabetes.
What do you think?
It has long been acknowledged that simple words have a great ability to influence the your thinking unconsciously. It’s still uncanny to realize how we understand and use the word “anxiety” greatly affects the public’s attitude toward and treatment of the Anxiety Disorders.
- Are there any words other than “anxiety” and “depression” that have this kind of ambiguity and potential for disaster?
- Do you think your attitude toward Anxiety is affected by the general definition of the word?
Updated: May 18. 2009
©2009 Anxiety, Panic & Health. All rights reserved.
As always, your comments are welcome!
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