Do I Have an Anxiety Disorder?

Woman anxiously bite her nails  while gazing outside

People who are experiencing a lot of anxiety are often preoccupied whether they have an anxiety disorder. The answer to that question is often more complicated than people expect it to be. We’re talking with Dr. Jane Rubin about how to approach the question of whether you have an anxiety disorder.

Why Do People With Anxiety Want To Know If They Have An Anxiety Disorder?

There are a number of reasons. One common reason is that people want to feel that they’re not alone, that they’re not “weird.” If their anxiety is a symptom of a diagnosable anxiety disorder, they often feel less anxious. They know they’re suffering from a condition that’s shared by lots of other people.

Another reason is simply that people want to understand what they’re experiencing. Sometimes, learning about anxiety disorders helps them understand themselves better.

Finally, people want to know that their anxiety can be treated. They feel more confident that treatment is available if they have a specific diagnosis.

Can Having A Label Be Helpful?

In many cases, it can be helpful, for the reasons I just described. However, if our understanding of what’s going on with a specific patient is limited to what their diagnosis tells us, we’re  often very limited in what we can do for them. I think we can be much more helpful to people if we think about anxiety in a more expansive way.

For one thing, many people’s anxiety doesn’t fit into strict diagnostic categories. Instead, their anxiety falls into the domain of what are sometimes called “shadow syndromes”. For example, many people who are perfectionists can look like people who have obsessive-compulsive disorder. They may need to be very organized and become anxious when things are disorganized; they become anxious if they don’t do things perfectly, etc. But they don’t have obsessive-compulsive disorder. They don’t have rituals that they need to perform regularly that interfere with their daily lives and they don’t suffer from intrusive thoughts.

How Do You Even Begin to Treat These Patients?

For me, the most important thing is to help people understand their anxiety so they can see that it actually made sense in the context in which it originally arose. I’ve had many patients who suffer from social anxiety. Even though their symptoms were somewhat similar, the reasons for their symptoms were completely different. One patient’s mother was always telling her that she was unattractive. Her social anxiety revolved around the idea that other people would reject her because she was physically “disgusting.”

Another patient’s parents never supported her when she had a conflict with teachers or with other kids. They always blamed her. Her social anxiety revolved around the idea that she was always wrong and that other people would reject her because she was incompetent.

As both of these patients came to understand how their anxiety arose, they became much more compassionate towards themselves. They stopped blaming themselves for their anxiety.

And, more importantly, they saw that the premises on which their anxiety was based were completely false. Their parents needed to believe their children were unattractive or incompetent for their own emotional reasons that had nothing to do with who their children really were.

So The Basis Of Your Approach Is To Treat The Underlying Causes Of Anxiety And Not Just The Symptoms?

In most cases, yes. For people who have some very specific types of anxiety, like specific phobias or obsessive-compulsive disorder, behavioral treatments are often the most effective. But, in my experience, most people looking for relief from anxiety have been suffering from shadow syndromes or types of anxiety, like social anxiety, that often has roots in early experiences.

For those people, just focusing on symptoms usually doesn’t work. As soon as they stop being anxious about one situation, they transfer their anxiety to another situation. Those patients find tremendous relief when we identify the actual sources of their anxiety. Only when they see that their current life situation is different from the situation that produced the original anxiety do they find sustained relief.

Click to learn more about anxiety therapy and treatment with Dr. Jane Rubin.

Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.