Which of the 2 kinds of anxiety do you have? 

How strong is your anxiety? 

What is causing it? 

Why do you have anxiety in the first place?

Etc, etc. 

If you want to overcome anxiety you need to know what you’re dealing with. 

“Know your enemy” is the motto for this section. 

This is the Assess your Anxiety step in the SMART anti-anxiety process.

This is the step #3!

First, let’s find out if you even have an anxiety problem. 

Is it normal to be anxious?

Anxiety is normal and even necessary, but when it gets out of control, then it becomes what’s called disordered anxiety.

Just like food… 

Food is good, but:

• Too little food is bad. 
• Too much food is bad. 

The key difference between normal anxiety and the disordered one is whether or not it interferes with daily life. 

(read more at National institute of Mental Health’s website:  https://www.nimh.nih.gov/health/topics/anxiety-disorders)

To find out how strong your anxiety is you can use the following questionnaire. 

It’s used by therapists to assess their clients’ depression and anxiety. 

It’s called DASS-21.

Depression Anxiety & Stress Scale. 21 is for the number of questions. 

You can view and download it below: 

DASS-21

This anxiety self-assessment tool will give you a better picture of how strong your anxiety (and depression) is. 

It also helps to monitor your progress over time. 

If you started at “Severe” anxiety, and in a couple months you have “Moderate” anxiety – that’s a big improvement in your quality of life. 

The fifty shades of anxiety

Next, you may want to understand what types of anxiety you suffer from. 

Not all anxiety is created equal and you need to know what type you’re dealing with.

It is best to ask for professional help. 

Therapists are trained to identify various types of anxiety and address each of them.

That’s the best case scenario.

However…

According to the Society of Clinical Psychology, recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover.

https://www.apa.org/ptsd-guideline/patients-and-families/length-treatment

The average cost of psychotherapy in the U.S. ranges from $100 to $170 per session (depending on the state), according to a 2019 report by SimplePractice.

https://www.simplepractice.com/blog/average-therapy-session-rate-by-state

So, you could spend 1500-3400 USD and have only a 50% chance of recovery using therapy. 

If therapy is cost-prohibitive for you, or you live in a place where it’s not available, then you will have to become your own therapist. 

Anxiety comes in various forms, each with its own characteristics and triggers. Here are some common types:

• Generalized Anxiety Disorder (GAD): GAD involves chronic anxiety, worry, and tension, even when there is little or nothing to provoke it. People with GAD often worry about a wide variety of everyday matters like health, money, work, and family. 
• Panic Disorder: Sudden and repeated episodes of intense fear, (known as panic attacks), which may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
• Social Anxiety Disorder: this type involves overwhelming worry and self-consciousness about everyday social situations. The fear often centers around being judged, embarrassed, or rejected by others.
• Specific Phobias: These cause an intense fear of a specific object or situation, such as heights, animals, or flying. 
• Agoraphobia: The fear of being in situations where escape might be difficult or help might not be available if things go wrong. This can include being in open spaces, using public transportation, or being in crowded places. Some people develop secondary anxieties (like driving anxiety).
• Separation Anxiety Disorder: Anxiety about being separated from those to whom you are attached. It’s common in children but can also occur in adults.
• Obsessive-Compulsive Disorder (OCD): OCD involves anxiety as a core component. It includes persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts.
• Post-Traumatic Stress Disorder (PTSD): PTSD sometimes develops after exposure to a terrifying event. People with PTSD may have flashbacks, nightmares, and severe anxiety related to the traumatic event. There’s also a C-PTSD type that develops over time. 
• Health Anxiety: Worry about having a serious illness despite having few or no symptoms.

As I mentioned, if you can’t go to therapy, then you’ll need to be your own therapist. 

In this case, I highly, highly, highly…

…highly recommend reading The Diagnostic and Statistical Manual of Mental Disorders (DSM).

Why?

You see, when you read it you will quickly understand how therapists think and how you should think as well. 

You may also see how little you knew about anxiety. 

For example, I used to consider myself a fairly well-read man. 

I thought I knew all the definitions of GAD, ADHD, PTSD etc, etc. 

And then I opened DSM…

I was both amazed at what a treasure trove of information it was, but also humbled by how much I still needed to learn. 

So, if you can’t go to a therapist (for any reason), you need to study!

It’s the “I” from the MIST framework. 

You need to know the same information a therapist has. 

For example, a therapist will diagnose GAD only if there’s no other disorder that would explain your symptoms. 

Otherwise, they may mis-diagnose your type and then mis-treat it. 

As of this writing, you can download DSM-5 from this page: https://archive.org/details/info_munsha_DSM5

The number after the letters DSM simply means its edition. The higher the number, the newer the edition. 

Hopefully, by now you understand how strong your anxiety is, and what type it is. 

What exactly triggers It

Next step is to identify what triggers your anxiety. 

If you know what triggers your anxiety, you will then be able to change your environment.

Here’s a story to illustrate. 

A couple years ago I realized that I was experiencing a lot of ADHD symptoms. 

I did the “right thing” and started therapy.

My therapist prescribed medication.

One side effect of the medication was sleepiness. 

If I took it in the morning I was non-functional throughout the day. 

Sleepy.

Unfocused.

Unmotivated to do anything.

But when I took it in the evening…

Oh, it was like a miracle!

I slept like a baby.

The pills were like a shut-down timer for my body. 

30 minutes after taking one I could barely move!

A couple weeks later I realized: I had more energy, more focus, better memory, better mood and less hunger.

Not due to lowering my ADHD symptoms, but by helping me sleep.

When I slept well, I could manage my mind (and life) better.

In my case, being sleepy and unable to focus was partially causing my anxiety and making it worse.

The pills were expensive and had side-effects, however.

So, I quit taking them and found better ways to sleep well.  

(I mention them in my course Outsmart Anxiety )

(Or here: Want To Overcome Anxiety Forever? Rebuild your Resilience! )

Some other common anxiety triggers include: 

• Stressful Life Events: moving, starting a new job, or losing a loved one. 
• Work or School Pressure: High expectations, tight deadlines, and a heavy workload can lead to anxiety. 
• Financial Concerns: Worrying about money, big upcoming purchases, debt, or job security.
• Health Issues: Chronic illness, injury, or health-related fears. 
• Relationship Problems: Conflicts with friends, family, or partners. Issues like communication problems, breakups, and feelings of loneliness or rejection.
• Environmental Factors: Living in a chaotic or unsafe environment. Noise, pollution, and overcrowded spaces.
• Substance Use: Alcohol, caffeine, drugs, and even certain medications can induce anxiety.
• Traumatic Experiences: Past trauma. Post-traumatic stress disorder (PTSD) is an example where past trauma continues to trigger anxiety.
• Genetics: A family history of anxiety disorders can increase the likelihood of experiencing anxiety. We’ll talk about it later.
• Personality Traits: Certain personality traits, like perfectionism or low self-esteem. These traits lead to a constant fear of making mistakes.

Other conditions can cause anxiety too!

For example, I believe that initially my social anxiety was caused by my symptoms of autism. 

Research shows that 17-30% of people with autism also have social phobia (https://pmc.ncbi.nlm.nih.gov/articles/PMC5772195/)

Here are some other disorders related to anxiety: Major depressive disorder (MDD) and bipolar disorder are common comorbidities of generalized anxiety disorder (GAD). Substance use disorders. Avoidant personality disorder (APD), ADHD, autism. 

Hopefully, now you have a better idea of what anxiety type you have. 

Why are some people more anxious than others?

So, where does anxiety come from?

The prevailing opinion in the scientific community right now is that anxiety is either learned or… 

“We don’t know”. 

Scientists don’t know why some people are more anxious than others. 

For example, I work with very young kids. 

I can see that some kids are open to new experiences while others are not. 

Some kids are more anxious than others, yet they haven’t had enough time on this planet to be traumatized or learn to avoid certain things. 

While early childhood trauma is real, what will be traumatic to one kid won’t necessarily traumatize another. 

If you go to any nearby playground you will see the following picture: 

Kid A and Kid B run. 

They both fall down the same way.

Kid A gets up, looks at the parent and starts running again. 

Kid B stays on the ground, cries.

What happened there? 

Why are they different?

Nobody knows. 

I’ve seen kids hit their face on the ground, then get up, smile and keep playing.

Scientists tried to find out what may be behind this difference in people. 

They found that a lot of it is due to genetics. 

For example, when scientists looked at GAD (generalized anxiety disorder) they found a genetic heritability of 31.6%.

(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573560/)

According to genetic studies, the heritability of panic disorder is in the range of 35-40% (https://pmc.ncbi.nlm.nih.gov/articles/PMC2760665/)

The heritability of intelligence (just a side note) increases from about 20% in infancy to perhaps 80% in later adulthood. (source: https://www.nature.com/articles/mp2014105)

Heritability of other diseases and disorders has been shown to also be high.

So, anxiety is somewhat inherited. 

For example, my grandma is probably the most anxious (cortex-type) person I know. 

My mother is also anxious. 

She lives in a country at war, yet she worries about ME when I don’t message her each day. 

So, I can clearly see what the scientists mean when they say that anxiety is heritable. 

On the other hand, one life experience taught me that my anxiety may have been learned and not “given to me” or inherited.

That experience showed me that if I learned it…

…I could unlearn it!

Do you create your own anxiety?

Many moons ago, I used to get overwhelmingly anxious at work.

It was seriously interfering with not only my work, but with my life as a whole. 

It made my life a real hell!

I struggled with symptoms of GAD: I had intrusive thoughts, worries, nightmares, racing heart, etc. – all the unpleasant physical symptoms of anxiety.

Then, I’d “self-medicate” with gaming which then developed into an addiction. 

And then, one day I thought: enough!

I started taking a supplement. 

It doesn’t matter which one.

You’ll see why.

Within a couple months, I felt much calmer. 

My environment wasn’t triggering my fight-flight-freeze response as much anymore. 

My thoughts changed too!

I stopped having so many worries and wandering thoughts. 

Then, I stopped taking the supplement and…

Something interesting happened. 

My thoughts remained in the “calm” mode. 

The supplement lowered my anxiety PERMANENTLY. 

So, that showed me something interesting: 

• You don’t really need your anxious thoughts.
• You can live with them, or without them. 
• That means that you learned them. 

Imagine you never learned how to run, or drive.

You could live your life without those two activities. 

So, my theory is that at some point in life you’ve learned to worry.

If you have panic attacks, you’ve probably learned them too. 

For example, when I was in university, I learned to worry about money (because I never had any!). After a sudden dog attack (mentioned later) I learned to be cautious around unfamiliar dogs.

My body learned to start panic attacks when I feel blood vessel damage, or hypoglycemia – both after some bad experiences.

So, if you’ve learned these thoughts and reactions, it means you can unlearn them. 

Is anxiety your guardian angel?

But why do we have these reactions? 

The reason is simple.

We can find it in evolutionary biology and evolutionary psychology. 

It’s a science that asks one question: why are we how we are?

• Why do people walk? 
• Why do cats have eyes on the front and deer on the sides?
• Why are we disgusted by the smell of rotten meat?
• Why do we appreciate kindness?

These two sciences have one premise in common: if a trait is present in modern humans it’s either a “side-effect”, or it’s beneficial to survival.

For example, the ability to collaborate with others would be beneficial to survival. 

Being vigilant and anxious would be beneficial too.

If you lived in a village and there were forests nearby, wolves and other animals could attack if you weren’t not careful. 

Most pop-psy books talk about this as if it was useful only “in the prehistoric times”, but it’s just not so…

You don’t need to travel that far into the past. 

In India, kids are being attacked and kidnapped by wolves to this day.

Being anxious and vigilant can save your or your kids’ life!

And it’s not limited to animals and other obviously dangerous things.

I remember listening to a conversation during one dinner. 

My whole family gathered that day. 

It was someone’s birthday.

My grandmothers were talking about the “good old days”. 

They usually disagreed on almost everything, but not this time. 

They were completely different people. 

Different backgrounds, born in different parts of the country, speaking different languages, politically, belonging to the opposite parties.

But that day, they agreed on one thing.

They had one thing in common. 

They both believed that it was VITAL to be aware, at all times, of what other people think of you. 

They both grew up in the time when an anonymous tip (true or not) could get you sent to a concentration camp.

There, you’d either be worked to death or shot.

They grew up in the USSR in the 30’s and 40’s and saw it first-hand.

In those times, what a child said in public could get their whole family sent to Siberia.

So, you had to be careful about what you say. 

And that requires some anxiety. 

You couldn’t be relaxed, honest and open-minded and have a long life. 

Such people died.

And that happened less than a hundred years ago. 

So, worrying helped people survive. 

And it still does!

Another example is my friend who left Ukraine a couple days before the war started in 2022. He was worried, so he left. Maybe, that saved his life. 

So, some anxiety is normal and even useful.

It’s formed due to genetic factors and life experiences. 

You can have either a tendency to be anxious, or a life experience that makes you anxious, or both.

What are the two types of anxiety and how to identify yours? 

So, now we know that anxiety is trying to protect you from something. 

But different people experience anxiety in different ways. 

For example, some people experience more worry, while others have more panic.

There’s no one thing or event that’s called anxiety. 

There are many different processes happening in your brain (and body) at the same time, and happen very near each other physically in your brain.

So, they often get mixed together. 

Fear, panic, worry, hope, love, images, smells and memories – can all coexist and confuse us. 

Let’s untangle this web.

Let’s begin with a simple analogy.

Imagine this: cats and dogs fall in the same category of pets (or animals), right? 

Same category. Different animals.

And just like cats and dogs, there are two different brain circuits in your brain that both can cause anxiety.

Same problem. Different reasons. 

Cats and dogs require different care and food – we all know that. 

These two circuits, too, require different approaches if you want to get rid of your anxiety. 

In their book  “Rewire your anxious brain”, Catherine M Pittman PhD and Elizabeth M Karle mention that the brain has two centers responsible for our reactions to the world.

They are cortex, and amygdala.

Anxiety can arise in either of them, independently.

Depending on where your anxiety originates, different approaches will work.

Let’s examine how to tell the difference. 

Amygdala-based anxiety

Amygdala-originated anxiety often manifests itself in:

• Feeling sudden emotions that come “out of nowhere”.
• Strong (and sudden) body-centered responses like sweating, a pounding heart, dizziness, nausea, disrupted breath, feeling paralyzed, and a dry mouth.
• You may also experience mental states like inability to think clearly, losing your focus, forgetting what you know (e.g. during a test), and losing ability to speak coherently. 
• Other emotional states include: anger and a desire for physical action (running, moving your body, breaking things, punching things/people)

Despite how strong amygdala-based anxiety can be, it is often easy to identify. 

Often, these responses don’t make sense or just feel inappropriate. 

We often feel “this is wrong” when we experience the above reactions. 

Now, let’s see how cortex-based anxiety shows itself. 

As you’ll now see – it’s very different. 

It’s more subtle.

This is one of the biggest obstacles to overcoming anxiety.

The following list will help you identify such patterns and start changing them to regain control and positivity in your life. 

Cortex-based anxiety

Cortex-originated anxiety manifests itself in: 

• Worry about the future (potential problems, conflict, trouble, events) and rumination about the past (past failures, negative interactions, problems and traumatic events)
• Pessimistic (negative) thoughts about the future
• Looking for solutions for hypothetical future problems at work, at home, concerning your health or relationships with others
• When interacting with others, being vigilant for possible signs of future negativity, aggression, disrespect, deceit, disappointment, criticism etc., coming from that person.
• Doubt and insecurity about your decisions, health, relationships and the need to confirm, check and make sure everything is in order and “feels right”.

As you can see, the amygdala- and the cortex-based anxieties manifest themselves very differently. 

This explanation was taken right from the course Outsmart Anxiety, where I also tell you how to overcome each of these two types of anxiety. 

Cortex-based anxiety is preparing you for future problems or dangers. This is what we talked about above. 

This is the worry type of anxiety.

It sometimes doesn’t have any specific trigger in the outside world. 

Amygdala-based anxiety is using your past experience to help you survive. 

I was once bitten by a dog. 

Totally unprovoked.

I was walking with my hands in my pockets. The dog was on a leash. 

It suddenly jumped towards me to bite.

Thanks to my and the owner’s quick reactions, the dog mostly bit my jacket, and not my arm.

I had just a little bruise.

Nothing seriously bad happened. 

But since then, I’ve been cautious around unfamiliar dogs.

My amygdala is sending signals to my mind: “Be careful!”

This doesn’t interfere with my life in any way, but I feel this “background” sense of danger every time I pass a dog I don’t know.

Amygdala-based anxiety often occurs suddenly and in response to very specific triggers. 

Is my anxiety forever? Can’t I overcome it?

As you saw above, anxiety exists for a reason. 

Anxiety helped and still helps people survive.

The human body is efficient. 

It doesn’t like to waste energy.

So, if it’s doing something, it does so to either survive or procreate.

It’s trying to protect you, but it overreacts.

Let’s see how that may play out in our mind. 

Imagine this…

You see clouds on the horizon. 

They are moving toward you. 

You have no umbrella. 

You worry about the possible rain. 

So, you see a potential problem that you have no solution for.

This same process happens with any other type of initial worry. 

We expect a potential future problem and realize that we’re unfit, unready or unable to deal with it.

This causes distress.

• We can’t talk to others well? Social phobia. 
• We’re afraid of dying in a car accident? Driving anxiety.
• We’re afraid of being alone? Separation anxiety.

And then, we come to an intersection where people choose their next move to end the distress. 

Some people choose to suppress their worries or distract themselves. 

Others, focus on what makes them worried and try to find a solution. 

Another way is to avoid the situations that cause distress.

• Distraction works only temporarily. Worry will come back stronger. 
• Suppression rarely works as it often backfires and leads to even stronger anxiety. 
• Avoiding stressful situations works (I’ve done it myself countless times!), but it robs you of life experiences. 

So, what do we do?

How do we deal with our distress and the situations that cause it?

First you need to make sure that your body is healthy.

Some anxieties originate in your body and they are best dealt with in that realm. 

As I say in this article Want To Overcome Anxiety Forever? Rebuild your Resilience!, you can’t meditate away a broken leg. 

For example, I’ve had GAD (Generalized Anxiety Disorder) for many years. 

No amount of relaxation, meditation, positive thinking and philosophy helped. 

I was only able to tame it using body-centered techniques.

So, if you have some imbalance in your body, you need to address it first.

But let’s assume you have a healthy body but you worry about a certain future situation…

Or a certain situation triggers your amygdala anxiety.

You need to examine the situation and check if there really is a problem, or it just seems so. 

If it is indeed a problem, then you need to find a way of dealing with it. 

To do that, we need:

• strong problem-solving skills
• strong self-management skills.

We talked about them in the M section of the SMART way to overcome anxiety.

You can read about them here: How to overcome anxiety with just 6 mental skills

But what if a person lacks these problem-solving and self-management skills?

Then, there is no option to act and solve your problem!

There are only two options left:

• Avoid the situation forever.
• Distract yourself or suppress the worry thoughts. 

But it never works!

The problem is still there. 

Your body is still reacting to the problem. 

And it makes you FEEL wrong.

Then, you experience those feelings and get anxious about the feelings themselves.

Claire Weekes in her lecture “Hope And Help For Nerves” described well what happens in this situation.

She explains that normal symptoms of stress often cause people to fear stress.

You look at the dark clouds moving towards you.

You start worrying. 

Your heart beat goes up, your breath speeds up, your palms start sweating. 

But you can’t do anything about it.

You’re powerless. 

And then you experience the infamous cognitive fusion.

You see all these symptoms of stress you feel “Oh my god! There’s something wrong with me! My heart is racing! I’m sick. I’m in danger!”

This makes you worried even more. 

Now, you’re worried about being worried. 

This doubles your stress instantly.

This also causes you to spiral down an anxiety rabbit hole. 

You feel anxious about the original problem (possible rain), then, you get worried about the symptoms of anxiety. 

You try to suppress them, but they don’t go away. 

So, now you’re anxious about not being able to control your anxiety. 

This is already level 3 of anxiety: 

1. Original problem anxiety
2. Anxiety about physical symptoms
3. Anxiety about being unable to control the physical symptoms.

This triple anxiety is so strong that now you want to avoid such situations in the future. 

You avoid anything that can stress you out. You avoid any feeling or sensation that resembles stress. 

And to avoid something, what do you need to do? 

You need to be constantly on the lookout for it. 

You need to keep in mind how it looks, how it feels and how it sounds. 

So, now, you keep anxiety in your mind constantly.

You search for possible signs of anxiety all the time. 

Needless to say, people always find what they’re looking for. 

When you buy a new car, suddenly you start noticing the same model on the road everywhere you go!

But what if you’re looking for signs of anxiety?

You find them anywhere you go!

This causes people to spiral even deeper into the anxiety rabbit hole. 

This is what Claire Weekes called sensitization. 

This state is more unpleasant and debilitating than the original problem was. 

Sure, rain could make you wet.

But worrying about rain (and worrying about worrying) can cause you to never leave your house, lose your job, friends and hurt your mental and physical health.

If you want to overcome anxiety you need to break this vicious circle and create a new, virtuous circle.

This new virtuous circle will act as an elevator, lifting you from the hell of anxiety and into the light of a normal, peaceful and resourceful life. 

How to do that?

Read about it in the next section called Rebuild your Resilience