What Is Anxiety?

Available with English captions and subtitles in Spanish.

McLean’s R. Meredith Elkins, PhD, walks us through the basics of anxiety—especially in children and adolescents—and helps us understand healthy and unhealthy signs and symptoms and how to know when to seek help.

Find resources and more about the expert below.

Anxiety 101

Anxiety is one of the universal human emotions. Anxiety exists in modern humans, because it allowed our early ancestors to survive.

Like all of our emotions, anxiety gives us a signal. It tells us something about our environment. And in the case of anxiety, it tells us that there’s something in our environment that’s dangerous to our life or to our well-being.

This means that when we feel anxiety, we’re sensing that there’s some sort of a threat to our safety or to the people, the things, or the position that we value in life.

When our brain gets this signal of anxiety, we have an urge to either run away or to defend ourselves. This is known as the fight or flight response. And it’s actually pretty amazing, because all of the uncomfortable physical feelings that we have in our body, because of anxiety, they actually serve a purpose.

When our brain perceives the signal of anxiety, it kicks off this automatic response, where it sends the energy in our body to the areas that we need it in order to fight or flee, and pulls energy away from the areas in our body where we need it less in the moment.

So, our breathing rate increases, our heart rate increases, and as the blood is pumped more quickly around our body, we feel funny things, we feel hot and sweaty, we feel dizzy and lightheaded, we might get butterflies in our stomach, or feel like we’re going to be sick.

Our thought patterns change. We might feel like we’re not thinking straight, or we’re worried that we might be losing control. As uncomfortable as all of these feelings are, they actually all have a purpose. The purpose is to keep us safe, and this is what enabled our early ancestors to survive.

Anxiety keeps us safe

Think about it. If you were in danger, would you want to be loose and relaxed, or would you want to be tense and alert? Our ancestors who had that fight or flight response were more likely to survive than the ones who didn’t.

Those ancestors who survived went on and had kids, and those kids had kids with anxious responses, and on and on, until you get modern humans, living with this anxious response.

Now, we aren’t worried about fighting off predators, but that same automatic reaction kicks into high gear when there’s a car that comes barreling around the corner at us.

And now we aren’t worried about being abandoned in the wilderness by our tribe, but we get that same uncomfortable feeling when we’re worried that our classmates don’t like us.

Healthy and Unhealthy Anxiety

Anxiety can give us great information about the things that are important to us. So, if we feel anxious about a test, it’s because we really want to do well.

If we’re nervous about starting a new school, it’s probably because we want to form good friendships. And if we’re stressed about our health, it’s probably because our health matters to us. We want to live a long and healthy life.

Anxiety is normal, natural, and harmless, and a lot of people will push back at this point and say, “How can you possibly say that anxiety is harmless? It’s making things really hard for me,” and that’s relatable.

Here’s where we need to distinguish between the physical feeling of anxiety and the emotion of anxiety from the things that we do because of anxiety. For example, if we stop eating because we’re so afraid to vomit, that’s a problem for us.

If we won’t go to school anymore because we’re scared of school, we lose so much pace academically, we lose the chance to make friends. So, it is really important that kids and parents understand that anxiety in and of itself is not dangerous. It is not pathological.

It is really what happens because of anxiety, what we do because of anxiety, that can make things harder for us.

People ask all the time whether anxiety can hurt you, because anxiety feels so uncomfortable.

In fact, a lot of times, people might even present to the emergency room, because they’re experiencing a panic attack, or high levels of anxiety, and they’re afraid that they’re going to die, they’re afraid they’re going to have a heart attack.

It is really important to know that as uncomfortable as anxiety is, it cannot hurt you. Only in extremely rare situations, when perhaps there’s another medical condition, co-occurring, would anxiety hurt you, but otherwise, the worst thing about anxiety is that it feels awful.

It cannot actually hurt you, and the things that we do because of anxiety are actually what caused the problem for us. It can be challenging to know when anxiety is a problem, because anxiety is a normal emotion, and we don’t want to jump to the conclusion that just because we’re experiencing anxiety, that means we have an anxiety disorder.

Duration, Distress, Interference

When we’re trying to determine whether or not anxiety is a problem, it can be helpful to anchor yourself in three different things: duration, distress, and interference.

For duration, has the anxiety issue been going on for more than a few days or weeks?

Regarding distress, is the anxiety making you feel way more anxious or way more upset than you should be feeling in a given situation? And a helpful way to distinguish this is think, “Is the anxiety that I’m feeling in this situation way more distressing than the anxiety that most of my friends are feeling in a similar situation?”

And then lastly, interference. Is the anxiety messing things up for you in your daily life? Is it making it harder for you to go to school, for you to go to work, for you to do the things that are important to you?

If all of these features are elevated, you might be struggling with an anxiety disorder, and you should start by speaking with your primary care physician.

Learn more about how anxiety affects children and teens

Want More Information?

Looking for even more information about anxiety in kids and teens? You may find these resources helpful.

About Dr. Elkins

R. Meredith Elkins, PhD, is a program director at the McLean Anxiety Mastery Program (MAMP), an intensive group-based outpatient program for children and adolescents with anxiety disorders and OCD. She is a clinical psychologist specializing in the cognitive behavioral treatment of anxiety, mood, and related disorders in children, adolescents, and young adults.

Dr. Elkins is experienced in providing evidence-based interventions through individual, group, family, and behavioral parent training formats. She has established integrated lines of research encompassing the development, identification, and treatment of anxiety disorders in childhood.

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Series

Child & Teen Anxiety Introduction