Suffering in Silence with Anxiety

February 6th, 2020

Today, I am proud to showcase a guest article from a community partner of Fitness for Health. Dr. Carey Heller, Psy.D., is a licensed psychologist and founding partner at The Heller Psychology Group, LLC in Bethesda, Maryland. He specializes in the evaluation and treatment of ADHD/executive function issues and co-occurring disorders including anxiety.

Thank you, Dr. Heller, for writing this insightful article for our families and highlighting a topic that is becoming more prevalent in the news and being discussed in homes.


There are many mental health disorders with very visible symptoms. For example, children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) often have trouble sitting still and may engage in behaviors that are disruptive to others. Anxiety on the other hand is not always as apparent to others, and in some cases, children, teens, and adults are not even aware that what they are struggling with is anxiety.

Anxiety Disorders are a variety of disorders that have in common features of excessive fear and nervousness. Fear is the emotional response that one has to a real or perceived threat. Nervousness or anxiety is the anticipation of a future threat.

It is quite normal to have some anxiety about big events such as performance in an important sports game (i.e., tennis championship), major life decisions, and other items along those lines. In fact, a mild level of anxiety increases arousal and in turn can actually improve performance. On the other hand, too high a level of anxiety can lead to decreased performance, trouble completing tasks, disorganization, deficits in executive functioning, and avoidance of situations that trigger anxiety. For those individuals who experience anxiety around social interactions, this can lead to decreased participation in group activities and greater social isolation.

In many instances, people may be more aware of the result of the anxiety (i.e., school avoidance, poor academic performance, social isolation) than the fact that it is anxiety that is causing the specific issues. This can be problematic because sometimes individuals try to address the result of the anxiety as opposed to the anxiety itself. For example, with poor school performance, if parents are not aware that anxiety is the major cause of trouble keeping track of assignments or doing well on exams, they may be well intentioned and seek out a tutor. It is highly possible that getting help keeping track of assignments and reviewing material with someone helps alleviate some of the anxiety and could in turn improve school performance. However, if anxiety is at the core of the difficulty, tutoring is likely only going to help so much if the anxiety itself is not also addressed directly.

Another common approach of people with anxiety who have some recognition of it, is to accept it as being their norm and attempt to push through. For parents of kids with anxiety, many try to get their children to overcome anxiety by putting themselves in the situations that make them anxious to illustrate to them that they are ok. For example, if a child is fearful of new situations such as going to a birthday party where they do not know most of the other kids there, a parent may drag their child kicking and screaming to the party assuming that he or she will be fine once they get there. In some instances, it is highly possible that that is the case. In other situations, not addressing the anxiety itself may lead to increased worry at the party and subsequent reinforcement of anxiety about similar situations in the future.

Each person’s experience with anxiety is somewhat different, which makes it difficult to figure out strategies that work universally. However, the first step is often recognizing that anxiety is at the core or a contributing factor to your difficulties or those of your child or loved one. The next step is seeking appropriate treatment or assistance to address the anxiety directly rather than focusing solely on fixing the consequence of the anxiety (i.e., poor work performance).

The purpose of this article is to help you recognize situations where you or your loved one are experiencing anxiety and understand that in order to treat the anxiety, one typically needs to address it at the core rather than focusing on addressing the consequence or result of being anxious. In addition, it is important to recognize not only anxiety in general, but distinguish when anxiety is normal versus when it rises to a level that warrants assistance. When in doubt, seeking a consultation with a mental health professional is one of the best ways to better understand if it is anxiety, learn more about how the anxiety is impacting you or your loved one, and determine how best to make changes in order to reduce or eliminate the presence of problematic anxiety symptoms.

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