I remember once being out on the golf course with a friend. He had brought along a few other friends who I hadn't met before. Whenever I answer the question of my profession that inevitably comes up anytime somebody is trying to get to know you I am usually met with a number of other follow up questions, some revealing the person's own experience with therapy or general awareness of mental health conditions. I told him how my favorite mental health issues to work with are obsessive-compulsive disorder or really just any type of anxiety disorder. The thing he said next to me I found quite peculiar.
He told me, "I don't think I've ever experienced anxiety."
I've heard lots of unique responses to telling people I am a therapist but this one was a first. Now, if I am being generous I could probably assume that he meant something more along the lines of "I have never had an anxiety attack" which would not be out of the question. About 35% of people report having experienced one in the past, so there is a decent amount of people who have not. But to say that he has never experienced feelings of anxiety would be just about impossible.
Occasional anxiety is part of our daily life. There is nothing that you can do to avoid it and there is good reason for that. Anxiety is our guide to let us know there is some level of risk at play with a decision that we have upcoming. And if you've ever made the decision to engage in any relationship with any person, you take on the risk that that person might one day hurt or betray you in some way.
My new friend later missed a short putt when his nerves had gotten the best of him, to which I quipped, "that was anxiety." The group erupted in laughter, although he didn't find it that funny.
Suffice it all to say, that in regards to answering the question of how long anxiety lasts, the answer is technically "forever, but it depends."
We experience different anxiety levels and to look at anxiety as something to be escaped will actually only exacerbate our anxiety. For the sake of this blog post we will explore a few different types of anxiety with some answers as to how long different anxiety symptoms stick around.
At the top of our anxiety pyramid we have panic attacks. When we are treating anxiety we often use a scale called subjective units of distress (or SUDS). I use a 10 point scale. When we have reached the point of panic we are at a 10 out of 10.
You do not necessarily need to have a diagnosis of panic disorder to experience a panic attack. Technically you don't need any diagnosis at all as a panic attack is simply a more extreme version of the physical symptoms of anxiety that one might experience. We experience panic when our parasympathetic nervous system begins to move off line and our sympathetic nervous begins to take over. Colloquially, we call this a fight or flight response that might happen when we find ourselves in stressful situations. This is the nervous system's way of letting us know we might be in danger and thus a feeling of intense fear comes over us.
This system is generally designed for bear encounters but unfortunately it continues to come up in everyday life even for people who are not seeing bears in their daily lives.
Panic attacks are generally short term and do not last for more than thirty or so minutes. They can also be over quite quickly, ending in just a few minutes. The symptoms of a panic attack can be quite uncomfortable and a lot of people describe feeling a shortness of breath as if they are gasping for air. I usually find that there is some sort of massive consequence that the person experiencing this severe anxiety is fearing. Often times people are afraid if they do not calm down they might have a heart attack or go crazy. While panic attacks bring on a certain feeling of unease, it is important for us to note that nobody has ever died of having a panic attack. I find this to be the most comforting piece of information to come back to is to recognize that a panic attack is occurring and I do not need to fight my way out of it. It will pass and my body will find a way to regulate itself.
Next up to bat in terms of the uncomfortable experiences of anxiety we have obsessing and rumination. Using our SUDS scale obsessions can certainly range in their intensity, but for the sake of organization let's say that obsessions generally take place in the 6-9 out of 10 range.
Although this is often a symptom of people who have more complex anxiety diagnoses such as social anxiety disorder, OCD, or specific phobia, it can also show up for anybody. Obsessions can last anywhere from thirty minutes to several days, months, or years. If you are thinking that is quite a big time frame, that's because it is. If you have not had a persistent worry for more than 30 minutes I would probably argue that it is not an obsession, but rather some anxious thoughts that you were experiencing for a short amount of time. Some people describe thinking about a certain obsession all day every day and only having temporary relief from it in moments. The thoughts will return as soon as they wake back up in the morning and generally do not go away until one of a few interventions have happened:
1. The person has sought out professional help and is engaging in a treatment plan.
2. Anti-anxiety medications, such as selective serotonin reuptake inhibitors are prescribed and taken.
3. The obsession resolves itself by the uncertain circumstance coming to pass.
When it comes to treating these types of anxieties, the therapist is probably going to recommend utilizing exposure therapy, which is a form of cognitive behavioral therapy. I have certainly used exposure work for generalized anxiety disorder in the past, but I usually take an acceptance and commitment therapy approach to those cases amongst a few other treatment options.
The idea with exposure is that we are trying to actually increase the anxiety associated with the obsessions. The research shows that when we seek reassurance or avoidance in regards to an obsession, the anxiety might quickly alleviate but will inevitably return to the same level that it had before. With exposure, the anxiety will go higher and eventually lower, though this will take a longer amount of time. However, the research shows that when the anxiety does return it is does return to quite as high of a level. As we decrease the peaks of anxiety over time the obsessive thought or feelings of worry eventually do not hit quite as high of a level. This approach can take a long time to really take root but the effort is well worth it.
Moving a bit lower in the hierarchy we might experience just some a more general form of anxiety. This takes place in the 3-5 range of the anxiety hierarchy. As anxiety shows up so much in the body, at times people are not even quite sure of what the anxious thought or situation even is. Their body is just sending stress hormones to signal that they are in a dangerous situation and need to get out, even though the situation usually isn't in and of itself physically dangerous. When we are in the 3-5 range we might have a slightly elevated heart rate but we haven't reached the same space that we reach in panic.
The length of time that these types of anxieties stick around ranged from a few hours to indefinitely. While our body can't sustain being at a 10 out of 10 anxiety wise for long periods of time, it can stay around a 4 all of the time. When people are in this place their anxiety generally hasn't "ruined their life" even though their quality of life may have diminished. Most people aren't leaving their jobs or relationships when anxiety has reached a 4 for a consistent period of time, which is part of the reason it can stick around for so long. Though it is uncomfortable it's tolerable and major changes aren't necessarily required.
I titled our last section "life" because trying to live a life where you never experience any sort of anxiety is preposterous. If you are going to engage in social situations, have relationships, works, take risks, try new thing, you are going to have to accept some level of anxiety. For our SUDS scale, we will say this is the 1-2 range. And if we are finding the 1-2 range problematic, then we have a bigger problem. The primary treatment for this range of anxiety is acceptance!
Accepting that you are a human who is moving through a difficult world and navigating people, which is going to create some anxiety and at times for no apparent reason. And even with this range, I believe we should occasionally be pushing ourselves to the point of seeing the higher ends of that SUDS scale. Whose anxiety doesn't raise a little bit for a job interview, first date, or any big moment? And having these experiences of anxiety is actually a good thing.
If you are looking for a support group to help improve the relationship with your anxiety, Thrive will be offers an Adult DBT Group, and will also be adding an Anxiety Group in the next few months. Additionally I would recommend checking out our course on Anxiety as well.
Of course, if you are already signed up for Thrive's membership all of these courses are included at no additional cost to you!