A calm approach to the anxiety disorders seen in general practice

When is anxiety a disorder, rather than a normal event?

The level of anxiety is not a criterion for determining if it is a disorder. Those hotly pursued by lions will be anxious indeed, but their anxiety will be normal under the circumstances. Disability is not a criterion. If I have a phobia of giraffes I have an anxiety disorder, but if I stay away from the zoo I have no disability.

The need for treatment is no criterion. If I have survived a terrifying air disaster and my occupation makes it necessary for me to fly, then in all probability I shall need treatment before I can fly again. Nevertheless, the anxiety generated by the crash and attached to flying could scarcely be regarded as pathological. A normal state may require treatment.

The criterion is the appropriateness of the anxiety. If someone is terrified by the sight of a mouse, or a moth, then their anxiety is pathological, for it is extremely unlikely that either of these creatures will attack them and unthinkable that harm would arise if they did – and were it to come to combat, there would be no doubt about who would win.