How Does Generalised Anxiety Differ from Performance Anxiety?

Comedians have often used humour to address mental health issues, building their struggles into standup act.

The recent death of a young Indian-origin comedian while performing a set that involved him talking about suffering from anxiety, and then collapsing, has led to a number of questions. Is performance anxiety the same as generalised anxiety? Could his anxiety have caused his death?

Medics tried to revive him, but he passed away of cardiac arrest. When he fell on stage while performing in Dubai, the audience thought it was part of the act.

Comedians have often used humour to address real mental health issues, building the struggles they face on a daily basis into their act. Australian comedian Hannah Gadsby sends out this zinger in the middle of her Netflix-famous Nanette act, “Generally, I like to take a story of woe from my actual factual life and make it hilarious. You’re welcome.”

Closer home, comedians Abish Mathew and others have spoken in detail about battling anxiety and depression and seeking therapy.

Generalised Anxiety vs Performance Anxiety

“In clinical classification Anxiety disorder is described to stem from excessive worry (apprehensive expectations) that occurs on a regular basis for at least a visible period of 6 months,” says Mumbai-based psychologist Scherezade Shiobhan.

The common signs include an inability to stop the worrying process, irritability, a sense of pervasive panic, feeling restless or unsettled quite frequently as well as physical symptoms like increase in heartbeat, palpitations, drop or rise in body temperature as well as a sinking feeling in the stomach.

“These are general descriptors for what is the most widely seen version of an anxiety condition (I personally detest the word disorder because it seems inaccurate) which is also called GAD or generalised anxiety disorder.”

Scherezade Shiobhan, Psychologist

Performance anxiety is a form of social anxiety, when the thought of performing in front of a crowd, a person, managers etc can send you into a tizzy. People who experience social anxiety may not always feel anxious unlike those who have generalized anxiety.

“This creates a sense of distress and impairment in the ability to decide how to engage socially without a sense of impending fear,” adds Scherezade.

Anxiety vs Stress

Stress and anxiety are again words that are used interchangeably. In an earlier interview with FIT, psychologist Shelja Sen explains the difference.

Stress is something everyone lives with, says Shelja. It’s inevitable and part of everyone’s life. However when this stress reaches debilitating levels, it's called anxiety.

“Anxiety is when this particular stress could escalates to the level that it becomes so strong that the person is not able to function. It could be because of the events of a person’s life, it could be because of the trauma of the person went through, it could be the wiring, it could be genetic, and it’s persistent.”

Shelja Sen, Psychologist

Dealing With Anxiety

Some of the top performers have battled anxiety. Having anxiety does not have to impede your life.

“Anxiety in itself is not an affliction but a negative emotion that impedes our functioning by making us feel dissonant and we ruminate endlessly. It is a part of our behavioral repertoire and serves a specific purpose. It is useful to us in the same way that certain other negative emotions including anger or sadness are useful to us,” says Sherezade.

It becomes problematic only when it becomes your go-to response. She further explains:

“If I am in a jungle and I am anxious about being attacked by a wild animal like a lion, that anxiety is rooted in rational fear. If am sitting in a high-rise in Bombay and I am panicking about being attacked by a lion because I just saw a documentary on lions, then my fear is irrational and unlikely to take shape right now.”

Tools To Help You Manage Your Anxiety

There are tools to manage your anxiety. Shelja Sen suggests we follow the ABC steps:

“Stay alert, breathe out and change the channel. Always be alert and pay attention to your body - do you feel your heart racing, shortness of breath, any other symptom you associate with anxiety?

The key is to become an expert in your anxiety. Once you have identified those, pay attention to your breathing. Take a deep breath through your nose and breathe out through the mouth. Try this several times.

Finally, change the channel - distract yourself. Get up and walk around, go for a jog, break into dancing, cook something or talk to someone - do whatever you have to, but break the loop of negative thoughts in your head.”

Scherezade talks about therapy tools she uses with her clients, some of who are high performers, business leaders, comedians and musicians.

“Therapeutic interventions like CBT and RECBT help people challenge their cognitive distortions which in simpler terms are maladapted thoughts which power are responses and behaviors. I practice existential therapy which is multi-modal and so we incorporate aspects of analysis, gestalt methodology as well as a little bit of EMDR for folks who have anxiety and trauma.”

Mental and physical health are interlinked. Anxiety attacks mimic symptoms of heart distress. It’s important to take care of your self, seek help and develop tools to manage your anxiety.