Over the course of life, when faced with a new, difficult or stressful situation, it can happen that you feel your breathing speed up, a strong tachycardia, the fear of not being able to manage the situation and of losing control. All these sensations point back to one state of anxiety which, in a more or less intense way, everyone may have experienced. In some cases, however, these manifestations can extend to multiple situations, leading the person to experience a condition in which he seems to be afraid of everything (panophobia).
In both of these situations, the sensations experienced can be so strong that they scare those who experience them, causing them to experience one secondary anxietyor the fear that they may recur.
What is secondary anxiety?
When you feel that sensations of physical tension and worries are beyond your control, the fear may arise that, even when they are not present, these symptoms may return. A vicious circle is thus created, in which the anxiety of feeling anxiety leads to an intensification of unpleasant sensations and living in a constant state of alert.
Where does it come from?
In a situation where you feel strong anxiety, such as during a panic attack, it may happen that the sensations are so intense that you lose control and don’t understand what is happening.
When these feelings finally subside, a new one can emerge fear: that of reliving those moments. We thus find ourselves constantly paying attention to all the small changes that could lead to a new attack, self-inducing anxiety.
Data and spread of secondary anxiety
Anxiety, in its various forms, is one of the most widespread psychological conditions globally. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), anxiety disorders represent one of the most common categories of mental disorders.
Although secondary anxiety is not always classified as a disorder in its own right, several clinical studies have highlighted that the fear of experiencing anxiety can affect a significant percentage of people who already suffer from primary anxiety. For example, according to research published in “Behavior Research and Therapy” (Clark & Wells, 1995), approximately 30% of people with anxiety disorders report a marked fear of reliving anxious symptoms, thus contributing to the maintenance of the problem.
These data underline how important it is to recognize and address secondary anxiety, not only for individual well-being but also for the impact it can have on quality of life and social relationships.
Causes and risk factors
Secondary anxiety can develop from several factors, which often intertwine with each other. Understanding the causes can help you recognize early signs and intervene more effectively.
- Traumatic or stressful experiences: Particularly intense events, such as a panic attack or a highly uncomfortable situation, can leave an emotional trace that fuels the fear of reliving those sensations.
- Personal predisposition: Some people are more prone to developing secondary anxiety due to increased emotional sensitivity or a family history of anxiety disorders.
- Thinking styles: Brooding, or the tendency to think repetitively and negatively about one’s sensations, can reinforce the fear of anxiety itself.
- Environmental factors: An unsupportive environment or one characterized by high levels of stress can increase the risk of developing secondary anxiety.
These factors never act alone, but combine in a unique way for each person, influencing the appearance and intensity of secondary anxiety.
Difference with primary anxiety
Secondary anxiety can become more disabling than anxiety symptoms in general, which instead can only be activated in limited situations. Primary anxiety can in fact emerge only in certain moments, for example:
- in situations of social exposure;
- when faced with specific stimuli.
Secondary anxiety, on the other hand, involves the person’s entire life, leading them into a situation constant state of alert which does not fade easily.
Primary anxiety, secondary anxiety, and other related disorders: an overview
To better understand the complexity of anxiety, it is useful to distinguish between its different forms and the disorders that may be related.
- Primary anxiety: Manifests itself as a direct response to a situation perceived as threatening. It is often limited and linked to specific contexts or stimuli.
- Secondary anxiety: It is the fear of experiencing anxiety or its symptoms again. It can extend to multiple situations and become pervasive, affecting daily life.
- Related disorders: In addition to primary and secondary anxiety, there are other anxiety disorders recognized by the DSM-5, such as panic disorder, generalized anxiety disorder and specific phobias. Similar but distinct disorders, such as obsessive-compulsive disorder, are instead placed in a separate category called “Obsessive-compulsive and related disorders”. Each of these has specific characteristics, but can be accompanied by secondary anxiety.
This distinction can help to understand that anxiety is not a unique phenomenon, but can take different forms and require personalized intervention strategies.
Possible consequences
In addition to intensifying unpleasant anxious sensations, as we have seen, secondary anxiety can lead to:
- decreased self-confidence: the belief that you are no longer able to manage your life can change your self-image in a negative sense;
- sense of helplessness: feeling of being unable to do anything to change things and feeling at the mercy of events;
- development of new disorders: Experiencing constant anxiety can lead to suffering from other anxiety-related disorders.
We must not forget that, in general, anxiety has an important function, as it is a alarm bell which indicates that something is wrong.
Secondary anxiety leads to divert attention from the underlying problem that initially triggered the primary anxiety, thus preventing us from seeing and solving it. Focusing on the fear leads to moving away from the reason that triggered it, thus making it increasingly stronger.
How to treat it
This fear of anxiety, just like anxiety itself, manifests itself at the same time as both on a physical and emotional level and for this reason it is essential to take both of these aspects into consideration in treatment.
- Physical level: The symptoms that are immediately perceived are often at this level. Sweating, anxious tremor, tachycardia, feeling of heat, dizziness and disorientation can be frightening. However, with therapy it is possible to start recognizing these signs and manage them early, for example through breathing or specific relaxation techniques.
- Emotional level: In therapy it is possible to see anxiety not as something to be eliminated, but rather as a wake-up call that indicates the presence of an underlying problem that needs to be addressed. Anxiety can then become a precious ally in the search for a greater state of well-being.
Clinical examples: how secondary anxiety can manifest itself in daily life
To make the concept of secondary anxiety more concrete, it may be useful to consider some examples taken from clinical experience (the data are anonymized and represent typical situations).
- Marco, 32 years old: After experiencing a panic attack on the subway, Marco began to fear experiencing those sensations again whenever he was in crowded places. This fear led him to progressively avoid many social situations, limiting his daily life.
- Sarah, 24 years old: Following a period of high stress at university, Sara experienced episodes of intense anxiety. Even when the symptoms subsided, she continued to constantly worry that they might return, developing real secondary anxiety that made it difficult for her to concentrate on her studies.
These examples show how secondary anxiety can profoundly influence people’s choices and well-being, going beyond simple momentary discomfort. In these cases, the support of a professional can be useful in recognizing and addressing secondary anxiety, promoting effective coping strategies and improving quality of life.
For further information: clinical guidelines and recommendations
The main international guidelines, such as those of the American Psychiatric Association (APA), underline the importance of an integrated approach in the treatment of anxiety and its secondary manifestations. According to the DSM-5, the accurate evaluation of symptoms and the personalization of the therapeutic path are considered fundamental to promote lasting results.
Clinical recommendations suggest combining psychotherapeutic interventions, such as cognitive-behavioral therapy, with stress management techniques and, when necessary, pharmacological support. This approach can help reduce both the symptoms of primary anxiety and the fear of experiencing them again, promoting a more complete recovery and better quality of life.
Does anything sound familiar?
Recognizing that you are in these situations may not be easy, just as it can be difficult to manage them on your own. An instrument to start gaining self-awareness are anxiety tests, which should always be read with the help of an expert. The support of a psychologist with experience in anxiety disorders can be a fundamental help in these cases to focus on the underlying problem and acquire useful tools for dealing with future situations.
