Category: Anxiety

Anxiety is a mental disorder that causes suffering to many. In Susan Schultz’s film “It’s Just Anxiety”, several people with different anxiety disorders are vulnerable in their interviews, showing a glimpse of the struggles they face daily. In this essay, I will highlight common symptoms given in the film, coping strategies that are found helpful by some people with anxiety disorders, and ways to offer support. I will also examine my experiences with anxiety and how they may relate to the film.

Anxiety encompasses several different disorders, for example, generalized anxiety disorder, panic disorder, social anxiety, OCD, and PTSD. Although these disorders are different, they have many similarities. In the film, people with different anxiety disorders are interviewed, making it clear to see similarities and differences between the disorders. Among the disorders, some common symptoms expressed in the film are Trouble breathing, excessive worry, fear, intrusive thoughts, and heart-pounding. These are just to list a few. The film demonstrates the main difference in disorders as what triggers worry, fear, etc. In social anxiety it may be social gatherings and events, for OCD it may be as an example shown in the film, phobias of germs, and for generalized anxiety, just about anything could be a trigger.

The film focuses on how each person may feel as they struggle with their disorder throughout their day. Coping mechanisms and helpful tips for loved ones are also shared. Many of the people who were interviewed explain a feeling that they need to “get out” or “escape” when having a panic attack and going to another room or leaving where they are may begin to help. One man explained how his medicine would calm him down, but that it made him very sleepy causing it to be dangerous to take depending on his location. Other coping mechanisms mentioned were taking things one step at a time when trying to get yourself to do something that is anxiety-inducing; such as driving to the store for some. Cognitive Behavioral Therapy was mentioned as a way to help work through specific anxiety-inducing phobias, and another person mentioned that exercise was very helpful for her. There were many more therapies and coping mechanisms mentioned in the film as well. When speaking of support that could be beneficial for people with anxiety, some mentioned getting informed on your loved one’s disorder, being patient and caring, and seeing the person as more than their disorder.

Growing up I was always a social person, trying to connect with as many people as possible. But at the same time, I struggled with social anxiety. I was often told by my mother and others close to me as well, “You are a people pleaser” or “You are an overthinker, you are overthinking again”. So I grew up thinking my anxiety was just that, I was overthinking again. Because of this, I had never been diagnosed or even tried to get help for my anxiety. When I become anxious, it is typically when I am not with other people but before or after I have seen or spoken with them. Sometimes I get off the phone with someone and begin to think about what I have said and how it may have been interpreted wrong and now they may be hurt or angry at what I have said. I do have panic attacks occasionally often with no known trigger but this social anxiety happens much more often.

When I am dealing with this anxiety I will begin to have intrusive thoughts, similar to ones demonstrated in the film. Telling myself very harmful things especially involving how others may perceive me. I do tell myself as some people in the film mentioned as well, it’s just anxiety but the feelings that it may be rational are very powerful in these moments. I begin to feel sick to my stomach and have trouble getting full breaths and the intrusive thoughts are hard to stop. When having a panic attack, I will have trouble breathing, feel faint, heart pounding, sweating, and intense fear as well.

In the film, no one mentioned being triggered or anxious about similar things to me. I have barely heard of people having social anxiety yet they are an extrovert and thrive when around others. I never understood how I could have so much anxiety when apart from others but when I am with them I am fine. This is part of the reason, along with the fact that I had always been told I was “just overthinking” that I only realized I had anxiety -apart from occasional panic attacks- this last summer. My friend helped me to realize that my constant worry and “overthinking” was anxiety and that I should see someone about it. She also shared coping mechanisms that work for her such as learning when she was starting to be anxious and talking herself down and out of panic attacks, similar to in the film when one person reminded themselves to breathe and that it was “just anxiety”. When realizing you are in these situations you may be able to talk yourself down, but sometimes the intruding thoughts telling you this is logical fear is very strong.

Many of the coping mechanisms shown in the film I have already learned but I am interested in trying art therapy and meditation as mentioned in the film. Schultz’s film gives a great overall picture of anxiety disorders, how they may affect people, and what can help with coping and supporting loved ones. It may help with providing understanding for people who are not familiar with anxiety in their own lives. The film provided me with a better understanding of different anxiety disorders and helped provide coping tips.

Anxiety is something that is experienced by everyone. It occurs in our everyday lives, causing us to worry and stress over the things that are happening to us. Having a busy schedule or a large workload can have considerable impacts on the amount of anxiety a person experiences. College students are expected to manage their schedules to do tasks such as meet deadlines for coursework or set aside time for studying. This study aims to observe any relations between the anxiety that college students experience and several factors that may impact it such as their year in college, their gender, and how many credits they’re taking.

How many years a student has been in college can play a large role in the amount of stress that they feel. College freshmen can feel especially anxious moving away from home for the first time, leading me to hypothesize that first year students will report experiencing higher stress levels than other years of students. A previous research study indicates that around 21% of college freshmen are affected by separation anxiety (Seligman & Wuyek, 2010). This research doesn’t examine or compare the other years of students, but it does provide a statistic that would indicate that freshmen are experiencing high levels of anxiety. Another research study supports this hypothesis by finding negative correlations between anxiety and age, where younger students reported experiencing higher levels of anxiety (Baloğlu et al., 2007). I didn’t find much prior research pertaining to the impacts of a students year in college and their levels of stress, but the two mentioned studies would indicate that first year students tend to be more stressed.

Gender is another factor that could have a possible impact on the level of anxiety a student reports having. A previous study examining the differences of anxiety experienced by male and female students of varying ages found that there was not a significant influence of anxiety on gender (Baloğlu, 2003). A similar study observed relationships between anxiety and self-consciousness in public, finding that women tend to experience higher levels of stress than men when it comes to taking tests and social situations (Sowa & LaFleur, 1986). Another study looked for a correlation between financial strain experienced by college students their levels of anxiety. The researchers found a positive correlation between financial strain and anxiety for female participants, while male participants indicated less anxiety. Male participant’s levels of anxiety were only shown to have statistically significant increases if they had reported low levels of family support in addition to their financial strain (Tran et al., 2018). It would appear from this study that there is a correlation between the level of anxiety that a student reports experiencing and their financial situation, with a larger impact for females than males. The findings of these studies would lead me to conclude that the gender of a student does play a role in the anxiety that they report having.

A student’s course load is another factor that could have an effect on their reported level of anxiety. A student who takes a lot of credit hours has a busier schedule and will have less free time, spending more time in class. Additional classes will also involve more assigned homework or projects, and more time required to study for exams. This overload of schoolwork may cause increases in stress and anxiety as students struggle to perform well and meet deadlines. A study on Pakistani students observed the effects of stress on a student’s academic performance. The study found that there was a positive correlation between the workload that a student has and their reported levels of stress (Talib & Sansgiry, 2011). Higher amounts of work assigned to students led to increases in the anxiety that they experience. Based on the findings of this study, I would expect to see that students with more credit hours will report having higher levels of anxiety.

Introduction

“No excellent soul is exempt from a mixture of madness.” Aristotle.

The link between creativity and mental health is a very difficult one to define and even harder to prove. Mental illness as long as history can record has been a taboo subject. It has always been something to be feared, hidden and ashamed of. However, displayed in the artistic form, whether fine art, prose, poetry, or musical composition it becomes acceptable. It becomes easy for the viewer to spectate and witness the mental decline of these creators. The psychological suffering becomes something that is no longer embodied by the physical being and is easy to view. But why is it that so many great artists suffer from a decline in mental health? Do Mental health issues drive the urge to be creative? Is creativity an outlet for the tormented mind?

For centuries the link between creativity and “Madness” has captured the imagination. From Van Gogh slicing off his own ear, to Tracey Emins Bed displaying her mental breakdown the idea of the mad artist, crazed musician or tortured poet still today continues to hold a grip on the human imagination. Many studies have been conducted in an attempt to establish a link between Mental disorders and creativity. These studies however have many areas of confliction and difficulties. Such difficulties are:

• Questioning whether certain creative professions are connected to higher levels of stress and psychological pressures.
• Difficulty in defining terms like “creativity and madness”.
• Today’s popular culture glorifying and excusing artists aberrant behavior.

What is madness?

The question of whether creativity and mental health disorders are related Is as old as art itself. It has long divided opinions of psychologists, theorists and historians. Aristotle wrote that the creative act was a natural event that conformed to natural law yet in contrast Plato claimed that a poet’s inspiration arose during moments of “divine madness”. As far back as the ancient Greeks it was believed to be a great divine madness that inspires creativity. Different from the madness such as melancholia or delirium these states of divine madness were believed to be produced by the gods. The god Apollo induced Prophetic madness enabling knowledge of the future. Dionysus through Ritual madness allowed emotional release. Love and love sickness were stimulated by Erotic madness induced by Eros or Aphrodite. And the Muse gave inspiration to poetic madness. It was believed that all creative acts, whether dance, art, writing philosophy or intellectual discovery was born from one of these forms of divine madness.

Throughout history the idea of the mad artist has compelled researchers to investigate this link between the creative mind and Mental health disorder. However, because of this fascination there have been far more studies conducted into the psychological imbalances in artists than those who work in more regular creative industries. Few would ever notice a study conducted into a hair dresser and how her mood swings effect the quality of cut and finish on her client’s hair, however the movie “Shine” which portrays the Pianist David Helfgott and his battle with mental illness received considerable notice. (The New York Times). The tortured artist haunted by personal demons, or visionary genius taunted by inner thoughts has always been a part of popular culture. But are Creative people really more prone to be born with or suffer mental illness than say an accountant or welder?

It would also seem that the artists who suffer “madness” or mental health issues have over the years been those whose work has been given a greater recognition. Artists and writers who kill themselves such as Van Gogh or Sylvia Plath who committed suicide by putting her head in a gas oven, become more captivating to the public and are often the subject of literary biographies. Artists and writers who live contented and well-adjusted lives such as mild-mannered Claude Monet have been equally prolific and talented as the “crazed” artists, however attract less attention. These artists suffering mental health problems have always proved far more captivating to the public (The New York Times).

Edward Munch is one example of an artist whose life was tormented by his mental health. Suffering anxiety and vivid hallucinations many of his paintings stem from this. Whist in Oslofjord, Norway the painter had a vivid and distressing vision. Looking out across the land he recalls how the world around him changed. “The sun began to set – suddenly the sky turned blood red, I stood there trembling with anxiety – and I sensed and endless scream passing through nature”. It was from this hallucination that the artist found inspiration for one of the greatest masterpieces of all time, “The Scream”.

Munch throughout most of his life struggled with the stress and angst of the modern man. It is said that’s Munch paintings are a direct response and representation of this turmoil. The artist saw this suffering as a deep, driving and vital force behind his art. He wrote in his diary: “My fear of life is necessary to me, as is my illness. They are indistinguishable from me, and their destruction would destroy my art”. Though one of the most famous artists to experience the fine line between artistic talent and torment he is not the only one.

Vincent Van Gogh swayed heavily between madness and genius. Writing in 1888 to his brother Theo he declared: “I am unable to describe exactly what is the matter with me. Now and then there are horrible fits of anxiety, apparently without cause, or otherwise a feeling of emptiness and fatigue in the head… at times I have attacks of melancholy and of atrocious remorse”. During one of these episodes after an argument with his friend Paul Gauguin the artist sliced off his own ear, and later committed suicide.

The struggles of these artists and other creatives are still evident in today’s popular culture and society. This gives weight to the belief that those with creative personalities are more susceptible to a range of mental illness, including bipolar disorder and schizophrenia. The fascination with the “mad artist” is still as strong today as ever and an ever-growing body of research would suggest that there is merit in the concept of the mad artist. For decades the potential link between creativity and mental health disorder has fascinated psychologists. Even in the earliest of studies examining subjects from across all fields, literature, art and music, it was found that those with creative personalities had an unusually high record of mood effecting disorders. Charles Dickens, Eugene O’Neill and Tennessee Williams were all known suffers of clinical depression, whilst Ernest Hemmingway, Leo Tolstoy and Virginia Woolf suffered from Bipolar disorder.

The work of American artist Jackson Pollock was often fueled by his alcoholism and depression. His sometimes-disturbing canvasses echo his emotional turmoil as shown in “Circumcision shown here’. Many aspects play a role in the causes of Mental Health disorder and for this question to be answered it must be investigated from all views. Genetics, Psychological, and Social. To examine the link between mental illness and creativity there are many factors to consider. The impact of nature and nurture, the impact of coming from a broken home, mental illness in close relatives, career choice, religious beliefs.

Scientific research

An article produced by the NHS in October 2012 set out to explore the link between creativity and mental illness, to examine this link they used a study published by BBC news. “Creativity is often part of a mental illness according to a study of more than a million people”. BBC News reported, “ancient issue of genius and madness is of interest to both public and doctors”.

As stated in the NHS Study looking at creativity and the link with mental illness, an attempt to find an answer to this long posed question of whether creatives are more prone to mental illness saw researchers funded by Swedish Medical Research Council and The Swedish Psychiatry Foundation, examine Swedish health records and used these to identify over one million people diagnosed with varying mental illnesses. They looked at the occurrence of creative occupation within this group and compared that to a matched sample of “healthy” people.

The BBC’s coverage of this research was accurate for the most part though the headline was rather misleading. It found that with the exception of bipolar disorder, overall, people in creative professions were no more likely to suffer from a psychiatric condition than anyone else. However, the quality of research into this question has often been poor and subject to bias. There was though one exception-writers. Writers were most likely more so than the general population to suffer a range of psychiatric disorders, including schizophrenia and depression. Writers were also more likely to commit suicide (named by one psychiatrist the “Sylvia Plath effect” after the writer who killed herself).

This study does not though explain the observed patterns, nor does it explain how or why, people with creative personalities may be more likely to suffer with mental health conditions. It is worth noting during this that researchers had to categorize people by “creative” profession. However, those who do not have a “creative job” can still have a creative personality, and also the researcher’s idea of what is “creative” may not be the same as anyone else’s.

The Swedish researchers were also interested in what is termed the “inverted U model”. This model questions whether there is an increased severity of symptoms up to a point beyond which it begins to diminish the creative abilities. For example, “German philosopher, Friedrich Nietzsche suffered a nervous breakdown in 1889 after which he produced no more coherent work”.

There is also an argument that any study on the association between creativity and mental health disorders also needs to examine the relatives of those afflicted by the mental illness. This being as many mental health conditions such as schizophrenia and bi polar are known to be affected by genetics. Research by this group however, suggested that people with these disorders and their relatives were over represented in creative occupations during the research. This study aimed to investigate if all psychiatric disorders are related to creativity or is it restricted to psychotic features. (psychotic features generally mean the presence of disordered thought patterns, delusions or hallucinations, Insert ref). It also aimed to investigate specifically if psychiatric illness is more prevalent in writers. This research was conducted using a study design called a nested case control study. within this type of study, each “case” (person with a mental health disorder) is matched for sex, age and other factors against a group of healthy controls, to measure a particular outcome, in this study it was creative ability.

The psychiatric and mental health disorders they included were:

• Schizophrenia
• Schizoaffective disorder
• Bipolar disorder
• Depression
• Anxiety disorders
• Alcohol abuse
• Drug abuse
• Autism
• ADHD
• Anorexia nervosa

The research also investigated a number of completed suicides.

The researchers defined ‘creative’ as anyone in a scientific or artist occupation, including professional writing, Individuals reporting a creative occupation were considered creative. However, the researches provide little further detail of what were considered creative occupations. Basic analysis of the results of this study show that of 1,173,763 of the patients diagnosed with specific psychiatric disorders almost half suffered from depression. Of these patients:

• Aside from bipolar, people in creative professions were no more likely to have a mental illness than those in the non-creative control group.
• Those working in creative professions were considerably less likely than the controls to be diagnosed with schizophrenia, schizophrenia effective disorder, depression, anxiety, alcohol abuse, drug abuse, autism, ADHD or to have committed suicide.
• One specific group, writers, were twice as likely to suffer from schizophrenia and bipolar as the controls. That were also more likely to suffer from eating disorder depression and to commit suicide.
• Direct relatives of people with schizophrenia, bipolar disorder, anorexia nervosa, and siblings of people with autism were more likely to work in creative occupations.

From this research, with the exception of bipolar disorders there was no link found between creative personality and having a psychiatric disorder. The findings from direct relatives (who share half their genes with affected cases) may support the ‘Inverted U model’ between psychiatric conditions and creativity. Definitions of creativity are always difficult to determine and this research relied on peoples occupations, as a proxy of ‘creativity’. Researchers considered “creative professions” as scientific and artistic occupations. These scientific occupations included those conducting research and teaching, but beyond writers there was no more explanation of what was considered an artistic occupation.

Artist Case Studies

Richard Dadd – 1817-1886

The paintings of Richard Dadd offer a valuable perspective into the affect of mental health and illness has upon art. The artist was clearly very ill, but did this illness contribute to his talent and make him a creative genius? Dadd was at first best known for his highly detailed Victorian Orientalist paintings. Having traveled through Europe the artist developed a fascination with the people and places he had visited. Early signs of his declining mental health can be seen by his obsessive compulsion for painting even the most minute detail within his work. The artist had a well off and happy start to life. The son of a chemist and well educated he was admitted to the Royal Academy of Art a rage 20 (Souter, 2012, p. 23).

Whilst at the academy the artist met William Powell Firth, August Egg and Henry O’Neil, these along with others founded the first group of British Artists to combine for greater strength (Greysmith, D., “Richard Dadd, The Castle of Seclusion”, p. 76). It was in July 1842 that Dadd was employed by Sir Thomas Philips as a draughtsman and they set off on a grand tour of Europe. It was towards the end of the trip whilst travelling through Egypt that the artists mental health began to rapidly decline. Dadd became violent and delusional believing himself to be receiving instruction from the Egyptian god Osiris (Aldridge 1974, Richard Dadd, p.22). It was initially believed that his condition was caused by sunstroke and sleep deprivation.

Returning to Britain in 1843 the artist wrote to a friend in England: “I have lain down at night with my imagination so full of vagaries that I have really doubted my own sanity” (Russel G. and Huddlestone S., Richard Dadd: The Patient The Artist and The Face of Madness 2015). During his return trip he expressed a desire to seek out and harm individuals, a desire he was never to fully execute.

On arriving home his family expressed concern for the artists mental state and took Dadd to Cobham in Kent where it as hoped he would recuperate. However, in August the same year he became disturbed. Incoherent babbling speech and bizarre beliefs troubled the artist. His delusional thoughts overcame him and convinced the Egyptian god Orisis was commanding him to do so he attacked and murdered his father (Alderidge 1974, Richard Dadd, p. 24). Fleeing police Dadd traveled to France, on route he attacked and attempted to kill a fellow passenger. Searched by police he was found to have list of people who he believed must die and told the police that he had received a message from the stars commanding him to hunt out and kill these people (Beveridge A, Richard Dadd The Artist and the Asylum).

Arrested and returned to England the artist admitted the murder of his father claiming that the devil had possessed his fathers body. He was remanded in custody at Maidstone Jail to stand trial at Chatham Magistrates Court. The Reporter of the local newspaper described the artist as having a “wildness in his manner” (Kentish Gazette, 13 August 1844). Dadd was however never to stand trial and was found to be insane rather than guilty of murder. He was sentenced and committed to Beltham (Bedlam) Hospital then later transferred to the newly built abroad or Hospital (Charley, 2006). Dadd one of 7 children was suspected by Doctors to be suffering schizophrenia, a condition which two of the artists siblings also suffered (Alderidge 1974, Richard Dadd, p. 22).

During his time at Bedlam and Broadmoor hospitals Dadds aggressive behavior continued, Attacking fellow patients the artist was classified as a danger to others. However as part of the authorities new therapy the artist was not punished but instead given a considerable amount of freedom. Given his own art studio and despite being at risk he was given access to tools such as knives for creating carvings, he was also allowed free access to the grounds of Broadmoor where he would spend time observing other patients.

Dadds case attracted considerable public and press attention. During his time in hospital he gained great notoriety as an artist. Whilst there is no doubt that Dadd is indeed a creative genius there is however questions that arise. Was Dadd a well known artist who attracted fascination due to his mental health disorder or were the public fascinated by the artists crimes and then captivated by the press release of his paintings? Had Dadd not been a patient at one of the worlds best known mental institutions would the public have ever discovered his art? The public and press had a great sympathy for the artist. He is often described as being sad and unhappy. One piece says “He has always been considered a young man of a most mild disposition and had ever exhibited the warmest and most affectionate attachment to his father (Kentish Gazette, 19 September 1843).

Dadds highly and obsessively detailed paintings received much acclaim during his life. The press and public alike were fascinated as people today still are by the romance and mystery of the mad artist. The artist who’s only escape from the bleak asylum life was to paint depictions of mythical imps and sprites and highly detailed memories of his travels. However following the artists death their was a decline in the popularity of his work. Was it that Dadds paintings had gone out of fashion or simply that his tragic story itself was more exciting to the public and press than his paintings? There was a revival of interest in Dadds paintings in the 1960’s when the Nascent anti Psychiatry movement saw Dadd as a heroic survivor of psychiatry (Thomas, Richard Dadd: The Artist and the Asylum published online on the Art of Psychiatry blog 18/02/2012). Once aging this interest in the artists work was not purely because of his artistic talent but linked to his mental condition. “We as are viewers are transfixed by Dadds fantastical paintings but not because he had a mental illness but because they are nothing like the leaden Victorian art of the day” (Jonathan Jones The Guardian).

Public speaking was described as the act of conveying a speech to the audience (Spencer, 2018). Based from the definition, it appears that conveying a speech to an audience is a simple exercise wherein it’s involuntary to address around a certain matter with someone to orate. Yet, it is quite distinctive nor connected with various factors to get into account when a person conducts an oration (Novakovic, 2015). Novakovic also delineates oration as a basis of the overall message. Oration was defined as a dangerous weapon wherein there are three basic methods by which a speaker can achieve something with the crowd. It can be compelled, it can be persuaded and it can be convinced” (Henz and Lemmerman, 1968 as cited by Teodosijevic, 2015). This shows that developing the skills of the student in the field of the public speaking will give benefits on how the students speak well, perform well, think critically, and express themselves clearly.

Having a developed skills in public speaking is really applicable and useful in life, some of its benefits are: it builds the confidence of a person, develop the research skill, develop a better writing skill, and mostly, it helps a person in overcoming the fear in the field of public speaking. (Spencer, 2018). Public speakers use different techniques to captivate the heart of the listeners. Some examples are having a gesture, creating a unique and entertaining tone of voice, and having rhetorical questions during the speech (Pomfret, 2016).

Public Speaking Anxiety

Public speaking creates anxiety for those who usually do that (Chandler, as cited by Pomfret, 2016). Fear of public speaking is called ‘glossophobia’, which is a major source of anxiety among the speakers. According to the National Social Anxiety Center, 73% of the population has some degree of glossophobia. While it may be intimidating, learning how to effectively speak in public is an important skill to cultivate, particularly as students prepare for college. According to the study of Raja (2017), overcoming anxiety in the field of public speaking is important before a student transmits from academic life to professional life. The study of Raja also revealed that exposure to a virtual environment can improve students’ confidence and improve student’s confidence and enable them to face the audience.

Recent researchers have also been proven that public speaking is very essential and useful to the students in developing the communication skills (Mabuan, 2017 as cited in the study of Soto–Caban, Selvi, & Auila- Medina, 2011). With that, the researchers see that students would do a lot of reading, research and practice to have an informative public speech. (Nguyen, 2015). Definitely, every learner need to develop even just the basics of public speaking, whether a person has a different goal of a profession (Teodosijevic, 2015).

In the study of (Pratama, 2017) the researchers investigated the factors that affect the student’s confidence in public speaking through applying the qualitative method to analyze the data. The researchers also used the technique recording, note-taking, and questionnaires in collecting data. A qualitative method was also used in the study of (Mabuan, 2017) to explain the student’s experiences and conducting a public speaking presentation.

Communication skills include public speaking as a way of creating and improving personal development on different stages. Developing the skills of a person in the field of public speaking gives much essence to meet the goals (Barnard, 2017). Public speaking is an effective skill that everyone should have and develop.it gets easier with practice and training for the senior high school students. Public speaking will be useful to the senior high school students in the form of presentation and oral assessment in school which could give a significant portion of the final grade. Public speaking will definitely useful to the students when entering the professional world, especially when working in a business setting. Being able to speak fluently and confidently could lead to a greater career opportunities. For the students, improving the basic skills in speaking still, provide benefits and preparing for real-life scenarios (Thomas, 2019).

Academic Performance

A lot of factors influence the academic performance of learners. Having a good performance might be from the learning process and way of educating the teachers (Baharom, et. al., 2015). According to Aziz (2015, as cited in the study of Hijazi & Naqui, 2006) students academic performance is not influenced by the profile of a learner. The fact is that having a good performance depends on the awareness of the students regarding its value and how the students developed the skills that may affect the academic performance.

In the study of Garcia (2017) as cited in the study by Mosha (2014), it revealed that the absence of learning materials in teaching and shortage of teachers affects the performance and development of the learners. This shows that if the teachers are not well-trained and lack of the skills as a teacher therefore, the academic performance of the students will be highly affected. Meanwhile, in the study Akinsola (2018), he concluded that there are many factors that affect the academic performance of the students. Akinsola has concluded that class size or the volume of the students in a room affects the learning of the students. In the study of Africa and Benedict (2015) they revealed that the relationship between parents and children or parental involvement has something to do with the academic performance of the students. The findings of Africa and Benedict supported the study of Narad and Abdullah (2016).

Critical Thinking

Critical thinking is a substantial factor in the progress of the student’s knowledge (Qamar, 2018). It allows a person to dissect and synthesize information to solve problems in a broad range of areas (Alcantara and Bacsa, 2017). In addition, it is the careful and deliberate determination of whether people should accept, reject or suspend judgment on a certain claim (Guevarra, Marquez, and Pecson, 2017). In the same study conducted by Guevarra, Marquez, and Pecson, they stated that critical thinking skill can be taught to students when they are given the chance to raise questions, explore possibilities and engage in meaningful discussion. Also, critical thinking is a knowledge updating, differentiate differences, identify cause-and-effect relationships, getting ideas from examples, and evaluate information regarding truth value, positive or negative effects as added by Florea and Hurjui (2015). In the study of Stefanova, Bobkina, and Perez (2017) they point out that the ability to think critically is one of the primary goals of education and it supported the study of Costillas (2016) in which she concluded that developing critical thinking is an essential goal of education.

Most students today are weak in critical thinking (Yanklowits, 2013) as cited by Costillas (2016). Therefore, critical thinking should be part of students learning and schools should be responsible to develop and evaluate critical thinking skills through teaching and learning process (Firdaus, Kailani, Bakar, and Backry, 2015). Furthermore, group work can be helpful in developing the critical thinking skills of the learners for the students are given the chance to work on a problem together and discuss difficulties (Belecina and Ocampo, 2018).

According to Jones and Pimdee (2017), critical thinking skills have become one of the key pillars of a new knowledge-based economy. Meanwhile, the Thailand Research Fund (TRF) evaluated the logical thinking and analytical skills of 6,235 students. The result was shocking for the average score was 36.5% with 2.09% of all students passing. Seeing that the results were very low, a new critical learning management model was developed (Changwong, Sukkamart, and Sisan, 2018). Despite of the results, Hussin, Harun, and Shukor (2018) have found a way to enhance critical thinking skills through Problem Based Learning (PBL) approach. In the study of Hamid, Waycott, Kurnia, and Chang (2018), they stated that learning through technologies can increase students’ motivation, improves work quality and enhance critical thinking.

According to Marquez (2017), Filipino children and youth should not only be sent to schools. The learners should be trained to become critical thinkers so as to be open, sensitive, and to understand the belief and values of others as well as not to be enslaved by their respective belief and value system. The benefits of thinking critically are: students become more open-minded and empathetic, better communicators, more inclined to collaborate with their peers and to receive and discuss their ideas (Tatsumi, 2018). Luckily, the general skills to be a critical thinker can be taught (Niu et al., 2013; Abrami et al., 2015) as cited by Schmaltz, Jansen, and Wenckowski (2017). Critical thinking in the 21st Century has been recognized as a skill for the citizens (Hussin, Harun, and Shukor, 2018) and it is one of the strongest predictors of long-term success in the workplace (Nord, 2017).

All these discussion driven the researchers to conduct this study to discuss the effects of public speaking anxiety among senior high school. The researchers are hopeful that the findings of this study will help to create a training plan in enhancing the public speaking skills among senior high school.

Abstract

This literature review will analyze the study of whether test anxiety interfered with how well students performed on the exam. This literature review will examine the different aspects of the study and how well it answered the question related to the study, also this review will breakdown the results within each area of the study to determine whether it worked. Finally, this literature review will dive into test anxiety to determine the background on it and how a student might feel anxious. The review will also determine whether different aspects in a student’s life contribute to further anxiety during an exam.

Test Anxiety and Academic Achievement among Undergraduate Nursing Students: A literature review

In 2016 there was a study conducted on the relationship between test anxiety and academic achievement among undergraduate nursing students. The researchers wanted to explore the study more when it was realized that “most nursing students experience high levels of test anxiety during final exam even though their marks are good throughout the semester” (Dawood et al., 2016). The study consisted of taking 277 nursing students from different levels in nursing school, the students were asked to do a questionnaire that included “participant’s demographic background such as age, GPA, academic level, history or medical and mental illnesses and Test Anxiety Inventory (Dawood et al., 2016) (Spielberger, 1980). The students were asked “20 statements to find out how often the participants experience the feeling described in each statement” (Dawood et al., 2016), this was done to determine how each student felt during certain high-stress situations. The purpose of this literature review is to determine if there is a relationship between test anxiety and academic achievement among undergraduate nursing students, by “identifying the level of test anxiety and second to explore the relationship between anxiety and academic achievement among undergraduate nursing students” (Dawood et al., 2016).

Test Anxiety

There is evidence that anxiety is a “universal cause of poor academic performance among students worldwide (Dawood et al., 2016). There is support for this theory when Asadullapoor, Fati, and Gharaee, 2010, state “anxiety was defined by as feeling that undesirable and unclear like when a person predicts a danger situation” (Asadullapoor, Fati, and Gharaee, 2010). On the other hand, other sources suggested there was no relationship between emotional aspects of performing that correlates with performing poorly on an exam, this is evidenced by Cassady (2001) stating “The prime view of the association between these two factors suggests the cognitive component that directly influences the performance of students in exams, while the emotionality component is associated but does not directly persuade test performance” (Cassady, 2001). Both sides evidence the standing of the argument that anxiety can have an impact on test performance, but there is also no correlation between a student doing poorly on an exam due to anxiety. Other researchers believed that having test anxiety was important for the student to do better in school, but other researchers disagreed and stated ‘Mounting up so much of anxiety will not help the student to perform rather it will influence the academic performance negatively (Coon & Mitterer, 2009).

Relationship Between Nursing students & Test Anxiety

There was also evidence that stated nursing school in general causes the student to feel anxiety because ‘Nursing programs can be viewed as highly stressful settings. Nursing students are under pressure for taking various tests throughout their college and professional lives (Dawood et al., 2016), this idea is supported when Beggs, Shields & Goodin 2011 state ‘Nursing students experience higher levels of test anxiety than others, especially because of struggle to balance multiple works, career adjustment and family responsibilities with long study hours that are required for success. Over time these stressors may put the student in chronic stress’ (Beggs, Shields & Goodin 2011). The downside to the study for nursing students and the relationship between performing negatively on an exam was the fact that the study did not take into account other students from different parts of the world to determine whether there was anxiety while taking an exam during nursing school, given this problem the study was conducted in Saudi Arabi and there was little evidence to support the nursing students there, but rather more so the nursing students in western cultures, this is evidenced when “Most of the studies that assessed anxiety and stress among nursing students were carried out in western population. However, there are limited researches on test anxiety among nursing students in the Saudi population” (Dawood et al, 2016), this is concerning considering the researchers wanted to make the connection of test anxiety to nursing students in this area.

Discussion

The study was conducted with 277 nursing students, some from different levels within school, using the Test Anxiety Inventory by (Spielberger, 1980) “which was used as a measure of the primary outcome variable of the current study, test anxiety among undergraduate nursing students. The TAI consists of 20 statements, and the participants indicate on a four-point Likert- type scale how often they experience the feeling described in each statement” (Dawood et al, 2016). The average age of the participant was between 19-23, the researchers considered whether the participant was married, as well as if the student had a medical diagnosis. When the study was evaluated it was determined that the students felt more anxious during an exam stating “during examinations I get so nervous that I forget facts I really know. Thinking about my grade in the course interferes with my work on tests” (Dawood et al, 2016) these were the statements that were ranked highest for students. The least ranked questions were those that showed the student as being confident during the exam, the statements were “I feel confident and relax while taking test” and “I find myself thinking about whether ill ever ger through school” (Dawood et al, 2016). When comparing the test anxiety inventory score there is a clear increase in the number of students who did not feel comfortable while taking an exam and the feeling of anxiety present “participants were distributed to four different levels of test anxiety according to their test anxiety inventory scores” (Dawood et al, 2016) “scores between 20 and 35 no anxiety, 36 – 50 mild anxiety, 51 – 65 moderate anxiety and 66 – 80 severe anxiety. Based on this classification, only 6.5% experienced no anxiety, more than one quarter of the participants experienced mild anxiety, half of the participants (50.9%) classified as having moderate anxiety while 14.4% demonstrated severe anxiety” (Dawood et al, 2016). Based on the findings above more students ranked with mild anxiety during an exam in nursing school. The study also presented that students with a high academic level had a decrease in anxiety while taking an exam. It was also learned that although different aspects like marriage, age, and children were taken into consideration neither had much of an impact on whether or not the student did well on the exam.

Conclusion

The purpose of this study was done to determine whether nursing students had test anxiety that interfered with academic achievement. During this study several things were taken into consideration when determining whether it had to do with a students performance on an exam, it was determined that age did not affect whether a student performed poorly on an exam, this is supported by “With regard to relationship between test anxiety and undergraduate nursing students age the present study showed no significant relationship; also indicate that test anxiety scores decreased with participant’s age. These findings agree to the work done by (Ebrahimi & Khoshsima 2014) that age does not play a significant role in the relationship between learners Test Anxiety” (Dawood et al,2016). It was also determined that test anxiety although most students admitted to it there is no correlation on the student’s test scores decreasing because of the anxiety felt while taking an exam. It was also suggested that the study needed to take into account more information to support what could potentially cause the student to have anxiety, the study could be re done and new questions could have been asked to students to see if there is a relationship to how well they prepared for an upcoming exam and whether or not It had caused the student anxiety for feeling underprepared for an exam. The study did suggest that students had ‘mild anxiety’ there was no set factor that determined the patient was going to perform poorly on the test, but rather the student was anxious because nursing school is hard work. The study was done to “(a) identifying the level of test anxiety and (b) to explore the relationship between anxiety and academic achievement among undergraduate nursing students” (Dawood et al., 2016). The reviewed study determined that although most nursing students felt anxious during an exam, it did not correlate with the students performing poorly during the exam.

References

1. Dawood, Eman, et al. “57 Relationship between Test Anxiety and Academic Achievement among Undergraduate Nursing Students.” Education and Practice, 6 Nov. 2016.
2. Afolayan J. A, Donald B, Onasoga O, Babafemi A & Juan A. (2013). Relationship between anxiety and academic performance of nursing students. Niger Delta University, Bayelsa State, Nigeria. Advances in Applied Science Research. 4 (5):25-33.
3. Akbary-boorang M. & Aminyazdi A. (2009). Test-Anxiety and Self-Efficacy. Horizon of Medical Sciences Journal. 2 (15), 70–7.
4. Amiri-Majd M. & Shahmoradi A. (2008). Effects of cognitive behavioral therapy in reducing anxiety. Behav Sci. 7 (3), 53–64.
5. Asadullapoor, A. Fati, L. & Gharaee, B. (2010) Metacognitive anxiety and the immediate and delayed judgment of learning. Journal psychiat clinic psychol. 16 (4), 412–19.
6. Beggs, C. Shields, D. & Janiszewski Goodin, H. (2011). Using guided reflection to reduce test anxiety in nursing students. Journal of Holistic Nursing. 29 (2), 140−147.
7. Cassady J. C. (2005). The effects of online formative and summative assessment on undergraduate students’ achievement and cognitive test anxiety. Journal of Tecnology Learning and Assessment. 4 (1), 14-21.
8. Chapell, M. Blanding, Z. Silverstein, M. (2005) Test anxiety and academic performance in undergraduate and graduate students. Journal Educ Psychol. 97 (2), 268–274.
9. Cheraghian, B. Fereydouni, M. BarazPardejani, S. Bavarsad, N. (2008). Test anxiety and its relationship with academic performance among nursing students. Journal Knowl Health. 3(4), 25–29. Coon, D. & Mitterer, J. (2009). Psychology of Test anxiety. Journey of Cengage Learning. 28(3), 48-53.
10. Donnelly R. (2009). Embedding interaction within a bend of learner centric pedagogy and technology. World Journal on Educational Technology. 1 (1), 6-9.
11. Dordinejad F, Hakimi H, Ashouri M, Dehghani M, Zeinali Z, Daghighi. (2011). On the relationship between test anxiety and academic performance. Procedia Soc Behav Sci. 15:3774-3778. Driscoll, R. Evans, G. Ramsey, G. & Wheeler, S. (2009). High test anxiety among nursing students. Education Resources Information Center. 14 (4), 350-356.
12. Ebrahimi M & Khoshsima H. (2014). On the Association(s) between Test Anxiety and Emotional Intelligence, Considering Demographic Information; A Case of Iranian EFL University Students. International Journal on Studies in English Language and Literature (IJSELL). 2 (7), 147-157.
13. Ferreira C, Almondes K, Braga L, Mata A, Lemos C & Maia E. (2009). Evaluation of trait and state anxiety in first year students. Cien Saude Colet. 14 (3):973-81.
14. Hill KT, Wigfield A. (1984) Test anxiety: a major educational problem and what can be done about it. Elem Sch J. 85:105-126.
15. Kahan L M. (2008). The Correlation of Test Anxiety and Academic Performance of Community College Students. Capella University. United State. Pro Quest LLC journal. Khosravi, M. & Bigdeli, I. (2008). The relationship between personality factors and test anxiety among university students. Journal of Behavioral Sciences. 2 (1), 13–24.
16. Leta, S. (2001). Depression Rates among College Students on the Rise. The Daily California. 3 (2), 189- 192. Mahat G, (1998). Stress and coping: Junior baccalaureate nursing students in clinical settings. Nursing Forum. 33 (1), 11-19.
17. Mailloux, C. (2006). The extent to which student’s perceptions of faculties teaching strategies students context and perceptions of learner empowerment predict perceptions of autonomy in BSN students. Nurse Educ Today. 26 (7), 578–85.
18. Markman U, Balik C, Braunstein-Bercovitz H Ehrenfeld M. (2010). The effects of nursing students’ health beliefs on their willingness to seek treatment for test anxiety. Journal of Nursing Education. 50, 248251. Moadeli Z & Hemsamabedi G. (2005). Survey on the students’ exam anxiety in the Fatemeh (P.B.A.H.) College of Nursing and Midwifery. Journal of Strides in Development Medical Education. 1 (2), 65-72.
19. Journal of Education and Practice www.iiste.org ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.7, No.2, 2016
20. Mohsen, R. Mansoor, T. (2009). Investigating the Relationship among Test Anxiety, Gender, Academic Achievement and Years of Study. English Language Teaching. 2 (4), 70-81. Nicholl H & F.Timmins. (2005). Programmed-related stressors among part-time undergraduate nursing ends. Journal of Advanced Nursing. 50 (1), 93-100.
21. Onyeizugbo E. U. (2010). Self-Efficacy and Test Anxiety as Correlates of Academic Performance. Journal of Educational Research. 1 (10), 477-48.
22. Porto, A. (2013). Definitions and classification of NANDA nursing diagnoses. NANDA International. 68 (4), 603-609. Shamsuddin, K. Fadzil, F. Ismail, W. Shah, S. Omar, K. & Muhammad, N. (2013). Correlates of depression, anxiety and stress among Malaysian university students. Asian Journal of Psychiatry. 6 (4), 318-23.
23. Spielberger, C. D. (1980). The Test Anxiety inventory. Palo Alto, CA; Consulting Psychology Press. Stanley, M. (2012). Integrating religion and spirituality into treatment for late-life anxiety. Cogn Behav Pract. 19 (2), 346-58.
24. Zahrakar, K., (2008). Stress Consultant. Tehran: Bal University Publication, 1sted. (chapter1).

Chapter I

Introduction

1.1. Background of the study

Before proposing this research, preliminary research was conducted by the researcher towards varsity students of EFL in Indonesia University of Education. Respondents of this research were English Education students who are in their senior year, three respondents from each of two classes were chosen randomly, therefore six senior varsity students of English Education major participated in the preliminary research. From the preliminary research, it was found that five students among six who became respondents of the preliminary research have listening anxiety issue.

According to C. D. Spielberge (1983 cited Horwitz, E., Horwitz, B., & Cope, J. 1986) Anxiety is the subjective feeling of tension, apprehension, nervousness, and worry associated with an arousal of the autonomic nervous system. Joiner (1986 cited Al-Sawalha 2016) defined listening anxiety as “a negative listening self-concept.”

The researcher believes that this is a case that needs a great deal of attention because varsity students who are majoring in English Education and in their senior year are supposed to master English fluently to some extent that listening anxiety cannot be in their way.

1.2. Statement of Problems

This research is conducted to answer questions :

1. To what extent do EFL students of Indonesia University of Education experience listening anxiety?
2. What is the cause of listening anxiety issue among EFL students of Indonesia University of Education?
3. How does listening anxiety affect the language proficiency of the EFL students?

1.3. Purpose of Research

Having the background of the research stated above, this research aims to:

1. Investigate to what extent does EFL students of the Indonesia University of Education experiencing listening anxiety.
2. Investigate the reason of why does listening anxiety issue among EFL students of Indonesia University of Education thrives.
3. Investigate how does listening anxiety affects the language proficiency of the EFL students.

1.4. Scope of the Research

The research will focus on investigating the reason behind listening anxiety issue that senior English Education students of Indonesia University of Education are having, how it affects their language proficiency, and to what extent does the students experience listening anxiety.

1.5. Significance of the Research

The result of this research is expected to give contributions for those who have a role in the related field.

The significances of this research are:

1. Theoretically, the result of this research is expected to add a certain deal of information concerning listening anxiety on senior-level English Education varsity students, how it affects their language proficiency, and to what extent do the students experience it.
2. Practically, the result of this research is expected to be of aid to future researchers who are intending to further study listening anxiety on senior-level English Education varsity students, how it affects their language proficiency, and to what extent do the students experience it.

1.6. Clarification of Key Terms

In this research, there are terms that need to be clarified to avoid misunderstanding concerning the terms used. The terms which need to be clarified are:

1. Listening skill

According to Richard (1985, p.51 cited Al-Sawalha 2016) listening is defined as “the process of understanding speech in a second or foreign language”. Listening in this research is considered as an element in the study of language that is needed to be mastered by the students in order to fully master the language.

2. Listening anxiety

Joiner (1986 cited Al-Sawalha 2016) defined listening anxiety as “a negative listening self-concept.” Listening anxiety in this research is considered as a hindrance that caused students to develop themselves slowly in the mastery of listening skill.

3. Students/University Students

According to Cambridge Dictionary, a student is a person who is learning at a college or university. In this research, varsity students are considered as people who are enrolling a higher education level in a higher education institution and majoring in English Education study.

Chapter II

Literature Review

2.1 Listening & Teaching Listening

2.1.2. Listening Skill

According to Richard (1985, p.51 cited Al-Sawalha 2016) listening is defined as “the process of understanding speech in a second or foreign language”. According to Howatt and Dakin (1974 as cited in Islam, 2012), listening is the ability to identify and understand what others are saying.

2.1.2. Listening Comprehension

Listening comprehension is the different processes of understanding the spoken language (Ahmadi, 2016). understanding the spoken language include knowing speech sounds, comprehending the meaning of individual words, and understanding the syntax of sentences (Nadig, 2013 as cited in Pourhosein Gilakjani & Sabouri, 2016 as cited in Ahmadi, 2016). According to Nadig (2013), Listening comprehension encompasses the multiple processes involved in understanding and making sense of spoken language. These include recognizing speech sounds, understanding the meaning of individual words, and/or understanding the syntax of sentences in which they are presented. Listening comprehension can also involve the prosody with which utterances are spoken (which can, e.g., change intended meaning from a statement to a question), and making relevant inferences based on context, real-world knowledge, and speaker-specific attributes (e.g., to what information the speaker has access and about what he/she is likely to be talking).

2.1.3. Teaching Listening

In accordance to Morley & Lawrence (1972), there are six criteria that havve been made in order to guide making of lessons, these aspects are able to carry out simple or sophisticated listening tasks, but not clouding the possibility for the criteria to be used in any other skill area, these are the criteria:

1. Lessons should be set with a definite goals and sub-goals.
2. Lessons require students’ overt participation by demanding students to give immediate written responses.
3. Lessons should be well-structured in order to make students aware of what, where, and how they should perform the lesson.
4. All of the lessons should guide students toward disciplined listening-self-discipllined concentration on the task.
5. Lessons should put more stress to conscious memory work with special attention to lengthen memory span and immediate recall.
6. Lessons should focus on teaching the students instead of testing the students’ ability.

2.2. Anxiety & Listening Anxiety

2.2.1. Anxiety

Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat According to C. D. Spielberge (1983 cited Horwitz, E., Horwitz, B., & Cope, J. 1986) Anxiety is the subjective feeling of tension, apprehension, nervousness, and worry associated with an arousal of the autonomic nervous system.

2.2.2. Listening Anxiety

Joiner (1986 cited Al-Sawalha 2016) defined listening anxiety as “a negative listening self-concept.” “Listening comprehension anxiety can undermine speech production because, in order to interact verbally, the listener must first understand what is being said” Vogely (1998: 68, Capan & Karaca 2012).

Al-Sawalha (2016) have conducted the research on listening anxiety towards undergraduate Jordanian EFL students at Jerash University, in his research he was focused on finding out the extent of the students experiencing listening anxiety, the way listening anxiety affecting their listening process in their major, and the students’ perceived methods in reducing their listening anxiety. There are some recommendations for the educators to: First, introduce more learner-centered activities in order to boost students’ confidence by allowing them to decide what to learn and serve the purpose of a teacher as a facilitator, Second, teachers should focus on teaching listening as skill rather than for the sake of meeting examination requirements, and Third, teachers should be more confident to experimenting on using new methods of teaching.

Chapter III

Methodology

This chapter presents research design, research subject, data collection, data analysis, and organization of the paper.

3.1. Research Design

This research will be using mixed method design, specifically explanatory sequential design. The research will be conducted by collecting the quantitative data and qualitative data separately, with the latter form of data collection help explaining the result of the former form of data collection (Cresswel, 2012).

The research will be conducted by first collecting quantitative data by using a questionnaire of FLLAS (Foreign Language Listening Anxiety Scale) (Kim, 2000cited in Kim, 2005). The scale consists of 33 items scored on a five-point Likert scale, the less the score means the lower listening anxiety that one has, the higher the score means the higher listening anxiety that one has. This questionnaire will be given to the research subjects, which will be chosen randomly, via an online form. After the quantitative data have been acquired from the subjects, the data will be processed to determine which aspects that need to be followed up on the next data collecting session. Once the quantitative data have been collected, and aspects to follow up on the qualitative data collection have been determined, then the qualitative data collection will begin by doing a one-on-one interview with each subject.

3.2. Data Resources

Participants of this research will be chosen from the same group as the participants of previous preliminary research. The participants will be chosen from senior students of English Education major of Indonesia University of Education.

3.3. Data Collection

In order to obtain the necessary data, the researcher will use a questionnaire and interview.

a. Questionnaire

A questionnaire is a form used in survey design that participants in a study complete and return to the researcher (Cresswel, 2012). This research will use FLLAS (Foreign Language Listening Anxiety Scale) (Kim, 2000 as cited in Kim, 2005). The scale consists of 33 items scored on a five-point Likert scale.

b. Interview

According to Cresswel (2012), An interview survey is a form on which the researcher records answers supplied by the participant in the study. It was further stated by Creswell (2012), that the researcher asks a question from an interview guide, listens for answers or observes behavior, and records responses on the survey. The interview will be conducted after the questionnaire results have been processed by the researcher.

3.4. Data Analysis

In this research, the data from FLLAS (Foreign Language Listening Anxiety Scale) (Kim, 2000) questionnaire that will be given to the subjects at the first phase of data collection will be analysed by using descriptive statistics method. According to Cresswel (2012), Descriptive Statistics is a method that indicate general tendencies in the data (mean, mode, median), the spread of scores (variance, standard deviation, and range), or a comparison of how one score relates to all others (z scores, percentile rank).

After the data have been obtained from the first phase of data collecting, and processed to find out the aspects that needs highlight and follow up, interview will be conducted to the subjects of the research. The result of interview will be analysed using descriptive analysis method.

References:

1. Capan, Seyit Ahmet, and Mehmet Karaca. “A Comparative Study of Listening Anxiety and Reading Anxiety.” Procedia – Social and Behavioral Sciences 70 (2013): 1360-373. Web.
2. Creswell, John W. Educational Research: Planning, Conducting, and Evaluating Quantitative and Qualitative Research. Boston, MA: Pearson, 2012. Print.
3. Horwitz, E. K., Horwiz, M. B., Cope J. “Foreign Language Classroom Anxiety.” The Modern Language Journal 70 ii (1986). Web.
4. Islam, M. N. “An Analysis on How to Improve Tertiary EFL Students’ Listening Skill of English”. Journal of Studies in Education 2.2 (2012). Web.
5. Kim, J. “The Reliability and Validity of a Foregn Language Listening” Korean Journal of English Language and Linguistics 5.2 pp. 213-235 (2005): 213.
6. Marsh, Joanne, and Gill Evans. “Generating Research Income: Library Involvement in Academic Research.” Library and Information Research 36.113 (2012): 48-61. 2013. Web. 2 Apr. 2013.
7. Morley, H. Joan, and Mary S. Lawrence. “The Use Of Films In Teaching English As A Second Language.” Language Learning 22.1. Web.
8. Nadig, A. (2013). Listening Comprehension. Encyclopedia of Autism Spectrum Disorders. Literacy-Listening Comprehension. 1743-1744. Web.
9. “Student.” Def. 1. dictionary.cambridge.org. Cambridge Dictionary, 14 January 2019 Accessed. Web.
10. Vogely, A. J. (1998). Listening Comprehension anxiety: Students’ reported sources and solutions. Foreign Language Annals, 31(1), 67-80.

In 2012, symptoms of Generalized Anxiety Disorder were recorded by 2.4 million Canadians (Statistic Canada, 2015). Stress is present in most individuals’ daily lives, and it can have negative effects on one’s life if ignored. This paper focuses on Generalized Anxiety Disorder (GAD) in college students and its effects on behaviour. Generalized Anxiety Disorder is defined as “a clinical anxiety disorder that is centrally characterized by excessive, pervasive, and chronic worry” (Treanor and Roemer, 2010, p.1). To be diagnosed with this disorder, one has to experience at least 6 months of excessive worry and stress. Students need to be informed in the many ways they can reduce or manage their anxiety towards events and issues they face daily.

Methodology

Generalized Anxiety Disorder can be associated with Richard Lazarus’ Cognitive Appraisal Theory. The purpose of this research is to analyze generalized anxiety in students and its effect on behaviour. This will be analyzed by examining the environment, the effects anxiety can have on behaviour, as well as finding solutions to better control emotions. When it comes to anxiety and stress, I do have a bias. Being a college student myself, I experience periods of stress. In addition, I am frequently in contact with other students, who themselves, also carry their fair loads of anxiety. These factors will be evaluated using a western social scientific perspective, with the use of psychology and sociology disciplines.

Historical Context

The origin of the word stress is dated from the seventeenth century and meant ‘hardship’ (Hinkle, 1973). Towards the end of the seventeenth century, “the word assumed a more technical importance (Lazarus, 1993) through the writing of Robert Hooke” (Cooper, Dewe, & Dewe, 2004, p.3). Robert Hooke’s work is significant in regards to the history of stress, as he compared it to engineering. He was “concerned with how man-made structures (e.g. bridges) could be made to withstand heavy loads without collapsing (Engel, 1985; Hinkle, 1973; Lazarus, 1999)” (Cooper et al., 2004, p.3). This engineering analogy can be compared to human stress whereas the human is the man-made structure and stress is referred to as the heavy loads. Hooke’s Law of Elasticity carried three different concepts, “load, stress, and strain” (Lazarus, 2006, p.31). Load was external factors, stress supported the load, and strain was referred to as deformation due to the combination of load and stress. Robert Hooke’s Engineering Analogy is still revenant in modern days wherein “the idea that stress is an external demand placed on a bio-social-psychological system” (Lazarus, 2006, p.3).

In the 1950’s, “‘stress as a legitimate subject of academic study had arrived’ (Newton, 1995, p.31)” (Cooper et al., 2004, p. 40). This meant that the study of stress was now part of psychology education. On account of the idea of stress being quite new, there were concerns about whether or not it was simply a trend.

In the 1960s, stress presented researchers with two challenges, “the causal relationship between life events and illness … and the role of individual difference and personality variables in illness (Lipowski, 1986c)” (Cooper et al., 2004, p. 41). In other words, the external and the internal factors that contributed to the illness. These two issues are factors contributing to the history of stress and they manifest the new era of research it was about to enter.

Moreover, the anxiety college students are facing today is more severe than college students before the 21st century. After the 1980s, college students “were more likely to report feeling overwhelmed and to believe they were below average in mental and physical health” (Twenge, 2015, par. 1). This new generation of extreme stress can be explained by the excessive use of social media and cell phones. Over the past decade, “the rapid development of social networking sites (SNSs) … has caused several profound changes in the way people communicate and interact” (Pantic, 2014, par. 2). In 2012, 86% of college students owned laptops, while 62% of them owned cellphones, and 33% owned computers at home, and finally, 15% of students owned a tablet (Mastrodicasa & Metellus, 2013, p. 21). This can be compared to the end of the 20th century when electronic devices were not as commonly used on a daily basis. The severe use of social media can pressure students into having to dress, act, and look a certain way. This urge to fit in and be accepted creates unnecessary stress. Henry (2012), found that “when students were procrastinating or wasting time using technology or social media, they showed higher measures of loneliness, depression, shyness, and social anxiety” (Mastrodicasa & Metellus, 2013, p. 24). Before the 21st century, resources were not as accessible as they are today. Student’s found their books in libraries instead of online and usually met friends in social settings.

Causes

A college student’s environment, goals, development, socio-economic status, gender, and use of social media are factors contributing to Generalized Anxiety Disorder. College is a critical period wherein individuals explore their identity, sexuality, and find themselves creating a career path. Their environment, friends, and life goals are very important aspects that will help shape these years and their future. Furthermore, the way in which they develop psychosocially is also very important in determining their future. Finally, their gender and the extent and reasons as to which they use social media can come into conflict with their levels of anxiety and loneliness.

Environment

The transition between two environments can create a sense of uncertainty and stress. During the transition from high school to college, most students did not yet experience “the developmental tasks indicative of a transition into adulthood such as marriage, parenting, or occupational stability, yet these topics are the focus areas for the transitions that will occur during this period” (Degges-White & Borzumato-Gainey, 2013, p. 3). This transition period focuses mainly on self-discovery, exploring career choices, and creating new relationships. Many changes occur within a student during this period, and “Pascarella and Terenzini (2005) identify areas of student change, such as psychosocial and cognitive-structural, that occur within the transition to college” (Degges-White & Borzumato-Gainey, 2013, p. 3). Richard Lazarus’ Cognitive Appraisal Theory “emphasizes the way in which ideas, memories, beliefs and expectations influence the interpretation of events and hence our emotional response to those events” (Forsythe, 2006, p.1). The way one feels they have control over a situation determines their emotional response to the event. This theory involves a two-stage process, “physiological arousal in response to an event or situation, followed by the interpretation and labeling of the physiological experience (Schachter and Singer 1962)” (Forsythe, 2006, p.1). Lazarus indicates stress as an association between an individual and the environment. In other words, the uncertainty someone feels toward a situation will determine their levels of anxiety. Moreover, students go from a familiar high-school environment to an unknown college environment where they are now obliged to take responsibility and follow their educational goals. Some students must move to another city to attend college, therefore changing their habitual setting completely. Therefore, moving away from home, from friends they’ve known their whole life, and from their family, as well as having entire new responsibilities and choices to make, undoubtedly comes with a load of stress.

Psychosocial Development

College years and stress are associated with psychosocial development in order to achieve secure identities. Erik Erikson was a developmental psychologist and offered eight stages of development experienced by individuals. There stages were created to “offer insight into the typical interpersonal conflicts and important life events during each period” (Degges-White & Borzumato-Gainey, 2013, p. 5). During the sixth stage, intimacy versus isolation, adolescents seek to become adults. This period is important for individuals to explore and form meaningful relationships, however, “conflict can arise when students are unable to concurrently balance their connection to their social network and their romantic partner or when they seek to find stability during this period of transition by coupling” (Degges-White & Borzumato-Gainey, 2013, p. 5). Erikson’s model for his stages of development is important for college student development because of the connection between identity and intimacy. If one has “a sense of identity [they] can have real intimacy with the other sex” (Bae, 1999, p.17). In like manner, if college students explore themselves and come to realize who they are, it can create a sense of confidence and autonomy, therefore leading to physical contact and experiences with partners.

Socioeconomic Status

A student’s socioeconomic status can also be a factor of anxiety. Whether a student comes from a high-income or a low-income household will affect their educational path and their stress levels. Evidence illustrates a correlation between higher socioeconomic status and “academic graduation, literacy, and time spent on homework (McBride Murry et al., 2011)” (Devenish, Hooley, and Mellor, 2017, p. 1). In fact, several research demonstrate an association between adolescents coming from a lower socioeconomic household and the “increased risk for poor mental health outcomes and decreased psychological well-being (McBride Murry, Berkel, Gaylord-Harden, Copeland-Linder & Nation, 2011; Quon & McGrath, 2014)” (Devenish et al., 2017, p.1). Thus, students coming from low socioeconomic statuses may not be able to afford education or may lack the self-confidence to push themselves to reach higher goals, and this can result in feelings of failure.

Social Media

In modern day, the use of social media can increase the risk of experiencing anxiety. Most students today have multiple social media applications on their smartphones, such as Instagram, Facebook, Snapchat, and Twitter. These platforms can be very useful and positive in terms of self-expression and freedom. On the other hand, they can also lead to cyberbullying, and feelings of loneliness and isolation. When it comes to college students, ‘research has shown that about a quarter of college students report being cyber-bullied at some point in their lives, and about 30% of those students said they were bullied for the first time in college (Held, 2011)” (Mastrodicasa & Metellus, 2013, p. 26). Cyberbullying increases the feelings of depression, and solitude in a victim, and therefore also increases the levels of stress. Another negative impact would be the use of social media for no purpose in general, for example, internet browsing, watching Youtube videos, or playing games, “those activities led to lower scores on the measures of psychosocial well-being and sense of community (Henry, 2010, 2012)” (Mastrodicasa & Metellus, 2013, p. 24). Indeed, using social media for solitary purposes, unlike meeting new people or chatting with friends, can lead to an increase in anxiety. In addition, in recent studies, researchers found a correlation between social media usage and “several psychiatric disorders, including depressive symptoms, anxiety, and low self-esteem” (Pantic, 2014, par. 3). The use of social networking in modern day can be very detrimental for college students’ mental state, most of them are exposed to different lifestyles and human diversity, which can lead to comparison. If not used appropriately and moderately, it can have negative impacts on one’s social life.

Gender

Gender differences can have an effect on levels of Generalized Anxiety Disorder. In fact, “women are also approximately twice as likely as men to be diagnosed with generalized anxiety disorder [91] and score more highly on self-report scales measuring anxiety [55, 79]” (Leach, Christensen, Mackinnon, Windsor, & Butterworth, p. 983). These results are due to health and lifestyle status, socio-demographic, and social and relational factors (Leach, et al., 984-985). Also, in the area of psychological factors, “a meta-analysis [25] found that females were less assertive, had lower self-esteem, and higher levels of anxiety than males” (Leach, et al., 984). As a result, women tend to experience higher levels of anxiety over men.

Consequences

Generalized Anxiety Disorder (GAD) has an evident effect on the behaviour of students. Some students might look at college as the best years of their lives, filled with new experiences, responsibilities, and relationships. On the other hand, some students might look at college as a time filled with stress, constant worry about academic achievement and demands, and a reexamination of their entire career goals. This period of stress does not necessarily lead to anxiety disorder, however, it may provoke the disorder if the person is predisposed.

Psychological and Physical Effects

Generalized Anxiety Disorder affects students psychologically as well as physically. The psychological symptoms of generalized anxiety disorders involve “excessive worry with symptoms of physiological arousal such as restlessness, insomnia, and muscle tension” (Degges-White & Borzumato-Gainey, 2013, p. 238). In order to be diagnosed with GAD, people need to be in a period of constant stress for at least 6 months. Furthermore, students who have this disorder have difficulty relaxing, sleeping, and concentrating. Also, they might come to realize that they are more irritable and impatient (Degges-White & Borzumato-Gainey, 2013, p. 238). In addition, physical symptoms of GAD “include sweating, an upset stomach, diarrhea, frequent urination, cold and clammy hands, a lump in the throat, a dry mouth, shortness of breath, headaches, and dizziness” (Degges-White & Borzumato-Gainey, 2013, p. 239). Overall, the physical and psychological symptoms of Generalized Anxiety Disorder can be extremely unpleasant and deteriorating unless treated.

Social and Occupational Life

Generalized Anxiety Disorder can have long-term detrimental effects on social and occupational life. The physical symptoms of GAD are not lethal, but they can worsen and become quite challenging to endure. In fact, two studies were conducted, one by “Harvard Medical School and the Lown Cardiovascular Research Institute; the other, by several Canadian medical colleges” concluded that men and women diagnosed with heart diseases, in addition to having an anxiety disorder history, were twice as much likely to experience a heart attack (‘Anxiety and physical illness”, 2018). Generalized Anxiety Disorder can also have negative impacts on an individual’s occupational life. Evidence shows that “persons with psychiatric disorders and perhaps especially social phobia are at increased risk for premature withdrawal from school [Am. J. Psychiatry 157 (2000) 1606]” (Van Ameringen, Mancini, & Farvolden, 2002, Abstract, para. 1). Living with an anxiety disorder can create isolation, and to refrain from having anxiety, people can cease their education. A study was conducted with a sample of 201 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and who suffered from anxiety disorder. The results suggest that 49% of the respondents left school prematurely and 24% of them reported the main reason for this was because of anxiety (Van Ameringen, et al., 2002, Abstract, para. 1). Several past research dated from the 1990s, “demonstrate the negative impact of childhood and adolescent anxiety on a broad range of psychosocial variables, including academic performance and social functioning” (Van Ameringen, et al., 2002, Introduction, para. 3). As expressed, anxiety that has been carried on from childhood all through adulthood without being resolved can affect the individual’s life in the long-term.

Anxiety is a very bad thing to have. You can never get out in public because it scares you. You are afraid of people, you don’t like meeting people that you don’t know, and you don’t do sports, cause you don’t like big crowds. My grandpa passed away in 2014, we had just started getting close, he was in the hospital for a while and then finally he told them that he was ready to go. So then they turned his pacemaker off and then he went to heaven to be with god, every now and then I go to the graveyard and talked to my grandpa about all my problems and what’s wrong with me. He’s the only person I ever open up to. My great-grandmother oh I loved that woman to death! She was the most amazing person she knew how to cook very well, nothing will ever taste like hers. She was everything to me she loved me like I was her daughter. My mother isn’t the greatest person but she tries. She really made me mad, summer of 2018 she got drunk and passed out on a bus stop bench and we literally had to walk way across at. Louis to get home. It was the worst time of my life. My dad, he isn’t the best person ever but he is the only person that stepped up to raise up. He tried his hardest so I give him that. He wasn’t a woman so he didn’t know how to do things like a mom could. But he gave his all and I respect and appreciate him for that. I think a mask should not be worn, especially because you start breathing in carbon dioxide after wearing it for long periods of time. I think that maybe just maybe all this junk will go away after the election and we can have a normal school year. I don’t think masks slow the spread on the account nobody wears them and it’s just thin cloth. Everyone doesn’t wear them right like one of my teachers he pulls his off his nose so then his mouth is all that’s covered. Maybe if everyone wore them from the start, and wore them right, or if they didn’t want to wear them they could’ve stayed in the house then maybe it wouldn’t have gotten as bad but then again there was a test proven to be false positive. If your state is required and has no option but to wear them then I don’t think the mask should be sold, I think maybe they should send them boxes since after all they are required and I think that the stores that require them should provide people with one that doesn’t have one, because if they keep telling people you can’t come in without a mask but won’t give them one then they are gonna start losing business. The COVID pandemic has taken a big toll on everyone’s life. I mean for weeks we couldn’t leave the house unless it was urgent, like to get groceries, and then we had a major toilet paper shortage. I think having to stay in the house may have put my happiness back, now that I can go do things and enjoy life it has gotten much better! Some things have changed like Walmart, changed their hours like, how are Nucor workers gonna get groceries if they need them and they work a late shift and get off early in the morning? They can’t! Most stores require masks or you can’t enter, some people can’t breathe with them on. Churches closed down and nobody could go to church, restaurants closed the dining area, so no more Sunday dinners at a restaurant. It hasn’t really changed my life that much but, it made it where people can’t see the people they love like grandparents, parents, and family members cause they are scared to get sick I wish this all could go away but I don’t see that happening anytime soon. I never thought COVID-19 would get this far. It started out as barely anyone had it and then I just started increasing more and more eventually our summer nights got ruined, we had curfews set by the towns and you couldn’t be close to anyone. COVID has really changed people’s lives, I still treated my summer like any other day because at first, I thought it was fake, but then close family members started getting it so then I just started hanging out with my boyfriend only.

People say oh y’all got out early so that means you had a longer summer I mean but did we actually even have a summer? You couldn’t go on vacations, you couldn’t hang out with friends, cause if you did you were risking getting COVID-19. I wish life would have never gotten this way it’s all so sad but this is how we have to live till it all goes away which most people think it will after the election, but I think that everything that is happening now is gonna stay the same even when it’s over. I also think that school is gonna shit down again which is really gonna be hard cause this is the last 2 years I have and I have waited my whole life to get to this so I could go to prom. You don’t get the point of why I posted them, well the reason I did is that covid is causing people to have anxiety and it will continue to do so because people are hoarding themselves in the house cause they think if they stay in then they won’t get it well bullcrap cause its an airborne sickness not because you’re around someone, because it cannot stay on a surface cause hot and cold, kills germs. Everyone is always going to have some anxiety, just some people have it worse than others. What follows along with anxiety is depression, most people get it after they hit a rough patch in their lives like when someone they love, or cares about dies or if their family is

Going through some things. At first, when I started this essay I didn’t know what to write because I’m not good at writing especially when a topic is picked out for me. Anxiety is a very bad thing to have. You can never get out in public because it scares you. You are afraid of people, you don’t like meeting people that you don’t know, and you don’t do sports, cause you don’t like big crowds. My grandpa passed away in 2014, we had just started getting close, he was in the hospital for a while and then finally he told them that he was ready to go. So then they turned his pacemaker off and then he went to heaven to be with god, every now and then I go to the graveyard and talked to my grandpa about all my problems and what’s wrong with me. He’s the only person I ever open up to. My great-grandmother oh I loved that woman to death! She was the most amazing person she knew how to cook very well, nothing will ever taste like hers. She was everything to me she loved me like I was her daughter. My mother isn’t the greatest person but she tries. She really made me mad, summer of 2018 she got drunk and passed out on a bus stop bench and we literally had to walk way across at.Louis to get home. It was the worst time of my life. My dad, he isn’t the best person ever but he is the only person that stepped up to raise up. He tried his hardest so I give him that.Anxiety is a very bad thing to have. You can never get out in public because it scares you. You are afraid of people, you don’t like meeting people that you don’t know, and you don’t do sports, cause you don’t like big crowds. My grandpa passed away in 2014, we had just started getting close, he was in the hospital for a while and then finally he told them that he was ready to go. So then they turned his pacemaker off and then he went to heaven to be with god, every now and then I go to the graveyard and talked to my grandpa about all my problems and what’s wrong with me. He’s the only person I ever open up to. My great-grandmother oh I loved that woman to death! The COVID pandemic has taken a big toll on everyone’s life. I mean for weeks we couldn’t leave the house unless it was urgent, like to get groceries, and then we had a major toilet paper shortage. I think having to stay in the house may have put my happiness back, now that I can go do things and enjoy life it has gotten much better! Some things have changed like Walmart, changed their hours like, how are Nucor workers gonna get groceries if they need them and they work a late shift and get off early in the morning? They can’t! Most stores require masks or you can’t enter, some people can’t breathe with them on. Churches closed down and nobody could go to church, restaurants closed the dining area, so no more Sunday dinners at a restaurant. It hasn’t really changed my life that much but, it made it where people can’t see the people they love like grandparents, parents, and family members cause they are scared to get sick I wish this all could go away but I don’t see that happening anytime soon. I never thought COVID-19 would get this far. It started out as barely anyone had it and then I just started increasing more and more eventually our summer nights got ruined, we had curfews set by the towns and you couldn’t be close to anyone. COVID has really changed people’s lives, I still treated my summer like any other day because at first, I thought it was fake, but then close family members started getting it so then I just started hanging out with my boyfriend only. This is my essay on anxiety, depression, and my life story all in one and how I have been doing I hope you enjoyed reading this, every day people are getting taken advantage of and people are dying left and right I hope everyone that I hang with and is my family I love yall and always will! It feels like the end of the world is coming very soon

1. https://en.wikipedia.org/wiki/Anxiety
2. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
3. https://www.verywellfit.com/sports-psychology-for-performance-anxiety-3119436
4. https://www.healthline.com/health/anxiety
5. https://www.webmd.com/anxiety-panic/guide/anxiety-disorders
6. https://adaa.org/understanding-anxiety
7. https://www.helpguide.org/articles/anxiety/anxiety-disorders-and-anxiety-attacks.htm
8. https://healthnfitness.net/read/examining-some-of-the-many-common-reasons-for-depression?k=what%20causes%20anxiety%20attacks&a=82078381594&cmp=6676644161&pl=&n=g&d=m&dm=&m=e&kid=kwd-187522494&c=387250655923&p=&tr=&cn=GxBBNSMbl9GUE%2Fy%2F5CymvW98sqBtujAM7MfYSycSpXI%3D&an=4PqJA7DS769wmrEMwDqXvLaFK3LwLrh%2Fpda5qTbBCdI%3D&gclid=EAIaIQobChMI8PmA58_E7QIVBKCzCh0IpgjFEAAYBCAAEgIb9PD_BwE
9. https://www.betterhelp.com/advice/anxiety/what-causes-anxiety-attacks-and-how-can-i-cope-with-them/?utm_source=AdWords&utm_medium=Search_PPC_m&utm_term=_b&utm_content=77548444015&network=g&placement=&target=&matchtype=b&utm_campaign=6459244691&ad_type=text&adposition=&gclid=EAIaIQobChMI8PmA58_E7QIVBKCzCh0IpgjFEAAYASAAEgKV2PD_Bw
10. https://www.medicalnewstoday.com/articles/323454

Introduction

Depression is a mood-affective disorder that causes a persistent feeling of sadness, loneliness, and starting loss of interest in things. A major depressive disorder or clinical depression is that which affects feeling, thinking, and behavior and can lead to a variety of emotional and physical problems. Depression causes feelings of sadness and a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and decrease a person’s ability to function at work and at home. Normally, depression symptoms can vary from mild to severe. Such as changes in appetite- weight loss or gain unrelated to dieting, trouble sleeping, loss of energy, increase in purposeless physical activity (e.g., Hand-wringing or pacing) or slowed movements and speech, feeling worthless or guilty. Symptoms must last at least 2 weeks for a diagnosis of depression. [1]

Depression affects approximately one in 15 adults (6.7%) in any given year and one in six people (16.6%) will be familiar with depression at some time in life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.[2]

Depression in adolescents is associated with several impairments but the most significant concern is the increased risk of suicide in youths with depression. Adolescence is a time for growth spurts and puberty changes. Girls also experience puberty as a sequence of events but their pubertal changes usually begin before boys of the same age. Beginning of puberty from 8 to 13 years. [3]

The teenage years bring many changes. These changes are not only physical but also mental and social. During these years, adolescents increase their ability to think abstractly and eventually make plans and set long-term goals. But due to COVID this period of their lives can be challenging even in the best times, as the majority of mental health disorders develop. Such as Depression is a mood that affects our thoughts, feelings, and daily activities, including eating sleeping, and working. Totally impact our life. Occurs in approximately 13% in the age of adolescents. [4] As we see masked faces walking alone across crowded streets, this is our current situation in which this young teen wonders if people will ever feel safe again. Depressive disorders are among the most common psychiatric diagnoses to emerge during adolescence. They can have a profound effect on key developmental tasks, such as educational achievement and social functioning. The disruption caused by adolescent depression is also known to affect health outcomes during young adulthood.

In late December 2019, Wuhan, China, reported having viral pneumonia due to an unknown microbial pathogen. A new coronavirus was subsequently identified as the pathogen and was temporarily named the 2019 new coronavirus(2019-nCoV). On January 30,2020, the World Health Organization (WHO) announced that the emergence of a new coronavirus (2019-nCoV) was a public health emergency of international concern (PHEIC).[5]

Adolescents may appear to be less at risk for severe COVID-19 Symptoms, but the pandemic has significantly disrupted their lives in different ways. Social distancing and the interruption of typical school routines can be especially challenging for adolescents. Being in the house with family members and not getting to see friends and peers. Adolescents have different developmental needs.

Teenagers are at a stage in life when they are very interested in social connections and separating them from their parents. So, COVID-19 social distancing requirements have a different impact on them. Depending on age and developmental stage, some adolescents may have a hard time understanding what the pandemic really means and how it impacts their world.

“Adolescents depend on their mobile devices to connect with their friends, and it’s more important for parents to help them use screen time in a good way rather than simply limiting its use.” [6]

Consistent with previous studies, female adolescents showed a higher risk of depression and anxiety during COVID-19. Teenage is a special group of the population who have different “Psyche”. More specifically, adolescents tend to experience emotions more intensely. Now teenagers confined to their homes with 24/7 parental attention or supervision may create a great degree of irritation as they are not handling such a situation. Adolescents find it quite difficult to practice social distancing because they make sense of what’s happening in the world. they have their inherent suggestibility to follow the rumors /myths being forwarded in social media. Researchers believe that brain changes in adolescence increase a teen’s vulnerability to depression and anxiety. Play an important role in the severe gender disparity in these disorders. Nearly, one in three adolescents (31.9%) will meet the criteria for an anxiety disorder by the age of 18. [7]

Anxiety and depression are increasing

• Social, political, and environmental causes are likely implicated in an increase in the number of teens each year who have had a depressive episode, up 37% between 2005 and 2014. [8]
• High school students today have more anxiety symptoms have more anxiety symptoms and are twice as likely to see a health professional as teens in the 1980s. [9]

The fact that we can recall adolescence better than other periods and that this is a time of change in many Brains is likely to be especially plastic at this time. Another indication comes from statistics on the average age of onset of serious psychological disorders. The adolescent brain is extraordinarily sensitive to stress. [10].Researchers believe that brain changes in adolescence increase a teen’s vulnerability to depression and anxiety, and play a vital role in the severe gender disparity.

Anxiety

Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder. [11] When an Individual faces potentially harmful or worrying triggers, feelings of anxiety are not only normal but necessary for survival. People of all ages are concerned about the spread of the coronavirus. Teenagers are a group that tends to experience emotions especially intensely. It is a natural and important emotion, signaling through stirring of worry, fearfulness, and alarm that danger or a sudden, threatening change is near. Sometimes anxiety becomes an exaggerated, unhealthy response. Anxiety disorders vary from teenager to teenager. Anxiety during adolescence typically centers on changes in the way the adolescent’s body looks and feels social acceptance, and conflicts about independence. When flooded with anxiety, adolescents may appear extremely shy. Sometimes, they avoid their usual activities or refuse to engage in new experiences. They may protest whenever they are apart from friends. In an attempt to diminish or deny their fears and worries, they may engage in risky behaviors, drug experimentation, or impulsive sexual behavior. Adolescents’ phobic fears tend to involve school and social performance.

More common in girls than boys, panic disorder emerges in adolescence. Feelings of intense panic may arise without any noticeable cause or they may be triggered by specific situations, in which case they are called panic attacks. A panic attack Is an abrupt episode of severe anxiety with accompanying emotional and physical symptoms.

Most research believes that a predisposition towards timidity and nervousness is inborn. If one parent is naturally anxious, there’s a chance that their child will also have anxious tendencies. At the same time, a parent’s own uneasiness is often communicated to the child compounding the child’s natural sensitivity. By the time a child reaches adolescence, his characteristic way of experiencing and relating to his world is tinged with anxiety. Some research suggests that children who are easily agitated or upset never learn to soothe themselves earlier in life.

In many cases, adolescent anxiety disorders may have begun earlier as separation anxiety, the tendency to become flooded with fear whenever separated from home from those to whom the child is attached. Adolescents can also have separation disorders. These teens may deny anxiety about separation, yet it may be reflected in their reluctance to leave home and resistance to being drawn into independent activity.

A worried teenager performs less well in school, sports, and social interactions. Too much worry can also result in a teenager’s failing to achieve his potential. A teen Experiences a great deal of anxiety maybe they overly conforming, perfectionistic, and unsure of himself/herself. Some teenagers with anxiety disorders can also develop mood disorders or eating disorders. Teenagers who experience persistent anxiety may also develop suicidal feelings or engage in self-destructive behavior.

Review of Literature

The anxiety and depression experienced by U.S. residents since the start of the COVID-19 Pandemic peaked in early April, according to a USC national tracking survey measuring the impact of the coronavirus on the lives of Americans. As Americans nationwide hunkered down during stay-at-home orders and tens of millions of workers lost their jobs,40% of U.S residents reported feeling anxious and 29% felt depressed in early April. By late May, that percentage had dropped to 27% who felt anxious and 25% who felt depressed. The survey found that one in three people said they felt lonely, up from one in five who reported feeling lonely prior to COVID-19. “Early April was a tumultuous time for many, people. Not only were we worried about the threat of COVID-19 but millions of people had just lost their jobs and families were being forced to adjust rapidly to school closure and new routines,” said Daniel Bennett, assistant professor(research) of economics at Centre for Economic and Social Research, part of the USC Dornsife college of letters, Arts and Sciences. “Since then, the pandemic caused a lot of destruction, but the changes to the daily lives of many Americans have been less extreme. [12] (Jenesse Miller, 5 June, 2020). Americans are reporting high levels of emotional distress from the coronavirus pandemic- levels that some experts warn may lead to a national mental health crisis. An estimated 10-20% of adolescents globally experience mental health conditions, yet these remain underdiagnosed and undertreated [13] Unipolar depressive disorder is a common mental health problem in adolescents worldwide.[14] with an estimated One-year prevalence of 4–5% in mid to late adolescence.[15] Depression in adolescents is a major risk factor for suicide, the second-to-third leading cause of death in this age group [16] with more than half of adolescent suicide victims reported to have a depressive disorder at the time of death.[17]

Tises the prevalence of depression in children is low (more than 1% in most studies) [18] with no sex differences, and then substantially throughout adolescence. [19] Studies have found that 3-9% of teenagers meet the criteria for depression at any one time, and at the end of adolescence, as many as 20% of teenagers report a lifetime prevalence of depression [20]

Childhood depression, like the depression of adults, can encompass a spectrum of symptoms ranging from normal responses of sadness and disappointment in stressful life events to severe impairment caused by clinical depression that may or may not include evidence of mania [21-23]. During the recent Coronavirus disease 2019 (COVID-19) outbreak in China, 54% of the participants of a large online study rated the impact of the outbreak on their mental health as moderate to severe, with depressive symptoms and anxiety being the conditions most often stated. [24] The current crises impose multifaceted burdens on children. They include the socio-ecological impact of the pandemic, which is understood to be enormous. The environment of children is affected at different levels- including community and family- as well as the individual child itself. [25

Rationale of the study

Adolescents are the future of our country and they play an important role in today’s time in nation building. They have the ability to create an identity for themselves and move the nation forward. They are filled with optimism and towering ambition. Country vision lies in the hands of adolescents. To achieve these objectives, an adolescent should be mentally and psychologically fit and free from all stresses during this COVID-19 era.

In adolescent depression and anxiety is a serious mental health problem that causes a persistent feeling of sadness and loss of attention in activities. Most of the time they are unhappy. Their mind is not conscious in one direction. In a group of people they feel lonely, not feel comfortable with their known too. When we include biological parameters that add hormone havoc to it that seems many other drastic changes happening in adolescent life, it’s easy to see their moods swing like a pendulum. Due COVID lockdown has created more problems for them. Schools are closed. They are tense about their studies, and future.

They sleep excessively, staying awake at night and sleeping during the day. Change in eating habits, the normal routine is imbalance. They spend more time with their parents than their peer groups. Most of the adolescents are frustrated. All the time they check social media in case parents make some restrictions on using cell phones which affects them badly. They are in control of the parents. Normally, in adolescent age children want some space from their parents. They want to live freely. But depression and anxiety can be treated as well as the serious problems that come with it. Normally, adolescent unhappiness lasts for more than 2 weeks. After that, they display other symptoms of depression and anxiety it may be time to seek help from a health professional. There are many methods used to treat depression and anxiety, including medications and psychotherapy.

The most important way for adolescents to fight depression and anxiety such as, first make routine of everyday. I awake early in the morning. Engaging ourselves in aerobic activity. Eat healthy food and fruits. Recognizing and challenging your critical inner voice. According to the current situation make ourselves resistant. identifying our talent and working on it. Read funny and interesting novels. Watch a funny movie or show with family. Refuse to punish yourself for feeling bad. Doing activities, you once enjoyed, even when you don’t feel like it. Work on ourselves to stay connected with friends.

Reference

1. American Psychiatric Association
2. American Psychiatric Association
3. STANFORD CHILDREN’S HEALTH 2020
4. World health organization
5. World Health Organization
6. Mendelson T, Greenberg MT, Dariotis JK, Gould LF, Rhoades BL, Leaf PJ. Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. Journal of abnormal child psychology. 2010 Oct 1;38(7):985-94.
7. Child mind org
8. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016 Dec 1;138(6):e20161878.
9. Twenge JM, Sherman RA, Wells BE. Changes in American adults’ sexual behavior and attitudes, 1972–2012. Archives of Sexual Behavior. 2015 Nov 1;44(8):2273-85.
10. Steinberg L, Brown BB, Dornbusch SM. Beyond the classroom. Simon and Schuster; 1997 Oct 17.
11. Felman A. Everything you need to know about nicotine. Medical News Today. 2018 Jan.
12. Siegel RS, La Greca AM, Harrison HM. Peer victimization and social anxiety in adolescents: Prospective and reciprocal relationships. Journal of Youth and Adolescence. 2009 Sep 1;38(8):1096-109.
13. Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Aguilar-Gaxiola S, Alhamzawi AO, Alonso J, Angermeyer M, Benjet C. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British journal of psychiatry. 2010 Nov;197(5):378-85.
14. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The Lancet. 2006 May 27;367(9524):1747-57.
15. Egger HL, Costello EJ, Erkanli A, Angold A. Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. Journal of the American Academy of Child & Adolescent Psychiatry. 1999 Jul 1;38(7):852-60.
16. Windfuhr K, While D, Hunt I, Turnbull P, Lowe R, Burns J, Swinson N, Shaw J, Appleby L, Kapur N, National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Suicide in juveniles and adolescents in the United Kingdom. Journal of Child Psychology and Psychiatry. 2008 Nov;49(11):1155-65.
17. Hawton K, Van Heeringen K. Suicide. Lancet [Internet]. 2009 [citado 22 mar 2012]; 373 (9672): 1372-81.
18. Kessler RC, Avenevoli S, Merikangas KR. Mood disorders in children and adolescents: an epidemiologic perspective. Biological psychiatry. 2001 Jun 15;49(12):1002-14.
19. Green H, McGinnity A, Meltzer H, Ford T, Goodman R. Mental health of children and adolescents in Great Britain, 2004. London: ONS. The Stationery Office. 2005.
20. Zuckerbrot RA, Jensen PS. Improving recognition of adolescent depression in primary care. Archives of pediatrics & adolescent medicine. 2006 Jul 1;160(7):694-704.
21. Kelleher KJ, Wolraich ML. Diagnosing psychosocial problems. Pediatrics. 1996 Jun 1;97(6):899-901.
22. Kovacs M, Akiskal HS, Gatsonis C, Parrone PL. Childhood-onset dysthymic disorder: Clinical features and prospective naturalistic outcome. Archives of general psychiatry. 1994 May 1;51(5):365-74.
23. Weller P. The Universality of Public Sector Reform: Ideas Meanings Strategies. Davis, G. 1996.
24. Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, Choo FN, Tran B, Ho R, Sharma VK, Ho C. A longitudinal study on the mental health of the general population during the COVID-19 epidemic in China. Brain, behavior, and immunity. 2020 Apr 13.
25. The alliance for child protection in humanitarian action.

Introduction

Anxiety disorder is one of the worldwide major public mental health problems. In the last decades, the number of people diagnosed with mental health disorders such as; anxiety has enormously increased. Anxiety is defined as a state of uneasiness, such as worry or dread, that might be minor or severe (NHS 2018). According to the Cleveland Clinic (2020), There are many types of anxiety disorders such as generalized anxiety, panic disorder, phobias, and separation anxiety. The Most common type of anxiety disorder is called (GAD) or generalized anxiety disorder (Mental Health no date). There are differences between normal anxiety and generalized anxiety disorder (GAD), during times of stress people experience anxiety however, generalized anxiety disorder (GAD) is when someone worries excessively to the point that it interferes with daily activities (Meek 2020a). Normal anxiety can worsen over time and seriously impair a person’s ability to operate properly (Meek 2020b). The reasons or the risks of developing anxiety are the build-up of stress, shock, illness-related stress, personality, other mental health issues, genetics, and addiction to alcohol and drugs (Mayo Clinic 2018a). There are other reasons for being diagnosed with anxiety disorders and they are medical causes. The most crucial and main cause of anxiety disorders is difficult childhood, adolescence, or adulthood life experiences (mind 2021a). There are several symptoms and signs that indicate that the patient is diagnosed with anxiety disorders. Mayo Clinic (2018b) investigated the symptoms of anxiety are; insomnia or having difficulty falling asleep, an elevated heart rate which means the heart beats faster than usual, rapid breathing, feeling exhausted, having difficulty concentrating and experiencing difficulty managing worry.

There are a variety of ways to treat anxiety disorders, such as psychotherapy and some medications (Mayo Clinic 2018c). One of the well-known medications used to treat anxiety is diazepam or Valium, and it is a type of benzodiazepine (Star 2021a). Diazepam is the generic name for Valium which means that Valium is the brand-name medicine and diazepam is the active ingredient of it (Bihari 2020). Gamma-aminobutyric acid (GABA) receptors are affected by diazepam or Valium, GABA is a neurotransmitter in the brain that is involved in sleep, relaxation, and anxiety management (Star 2021b). Valium slows down the central nervous system by affecting GABA receptors (Star 2021c). This effect reduces anxiousness and agitation while also promoting a sense of peace and relaxation (Star 2021d). This project will evaluate the various types of treatments, the effectiveness of diazepam, and the safety of taking diazepam as a medication for anxiety. This report will begin by arguing If diazepam is more effective for treating anxiety disorders than (SSRI) antidepressants. Then proceed to argue and prove that diazepam is safe.

Is diazepam the ideal treatment for anxiety disorders?

Anxiety could last for years or even endure forever. Treating it might take some time to be effective). Medications used to treat anxiety disorders are benzodiazepines (usually prescribed for short-term use) and there are medications recommended as a long-term anxiety solution called selective serotonin reuptake inhibitor or (SSRI) antidepressants and one of the newer options (Smith et al. 2021a). Mind (2021b) stated that sedative medications such as benzodiazepines slow down the function of the brain and the body. Benzodiazepines like diazepam are used to alleviate anxiety and sleeplessness (Mind 2021c).

Many argued that diazepam could cure anxiety disorders effectively. Star (2021e) stated that Valium (diazepam) is an anti-anxiety medicine used to treat panic attacks and other anxiety disorders. Moreover, benzodiazepines like diazepam are also known as sedatives due to their calming and tranquilizing effects (Star 2021f). Diazepam acts rapidly, usually providing relief within 30 minutes to an hour (Smith et al. 2021b). Diazepam relieves anxiety quickly as it is one of the fast-acting drugs (Star 2021g). According to Henderson (2020), diazepam is used to treat sleeping problems that are associated with anxiety-like insomnia. Diazepam is also an anticonvulsant and may be used to relieve anxiety caused by certain conditions (Star 2021h).

However, others believe that the SSRI antidepressants are more effective to cure anxiety disorders. Bhatt (2019) explored that, the newer agents of antidepressant medications have lower side effects and greater convenience of use. Antidepressants help people diagnosed with anxiety disorders to feel calmer and more capable of dealing with other issues (Mind 2020a). In addition to that, it may also assist in feeling more capable of benefiting from other anxiety therapies (Mind 2020b). Antidepressants might take up to 4 to 6 weeks to start reducing anxiety symptoms, therefore they cannot be used ‘as needed’ (Smith et al. 2021c).

It seems that when combining selective serotonin reuptake inhibitor (SSRI) antidepressants, it becomes more effective, safe, and recommended in curing anxiety disorders. There are a variety of (SSRI) antidepressants in which one does not work well for the patient. Moreover, it depends on the patient’s situation. Some patients cannot benefit from the (SSRI) antidepressants as their level of anxiety is high and they need something strong for it. So, (SSRI) antidepressants are not effective all the time as it take weeks to work and diazepam is more effective to cure all anxiety disorders.

Is diazepam medicine safe?

Diazepam medicine is one of the most effective anti-anxiety medications. It is given as a primary medicine to help reduce anxiety symptoms when other medications or treatments are not effective enough for the patient diagnosed with any anxiety disorders.

It has been argued that the side effects of diazepam are less dangerous in comparison with other medications that are used to treat anxiety disorders. Medline Plus (2021a) explored that, the side effects of diazepam could be mild or severe. Dry mouth, nausea, headache, and are the most common side effects of diazepam (Medline Plus 2021b). These side effects are normal and disappear after a couple of days or weeks (University of Illinois 2020). According to Williams (2020), Valium or diazepam medicine is one of the safest benzodiazepine medicines.

On the other hand, Some researchers think that diazepam is not safe and could cause harmful and unwanted side effects. Drug Enforcement Administration (2019) stated that people who have abused benzodiazepines like diazepam were more than 20 million, which means that diazepam could cause addiction. Diazepam has a high potential for abuse, misuse of these medicines over time can easily lead to addiction (Patterson 2022). Moreover, diazepam could affect pregnancy and it is possible that an unborn baby will be harmed (Everyday Health 2021).

Nonetheless, the benefits of diazepam are more than its risks and its side effects. The specialist will plan the whole procedure for the patient, each patient has a unique and different plan. Moreover, the patient would experience some common side effects. However, These side effects are normal and not harmful and could be easily controlled if the patient follows the specialist plan and takes their medications in time and as directed. According to addiction treatment centers (2021), having a physical dependency on diazepam does not imply that a person is addicted to it. When a patient is not using the medication as directed it is possible that diazepam becomes an addictive drug. The dangerous side effects of taking diazepam are uncommon, and even if the patient experienced those unwanted side effects, the specialist would suggest another plan to overcome these side effects. The patient should update the specialist of any new symptoms or side effects of diazepam to get help as soon as possible. One of the most important things that the patient should do is to discuss with the specialist if they are taking any medications, have allergies, if a woman is pregnant or breastfeeding, and if experienced any diseases before, that will help the specialist to decide if diazepam is the accurate medicine for the patient or no. Also, that will help to minimize the harmful side effects.

Conclusion

To sum up, everything that has been stated so far, anxiety disorders have been limiting and affecting human life. Many individuals are suffering from anxiety disorders, which are a worldwide known disease. This essay argued two main aspects; benzodiazepine medicines like diazepam being effective and diazepam being safe. (SSRI) Antidepressants could treat many types of mental health diseases and one of them is anxiety disorders. However, benzodiazepines like diazepam are the most effective and fast-act medications to treat anxiety disorders. Moreover, diazepam helps to reduce other issues related to anxiety such as insomnia. Also, diazepam has calming effects that help the patient to feel happy and relaxed. (SSRI) Antidepressants are not the ideal treatment every time for anxiety disorders, but that does not mean it could not be prescribed for a patient diagnosed with anxiety however, it is not effective for everyone and depends on the patient’s situation. All anti-anxiety medications have side effects that a human being could experience them, and each could differ from one to another, some could be harmful, and some harmless. Diazepam drug is widely used to treat anxiety disorders, because of its light side effects. The side effects of diazepam are more adaptable to live with.