When FDR famously proclaimed there is nothing to fear but fear itself, little did he know was forecasting a psychological phenomenon known as anxiety sensitivity.

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The term wasn’t coined until 1985, but when the concept was defined, it was kind of a big deal. I’ll stop short of calling anxiety sensitivity the mother of all anxiety disorders (which sounds like a Freudian comic book villain), but high anxiety sensitivity puts you at greater risk for developing a problem with anxiety, from panic to PTSD to phobias and beyond.

So what exactly is this fiendish phenomenon? It’s a belief that the physiological experience of anxiety itself, like a racing heart, sweating, or shaking, is dangerous and could lead to devastating outcomes. In other words, it’s the tendency to interpret anxious sensations as catastrophic—it really is fear of fear.

For example, someone with high anxiety sensitivity might fear the dizziness that comes with being anxious, thinking it means they’re going to snap and have a mental breakdown. Another might fear the pounding heart that comes from walking into a room of strangers, thinking a heart attack is around the corner. Yet another might interpret their nervous trembling as a sign that they’re losing control of their faculties.

Of course, most, if not all, people find anxiety-related sensations uncomfortable—most would prefer to avoid getting clammy on a first date or feeling our heart pound through our chests before giving a wedding toast. The distinction is that those low in anxiety sensitivity can be anxious, but interpret the sensations as transient and harmless.

For example, someone with low anxiety sensitivity may interpret a racing heart as “I’m pumped! I’m ready—let’s do this!” Butterflies in the stomach might be met with, “Eh, who doesn’t get nervous before a big speech?” Shaking before accepting a big award might be chalked up to an overly air-conditioned venue.

Now, if you recognize yourself as someone who definitely has this anxiety sensitivity thing going on, does that mean you’re doomed to a full-blown anxiety disorder? Not necessarily. While anxiety sensitivity definitely increases your chances, it’s impossible to predict who exactly will develop a problem with anxiety.

Think of it this way: picture a pizza. If an entire pizza represents the causes of an anxiety disorder, one or two slices might be genetics, two or three slices might be family environment. Life circumstances determine several pieces: bullying might steer you toward social anxiety, a car crash toward PTSD. Anxiety sensitivity is often one of the remaining slices—not a sole cause, but definitely a contributing factor. (I bet you’ll never look at pizza quite the same again).

OK, so what to do?

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