anxiety

By Jen L’Insalata

Socioeconomic status includes aspects of ownership, wealth, and class identity. Gradients between rich and poor highlight the variation of outcome linked to mental and physical health outcomes, access to resources, opportunity, and education. Socioeconomic status provides a pathway to power through access and acceptance in a status-driven western economy. As socioeconomic differences increase, so does the subjective emphasis on the importance of status and income (Wilkinson, & Pickett, 2017).

Dominance hierarchies form a social organizational structure through which individuals are stratified into a class system. Stratifications encompass more than financial status, further dividing individuals based on cultural drivers and social values. Stratified societies maintain a ranking system used to evaluate and maximize perceived value within the hierarchy. Social ranking is based on access to valuable or scarce resources and the accumulation of resources provides a pathway to power (Wilkinson, & Pickett, 2017).

Egalitarian framework counterbalances resource-based social ranking systems to a small degree through the value of generosity and selflessness. Cultural aspects associated with selflessness and community provide an avenue through egalitarian endeavors provide recognition and prestige. However societal inequality increases internal status-driven anxiety as socioeconomic based access becomes a valuable attribute (Wilkinson, & Pickett, 2017).

According to an intrapersonal perspective, global self-esteem is based on an individual’s perception of performance in domains deemed important. American societal constructs emphasize a high degree of value and prestige associated with socioeconomic status and occupations. High education, income, and status-based occupations are valued in American society and serve as a basis of assessing an individual’s worthiness (von Soest, Wagner, Hansen, & Gerstorf, 2018). This in turn serves as a validation for self-esteem in adults.

Interpersonal framework emphasizes the role of social interaction and social symbolism on self-esteem. Individuals who maintain healthy social interactions experience higher self-esteem outcomes. On the contrary, individuals with poor social connections experience low self-esteem outcomes. The internalization of the perceptions of others establishes a framework for self-evaluation. Individuals with low socioeconomic status are often marginalized and alienated in professional roles. Threats of social exclusion negatively influence self-perception (von Soest, Wagner, Hansen, & Gerstorf, 2018) leading many individuals to increase socioeconomic standing as a form of social inclusion.

Social mobility becomes restricted by socioeconomic class origins as cultural worldviews are influenced by economics and access to resources. The expectations and demands that culture places on the individual limits the ability to transcend socioeconomic stratifications. Awareness of the degree in which socioeconomic stratification impacts self-esteem drives many high achieving individuals to pursue avenues to socioeconomic advancement (Sánchez, Liu, Leathers, Goins, & Vilain, 2011).

Individuals experience class mobility in three directions, their class or origin, their current class, and their class as others ascribe them. Throughout life, individuals move between classes shifting their sense of self and belonging. Individuals of lower or working classes find themselves straddling class divisions and developing the need to operate between two distinct class identities. Lower income classes are often faced with the choice to be loyal to their class of origin, while striving to achieve career goals. In order to achieve career goals, individuals are often forced to assimilate into cultural norms and expectations of a higher socioeconomic class. This frequently results in the individual feeling alienated from both class environments (Ardoin, 2018).

Imposter Phenomenon relates to one’s desire to appear in a particular manner within a peer group (Langford, & Clance, 1993). Individuals shift between social classes throughout educational and career progression. Transitioning socioeconomic class is a source of anxiety for many individuals. Individuals in working classes find themselves to be out of place when working toward financial and occupational advancement. There is a lack of comfortability and belonging to both the aspirational social class and the social class of origin (Ardoin, 2018). Straddling socioeconomic classes results in behavioral adaptations of separate personas when interacting in each class.

American mythology maintains the belief that higher education is a pathway to upward mobility despite the socioeconomic stratifications of one’s origin (Sánchez, Liu, Leathers, Goins, & Vilain, 2011). Socioeconomic position encompasses aspects of education and the prestige associated with institutions of higher education. Higher education continues to be an avenue for socio-economic mobility by serving as a training ground for the labor market. Human capital theory connects educational qualifications to employee productivity and thus increased earning potential. Employers often select employees based on educational credentials (Delaney, & Farren, 2016).

Institutions of higher education have a longstanding history of inequality and exclusionary practices based on socioeconomic status. The increasing cost of education, ranked and selective admissions, and tuition assistance contribute to contribute to illusion of education as a privilege. Students are often expected to conform and assimilate in order to “catch up” to more well-off peers (Ardoin, 2018).

Many individuals from lower socioeconomic classes choose avenues of distance learning or pursue lower level higher educational qualifications in order to balance financial and academic responsibilities (Delaney, & Farren, 2016). Those who do gain entrance to prestigious institutions or purse high level educations experience a marginalization and find difficulty connecting to peers in higher socioeconomic positioning (Ardoin, 2018). As higher education is a prerequisite for many forms of employment, individuals from lower socioeconomic standing are forced to assimilate with a new socioeconomic culture while mitigating the dissonance of class identity.

Aspects of social expression through dress, dialect, and manners contribute to the perception of a particular social standing sending a message that is then affirmed by society (Ardoin, 2018, & Wilkinson, & Pickett, 2017). Individuals with low self-esteem rely on the validation of others and are often compelled to adopt the behavioral patterns and appearance of the aspirational social class. Straddling socioeconomic class divisions contribute to additional dissonance surrounding one’s identity. The feeling of fraudulence may be increased due to conforming with social class expectations of two groups in varying environments. The desire to be validated within the aspirational in-group is compounded by intense fear and anxiety that that group will recognize an individual’s fraudulence (Gibson & Schwartz, 2008) which ultimately increase the occurrence of Imposter Phenomenon at the socioeconomic level.

References

Ardoin, S. (2018). Helping Poor‐ and Working‐Class Students Create Their Own Sense of Belonging. New Directions for Student Services, 2018(162), 75–86. https://doi-org.library.capella.edu/10.1002/ss.20263

Delaney, L., & Farren, M. (2016). No ‘self’ left behind? Part-time distance learning university graduates: social class, graduate identity and employability. Open Learning, 31(3), 194–208. https://doi-org.library.capella.edu/10.1080/02680513.2016.1208553

Gibson-Beverly, G., & Schwartz, J. R. (2008). Attachment, Entitlement, and the Impostor Phenomenon in Female Graduate Students. Journal of College Counseling, 11(2), 119–132. https://doi.org/10.1002/j.2161-1882.2008.tb00029.x

Langford, J., & Clance, P. R. (1993). The imposter phenomenon: Recent research findings regarding dynamics, personality and family patterns and their implications for treatment. Psychotherapy: Theory, Research, Practice, Training, 30(3), 495–501. https://doi-org.library.capella.edu/10.1037/0033-3204.30.3.495

Sánchez, F. J., Liu, W. M., Leathers, L., Goins, J., & Vilain, E. (2011). The subjective experience of social class and upward mobility among African American men in graduate school. Psychology of Men & Masculinity, 12(4), 368–382. https://doi-org.library.capella.edu/10.1037/a0024057

von Soest, T., Wagner, J., Hansen, T., & Gerstorf, D. (2018). Self-esteem across the second half of life: The role of socioeconomic status, physical health, social relationships, and personality factors. Journal of Personality and Social Psychology, 114(6), 945–958. https://doi-org.library.capella.edu/10.1037/pspp0000123

Wilkinson, R. G., & Pickett, K. E. (2017). The enemy between us: The psychological and social costs of inequality. European Journal of Social Psychology, 47(1), 11–24. https://doi-org.library.capella.edu/10.1002/ejsp.2275

by Jen L’Insalata

Benzodiazepines, sometimes referred to as anti-anxiety medications, are intended for the use in treating severe rehabilitating panic attacks and panic disorder. However all too often, benzodiazepines are prescribed for generalized anxiety disorder. From a biological etiology, anxiety is the result of stimuli triggers that activate a series on neurochemical and hormonal responses that prepare the body and mind for immediate activation. This sequence is commonly referred to as the fight or flight response and the limbic system and amygdala become activated. The excitatory hormones cortisol, adrenaline, and norepinephrine are released and the locus coeruleus or gated chloride ion channels are excited (Preston, O’Neal, & Talaga, 2013).

Generalized anxiety disorder is the low level chronic stress experienced throughout an individual’s life. This differs from panic attack in that there is a persisting anticipation of stressful or dangerous events. The limbic system is kept on a lower level of alert but does not cross the threshold into full activation of the fight or flight response.

Panic disorder is characterized by a series of reoccurring panic attack which may appear to be unprovoked. There is strong evidence suggesting the biological etiology of panic attacks stem from hypersensitive neurons within the limbic system, specifically when concerning GABA (Preston, O’Neal, & Talaga, 2013). This causes individuals to experience dizziness, nausea, chest palpitations, shortness of breath, and profuse sweating that accompany and intense fear.

Benzodiazepines bind to chloride ion channels enhancing the flow of negative chloride ions. This inward flow of negatively charged chloride ions decreases neuron excitation and produces a calming effect on the brain. Benzodiazepines work by interacting with benzodiazepine receptors during presynaptic inhibition. By binding with the receptor sites, the calming effects of the influx of negative chloride ions as well as the effects of GABA are enhanced (Preston, O’Neal, & Talaga, 2013).

The first Benzodiazepine, chloriazepoxide was developed in 1957 for anxiety and insomnia. Since then several other forms of the drug have been developed with varying degrees of anti-anxiety and hypnotic properties. Benzodiazepine gained popularity in pharmisudical anxiety treatment due to its rapid effectiveness. Therapeutic effects can be experienced in as little as 30 minutes. Additionally, benzodiazepines are well tolerated by most individuals (Preston, O’Neal, & Talaga, 2013).

Although considered relatively non-addictive, I have seen numerous cases of benzodiazepine abuse while working with addictions. Many individuals utilizes benzodiazepine to escape unwanted generalized anxiety symptoms and do not have adequate coping skills. Such coping skills can be developed through psychotherapeutic means.

I have observed the use of benzodiazepines to alleviate anxiety cause by other drugs, withdrawal, and the lack of healthy coping skills. Many individuals use benzodiazepines as an intermediary drug or for relaxation purposes. I often observe the illicit use of benzodiazepine coupled with various forms of opiates, a combination that can often be fatal.

For this reason, I question and caution the frequent and over use of benzodiazepines as a primary pharmaceutical treatment for anxiety. As they are effective to reduce dehabilitating anxiety quickly, this medication should be reserved for panic attacks and panic disorder. If prescribed, the duration should be limited and quantity should begin at a low dosage.

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References

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2013). Handbook of clinical psychopharmacology for therapists (7th ed.). Oakland, CA: New Harbinger. ISBN: 9781608826643.