ANXIETY
WHAT IS ANXIETY?
Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is a natural human response when we perceive that we are under threat. It can be experienced through our thoughts, feelings and physical sensations.
Most people feel anxious at times. It's particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life. (See my page on managing stress for more information about stress.)
What is the 'fight, flight or freeze' response?
Like all animals, human beings have evolved ways to help us protect ourselves from danger. When we feel under threat our bodies react by releasing certain hormones, such as adrenaline and cortisol. These hormones:
- make us feel more alert, so we can act faster
- make our hearts beat faster, quickly sending blood to where it's needed most.
After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to shake.
This is commonly called the ‘fight, flight or freeze’ response – it’s something that happens automatically in our bodies, and we have no control over it.
When is anxiety a mental health problem?
Anxiety can become a mental health problem if it impacts on your ability to live your life as fully as you want to. For example, it may be a problem for you if:
- your feelings of anxiety are very strong or last for a long time
- your fears or worries are out of proportion to the situation
- you avoid situations that might cause you to feel anxious
- your worries feel very distressing or are hard to control
- you regularly experience symptoms of anxiety, which could include panic attacks
- you find it hard to go about your everyday life or do things you enjoy.
If your symptoms fit a particular set of medical criteria then you might be diagnosed with a particular anxiety disorder. But it's also possible to experience problems with anxiety without having a specific diagnosis.
What are anxiety disorders?
Anxiety can be experienced in lots of different ways. If your experiences meet certain criteria your doctor might diagnose you with a specific anxiety disorder.
Some commonly diagnosed anxiety disorders are:
- Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person's experiences.
- Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or any situation in which you have to talk to another person). It is also known as social phobia. (See my page on types of phobia for more information.)
- Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks. (See my page on panic attacks for more information.)
- Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as social situations) or a particular object (such as spiders). (See our pages on phobias for more information.)
- Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can cause flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced during the actual event. (See our pages on PTSD for more information.)
- Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges. (See our pages on OCD for more information.)
- Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD.
- Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance.
- Perinatal anxiety or perinatal OCD – some women develop anxiety problems during pregnancy or in the first year after giving birth.
You might not have, or want, a diagnosis of a particular anxiety disorder – but it might still be useful to learn more about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.
WHAT DOES ANXIETY FEEL LIKE?
Anxiety feels different for everyone. You might experience some of the things listed below, and you might also have other experiences or difficulties that aren't listed here.
Effects on your body
- a churning feeling in your stomach
- feeling light-headed or dizzy
- pins and needles
- feeling restless or unable to sit still
- headaches, backache or other aches and pains
- faster breathing
- a fast, thumping or irregular heartbeat
- sweating or hot flushes
- problems sleeping
- grinding your teeth, especially at night
- nausea (feeling sick)
- needing the toilet more or less often
- changes in your sex drive
- having panic attacks.
Effects on your mind
- feeling tense, nervous or unable to relax
- having a sense of dread, or fearing the worst
- feeling like the world is speeding up or slowing down
- feeling like other people can see you're anxious and are looking at you
- feeling like you can't stop worrying, or that bad things will happen if you stop worrying
- worrying about anxiety itself, for example worrying about when panic attacks might happen
- wanting lots of reassurance from other people or worrying that people are angry or upset with you
- worrying that you're losing touch with reality
- rumination – thinking a lot about bad experiences, or thinking over a situation again and again
- depersonalisation – feeling disconnected from your mind or body, or like you're watching someone else (this is a type of dissociation)
- derealisation – feeling disconnected from the world around you, or like the world isn't real (this is a type of dissociation)
- worrying a lot about things that might happen in the future
How else might anxiety affect my life?
Anxiety symptoms can last for a long time, or come and go. You might find you have difficulty with day-to-day aspects of your life, including:
- looking after yourself
- holding down a job
- forming or maintaining relationships
- trying new things
- simply enjoying your leisure time.
WHAT CAUSES ANXIETY?
No one knows exactly what causes anxiety problems, but there probably lots of factors involved.
Can anxiety problems be inherited genetically?
Research shows that having a close relative with anxiety problems increases your chances of experiencing anxiety problems yourself. But at the moment there is not enough evidence to show whether this is because we share some genetic factors that make us more vulnerable to developing anxiety, or because we learn particular ways of thinking and behaving from our parents and other family members as we grow up.
Past or childhood experiences
Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma is likely to have a particularly big impact if it happens when you're very young. Experiences which can trigger anxiety problems include things like:
- physical or emotional abuse
- neglect
- losing a parent
- being bullied or being socially excluded.
Having parents who don't treat you warmly, are overprotective or are emotionally inconsistent can also be a factor..
Your current life situation
Current issues or problems in your life can also trigger anxiety. For example:
- exhaustion or a build up of stress
- long working hours
- being out of work
- feeling under pressure while studying or in work
- having money problems
- homelessness or housing problems
- losing someone close to you
- feeling lonely or isolated
- being bullied, harassed or abused.
Physical or mental health problems
Other health problems can sometimes cause anxiety, or might make it worse. For example:
- Physical health problems – living with a serious, ongoing or life-threatening physical health condition can sometimes trigger anxiety.
- Other mental health problems – it's also common to develop anxiety while living with other mental health problems, such as depression.
Drugs and medication
Anxiety can sometimes be a side effect of taking:
- some psychiatric medications
- some medications for physical health problems
- recreational drugs or alcohol.
HOW CAN I HELP MYSELF?
Living with anxiety can be very difficult, but there are steps you can take that might help. Here are some suggestions for you to consider.
- Identify triggers
- Communication
- Exercise
- Diet
- Keep a diary
- Avoid nicotine, alcohol and caffeine
- Relaxation
- Complementary therapies.
- Doing sports/fitness
- Get involved
- Arrange social activities
WHAT TREATMENTS ARE AVAILABLE?
There are various evidence-based treatments that have been found to help with anxiety problems and panic disorder.
- CBT
- Councelling and psychotherapy
- Anxiety management courses
- Hypnotherapy
- Therapy groups
- Self help groups.
