Anxiety information

Reading time: about 13 minutes.

Introduction.

Welcome! here you can find out more about anxiety, its causes, effects and treatment.

What is anxiety?

It’s normal to feel afraid from time to time. Most of us feel afraid if we’re startled, or if we feel threatened in some way. Fear passes quickly when we realise there’s no threat. While fear prepares the body for fight or escape, the symptoms of anxiety tend to be associated with avoiding situations, chronic tension, and with being preoccupied with future danger.

Image of cat scavenging in dustbinFor example, it’s the middle of the night. I’m getting ready for bed when I hear a noise outside. I’m startled; my muscles tense, my heart beats faster and my breathing speeds up. I go outside to look around. When I find my cat caused the noise by knocking the bin over, I take a deep breath and my fear begins to fade.

Anxiety is different. To be anxious means to feel afraid in the absence of any real danger or threat. Fear and anxiety feel similar, but anxiety lasts longer, and is out of proportion to the danger.

Sometimes we’re so anxious that we start avoiding things. Avoid things for too long and we might develop a phobia. Some people have rituals such as counting or cleaning, which stop them getting on with life.

We might have an anxiety disorder if fear is very intense, if it goes on too long, or if it stops us getting on with things.

There are several anxiety disorders, including:

  • Panic disorder.
  • Obsessive-compulsive disorder.
  • Post-traumatic stress disorder.
  • Generalised anxiety disorder.
  • Social anxiety.
  • Phobias.

What causes anxiety?

There’s rarely one thing. Psychologists think the causes are biological, social and psychological. Our genes, our experiences and the way we think, all play a part. Often anxiety starts when we’re under stress, or are exposed to sudden or repeated trauma.

The amygdala.

Amygdala

The amygdalae are a pair of almond-shaped organs in the centre of the brain. The amygdalae control strong emotions like fear and anger. The right-amygdala in particular helps regulate fear. In prehistoric times it was important that we avoided the things that scared us.

If something was dangerous, we learned to avoid it. We had to learn from one event and remember the situation well. Those who survived learned quickly and had good memories.

Today, the amygdala helps us take action when we’re afraid. It also helps us remember the things that scare us, and motivates us to avoid them.

Other parts of the brain, for example the frontal lobes, can help quieten the amygdala. We can help them do this by changing our thinking, our behaviour, and learning to change the body’s reaction to fear.


Am I anxious?

Take a look at the following two questions. They’re adapted from a questionnaire called the GAD-2. They check for generalised anxiety, the most common anxiety disorder.

1.   Over the last two weeks, how often have you been feeling nervous, anxious, or on edge?

Not at all = 0.   |   several days = 1.   |   more than half the days = 2.   |   nearly every day = 3.

2.   Over the last two weeks, how often have you been unable to stop, or control, worrying?

Not at all = 0.   |   several days = 1.   |   more than half the days = 2.   |   nearly every day = 3.

Add up your scores for the two questions. It will be somewhere between 0 and 6. If you score 3 or more, you might want to complete the GAD-7 assessment. It won’t give you a diagnosis, but it will give you a better idea about your symptoms.

If you score less than 3 but still think you might have anxiety, ask yourself:

“Do I avoid places or activities, and does this cause me problems?”

If yes, an anxiety disorder is possible, and you might want to discuss the issue with a health professional. It’s common for people to suffer from more than one anxiety disorder at a time. The most common mental health problem of all is mixed anxiety and depression, where people have the symptoms of both anxiety and depression at the same time.

Panic disorder.

People with panic disorder have short, but intense, periods of fear. When panicking, they feel sick, shaky, dizzy, and short of breath. Many feel somehow unreal, and worry they’re losing their mind.

Panic attacks can start and stop quickly. A few people find they can last for several hours. Sometimes they start in response to a thought or a memory. Sometimes, they seem to come with no warning at all. Panic attacks often cause chest pain, making people think there’s something seriously wrong.

People with panic disorder tend to worry about future panic. They might avoid places or situations where they think they might panic. For some, this can lead to agoraphobia.

It’s easy to feel anxious about feeling anxious. The diagram below shows how anxiety can build up, leading to a panic attack.

Anxiety spiral

  1. I have to go out, but I am feeling nervous about meeting people.
  2. I notice my heart beating faster. My stomach muscles feel tense.
  3. As I focus on my heart beating, it beats faster still.
  4. What if there’s something seriously wrong? Am I having a heart attack?
  5. I become more anxious, I breathe faster. I begin to tremble and sweat.

People can become acutely aware of sensations in the body. This can lead to a vicious circle of fear, especially when normal feelings are mistaken for a sign of serious illness. For more information, follow the link to download our panic disorder information leaflet (0.8Mb PDF).

Obsessive-compulsive disorder (OCD).

People with OCD have upsetting, intrusive thoughts. They feel an urge to perform certain acts or rituals to help them feel safer or less tense. The intrusive thoughts are “obsessions,” the rituals are “compulsions.” Some people have obsessions without compulsions, known as “Pure O”.

They know the compulsions have no logical basis, but this doesn’t make things any easier. Some find that, without treatment, rituals can become more intrusive over time. When severe, they can consume many hours of a person’s day. For more information, follow the link to download our OCD information leaflet (1Mb PDF).

Post-traumatic stress disorder (PTSD).

Post-traumatic stress disorder can result from one or more traumatic experiences. The trauma might be an extreme situation, such as war, disaster, abuse or a serious accident. PTSD can also result from long-term stress.

Common symptoms of PTSD include:

  • Being tense and on guard all the time.
  • Flashbacks (re-living memories).
  • Avoiding people or situations.
  • Anxiety, anger and depression.

Generalised anxiety disorder (GAD).

People with GAD feel anxious much of the time. GAD causes both psychological and physical symptoms. These can include feeling tense, restless and worried; having trouble concentrating, and problems sleeping. People with GAD often feel tired and irritable. For a diagnosis of GAD, these symptoms must have continued for several months.

Phobias.

A phobia can be about anything from an animal, to a location or a situation. About 1 person in 10 suffers from one or more phobias. A specific object, event or situation triggers their anxiety. About three quarters of people with a phobia fear more than one object or situation. Twice as many women as men report phobias; though an equal number of men and women have a blood or injection phobia.

Phobia sufferers understand their fear is not rational, but knowing this doesn’t help. Avoiding the feared object or situation fuels the phobia. Recovery often involves being close to the feared object until anxiety reduces. Many people with phobias organise their life to try to avoid the feared object, or situation.


Treatments for anxiety.

There are many approaches to the treatment of anxiety. If one doesn’t work, you can try a different approach until you find one that works for you. Remember to give each one a fair trial, though. It’s tempting to move on to the next treatment before the last has had a chance to work.

Most people with anxiety are treated by their GP. However, medication might not be your GP’s first choice. Talking therapy can be just as effective as pills. There are over 400 different types of talking therapy available in the UK, the most common being CBT and person-centered counselling.

If you’re taking medication, it can take some time to work, so don’t give up hope if you don’t feel better straight away, it usually works best when taken for a longer time. Remember to take medical advice before stopping or changing medication.

Anxiety can make us feel alone, wretched and hopeless. It can be hard to gather the energy to get help. A quick phone call to your GP can get things moving, and could be your first step on the road to recovery.

A medical or mental health appointment can feel daunting. It’s often helpful to write down what you want to talk about before you go. Make a note of any questions or worries you might have. Some people find it helpful to take a friend or family member along.


Anxiety – what works.

Act opposite.

Anxiety makes us want to avoid people or situations. It’s hard, but facing our fears and staying with things is usually helpful. Staying in work, or returning to work or education, might be difficult, but it can help us keep a sense of control.

Keeping to a daily routine is better than withdrawing. Shutting ourselves away might seem like a good option, but it tends to make things worse. When we avoid a situation, it’s harder to gain control over our fear.

When you want to run, stay. When you want to avoid, lean in. When you feel like hiding, step forward.

What situations, or people, or places, do I feel like avoiding? What could I do differently?

Talk.

There are many types of talking therapy. Many think the most effective for anxiety is cognitive-behaviour therapy (CBT). In CBT we learn to change our thinking and face our fears. A CBT therapist can help you learn the skills to deal with things you may have been avoiding.

Other treatments are available for other anxiety disorders. For example, EMDR is proving to be an effective treatment for PTSD.

Deal with stuff.

Putting off problems makes them mount up. Are there things you’re putting off dealing with? Could you use an advocate or some extra support? Citizens Advice can help with a range of issues from housing to money worries. Doing things to address our problems relieves the burden, and helps us feel in control again.

Re-learn to relax.

Relaxation sometimes doesn’t come easily. It can take an act of willpower to decide to sit back, breathe slowly and calm ourselves down. Breathing exercises help. Here’s a simple breathing exercise to help restore calm.

  1. Place the palm of your hand over your stomach.
  2. Open your mouth and breathe out with a sighing sound. As you breathe out, allow your shoulders and upper body muscles to relax.
  3. Close your mouth and pause. Keep your mouth closed and breathe in through your nose, your stomach should move out as you breathe in.
  4. If your shoulders rise or your stomach doesn’t move out, slow down and try again till you’re breathing by pushing your stomach out.
  5. Breathe out slowly, gently and deeply.
  6. Repeat steps 3 – 4 – 5 until you feel more calm.

Repair relationships.

Struggling with your partner? Anxiety causing problems in your relationship? Contact Relate on 0845 456 1310. Health professionals will also have information about other types of counselling.

Try answering the following question. What relationship, or relationships, would I like to improve? What could I do this week to make them better?

Avoid alcohol and drugs.

Alcohol is a depressant – it lowers the mood. Non-prescribed drugs are best avoided. If alcohol is a problem, contact Alcoholics Anonymous on 0845 769 7555. If you’re using drugs and want help, contact Narcotics Anonymous on 0300 999 1212.


Anxiety – what doesn’t work.

Some things seem to help, but actually hold us back. Some of these things, like doing more rituals, might help us feel a bit less tense in the short-term, but make things worse in the long run.

Holding your breath.

It seems natural to hold our breath when we’re anxious. It’s much more helpful to relax our breathing and take slower, deeper breaths.

Putting up with it.

Anxiety may get better on its own, or it may not. About a third of people with anxiety recover completely without doing anything at all. Others feel afraid of their anxiety; some feel ashamed and try to cover it up. Both of these can make symptoms worse. Thankfully, there’s much less stigma around mental health issues than there used to be, and new treatments are often simpler and more effective than we expect.

Focusing on symptoms.

Anxiety narrows our attention. It’s a survival mechanism; it used to make sense to focus on threats so we can deal with them. However, as there’s no real threat, focusing on our anxiety symptoms just brings them to the foreground. Attention intensifies sensation.

Rituals and compulsions.

Rituals tend to increase over time. Trying to avoid thinking about something makes us think of it more. Distraction, mindfulness and acceptance strategies work better.

Avoiding stuff.

When we avoid things:

  • We don’t learn the skills to deal with them.
  • We’re more likely to avoid other important stuff.
  • We don’t grow through challenging our fear.
  • Problems mount up.
  • We shut down future possibilities.
  • We don’t get to feel good about ourselves for tackling stuff.

So … avoid avoiding!

Tensing muscles.

Makes us tired, and makes anxiety hurt more and last longer.

Have a think. What could I do today to help my mind and muscles relax?


Self-help resources.

There are many helpful books and websites. A health professional will be able to recommend from a range of resources.

Act now!

If you’re affected by anything you’ve read here, contact a health professional. Don’t delay in seeking help. Anxiety sometimes lifts on its own, but why wait?

Speak with your GP or a health professional for extra information, get on the road to recovery today!

Are you currently in a crisis? remember the Samaritans are open 24 hours a day, 7 days a week – in the UK, call free on 116 123.


Disclaimer.

This material is for information only. We take care in compiling these resources, but don’t guarantee their accuracy or completeness. Please consult a health professional if you are worried about your health.

Written by: SC.
Written on: 20 September 2017.
Last updated on: 14 July 2018.
Checked by: JL.
Checked on: 14 July 2018.
Date for review: July 2020.
Flesch Reading Ease: 71.

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