What is Anxiety?

Feelings of anxiety represent a natural response to perceived fear or threat. It is a normal human reaction, but when this response becomes excessive and individuals begin to excessively worry about relatively harmless situations, it can disrupt their daily functioning and overall well-being.

When an individual is experiencing anxiety, they may feel a sense of fear or apprehension, accompanied by tension and a range of unpleasant mental or physical symptoms. These symptoms can include restlessness, difficulty concentrating, irritability, muscle tension, and difficulty sleeping.

Anxiety Symptoms

Physical symptoms of anxiety include:

• The sensation of having a ‘Thumping Heart’ (palpitations)
• A feeling of Sickness (nausea)
• Shaking (tremor)
• Sweating
• Dry Mouth
• Chest Pain
• Headaches
• Fast Breathing
• Dizziness

When you experience anxiety, your brain sends numerous signals through your nerves to different parts of your body, triggering physical symptoms. This anxiety-induced response includes the release of stress hormones like adrenaline (epinephrine) into your bloodstream. These hormones interact with your heart, muscles, and other bodily systems, resulting in symptoms such as a pounding heartbeat and clammy hands.

Mental symptoms of anxiety include:

• Feeling Tired
• Feeling Restless or Irritable
• Unable to Concentrate or Make Decisions
• Difficulty Sleeping
• Worrying about the past or thinking something wrong will happen

Behavioral symptoms of anxiety include:

• Sometimes, there is a need to be alone and avoid friends and social situations
• Selective mutism is when a child cannot speak in certain situations, such as at school, even when they can speak in other situations, such as at home with close family members
• Compulsions may develop to get rid of harmful, anxiety-producing thoughts, such as compulsively washing hands because of a fear of germs
• Sometimes anxiety can cause agoraphobia, i.e., a fear of leaving your home because of anxiety about what might happen if you leave your house
• Unhealthy coping tools, such as alcohol misuse or substance abuse, which may initially dull the symptoms of anxiety but make the anxiety worse

What Causes Anxiety?

• Some people may be more prone to anxiety because of their genetics, and there may be a chemical imbalance in the brain, which makes them feel much more anxious
• Difficult past experiences in childhood, adolescence, or adulthood are a common trigger for anxiety problems
• Current stressful life events/trauma can also trigger anxiety
• Anxiety can sometimes be a medication side effect, such as some psychiatric medications, or due to using recreational drugs or alcohol
• Anxiety may also be a symptom of other illnesses, particularly hyperthyroidism

Is Anxiety Normal?

It’s typical to experience feelings of anxiety in demanding circumstances, which can be beneficial. For example, most individuals will feel anxious when confronted by a threatening individual or preparing for a significant competition. Our bodies respond to these stressful situations with an adrenaline rush and nerve impulses that can trigger a ‘fight or flight’ response.

Anxiety is abnormal and can be classed as a mental health condition if it:

• Is out of proportion to the stressful situation or
• Persists when a stressful situation has gone, or the stress is minor, or
• Appears for no apparent reason when there is no stressful situation

Risk Factors

There are some risk factors for anxiety, which include:

• Females are more often affected than males
• Family history of anxiety, depression, or other psychiatric disorders
• Childhood abuse or neglect or parental mental health problems
• Being a victim of bullying as a child
• Sudden bereavement
• Being separated, widowed, divorced
• Being unemployed
• Substance dependence or exposure to organic solvents
• Chronic health conditions, e.g., heart disease, cancer, respiratory disease, diabetes, or arthritis

What are Anxiety Disorders?

It is possible that an individual may be experiencing an anxiety disorder if the symptoms of anxiety significantly disrupt their routine activities or if they express concern regarding the potential impact of anxiety symptoms on their daily functioning. Current estimations suggest that approximately 1 in 20 individuals may be affected by an anxiety disorder at any given time.

Anxiety serves as a primary symptom in various conditions (disorders), with some individuals manifesting features of more than one type of disorder concurrently.

See the links below for more information on some of the main types of anxiety disorders:

• Social anxiety disorder
• Panic attack and panic disorder
• Generalized anxiety disorder
• Acute stress reaction
• Post-traumatic stress disorder
• Phobias – e.g., agoraphobia and other specific phobias
• Obsessive-compulsive disorder (OCD)

Dealing with an adjustment reaction can feel like acute stress, but it often shows up a few days or weeks after a big life change like a divorce or moving to a new home. This reaction happens as we try to adapt and can bring about symptoms similar to acute stress, like feeling down. The good news is that these symptoms usually get better over a few weeks.

Anxiety Treatment

The primary objective of anxiety treatment is to assist individuals in effectively managing and reducing their symptoms, enabling them to regain control over their daily lives without the impact of anxiety.

The treatment options depend on your condition and the severity of your symptoms. They may include one or more of the following:

NON-MEDICATION TREATMENTS

Understanding

Understanding what’s causing your symptoms and talking about them with someone you trust, like a family member or healthcare professional, can really help. For example, some people might worry that physical signs of anxiety, like heart palpitations, mean they have a serious physical issue, like heart problems, which can make their anxiety worse. But realizing that it’s just anxiety won’t magically make the symptoms go away, but it often helps people feel better.

Counselling

This intervention may be beneficial for individuals with specific conditions. For example, counseling focused on problem-solving skills can be advantageous for those diagnosed with generalized anxiety disorder (GAD).

Anxiety Management Courses

If courses are available in your area, they might be a great option for dealing with certain conditions. These courses could teach you how to relax, develop problem-solving skills, learn coping strategies, and receive support from a group.

Cognitive behavioral therapy (CBT) for anxiety

If it’s available in your area, this therapy can really help with persistent anxiety disorders and phobias:

Cognitive Behavioral Therapy (CBT) focuses on your current thought processes and behaviors, aiming to change them in a way that may help you manage your anxiety.

Self-help

Various national organizations are available to offer assistance by providing valuable information, helpful advice, and ongoing support. Additionally, your doctor or practice nurse can be an excellent resource in connecting you with a local support group for face-to-face assistance. In addition, you have access to a wide range of resources such as leaflets, books, CDs, DVDs, and MP3s, all of which focus on teaching effective deep-breathing techniques and other proven methods to alleviate stress, promote relaxation, and potentially help manage anxiety symptoms.

MEDICATION

Antidepressant Medicines

Selective serotonin reuptake inhibitors (SSRIs) are commonly used antidepressants that also effectively function as anti-anxiety medications.

SSRIs often used for anxiety are:

• Escitalopram
• Sertraline

These medications are often prescribed to alleviate symptoms of depression and are also found to be effective in managing symptoms of anxiety, even in individuals who do not experience depression. They function by modulating brain chemicals, also known as neurotransmitters, particularly serotonin, which are implicated in the development of anxiety symptoms. Importantly, it should be noted that antidepressants are non-tranquilizing and typically do not lead to addiction.

Other similar medications that your doctor can use to help manage anxiety are:

• Mirtazapine
• Venlafaxine
• Paroxetine

Benzodiazepines

Benzodiazepines such as diazepam used to be the most commonly prescribed anxiety treatment. They were known as minor tranquilizers, but they do have some known severe side effects. They often work well to ease symptoms in the short term.

The problem is they are addictive and can lose their effect if you take them for more than a few weeks. They may also make you drowsy. They are not used often for persistent anxiety conditions now.

A short course of up to two weeks may be an option for anxiety, which is very severe and short-term, or now and then to help you over an evil spell if you have persistent anxiety symptoms.

Buspirone

Buspirone is sometimes prescribed to treat GAD. It is an anti-anxiety medicine but different from benzodiazepines and is not thought to be addictive. It is not clear how it works. It is believed to affect serotonin, a brain chemical that may be involved in causing anxiety symptoms.

Beta-blocker medicines

A beta-blocker—for example, propranolol—can ease some physical symptoms, such as trembling and a ‘thumping heart’ (palpitations). However, beta-blocker medicines do not directly affect mental symptoms, such as worry.

However, some people relax more quickly if their physical symptoms are eased. These tend to work best in short-lived (acute) anxiety. For example, if you become more anxious before a test (e.g., a driving test or an exam), then a beta-blocker may help to ease ‘the shakes.’

In some cases, a combination of anxiety treatments, such as cognitive therapy and an antidepressant, may work better than either treatment alone.

Alcohol and anxiety

Although alcohol may ease symptoms in the short term, don’t think that drinking helps to cure social anxiety. It does not.

Drinking alcohol to ‘calm nerves’ can lead to problem drinking and may make problems with social anxiety and depression worse in the long term. See a doctor if you are drinking alcohol (or taking street drugs) to ease stress.

When to see a doctor for anxiety

You should see a doctor if you’re struggling to cope with anxiety, fear, or panic or if things you’re trying yourself are not helping.

You can also get complimentary talking therapies like cognitive behavioral therapy (CBT) on the NHS. You can refer yourself directly to an NHS talking therapies service without a referral from a.