What is anxiety?
Anxiety is a feeling of unease. Everybody experiences it when faced with a stressful situation; for example before an exam or an interview, or during a worrying time such as illness. It is normal to feel anxious when facing something difficult or dangerous and mild anxiety can be a positive and useful experience.
However, for one in ten people in the UK, anxiety interferes with normal life. Excessive anxiety is often associated with other psychiatric conditions, such as depression. Anxiety is considered abnormal when:
- it is very prolonged or severe
- it happens in the absence of a stressful event
- it is interfering with everyday activities such as going to work or socialising
Symptoms of anxiety
The physical symptoms of anxiety are caused by the brain sending messages to different parts of the body to prepare it for "fight or flight". The heart, lungs and other parts of the body work faster. The brain also releases stress hormones, including adrenaline. The following symptoms can occur as a result:
- abdominal discomfort
- dry mouth
- rapid heartbeat or palpitations
- tightness or pain in chest
- shortness of breath
- frequent urination
- difficulty swallowing
Psychological symptoms can include:
- irritability or anger
- inability to concentrate
- fear of madness
- feeling unreal and not in control of your actions (depersonalisation)
Types of anxiety disorders
Sometimes anxiety is associated with a physical illness, such as a thyroid disorder. When the illness is treated the anxiety usually improves.
Anxiety is often a symptom of another mental health problem, such as depression, personality disorder, alcohol misuse or withdrawal from long-term use of tranquillisers such as diazepam (Valium).
Anxiety is the main symptom of several other mental illnesses. These are called anxiety disorders.
Acute stress reaction - acute means the symptoms develop quickly, minutes or hours after the stressful event. This type of reaction typically occurs after an unexpected life crisis such as bereavement. Sometimes symptoms occur before a forthcoming event, such as an important exam. This is called situational anxiety. Symptoms usually settle fairly quickly and no treatment may be needed.
Adjustment reaction - This is similar to acute stress reaction, but symptoms develop over days or weeks after a stressful situation, for example as a reaction to a divorce. Symptoms tend to improve over a few weeks or so.
Post-traumatic stress disorder (PTSD) - this may follow after experiencing or witnessing a traumatic event such as a major accident or military combat. Anxiety is only one of the symptoms, which may come and go. The person may re-live their traumatic experience in dreams or flashbacks. It is normal to react with anxiety to a frightening experience - the term PTSD is only applied if symptoms persist. It may start years after the triggering event.
A phobia is a fear that is out of proportion to the real danger posed by the thing or event that triggers it. Phobias interfere with a person's ability to lead a normal life. The most common phobias are fear of heights, spiders, mice, blood, injections or enclosed space (claustrophobia).
Social phobia is one of the more common phobias. Meeting people causes anxiety and people are worried about what others think of them. One form of social phobia is severe anxiety about speaking or performing in public. It is common to feel nervous in these situations, but people with social phobia find these activities impossible.
Agoraphobia, another common phobia, is a fear of various places and situations, such as crowds or public places.
Obsessive-compulsive disorder (OCD)
This consists of recurring obsessions or compulsions. Obsessions are recurring thoughts or images that cause feelings of disgust. Common obsessions include germs, dirt or violence. Compulsions are thoughts or actions that people feel they must do or repeat. A compulsion is usually a response to ease the anxiety of an obsession; excessive handwashing to deal with an obsession about dirt, for example.
This is characterised by panic attacks - a sudden sense of anxiety that occurs without warning and with no apparent trigger. The physical symptoms of anxiety can be very severe. Panic attacks usually last 5-10 minutes.
Generalised anxiety disorder (GAD)
Anxiety can be a long-term disorder in which people feel worried most of the time about things that might go wrong. This is called generalised anxiety disorder.
Can I learn to manage my anxiety myself?
There are many things you can do to reduce your anxiety to a more manageable level. Taking action may make you feel more anxious at first. Even thinking about anxiety can make it worse. But facing up to anxiety, and how it makes you feel, can be the first step to breaking the cycle of fear and insecurity. It's important to remember how much better you will feel when you can begin to relax, take control, and lead a fuller life.
Controlling the symptoms
The symptoms of anxiety can be controlled by breathing and relaxation techniques, and by replacing distressing, negative thoughts with positive, peaceful ones. These methods are straightforward and can be learnt from books, the internet, video and audio tapes, through counselling, and attending relaxation classes. Often the techniques employed are based on the principles of cognitive behavioural therapy (CBT). Your GP may be able to help you access a large-group, lecture-style CBT programme. He or she can also advise you about local support groups run by and for people with similar problems. There are also classes in anxiety management.
Learning how to handle difficult situations and to stand up for yourself can make you feel more confident and, therefore, more relaxed. Some people find that learning self-defence makes them feel safer.
Complementary therapies can help you to relax, sleep better, and deal with the symptoms of anxiety. Yoga, meditation, aromatherapy, massage, reflexology, herbalism, Bach flower remedies, homeopathy, and hypnotherapy are some of the methods people have found successful. Many chemists and health shops stock different remedies and may be able to offer advice.
Taking more exercise can help you cope with anxiety and feelings of tension, and make you sleep better. Exercise uses up the adrenalin and other hormones that are produced under stress, allowing muscles to relax. Furthermore there are mood enhancing brain chemicals, such as serotonin, which are released during exercise.
Walking and swimming allow you to be active at your own pace and you can do them alone or in company. If you feel embarrassed exercising in front of others, do it at home: dance, stretch or move along to music or a video
Avoid stimulants, such as coffee, cigarettes and alcohol, which can promote anxiety. Eating a healthy diet and getting plenty of sleep can also make a big difference to your ability to cope with stress.