anxiety
by Sally Burningham
Anxiety is a general term that covers a wide range of feelings from mild worry to crippling distress. Because we all expect to feel anxious from time to time we may sometimes underestimate the problems that severe or persistent anxiety can cause.
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A certain amount of anxiety can be helpful. It can alert us to things that need to be done, warn us that things are not quite right or help us to focus our energies in order to deal with difficult or dangerous situations. However, too much anxiety can prevent us from functioning properly and we need to take steps to try and deal with it appropriately.
different kinds of anxiety
It is quite normal to feel anxious if, for example, someone close to you is ill, you are having difficulty in getting a job, money is tight or a relationship is not going as it should. It is also quite common to feel anxious if you have to deal with a new situation, such as a new job, or a major change such as moving house, or with too many stresses. This kind of anxiety usually dissipates once the problems have been sorted out or we come to terms with the situation.
There are a number of measures you can take to help you cope with this kind of anxiety. For more information see the section on self-help tips below. Of course, if your anxiety becomes overwhelming or is starting to drag you down, you should talk things through with your GP.
However, this kind of anxiety, which usually has an identifiable cause, is rather different from the severe and persistent anxiety, often known as underlying or generalised anxiety, that can considerably restrict people's lives.
If you are affected by underlying anxiety you may find that you experience feelings of unease or dread for most of the time for no particular reason that you can identify, or that you are excessively anxious about certain matters where there is no real need. For example, you might worry constantly about your financial situation although you are financially secure, or the health of your children even though they are quite well, or that something dreadful is about to happen, although the chances are remote.
It is important to see your GP and ask for help as soon as possible as this type of anxiety may well affect your ability to cope and is likely to considerably impair your quality of life.
You may also like to find out about other forms of anxiety by looking at our features on phobias, panic attacks and obsessive compulsive disorder. Many sufferers of anxiety experience a mix of these conditions, often over a period of time. Anxiety often occurs alongside other mental health problems such as depression. See our feature for more information on depression.
symptoms
Although there is no precise definition of anxiety, most people recognise they are feeling anxious because they experience a number of physical, emotional and mental changes. These will vary from person to person but may include:
- stomach churning, nausea, vomiting
- diarrhoea
- dry mouth
- trembling
- difficulties in swallowing
- hot flushes, chills
- shortness of breath
- dizziness
- sweating
- accelerated heart rate
- increased muscle tension
- trouble in falling or staying asleep
- feeling restless, tense, unable to concentrate
- feeling irritable, fearful, apprehensive.
For many people the feeling of generalised anxiety often becomes worse as the day progresses.
If anxiety persists for any length of time it can be very exhausting.
It is important to remember that anxiety can also be expressed through various physical ailments such as headaches, stomach aches or skin rashes.
causes and contributory factors
It may be clear as to why we are feeling anxious if, for example, we are waiting for an important exam result or our job is in jeopardy. But it is not clear why some of us become excessively anxious for no apparent cause or become overanxious about certain situations.
One possibility is that some people inherit a genetic predisposition to anxiety. This does not mean that they will necessarily become very anxious but that they are more likely to do so than other people if certain circumstances occur.
Sometimes the onset of persistent or excessive anxiety seems to coincide with a distressing event such as a physical illness or a period of stress and then simply continues even though the situation has improved. In other cases there seems to be no particular trigger.
Quite often the attitudes people hold increase their anxieties. For example, you may well be highly anxious if you are a perfectionist and want to excel in all areas. This is because you have set yourself unrealistic goals.
Anxiety can also be caused or increased by a person's lifestyle. Too little exercise, for example, allows tension to build up in the body and too many caffeine-containing drinks give rise to anxiety. In addition, drinking too much alcohol will increase anxiety as well as resulting in other problems, and certain recreational drugs can give rise to anxiety symptoms.
Too many stresses can also cause or contribute to anxiety. Although people vary in the amount of stress they can handle, taking on too many responsibilities, or working constantly against the clock, can give rise to tension and anxiety that may eventually affect all areas of your life.
Occasionally, anxiety symptoms can be produced by an undiagnosed physical condition such as a thyroid disorder. Check with your GP.
treatment
You should see your GP if your anxiety is severe or persistent or is making it difficult for you to cope with life. There is no one treatment for anxiety. Among the treatments or measures your GP may suggest are:
- cognitive behaviour therapy (CBT). People with prolonged anxiety often have a fairly negative view of themselves and their environment which may in turn reinforce their anxiety. CBT helps people to see themselves and situations in a more realistic way and to make appropriate changes in their behaviour that will help them to cope. For more information see our feature on cognitive behaviour therapy.
- some kind of relaxation technique. Learning to relax can often help reduce the physical symptoms of anxiety and help you to feel calmer and more able to manage life. You may like to look at more information on relaxation on the complementary medicine site.
- changes in your life style, such as taking more exercise, as this can help improve your mood; avoiding or cutting down on caffeine-containing drinks, alcohol or recreational drugs, as these can induce anxiety; and eating regular, balanced meals since missing meals or an inadequate diet can increase anxiety.
- medication. If your anxiety is very severe and long lasting and does not respond to other types of treatment, your GP may advise medication. Beta blockers are sometimes used to treat the physical symptoms of anxiety. Some of the newer antidepressants are also used to treat anxiety. For more information see our feature on antidepressants and tranquillisers.
You may want to try out one or more forms of complementary medicine to see if they help. However, always check with your GP first. For information on complementary medicine see the therapies section of the complementary medicine site.
self-help tips
- Dealing with new situations or unfamiliar surroundings makes many people anxious. It may help to admit to those with you that you are anxious so they can help. If you feel very agitated try to sit down somewhere quietly and breathe slowly and deeply for a few minutes to calm yourself.
- Too much stress can cause anxiety. Try to sort out your priorities, say no to unwanted demands and allow yourself vital time for relaxation.
- People often become anxious when they feel they have little control over what is going on, or feel unappreciated or not needed. If you are unable to change the situation it can help to find other appropriate outlets for your energy, or abilities that can build up your confidence such as sport or voluntary work or other interests.
- Changes in life, particularly major changes, are a common cause of anxiety. Recognising that it is normal to feel anxious in these circumstances, and talking about your feelings rather than bottling them up, can often relieve the strain. A number of changes occuring close together are even harder to handle so try to avoid changing jobs in the midst of a divorce, or moving home after a bereavement.
- Uncertainty is often a cause of anxiety. If there is nothing you can do to put your mind at rest more quickly, then keeping as busy as possible, or relieving your tension through exercise or relaxation techniques, may help keep your anxiety under control.
- People usually feel anxious when a relationship seems to be going wrong. It may help to talk things over with a trusted friend. However, if it is quite complex, you may need professional help. Ask your GP.
- If you are a perfectionist you will expect too much from yourself, and sometimes from other people too, and this will often make you anxious. Try to relax your standards in those areas where it matters less and accept that it is sometimes alright for you or others to make mistakes.
help and info
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organisations
Anxiety Care
Cardinal Heenan Centre
326 High Road
Ilford IG1 1QP
Helpline: 020 8478 3400 (Weds 10am-3pm)
Telephone: 020 8262 8891
E-mail: enquiries@anxietycare.org.uk
Website: www.anxietycare.org.uk
Anxiety Care is a registered charity based in East London that specialises in helping people to recover from anxiety disorder and to maintain that recovery.
First Steps to Freedom
1 Taylor Close
Kenilworth CV8 2LW
Helpline: 0845 120 2916 (every day 10am-10pm)
Info: 01926 864473
E-mail: info@first-steps.org
Website: www.first-steps.org
A confidential helpline for people suffering from general anxiety, panic attacks, phobias, obsessive compulsive disorder, anorexia and bulimia, and their carers. Offers counselling, listening, advice, support and information.
National Phobics Society
Zion CRC
339 Stretford Road
Hulme
Manchester M15 4ZY
Helpline (members only): 0870 7700 456 (Mon-Fri 10am-4pm)
E-mail: nationalphobic@btconnect.com
Website: www.phobics-society.org.uk
A membership-only organisation, run by sufferers and ex-sufferers of anxiety disorders, that provides support and advice to people affected by phobias and anxiety disorders. Offers one-to-one therapy (with home visits for those who are housebound through agoraphobia etc.) including CBT, clinical hypnotherapy and counselling.
No Panic
93 Brands Farm Way
Telford TF3 2JQ
Helpline: 0808 808 0545 (every day 10am-10pm, answerphone 10pm-10am)
E-mail: ceo@nopanic.org.uk
Website: www.nopanic.org.uk
Provides a range of services for people who suffer from panic attacks, phobias and OCD including literature, audio/ video cassettes, a membership scheme and "contact" service. Also offers telephone recovery groups for people who live in rural or isolated areas where access to local support is limited.
websites
Anxiety Coach
www.anxietycoach.com
This site is an American-based self-help guide for people who have significant trouble with anxiety and phobias. Useful articles and resources.
Anxiety Disorder Education Program
Anxiety Disorder Education Program
Has information about panic attacks and other anxiety disorders, including obsessive compulsive disorder and treatments, plus links and contacts. Part of US National Institutes of Health website.
NetDoctor – Generalised Anxiety Disorder (GAD)
NetDoctor Women's Health Anxiety Feature
A NetDoctor article that looks at generalised anxiety disorder (GAD) – when worrying becomes an illness.
Social Anxiety UK
www.social-anxiety.org.uk
Information and support for sufferers of social anxiety (SA) and related problems. Features chatrooms and details of local meetings across the UK.
The Royal College of Psychiatrists – Anxiety and Phobias
www.rcpsych.ac.uk/.../anxietyphobias/anxietyphobias.aspx
Factsheet including symptoms, causes and where to get help.
reading
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How to Stop Worrying by Louise Flory (Mind, 1998) £1 plus 44p p&p |
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Overcoming Anxiety by Helen Kennerley (Constable Robinson, 1997) |
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Overcoming Social Anxiety: A self-help guide using cognitive behavioural techniques by Gillian Butler (Constable Robinson, 1999) |
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The Anxiety and Phobia Workbook by Edmund Bourne (New Harbinger Publications, 2001) |
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(November 2002, resources updated November 2004)
