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Anxiety

Written by Dr Claudia Pastides, 20th February 2019

Anxiety disorders are the most commonly diagnosed mental health conditions in the World. Although 1 in 10 people are diagnosed1, the reality is that many more are struggling in silence. As many as 1 in 4 people are believed to go through an episode of anxiety disorder at some point in their life.

Humans have a built-in ‘fight or flight’ response to scary situations, which was very useful once upon a time when we were cave-men and women running away from predators. Although the fear of being eaten alive comes up less often nowadays (thank goodness), we have plenty of other challenges and stresses in life that cause us to feel anxious. This isn’t always a negative thing. A little stress here and there keeps us motivated and alert, but sometimes stresses can add up, be overwhelming and affect day to day life in a negative way,


The different types of anxiety

Of the various types of anxiety, the most common are1:

  • Phobias (an overwhelming fear of a place/animal/object/feeling/situation)
  • Panic disorders (recurrent unexpected panic attacks)
  • Social anxiety disorder (intense fear and avoidance of social situations)
  • Generalised anxiety disorder

Anxiety can also co-exist with depression, meaning that you might be very low in mood and feeling incredibly anxious at the same time.

How anxiety feels

Anxiety disorders often have a combination of psychological and physical symptoms. The usual physical symptoms that happen as a result of the ‘fight or flight’ response include:

  • Palpitations (heart feeling like it is racing in your chest)
  • Hyperventilating (breathing a lot and very quickly)
  • Sweating
  • Nausea (feeling sick)
  • Pins and needles
  • Feeling light-headed or dizzy
  • Legs feeling weak/wobbly

We have all experienced some of these symptoms before when scared or anxious about something and the feeling will often pass just as quickly as it comes on. The difference between this response and that experienced by people with anxiety disorder is that these feelings keep coming on regularly, last for months and interfere with daily life.

Anxiety disorder can also cause longer lasting physical symptoms, such as

  • Headaches
  • Difficulty sleeping
  • Feeling restless
  • Reduced sex drive
  • Headaches, backaches and other aches and pains

Sometimes people will see their GP because of those symptoms, without realising they are due to anxiety disorder.

Both the physical and psychological effects of anxiety are incredibly distressing. Psychological symptoms and fears include:

  • Feeling like you might die
  • Avoiding situations that might cause you to feel anxious (for example, going outdoors)
  • Feeling that people are watching you and judging your every move/word/how anxious you are
  • Being very alert all the time or feeling on-edge
  • An overwhelming feeling to run away and escape situations that make you anxious

Occasionally, anxiety can get so bad that you think that life is not worth living and you might contemplate suicide. In such cases it is important to speak to a healthcare professional urgently.

If you're worried about acting on thoughts of suicide, you can call an ambulance, go straight to A&E or call the Samaritans for free on 116 123 to talk.

Who is more likely to develop anxiety disorder?

Much like most health conditions, a combination of genetics and life experiences play a role in the cause of anxiety disorders.

For example, females and people with a family history of mental health conditions are more likely to develop anxiety disorders, as are individuals that have been exposed to:

  • A challenging childhood (abuse, bullying, alcoholism at home)
  • Difficult environments (unemployed, domestic violence, low socioeconomic status)
  • Substance abuse
  • Chronic or painful illness ( i.e. cancer, heart disease, stroke, arthritis)

How does a GP diagnose anxiety disorder?

Diagnosis is based on the GP taking a really good history around your psychological and physical wellbeing, family history, social situation and how all of this is impacting on your day to day life. You might find they ask you to complete a questionnaire, called the Generalised Anxiety Disorder Assessment (GAD-7)2. This screening tool (which you can also find online) helps measure the severity of someone’s anxiety, although it is not 100% so it is always important to speak to a healthcare professional about it too.

What treatment is available?

Treatment options depend on the type and severity of symptoms. You might be offered:

  • Self-help options, such as websites and online Cognitive Behavioural Therapy (links to a few at the bottom of the page)
  • Psychological therapy
  • Medication, such as Sertraline, Paroxetine (Seroxat) and Escitalopram (Cipralex).

It is also important to consider how valuable self-care can be when it comes to anxiety. Exercise has been shown to reduce the symptoms of anxiety for some and making sure you practice good sleep hygiene (regular bedtime, no caffeine before sleep etc) can be valuable too.


More information

For more information on anxiety, links to support organisations and online, take a look at:

MIND - https://www.mind.org.uk/

Anxiety UK - https://www.anxietyuk.org.uk/

Living Life To The Full (free online CBT) - https://llttf.com/


References

1. Thibaut F. Anxiety disorders: a review of current literature. Dialogues Clin Neurosci. 2017;19(2):87-88.

2. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092–1097