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Anxiety

Anxiety

Everything you need to know about living well with anxiety

Introduction

Introduction

You may be wondering, what is anxiety? We’re here to help explain this, as well as explore anxiety symptoms, treatment for anxiety, what causes anxiety, and types of anxiety. We hope you find this guide useful and that you find some practical information on how to get help for anxiety.

What is anxiety?

Anxiety is a feeling of worry or fear. Most people will experience feelings of anxiety at some point in their lives. Anxiety itself is not an illness – it is part of being human, and anxiety exists to protect us from threats. However, for some people, their feelings of anxiety persist for long periods of time and may affect their day to day lives. Some people experience anxiety symptoms as a result of a big life change or after a trauma, whereas other people may not know what causes anxiety for them. Some people will experience anxiety symptoms for short periods, whereas others may live with anxiety for many years or their whole lives. Everyone experiences anxiety differently.

Anxiety may involve a variety of physical sensations, psychological thoughts and feelings, and behaviours. Feelings of anxiety are symptomatic of other mental health conditions such as post-traumatic stress disorder (PTSD), depression ,panic disorder and phobias.

Anxiety disorders are common, although it is difficult to say how many people in the UK have anxiety symptoms. Many people do not seek help for their anxiety, even if they have lived with it all of their lives. Some people choose to seek help for anxiety if they feel it is taking over their life. There are different types of anxiety, and a variety of possible causes of anxiety, which we explore later in more detail.

There are a variety of anxiety treatments available which may include medications, psychological therapies, self-help and alternative therapies.

To find out more about anxiety, visit Anxiety UK.

What causes anxiety?

Anxiety can be caused by different factors for different people. It’s likely to be caused by a multitude of internal and external things, and everyone with anxiety will experience it differently. Anxiety causes may include:

  • Neurotransmitters (brain chemistry)
  • Childhood experiences e.g. being bullied, abused or neglected
  • Adulthood experiences e.g. someone you love dying, miscarriage, divorce/relationship breakdown
  • Current life challenges e.g. money problems/debt, problems at work/being out of work, loneliness, housing problems, ill health, disability
  • Other mental health problems
  • Medication or illegal drug side effects
  • Alcohol use or abuse
  • The way you were brought up
  • Genetics

There are many theories about what causes anxiety. For example, neurological responses may be what causes anxiety. Anxiety is a biological, natural response that all humans have. It forms part of our ‘fight or flight’ response, which readies the body for action against perceived threats. Anxiety and stress are closely linked, in that stress is felt as a result of the cortisol and adrenalin that flood our bodies ready to react to face something that is threatening us. Anxiety is the feeling of fear, worry or dread that we feel when threatened, but once the threat is over, it should go away. Humans have evolved and our world has changed so much that many experiences cause us to feel threatened and can become anxiety triggers.

Psychologists suggest that the way we perceive and think about situations can make them seem like a threat and create negative thought patterns of worry and feeling afraid. Some people may be more prone to anxiety than others, depending on all the factors listed above i.e. their past experiences and present day life may all shape the way they perceive the world, the thoughts they have, and how they feel about situations that occur.

Did you know
Anxiety is a natural, human response to fear, but it can develop into a disorder that affects how a person thinks, feels and acts.

Types of Anxiety

Some people may think they are having anxiety symptoms, and may choose to see their GP about this. If your GP makes a diagnosis of anxiety, they may suggest what type of anxiety you have, or they may not. Sometimes it is hard to pinpoint this. However, there are identifiable types of anxiety, depending on what symptoms of anxiety are present, which we explore further here.

Types of Anxiety

Some people may not need to know what ‘type’ of anxiety they have, but others may find it easier to understand their anxiety and know what they are dealing with. Certain types of anxiety respond better to different anxiety treatments, so it may be useful to have a diagnosis of anxiety so that you can find the best help.

Types of anxiety that a person may be diagnosed with are as follows:

  • Generalised anxiety disorder (GAD) – everyday life and occurrences cause constant uncontrollable worries, feelings of fear and possibly physical symptoms. For more information, visit Anxiety UK
  • Panic disorder – when a person has regular panic attacks. For more information, visit the No Panic website
  • Social anxiety disorder – anxiety symptoms occur when a person has to socialise or go to social events or be in situations where they need to talk to other people such as work, school, etc. For more information, visit the NHS website
  • Post-traumatic stress disorder (PTSD) – anxiety caused by experiencing a traumatic event, which usually involves re-living the fear that occurred at the time. For more information, visit the PTSD UK website
  • Phobias – symptoms of anxiety are caused by a deep fear of a situation or object e.g. fear of heights, flying, spiders. For more information, visit TOP UK website
  • Obsessive compulsive disorder (OCD) – anxiety occurs due to obsessive thoughts that can lead to compulsive actions, which may be repeated over and over to ease the anxiety or fear. For more information, visit OCD UK
  • Health anxiety – worries and fears about becoming ill, or loved ones experiencing illness become an issue
  • Trichotillomania – a condition where a person physically pulls out hair on their body to relieve anxiety and finds it difficult to stop. For more information, visit OCD UK
  • Body dysmorphic disorder – a person has constant and obsessive, negative thoughts about their appearance. For more information, visit BDD Foundation website
Did you know
Anxiety is caused by a multitude of factors which may include trauma, upbringing, childhood experiences or difficulties in life.
Anxiety Symptoms

Anxiety Symptoms

Everyone will have different anxiety symptoms. Here we describe the most common symptoms of anxiety.

Anxiety symptoms can be felt by everyone and it doesn’t necessarily mean a person has an anxiety disorder. Anxiety is a normal human experience but, for some people, anxiety symptoms become intense, uncontrollable, long-lasting and may affect their ability to live their lives. If this sounds like you, you may wish to talk to your GP for advice on whether or not you have an anxiety disorder. Anxiety symptoms are varied and may be both psychological and physical.

Symptoms of anxiety may include:

  • Worrying about things that have happened or may happen in the future
  • Obsessive and/or irrational thoughts
  • Low mood or depression
  • Thinking about bad things
  • Being perfectionistic
  • Feeling out of control or a need to control things
  • Feeling self-conscious
  • Being unable to relax
  • Dissociation
  • Derealisation
  • Depersonalisation
  • Stomach problems
  • Panic attacks
  • Insomnia or sleep problems
  • Feeling sick
  • Heart palpitations
  • Fast and shallow breaths
  • Aches and pains
  • Sweating and feeling hot
  • Shaking
  • Chest pains
  • Feeling ‘odd’ or spacey

As you can see, there are lots of different anxiety symptoms and this list is not exhaustive. Symptoms of anxiety may last for short periods of time, or all day, or may come and go. Physical anxiety symptoms are caused by chemicals and processes in the body that are reacting to a perceived ‘threat’ (which may be a worrying thought). Adrenalin surges through the body and makes breathing faster, slows down digestion, pumps blood to the muscles and brain, and these things cause strange sensations and feelings within the body.

Anxiety causes difficulties in everyday life for some people, which we cover in the section Living with Anxiety.

If you feel you are experiencing any of these symptoms, see your GP or talk to the mental health charity, Mind.

Diagnosis of anxiety

If your GP thinks you are displaying symptoms of anxiety, he or she will ask you how long you’ve felt like this. They may ask if there is anything going on in your life that you are finding difficult. Some doctors will make a diagnosis of anxiety based on your symptoms, whereas others may wish to rule out other health conditions before diagnosing your symptoms as cognitive. In this case, you may need to have some blood tests. Symptoms of anxiety can be similar to symptoms of conditions such as anaemia or thyroid problems.

To find out more about anxiety symptoms and anxiety diagnosis, visit the No Panic website.

Did you know
Anxiety symptoms are varied, may be physical and emotional, and may include panic attacks, palpitations or low mood.

Living with Anxiety

Lots of people living with anxiety can find ways to improve their wellbeing and reduce the impact that anxiety has on their lives.

Anxiety can be difficult to live with, for the person who has it and also their loved ones, who may see and feel the effects as well. In this section, we look at positive ways of living with anxiety symptoms, finding the right anxiety treatment and how healthy living, including diet and exercise, can be a great help.

Living with Anxiety

Impact on daily living

Living with anxiety can be difficult. Anxiety can affect the way you feel about yourself, your job, your family and friends, your past, future and present. Anxiety can change your personality and affect your sense of self. Here are some examples of ways that anxiety may affect your daily life:

  • Anxiety and employment 
    Work takes up a large portion of most adults’ days and lives so, inevitably, it can become a source of anxiety or an anxiety trigger. You may have work-related worries about missing deadlines, achieving targets or even injuring yourself.

    You may worry that you are not doing a good enough job at work. You may worry that you will lose your job. You may be out of work and fear you will never get another job or that you are unable to work because of your anxiety. You may worry you have done something wrong at work. Despite all of these things being a possibility, there are some people who may find that work actually takes their mind off their anxious thinking
  • Anxiety and health 
    Some people may have health anxiety, which manifests as a fear of becoming ill; or, if they have a health condition already, they may fear their health getting worse. Some people fear their loved ones will become ill or die. Symptoms of anxiety can also make a person feel ‘ill’ and can cause even more anxiety. Some people may fear that having anxiety will damage their body, but this is not actually the case – it feels unpleasant but there is no evidence that anxiety causes permanent damage or illness
  • Anxiety and leisure time 
    Having anxiety can cause you to opt out of socialising, which you may find worrisome. Anxiety causes some people to feel unable to relax or enjoy activities
  • Anxiety and relationships 
    Having anxiety can affect a person’s relationships with family, friends, colleagues and neighbours. Anxiety is difficult for people to understand, especially if they’ve never had an issue with it. A person with anxiety may feel unable to talk to their partner, family or friends about how they are feeling. Some people have anxiety about their loved ones, and may worry that their partner doesn’t love them, that they will get divorced or have an affair.

    Anxiety can make some people come across ‘needy’ to their partners because the person needs constant reassurance. The charity Relate provides information on how relationships can be affected by anxiety, and what to do about this

Young people living with anxiety

People of all ages feel anxious sometimes, and both children and young adults can develop anxiety disorders. Some anxiety in childhood is normal, but if you are a parent and feel your child is overly anxious, you may wish to discuss this with a GP.

Young people may have anxiety related to school or college, relationships with friends, peer pressure and feeling they need to fit in, being bullied, family life, or for many other reasons.

Young people and their families can find anxiety support from the charity Young Minds.

Anxiety treatments

It can be difficult for a person to come to a stage where they feel they need treatment for anxiety, and seeking anxiety help can be a challenge in itself. Treatments for anxiety are varied and, depending on which type of anxiety you have, different anxiety treatments may work better for you. The best course of action is to visit your GP in the first instance.

Cognitive behavioural therapy (CBT)

This psychological therapy involves a combination of talking about your worries as well as breaking down negative thought patterns. Most therapy sessions last for around one hour and the length of time a person will need sessions for will depend on the individual, how much anxiety symptoms are affecting their life, and how deeply rooted their anxiety is. CBT attempts to help a person shift into a more positive frame of mind, work through past experiences that may be causing their anxiety, and challenge their beliefs. CBT does not work for everyone and requires quite a bit of commitment, as most therapists will encourage a person to work on things outside of their sessions and keep a record or workbook.

To find out more about whether this anxiety treatment is suitable for you, visit the Mind website.

Your GP should be able to tell you about local NHS funded CBT services, which you are able to refer yourself to. Alternatively, you may wish to seek a private therapist who specialises in CBT. You may wish to search for a suitably qualified CBT therapist on the CBT register from The British Association for Behavioural and Cognitive Psychotherapies (BABCP).

You are also able to search for a variety of local therapy services on the NHS website.

Relaxation therapy

Some people find that learning relaxation techniques helps form part of their anxiety treatment plan. Anxiety symptoms occur as a result of the body’s reaction to fear, worry and stress. Relaxing the body and calming the breathing can help control and reverse this automatic reaction, which gives the body the message that there is no danger, which in turn makes symptoms of anxiety lessen.

The type of relaxation required is deep muscle relaxation. It’s different to ‘relaxing at home’, watching TV, reading, etc. There are many online resources that can help you learn to relax your muscles, and No Panic provides lots of information and guidance about how to learn what it feels like when muscles are tense, compared to when they are relaxed, as well as the benefits of this type of technique for reducing anxiety symptoms.

Self-help

Some people prefer to use self-help tools and methods as a treatment for anxiety. Self-help means you use widely available tools such as apps, websites, books, etc. to try to work through your anxiety in your own time. This is undertaken without the support of a therapist, although many psychological therapies such as CBT will recommend some self-help methods for you as well.

There are lots of mental health helplines that may also be able to offer you support and guidance, or just a friendly ear if you need someone to talk to – for example, Samaritans offers 24 hour-a-day emotional support over the telephone.

Many people find self-help useful. To find out more, visit the NHS Moodzone.

Mindfulness

Mindfulness is an age-old practice related to the Buddhist tradition which, in the past decade, has grown in its popularity because of its evidenced benefits to people experiencing anxiety, stress, depression and other cognitive-related health problems.

Mindfulness, in a nutshell, is the practice of being ‘present’ in everyday life rather than getting caught up in thoughts, stories and memories of the past or plans for the future. Mindfulness can be practiced during day-to-day activities or during short meditations, and involves watching or noticing what thoughts arise whilst you are doing something or doing nothing.

For example, whilst making a cup of tea, a person could be mindful about this activity by really focusing on the task at hand, feeling the weight of the kettle, watching the steam when it boils, stirring the tea, and when their thoughts drift onto other things, bringing their attention back to the task at hand.

Mindfulness meditation usually involves sitting alone and doing nothing. Many of us are so busy, we rarely sit and do nothing – no phone, no TV, no talking to others. Inevitably, as a person sits doing nothing, their thoughts continue to whirl around their head. Mindfulness is not about stopping those thoughts, but noticing them and not judging them.

There are many different techniques that can be adopted to help develop this skill, and it does take time, but evidence shows mindfulness actually alters the human brain. Research has shown that even after developing a short mindfulness practice, a person’s brain has the capacity to physically change – the amygdala shrinks and the pre-frontal cortex expands, which means our brains become more aware, abler to make decisions and concentrate, whilst the stress and fear part of our brain becomes less active.

Mindfulness can be challenging for people who have negative thoughts that they want to escape, but many people with anxiety disorders report that the realisation that their thoughts are not ‘real’ and do not control them, is a refreshing and motivating experience.

For more information on mindfulness, visit the Mind website. You may also wish to explore apps with audio meditations, such as Headspace or Buddhify.

Medication

If a person has a diagnosis of anxiety disorder, this can have an impact on their overall mood, and if this is the case, their GP may recommend the use of antidepressant medication. There are lots of types of antidepressant, but common ones prescribed for low mood related to anxiety are called selective serotonin re-uptake inhibitors (SSRIs), such as citalopram or fluoxetine (known by the brand name Prozac).

SSRIs tend to start to work in a couple of weeks and it’s thought that they help with low mood and depression by altering the levels of chemicals in the brain that are related to mood and emotion.

It is entirely up to each individual if they choose to take the medication prescribed to them, and it is advisable to undertake a psychological therapy or self-help anxiety treatment alongside an antidepressant medication. SSRIs do not necessarily help reduce anxiety symptoms or anxious thoughts, although many people respond well in terms of their mood. Sometimes, people find that they are able to face having therapy when their mood is a little improved, and they feel less emotional, so the two can work hand in hand.

There are potential side effects of SSRIs, and how long you will need to take them will be up to you and your GP. Most people take them for at least 6 months. SSRIs are not addictive, but people do have withdrawal symptoms when they decide to stop taking them, so it’s important to very gradually reduce the dosage to avoid this.

For more information on antidepressant medication, visit the Rethink website.

The NHS also provides information about a range of other antidepressant medications.

Anxiety diet

Eating a healthy, balanced diet is important for everybody, and if you have an anxiety disorder, getting the right nutrition is essential. Some people find their anxiety symptoms make them less hungry or have less appetite. Other people may overeat or choose to eat unhealthy foods.

Our bodies function best when we have the optimum fuel, so eating a varied and balanced diet is important for a person with anxiety. Not eating enough means we are not getting the energy we need, which can make us feel more tired, and it’s harder to function properly and think straight. Eating too much, or too much of the less nutritious foods such as junk food, can cause issues with weight gain, which may affect our body image and cause low mood. Eating too many high sugar foods can affect our blood sugar levels, which are closely related to our moods. If you have anxiety symptoms and feel you could be eating more healthily, talk to your GP or download the Eatwell Guide.

Caffeine is known to increase anxiety symptoms, so it’s advisable for people experiencing anxiety to cut right down or cut out caffeine completely.

Many people take herbal, vitamin and mineral supplements for anxiety. Always speak to your GP before taking anxiety supplements of any sort. There are herbal remedies available that some people report help them with mood-related issues, such as St. John’s Wort, Valerian and Bach Flower Remedies. Some people take B vitamins, vitamin D or magnesium, but be advised that some supplements may interact with other medications, and there’s little scientific evidence that these actually work.

Exercise for anxiety

Regular, moderate intensity exercise is important for everyone, and people with anxiety disorders often report exercise helps them beat their anxiety symptoms. Exercise boosts feel-good hormones called endorphins, and burns off excess adrenalin that the body creates when it is responding to anxiety. Exercise can increase appetite, provide opportunity for socialising, reduce stress and boost energy.

Any physical activity can help but many people find that yoga, pilates, walking and tai chi are beneficial. If you have any existing medical conditions, talk to your GP before starting a new exercise regime.

Anxiety and employment

People with anxiety are usually able to work, but work may be part of their anxiety. Some people are happiest at work where they are busy. If you are experiencing anxiety, it can be difficult to talk about this at work, to colleagues or your employers. Sometimes though, it can help to share the problems you are having, especially if work is what triggers anxiety for you. Your employer may be able to make reasonable adjustments to your working day, deadlines, job role, etc in order to help reduce your anxiety. If you are finding work really difficult, speak to your GP or read our blog for tips on coping with work anxiety. If you are an employer concerned about anxiety at work, Anxiety UK offers online resources that may be useful for you.

Did you know
There are many anxiety treatments including psychological therapies, self-help and antidepressant medication.
Support

Support

Remember, you are not alone!

We hope this guide has helped explain what anxiety is, how anxiety symptoms affect a person, what anxiety treatments may help, and the different types of anxiety disorder.

If you feel you need anxiety support, there is a wealth of advice and information available online, through various charitable organisations and the NHS. If you have anxiety you may find it useful to talk to other people who have anxiety symptoms too, to share your experiences and hear about what other people are going through. Here, we point you to anxiety help and support groups and other online resources that offer further information and advice.

Communities

Anxiety, Depression & Mental Health Support Group – a Facebook community for people across the world to share their experiences if they have anxiety or related mental health difficulties

Anxiety and I – an online, Facebook community for people to share experiences of anxiety

Resources

Anxiety UK – information and advice specifically about anxiety and anxiety-related conditions, advice about accessing therapy, and a range of specialist helplines and support for paying members

Get Self Help – a website full of practical, self-help resources such as worksheets, and vast amounts of information for people experiencing a wide range of issues such as anxiety, phobias, health anxiety, social anxiety and OCD

Mental Health Foundation – a charity supporting people with mental health issues and their families, as well as helping to understand mental health through research

Mind – the leading mental health charity, offering a wealth of advice and information online as well as an information helpline, online emergency help advice, workplace wellbeing advice, and details about lots of mental health conditions and treatment options

NHS – information on anxiety and related conditions, including treatments for anxiety, anxiety symptoms and tips for healthy living

No Panic – a website dedicated to supporting people with anxiety disorders, featuring a wealth of information about all aspects of living with anxiety

OCD UK – support for people with OCD symptoms, with online advice about all aspects of OCD and an advice line

Rethink – a charity supporting people with mental health problems and their families, including online information about various conditions such as anxiety, what it’s like living with mental illness, advice for carers and families, and lots of support options such as local groups and helplines

Samaritans – a charity providing telephone helpline support 24 hours a day, 7 days a week for people having emotional difficulties, mental health problems, suicidal thoughts, or any related problems

See Me – a Scottish programme aiming to reduce the stigma of mental health problems, with information and advice on lots of mental health issues, including anxiety

TOP UK – the OCD and phobia charity supporting people with these conditions, providing online information and local therapy groups

Young Minds – the leading charity aiming to support young people with mental health difficulties, with advice about looking after yourself, how to get support and advice for parents

Did you know
A healthy lifestyle can help reduce anxiety and improve mood.

Glossary

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology.

Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of anxiety as straightforward as possible.

A hormone produced in the body which gives the body energy, raises blood pressure, increases heart rate, and prepares the body for action

A type of drug medication to treat mood disorders, which may work by changing the chemicals in the brain

Natural products made of water and flowers, which are thought to help with emotions, moods, stress and anxiety

Related to the processes of the brain

A hormone that is involved in a variety of bodily processes including metabolism, inflammation, blood sugar, blood pressure, salt and water balance. It is also released during periods of stress and can be the cause of many symptoms such as palpitations and tension

An experience of some people with depression, or related psychiatric disorders such as anxiety, where a person feels that their thoughts are unreal or do not belong to them

A condition where feelings of sadness or negative thoughts encompass a person and affect their moods, experiences, feelings and emotions

The perception or feeling that a person is not ‘real’ in their body, which may feel as though they are going through the motions but feel detached from their life, emotions or actions; or that they are viewing their life as if it was a film, which is all common with anxiety, depression and related psychiatric disorders

A symptom of some mental health problems, and a disorder in itself, caused by the mind’s response to stress, which causes a person to feel disconnected to their body/life or from the world around them

Hormones produced in the brain that are released to relieve pain or discomfort in the body, and which give feelings of pleasure

A state of arousal in the body when the brain perceives a threat, which may be a physical or emotional threat, and prepares the organs and body to respond

Related to the brain and nervous system

Chemicals in the body that enable messages to be transmitted around the body’s nervous system

A feeling of intense fear that may be caused by an external or emotional trigger, or a thought, and which may cause the body to have physical symptoms such as palpitations, hyperventilation or shaking

An anxiety disorder where a person has lots of panic attacks

An extreme fear of something

A disorder where a person experiences stress and anxiety after a traumatic event, which many involve reliving the experience through flashbacks

Treatment for various disorders related to the mind, which varies according to the discipline of the therapist and theoretical frameworks that they use to structure their therapy e.g. cognitive behavioural therapy, compassion therapy, psychoanalysis, talking therapy, etc

A type of antidepressant medication that tend to have few side effects for the majority of people, and which are often used to treat anxiety and depression

A popular herbal remedy used to treat mental health problems such as anxiety

A herbal remedy thought to have a relaxing, calming or sleep inducing effect on the nervous system

Unpleasant physical and mental reactions that occur when a person stops taking, or reduces their dose of, a particular drug or medication

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