What is anxiety?
Anxiety is a natural emotion that everyone can feel in response to a threat or a stressful situation.
There are many different things that can make us feel anxious. For example, we may feel anxious when we are about to take an important exam, or when we are about to give a speech in public.
Anxiety can actually be useful in some cases. For example, if we feel anxious before we give a presentation, or before we enter into a race, a natural hormone called adrenaline is released into our body.
This release of adrenaline causes certain changes to occur in our bodies, that can help prepare us for the stressful situation that is causing our anxiety. In other words, anxiety can help us when we face stressful times in life. So it is not always bad to feel anxious, and not all anxiety is considered to be a mental health problem.
Anxiety only becomes a problem if it:
- Lasts for a long time (e.g. several weeks or months)
- Becomes so extreme that is starts to cause problems in your life
- Stays with you even after the stressful event or situation has passed
- Is present even when you are not in a stressful situation
Although it is normal for all of us to feel anxious in certain situations, the feelings of anxiety are sometimes stronger or more difficult to handle for some people.
What are the different types of anxiety?
Anxiety can affect people in a number of different ways. When anxiety affects someone severely, they may develop a mental health condition called an “anxiety disorder”.
There are many different types of anxiety disorders. These include:
People with generalised anxiety disorder feel like they always have anxiety, and they worry about things constantly.
Not everyone with generalised anxiety disorder feels the same way. People with this condition can have different symptoms, and some people can have more severe symptoms than others.
The symptoms of generalised anxiety disorder can include the following:
- Dizziness or light-headedness
- Chest pain
- Fast heartbeats
- Breathing getting faster
- Dry mouth
- Not being able to concentrate
- Feeling restless and tense
- Feeling like you cannot relax
- Feeling sick (nausea)
- Having difficulty looking after yourself
- Struggling to maintain relationships
- Feeling unable to enjoy certain things in life
- A change in appetite (e.g. overeating or not eating enough)
- Problems with sleep (e.g. not being able to fall asleep)
How can you check how severe your generalised anxiety disorder is?
There is an assessment called the “GAD-7” that can help you do this. This is a questionnaire that can help check how severe someone’s anxiety is. Depending on the answers you give, the questionnaire can help check if your anxiety is mild, moderate, or severe.
WARNING: It is important to keep in mind that this questionnaire cannot give you a formal diagnosis. It is just a helpful tool that can help you understand your anxiety a little bit better. If you have symptoms of anxiety and want to get a diagnosis, you should speak to your doctor or a mental health professional. Do not rely on this questionnaire for a diagnosis.
What causes generalised anxiety disorder?
The exact cause of this condition is not known. However, the research done on this topic suggests that some possible things that may play a role in causing it to develop include:
- Past life traumas (e.g. abuse, violence or an unsettled childhood)
- Your genetics
- An imbalance of the brain chemicals serotonin and noradrenaline (these chemical are both involved in controlling our mood)
- Long term health conditions (some conditions may cause pain and upset that can later lead to anxiety)
Why do some people feel anxious in the morning or in the night?
Morning and night anxiety are two types of generalised anxiety disorder. With this type of anxiety, some people might feel more anxious in the morning, and then better towards night. Other people may feel better in the morning, and more anxious in the night.
It is thought that these types of anxiety may be caused by caffeine, or high levels of the stress hormone called cortisol.
Obsessive compulsive disorder, which is often called OCD, is a mental health condition that makes you worry that something terrible will happen if you do not perform certain habits, rituals, and behaviours. For example, if you have OCD, you might be obsessed with:
- Washing your hands
- Counting certain things
- Checking the locks
- Turning the lights on and off
This obsession with a certain ritual or behaviour can take over some people’s lives, and it can make performing even the simplest of tasks extremely time consuming and stressful.
A phobia is an extreme and overwhelming fear of specific things such as:
Phobias are more severe than just having a “fear” of something. They develop when someone has an exaggerated or illogical feeling of danger of certain things.
There are different types of phobias that can affect people:
This is a type of phobia that can make people feel incredibly anxious when they are in a specific environment or place.
Agoraphobia can make people feel:
- Trapped, and like there is no escape from a certain place
- Fearful of crowded places
- Fearful of open spaces
People with agoraphobia often feel too scared to leave their own home.
There are some types of phobias that make some people fear a particular object or situation. People with these specific phobias will then try their best to avoid the situations or objects that they fear. Examples of specific phobias include:
- Arachnophobia – A fear of spiders
- Claustrophobia – A fear of being trapped in a small space and being unable to get out (e.g. being stuck in a lift)
- Aviophobia – A fear of flying
- Acrophobia – A fear of heights
- Zoophobia – A fear of animals such as wild dogs or snakes
- Trypanophobia – A fear of medical procedures that involve needles or injections
- Hemophobia – A fear of blood
- Glossophobia – A fear of public speaking
Although many of us may feel uncomfortable or anxious when faced with these objects or situations, this does not always mean that we have a phobia. A phobia develops when the fear and anxiety people feel is so severe that it interferes with their daily lives.
Panic disorder is a type of anxiety disorder that develops when someone has regular panic attacks that start suddenly.
During a panic attack, people may feel a sudden sense of anxiety and heightened fear. The physical symptoms of a panic attack can be so severe that some people feel like they are having a heart attack.
The symptoms of panic disorder include:
- Shortness of breath (finding it difficult to breath)
- A sense of extreme worry or doom
- Chest pain
- Fast or irregular heartbeats
- Feeling your heart pounding (palpitations)
Most of the time, a panic attack will usually go away by itself. In some people however, the symptoms may be so severe that they need to have treatment.
Can a panic attack kill you?
Although a panic attack cannot kill you, it can feel like having a heart attack for some people.
If you have panic disorder and leave it untreated, it can get worse and worse, and can really negatively affect your quality of life.
Post-traumatic stress disorder (PTSD) is a mental health condition that can occur after someone goes through a traumatic life event. Examples of life events that may lead to PTSD include:
- War, or being in the army in a war-torn environment
- An assault or abuse
- A natural disaster (e.g. being involved in a horrific event)
- An accident (e.g. a car crash or an aeroplane crash)
- Witnessing the death of a family member or loved one
The symptoms of PTSD can be different for different people, and they can include:
- Having flashbacks of the traumatic event
- Finding it difficult to relax
- Having disturbing dreams
- Feeling unable to sleep or having disrupted sleep
- Feeling depressed or anxious
- Avoiding places or situations that might trigger or remind you of the trauma
Selective mutism is a type of anxiety disorder in which someone feels that they cannot speak in certain social situations.
It is a condition that usually starts in childhood. If it is left untreated however, it can also persist into adulthood.
How does selective mutism affect children?
A child with selective mutism may not feel able to talk in certain situations. This happens because the child feels anxious in certain situations, which causes them to “freeze up”, leaving them unable to speak.
Children may experience this in different places, for example in school. While they are in school, the child may seem very quiet, or they may choose to remain completely mute. Once they get home however, they might begin to feel more comfortable, and in turn may start to speak again.
This sort of behaviour may develop at school because there might be something at school feeding into the child’s anxiety, for example:
- Extreme shyness
- Feeling insecure
Separation anxiety disorder is a childhood condition that develops when a child gets very anxious or upset when they are separated from their parents or guardians. Separation anxiety can be normal for young children up to 18 months old. It becomes abnormal however, when older children experience high levels of anxiety, or have extreme reactions when they are separated from their parents or guardians.
This type of anxiety involves an intense fear of social situations. People with social anxiety often think that others are viewing them negatively. Because of this, they tend to avoid social gatherings.
Social anxiety can really affect relationships and daily life. People who suffer with this type of anxiety often feel embarrassed, self conscious, and dread certain social or work events. The symptoms of this can be so severe that people with social anxiety disorder can make themselves physically unwell.
It is important to see your doctor if you think you have social anxiety disorder. There are many treatments that can help you cope with your symptoms, such as:
- CBT (Cognitive Behavioural Therapy)
- Specific medications
- Self help techniques
What can cause social anxiety disorder?
There are a number of things that can cause or contribute to social anxiety. These include:
- Caffeine – drinks containing caffeine such as tea, coffee and energy drinks are stimulants and can make you feel jittery and on-edge.
- Alcohol – alcohol can affect the levels of certain chemicals in the brain which can trigger anxiety.
- Stress – stress can instantly affect your mood and trigger symptoms of anxiety to develop.
Which anxiety disorder do I have?
If you are experiencing symptoms of anxiety, you should speak to your doctor or a qualified mental health professional. They will be able to do an assessment and check to see if you have any of the above anxiety disorders.
Who usually gets anxiety?
Anyone can get anxiety. It is a mental health condition in its own right, but it is also a symptom of other illnesses. It is common to experience anxiety if you have other mental health conditions such as depression.
Both men and women can have anxiety, and it can affect people at any age.
Anxiety in teenagers
Teenagers can experience anxiety for a number of reasons. The symptoms they experience are often similar to anxiety in adults, and can include:
- Difficulties concentrating at school
- Changes in their appetite (e.g. eating less or more)
- Problems with their sleep
- Having negative thoughts
- Feeling angry
- Withdrawing from family or friends
- Having problems with different relationships
Anxiety in children
It is common and natural for very young infants (aged between 6 months to three years) to have separation anxiety. Children at this age are often clingy and want to be with their parents or guardians all the time. When a child grows up however, they should start to feel more independent and less scared of separation.
If older children do show signs of separation anxiety, it may be useful for them to see a psychologist or to try some play therapy.
Signs of anxiety in children include: irritability, bedwetting, difficulty sleeping, being clingy, being tearful, and having bad dreams.
What causes anxiety?
Anxiety is a condition that can be caused by a number of things. Different situations can trigger anxiety in different people, and for some, the anxiety can feel like it has appeared for no reason at all.
Some causes of anxiety include:
- Alcohol or drug misuse
- Genetics – If your parents or grandparents had problems with anxiety, you might be more prone to getting it too.
- Hormonal changes – Some women experience anxiety when they are about to ovulate, or when they are about to get their period.
- Thyroid problems – Some people may have a thyroid that produces too much of the hormone thyroxine. This condition is called hyperthyroidism, and one of the symptoms of this condition is anxiety.
- Chemical imbalance – There may be an imbalance of certain chemicals in the brain that affect your mood (e.g. serotonin and noradrenaline).
- Vitamin B12 deficiency – If you have low levels of the Vitamin B12, this can cause anxiety and stress to develop.
- Medical conditions – Anxiety may be caused by long-term medical conditions.
How does anxiety affect the brain?
The physical symptoms of anxiety are partly caused by the brain. When you are feeling anxious, the brain sends messages to the nerves in various parts of your body. These messages make your lungs and heart work faster, which causes you to start breathing faster, and sometimes start noticing that your heart is beating faster too.
Which other conditions have similar symptoms to anxiety?
Anxiety can have similar symptoms to other medical conditions, such as:
Some symptoms of depression can be similar to anxiety, for example having a low mood, negative thoughts or trouble sleeping.
Bipolar disorder is a mental health condition that causes very low moods, followed by very high elated emotions. It can have similar symptoms to anxiety such as low mood, irritability, and trouble sleeping.
Stress is something that affects everyone at some stage in their lives. It can have symptoms that are similar to anxiety, such as headaches, dizziness, loss of appetite, chest pain, irritability, and problems with sleep.
ADHD is a condition that is most commonly seen in young people, and can have similar symptoms to anxiety including: irritability, restlessness, sleep difficulties, and problems with concentration.
People with autism can sometimes experience things that may be similar to anxiety, for example social withdrawal, feeling uncomfortable or upset in unfamiliar situations, and finding it difficult to communicate and talk with people they are not familiar with.
There are many physical symptoms of a heart attack that can be very similar to symptoms of anxiety, for example having a fast heartbeat, feeling restless, and having chest pain or discomfort.
How will I know if I am having an anxiety attack or a heart attack?
If you are experiencing a heart attack, the pain you will feel will be a “squeezing” and “pressure-like” pain.
The main difference is that the pain felt during a heart attack pain will often (but not always) get worse over time, and it can sometimes (again, not always) radiate down the jaw or arm.
WARNING: If you think you are having a heart attack, or even if you are not sure, you must immediately contact an emergency medical service.
The information in this article is written for general information purposes only, and is not a substitute for professional medical advice, treatment or care. It is incredibly important that you do not make decisions regarding any symptoms based on this information alone. If you are worried about any symptoms you may be having, or have any further questions about this condition, please speak to a qualified and trustworthy medical professional.
How do you treat anxiety?
There are a number of different techniques, medications and therapies that can help treat anxiety. What works for one person may not work for another person, so it is important to speak to your doctor about your anxiety so that they can help you come up with a treatment plan that works for you.
Things you can do at home
People who suffer from anxiety can sometimes develop some useful self-help techniques that help them process their emotions and deal with their anxiety. These include:
- Exercise – Exercise releases ‘feel-good’ hormones called endorphins that can help reduce anxiety.
- Avoid alcohol & recreational drugs – Both drugs and alcohol can increase symptoms of anxiety.
- Stop smoking – The nicotine found in cigarettes can make the symptoms of anxiety worse.
- Try relaxation & stress management techniques – Techniques such as meditation, mindfulness and yoga can help you relax.
- Get enough sleep – A lack of sleep or having poor sleeping patterns can increase feelings of anxiety during the time you are awake.
- Eat a well-balanced diet – Making sure that you eat lots of fruits, vegetables, fibre, whole grains, and protein can help your symptoms get better.
- Seek support – If you feel able to, you can try talking to your family or your close trusted friends about your anxiety. If that doesn’t help, you can also join a support group to meet and talk to other people who are also suffering with anxiety.
- Get to know your anxiety – Understanding your condition, its triggers and what helps and what does not, will help you manage your anxiety better.
- Mindfulness – This is a psychological technique that helps you live in the moment, become aware of your thoughts, and not worry about the past or the future. It can be a powerful tool to help you manage your emotions and feelings.
- Aromatherapy – Some people find that using scented oils, with or without massages, can help them get in a more relaxed state of mind, and as a result help to reduce their anxious feelings.
For some people however, their symptoms may be more severe and may be interfering with their daily lives, prompting them to seek professional treatment.
Anxiety disorders can be treated with:
- Psychological therapy
- A combination of both
There are many different medications that can be used to treat anxiety. These include:
Beta blockers are medications that can sometimes be used to treat some anxiety disorders. They work by reducing the effect that adrenaline has on our body when we feel anxious. Examples of beta blockers used to treat anxiety include:
Selective serotonin reuptake inhibitors (SSRIs) are a specific type of antidepressant. They work by increasing the amount of serotonin in the brain. Serotonin is a chemical that is naturally found in our brains, and that can affect our moods.
As with many other antidepressants, SSRIs can take weeks before they start working. Some people can also feel worse before they start to feel better when they are taking SSRIs.
Examples of common SSRIs that are used include:
- Fluoxetine (Prozac®)
- Sertraline (Zoloft®)
- Paroxetine (Paxil®)
- Escitalopram (Lexapro®)
- Citalopram (Celexa®)
What are the side effects of SSRIs?
As with any type of medication, SSRIs can cause a number of side effects to develop. These include, but are not limited to:
- Agitation (feeling uneasy and restless)
- Nausea (feeling or being sick)
- Constipation or diarrhoea
- Loss of appetite and weight loss
- Blurred vision
- Dry mouth
- Excessive sweating
- Low sex drive and sexual problems
- Difficulty sleeping
If you start taking SSRIs and you think that your medication is still not helping after about two months of treatment, or if you are having some unpleasant side effects, you should speak to your doctor as soon as possible. They will review your treatment plan, and help you find a solution.
WARNING: If your doctor recommends that you stop taking your SSRI medication, they will prepare a plan for you to slowly and gradually come off the medication. It is incredibly important that you do not suddenly stop taking your medication and that you strictly follow your doctor’s instructions.
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are another type of antidepressant that is sometimes used to treat anxiety.
They work by increasing the amount of two chemicals in your brain called serotonin and noradrenaline. These two chemicals can affect your mood, and increasing them can help reduce your anxiety.
Examples of some SNRIs that are used to treat anxiety include:
- Venlafaxine (Effexor®)
- Duloxetine (Cymbalta®)
What are the side effects of SNRIs?
As with any other medication, SNRIs can cause certain side effects to develop, for example:
- Feeling sick (nausea)
- Dry mouth
- Problems sleeping
- Sweating or feeling very hot
- High blood pressure
As with SSRIs, some of these side effects are more common in the first few weeks of treatment, but these usually go away as your body gets used to the medication.
Pregabalin is a medication that is usually used to treat epilepsy. In some cases however, it can also be used to treat anxiety. It is unclear exactly how pregabalin works to help anxiety, but it is thought that it prevents certain chemicals which contribute to anxiety from being released in your brain.
These are a specific type of antidepressant that are usually used to treat depression, but that can also be used to treat anxiety. Tricyclic antidepressants work by affecting the way that a certain chemical called norepinephrine is used in certain parts of the brain.
Tricyclic antidepressants have a number of side effects, and because they can affect both your heart rate and blood pressure, these two things need to regularly be checked by your doctor.
This is a medication that is used in particular to treat generalised anxiety disorder (GAD).
This is a medication that is often used to treat social anxiety. It works by increasing the amount of the chemicals serotonin and noradrenaline in the brain. These two chemicals can affect your mood, and increasing their levels in the brain can help your anxiety.
Benzodiazepines are a type of sedative that are used as a short-term treatment to help treat an anxiety attack. They usually take around 30 to 90 minutes to work.
Because benzodiazepines can be highly addictive, your doctor will usually only prescribe this medication for a short amount of time (e.g. 2 to 4 weeks). This helps reduce the risk of developing an addiction to this medication.
Commonly used benzodiazepines include:
- Alprazolam (Xanax®)
What are the side effects of benzodiazepines?
Benzodiazepines can have a number of different side effects including, but not limited to:
- Vertigo (feeling unsteady on your feet and dizzy)
- Difficulty concentrating
- Shaking sensation
- Low sex drive
Which anxiety medication is right for me?
Your doctor will work with you to try and find the best medication for your anxiety. You may not find the perfect medication at the start, and may need to try different ones before you find one that works for you.
WARNING: It is important that you only try or switch medications under the supervision of your doctor.
There are also options for psychological treatment too.
Cognitive behavioral therapy (CBT) is a common treatment for people with anxiety.
How does CBT work?
Your therapist will talk you through some guided steps on how to approach your problems. The main purpose of CBT is to try to help you change your thinking and behaviour. For example, your therapist may support you in discovering certain strategies that help you manage your anxiety.
Can you prevent yourself from getting anxiety?
A little bit of anxiety is a natural feeling that everyone has, so it is not something that can be removed entirely from someone’s life. However, knowing what can cause or trigger your anxiety can help you manage your symptoms and come up with strategies to reduce or prevent those anxious feelings.
Try asking yourself:
- What triggers my anxiety?
- What makes my anxiety worse?
- What helps me cope with my anxiety or make it better?
Knowing the answers to these questions can help you better understand your anxiety, and can also help your doctor or therapist work with you to come up with the best way to manage your anxiety.
Is there a cure for anxiety?
Anxiety does not have a specific cure that can be used for everyone, but it is a very treatable condition. The key to treating anxiety is to get help early by speaking to your doctor or other mental health professional. Be prepared for the fact that some trial and error can be part of the recovery. You may have to try a few different therapies or medications before you find one that works for you.
Is there a test or quiz for anxiety?
You can take this simple anxiety test to check how severe your symptoms are. Please be aware that this test does not give you a formal diagnosis, and it does not replace a full assessment by a qualified mental health professional.
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- Gale CK, Millichamp J. Generalised anxiety disorder in children and adolescents. BMJ Clin Evid. 2016;2016:1002. Published 2016 Jan 13. Generalised Anxiety Disorder in Children and Adolescents. PMID: 26763675 PMCID: PMC4711893 (Access here)
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