Anxiety

WHAT IS ANXIETY?

 

Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is a natural human response when we perceive that we are under threat. It can be experienced through our thoughts, feelings and physical sensations.

Most people feel anxious at times. It’s particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life.

WHAT DOES ANXIETY FEEL LIKE?

Anxiety feels different for everyone. You might experience some of the things listed below, and you might also have other experiences or difficulties that aren’t listed here.

EFFECTS ON YOUR BODY

  • A churning feeling in the stomach
  • Feeling light-headed or dizzy.
  • Pins and needles.
  • Feeling restless or unable to sit still.
  • Headaches, backache or other aches and pains.
  • Faster breathing.
  • A fast, thumping or irregular heartbeat.
  • Sweating or hot flushes.
  • Problems sleeping.
  • Grinding your teeth, especially at night.
  • Nausea (feeling sick).
  • Needing the toilet more or less often.
  • Changes in your sex drive.
  • Having panic attacks.

EFFECTS ON YOUR MIND

  • Feeling tense, nervous or unable to relax.
  • Having a sense of dread, or fearing the worst.
  • Feeling like the world is speeding up or slowing down.
  • Feeling like other people can see you’re anxious and are looking at you.
  • Feeling like you can’t stop worrying, or that bad things will happen if you stop worrying.
  • Worrying about anxiety itself, for example worrying about when panic attacks might happen.
  • Wanting lots of reassurance from other people or worrying that people are angry or upset with you.
  • Worrying that you’re losing touch with reality.
  • Rumination – thinking a lot about bad experiences, or thinking over a situation again and again.
  • Depersonalisation – feeling disconnected from your mind or body, or like you’re watching someone else (this is a type of dissociation).
  • Derealisation – feeling disconnected from the world around you, or like the world isn’t real (this is a type of dissociation).
  • Worrying a lot about things that might happen in the future – you can read more about these sorts of worries on the Anxiety UK website.

HOW ELSE MIGHT ANXIETY AFFECT MY LIFE?

Anxiety symptoms can last for a long time, or come and go. You might find you have difficulty with day-to-day aspects of your life, including:

  • Looking after yourself.
  • Holding down a job
  • Forming or maintaining relationships.
  • Trying new things.
  • Simply enjoying your leisure time.

WHEN IS ANXIETY A MENTAL HEALTH PROBLEM?

Anxiety can become a mental health problem if it impacts on your ability to live your life as fully as you want to. For example, it may be a problem for you if:

  • Your feelings of anxiety are very strong or last for a long time.
  • Your fears or worries are out of proportion to the situation.
  • You avoid situations that might cause you to feel anxious.
  • Your worries feel very distressing or are hard to control.
  • You regularly experience symptoms of anxiety, which could include panic attacks.
  • You find it hard to go about your everyday life or do things you enjoy.

HOW I CAN HELP MY ANXIETY

COPING STRATEGIES

Try these when you’re feeling anxious or stressed:

  • Take a time-out. Practice yoga, listen to music, meditate, get a massage, or learn relaxation techniques. Stepping back from the problem helps clear your head.
  • Eat well-balanced meals. Do not skip any meals. Do keep healthful, energy-boosting snacks on hand.
  • Limit alcohol and caffeine, which can aggravate anxiety and trigger panic attacks.
  • Get enough sleep. When stressed, your body needs additional sleep and rest.
  • Exercise daily to help you feel good and maintain your health.
  • Take deep breaths. Inhale and exhale slowly.
  • Count to 10 slowly. Repeat, and count to 20 if necessary.
  • Do your best. Instead of aiming for perfection, which isn’t possible, be proud of however close you get.
  • Accept that you cannot control everything. Put your stress in perspective: Is it really as bad as you think?
  • Welcome humour. A good laugh goes a long way.
  • Maintain a positive attitude. Make an effort to replace negative thoughts with positive ones.
  • Get involved. Volunteer or find another way to be active in your community, which creates a support network and gives you a break from everyday stress.
  • Learn what triggers your anxiety. Is it work, family, school, or something else you can identify? Write in a journal when you’re feeling stressed or anxious, and look for a pattern.
  • Talk to someone. Tell friends and family you’re feeling overwhelmed, and let them know how they can help you. Talk to a physician or therapist for professional help.
FITNESS TIPS
  • 5 X 30: Jog, walk, bike, or dance three to five times a week for 30 minutes.
  • Set small daily goals and aim for daily consistency rather than perfect workouts. It’s better to walk every day for 15-20 minutes than to wait until the weekend for a three-hour fitness marathon. Lots of scientific data suggests that frequency is most important.
  • Find forms of exercise that are fun or enjoyable. Extroverted people often like classes and group activities. People who are more introverted often prefer solo pursuits.
  • Distract yourself with an iPod or other portable media player to download audio books, podcasts, or music. Many people find it’s more fun to exercise while listening to something they enjoy.
  • Recruit an “exercise buddy.” It’s often easier to stick to your exercise routine when you have to stay committed to a friend, partner, or colleague.
  • Be patient when you start a new exercise program. Most sedentary people require about four to eight weeks to feel coordinated and sufficiently in shape so that exercise feels easier.

WHAT TREATMENTS ARE AVAILABLE?

There are various evidence-based treatments that have been found to help with anxiety problems and panic disorder.

Self-help resources

A self-help resource might be the first treatment option your doctor offers you. This is because it’s available quite quickly, and there’s a chance it could help you to feel better without needing to try other options.

Self-help could be delivered through:

Workbooks. For example, your GP might recommend particular titles from a scheme called Reading Well Books on Prescription. This scheme is supported by most local libraries, so you can go and check the books out for free – you don’t actually need a prescription from a doctor.

A computer-based CBT programme for treating anxiety, panic and phobias, such as Fearfighter. Fearfighter costs money if you use it privately, but in some areas it’s free to use on the NHS with a referral from your GP.

You might be offered a resource to work through your own or on a course with other people who experience similar difficulties.

TALKING TREATMENTS

If self-help resources aren’t likely to help with the anxiety problems you’re experiencing or you’ve already tried them and they haven’t helped, your doctor should offer you a talking treatment. There are two types of talking treatment recommended for anxiety and panic:

Cognitive behavioural therapy (CBT) – this focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour, and teaches you coping skills for dealing with different problems.

Applied relaxation therapy – this involves learning how to relax your muscles in situations where you normally experience anxiety.

MEDICATION

Your doctor might offer to prescribe you medication to help manage some symptoms. Some people find it helpful to try talking treatments and medication at the same time, but medication shouldn’t be the only thing you’re offered.

Medications you might be offered include:

Antidepressants. Usually this will be a type called a selective serotonin reuptake inhibitor (SSRI), but these drugs can sometimes cause side effects such as sleeping problems or feeling more anxious than you did before. If SSRIs don’t work or aren’t suitable you may be offered a different kind called a tricyclic antidepressant.

Pregabalin. In some cases, such as if you have a diagnosis of generalised anxiety disorder (GAD), your doctor may decide to prescribe you a drug called pregabalin. This is an antiseizure drug which is normally used to treat epilepsy (a neurological disorder that can cause seizures), but is also licensed to treat anxiety.

Beta-blockers. Beta-blockers are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). However, they are not psychiatric drugs so they don’t reduce any of the psychological symptoms. They may be helpful in certain situations; such as if you have to face a phobia.

Benzodiazepine tranquillisers. If you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser. But these drugs can cause unpleasant side effects and can become addictive, so your doctor should only prescribe them at a low dose for a short time, to help you through a crisis period.

WHAT IF I DON’T FEEL BETTER?

Your doctor should offer you regular appointments to check how you’re doing, and see how well any treatment is working for you. Different things work for different people, so if a particular medication or talking treatment doesn’t work for you, your doctor should offer an alternative.

If you’ve tried a range of treatments and none of them have helped, your doctor might refer you to a community mental health team (CMHT). This is made up of a number of different healthcare professionals, such as psychiatrists and clinical psychologists. Your CMHT can assess you separately and offer you a personalised treatment plan.

This is particularly recommended if:

  • Your symptoms are making it very difficult to carry out everyday activities
  • You have a serious physical health problem or another mental health problem
  • You’re having thoughts of self-harm or suicide.

It’s important to remember that recovery is a journey, and it won’t always be straightforward. You might find it more helpful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of every symptom of your anxiety problem.

CARING FOR THOSE WHO SUFFER ANXIETY/PANIC ATTACKS

DON’T PRESSURE THEM
Try not to put pressure on your friend or family member to do more than they feel comfortable with. It’s really important to be patient, listen to their wishes and take things at a pace that feels okay for them.

It’s understandable to want to help them face their fears or find practical solutions, but it can be very distressing for someone to feel they’re being forced into situations before they feel ready. This could even make their anxiety worse. Try to remember that being unable to control their worries is part of having anxiety, and they aren’t choosing how they feel.

TRY TO UNDERSTAND
Find out as much as you can about anxiety. This will help you understand what they are going through. Reading personal experiences can help too.

Ask about their experience. You could ask them how anxiety affects their day-to-day life, and what makes it better or worse. Listening to their experience could help you to empathise with how they feel.

SUPPORT THEM TO SEEK HELP
If you think your friend or family member’s anxiety is becoming a problem for them, you could encourage them to seek appropriate treatment by talking to a GP or therapist. You could:

Offer to help them arrange a doctor’s appointment. If they are scared of leaving the house, you could suggest they ring their GP to find out if they will do home visits.

Offer support when they attend appointments. You could offer to go with them to their appointments and wait in the waiting room. You can also help them plan what they’d like to talk about with the doctor

HELP THEM SEEK HELP FROM A THERAPIST
Help them research different options for support, such as community services or peer support groups such as those run by Anxiety UK and No Panic.

LOOK AFTER YOURSELF
It can sometimes be really challenging to support someone with a mental health problem – you are not alone if you feel overwhelmed at times. It is important to remember to look after your own mental health too, so you have the energy, time and distance you need to be able to help.

Set boundaries and don’t take too much on. If you become unwell yourself you won’t be able to offer as much support. It is also important to decide what your limits are and how much you feel able to help.

Share your caring role with others, if you can. It’s often easier to support someone if you’re not doing it alone.

Talk to others about how you’re feeling. You may want to be careful about how much information you share about the person you’re supporting, but talking about your own feelings with someone you trust can help you feel supported too.

Find support for yourself.

Some helpful web links

https://www.anxietyuk.org.uk/

https://www.helpguide.org/articles/anxiety/panic-attacks-and-panic-disorders.htm?pdf=true

https://www.nhs.uk/conditions/generalised-anxiety-disorder/

https://www.nhs.uk/conditions/stress-anxiety-depression/overcoming-fears/