Anxiety

This factsheet aims to explain anxiety. You will find a description of anxiety, its symptoms, and the treatments available. If you are experiencing anxiety, you will find suggestions of ways that you may help yourself and the options open to you. You will also find ideas on how friends and family may help.

What is anxiety?

Everyone knows the feeling of anxiety: the fear that something unpleasant is about to happen. People often become anxious when they face difficult situations such as illness, unemployment, moving house, or job interviews. Mild anxiety prior to an examination, for example, can be useful as it can make you feel more alert and enhance your performance. Mild, short-term anxiety is extremely common, however, for some people anxiety can become so extreme that it is disabling. A doctor may make a diagnosis of generalised anxiety disorder if a person has been experiencing a high level of tension and anxiety for several months for no clear reason. Anxiety often goes hand-in-hand with depression, making it difficult for doctors to diagnose whether an individual has depression with symptoms of anxiety, or anxiety problems that are making them depressed.

What are the symptoms of anxiety?

Anxiety can affect individuals in different ways. Some people experience anxiety primarily through psychological and emotional symptoms, whilst others may experience a wide range of physical effects. Anxiety has a certain self-perpetuating quality, because the physical symptoms of anxiety can be so distressing that they can make people even more anxious.

Psychological effects
The psychological effects of anxiety include:

a sense of fearful anticipation
an inability to concentrate
irritability
constant worrying
heightened alertness
getting tired easily
sleep disturbance
depression

Physical effects

feelings of tightness in the chest
chest pains
nausea
rapid shallow breathing
loss of appetite
butterfly feelings in the stomach
headaches and dizziness
muscle tension
pounding heart
faintness
sweating
frequent urination
loss of interest in sex
panic attacks

What causes anxiety?

There is no one cause for anxiety. It varies from person to person. For some people anxiety begins after a long period of stress that has gradually built up. Other people may feel they are not in control of certain aspects of their life, and may develop a general anxiety about the future. Some people may have experienced stressful life events in the past and become anxious about encountering similar experiences in the future. Some people appear to have a genetic predisposition towards anxiety; certainly there is an increased risk of developing anxiety problems if there is a family history of anxiety. There is also evidence that anxiety problems can be caused by physical factors such as over-activity of the thyroid gland that controls many bodily functions. Anxiety can also be caused as a side-effect of certain drugs including commonly prescribed antidepressants. Anxiety is also a common symptom of withdrawal effects from benzodiazepine drugs such as Valium. Use of recreational drugs can also trigger episodes of anxiety.

Some people experience many of the physical effects of anxiety because of involuntary rapid, shallow breathing, called hyperventilation or over-breathing. Hyperventilation can trigger panic attacks; episodes of severe and sudden anxiety that can make people feel like they are having a heart attack or similar condition.

How common is anxiety?

Anxiety can affect anyone at any time. Anxiety can occur in people from all backgrounds, any occupation, and at any time of life. It is a commonly diagnosed mental health problem, affecting approximately five per cent of the population at some point in their lifetime.

What treatments are available?

Most people diagnosed with anxiety are treated by their family doctor, although a small minority of people may be referred to a psychiatrist, or a member of the local Community Mental health Team for more specialised help. Depending on your symptoms, the severity of the anxiety, and your circumstances, the doctor may suggest some form of talking treatment, anti-depressant drugs, anxiolytic drugs, or a combination of these treatments.

Antidepressants
Antidepressant drugs are used to treat anxiety as well as depression. Antidepressants affect the chemicals in the brain that lift your mood. These drugs can be effective in treating anxiety, however, in themselves they are not a cure for anxiety. The drugs treat the symptoms of the condition, but cannot treat the root cause of the anxiety itself. This is why talking treatments are often prescribed in conjunction with antidepressants, so that people can be helped to address the reasons why they became anxious in the first place. It may take a few weeks before the drugs begin to have a noticeable effect, but it is important that you continue to take the drugs or the treatment will not be effective. As with any medication, some people may experience unwanted side-effects. If this happens to you, it is important that you discuss this with your doctor, as they may be able to prescribe a different anti-depressant drug for you. It is normally recommended that you stay on the drug treatment for a period of around six months in order to minimise the chance of the condition recurring.

Anxiolytic drugs
Anxiolytic drugs, also known as minor tranquillisers, can bring the symptoms of anxiety under control quickly, however, they should not be used for long as people can develop a dependency on the drugs very quickly. Therefore, drugs such as diazepam are usually only prescribed for the temporary relief of the most distressing symptoms of anxiety. Some people may experience unwanted side-effects. If this happens to you, it is important that you discuss this with your doctor, as they may be able to prescribe a different drug for you.

For more information on drug treatments please see: Medical Methods of Treatment

Talking treatments
Talking treatments alone can be effective in treating anxiety for some people, for others a combination of talking treatments and drug treatment may be the most effective treatment. Talking treatments aim to help people recognise the stress factors in their lives, and work out coping strategies in order to be able to deal with these. A wide variety of talking treatments are available, ranging from counselling and psychotherapy to cognitive behaviour therapy. A referral for talking treatments can be arranged by your doctor. However, frequently there are long waiting lists for these types of treatment on the NHS. Free or low-cost counselling is also provided by a number of charities and voluntary organisations, and, for those who can afford to pay, there are many private practitioners.

For more information on talking treatments please see: Psychological Methods of Treatment

Relaxation Training
Relaxation training can reduce anxiety if you practise regularly, however, it can be difficult to find the motivation to practise alone. For this reason, relaxation training is often provided in group sessions. This treatment aims to train people to relax their muscles, to breathe slowly and deeply, and to clear the mind of worrying thoughts. After a few sessions, most people are able to relax rapidly and use this new skill at times of stress. Your therapist may provide you with a tape-recording of relaxation instructions in order that you can continue to practise at home after your formal training has ended. Some GP practices offer relaxation training groups, if not, your GP may be able to refer you to a psychology department for treatment. Some charities and voluntary organisations also offer relaxation groups and training.

Which treatment may be right for me?

Individuals respond to different treatments in different ways. What works well for one person may not work well for another. Speaking to your doctor will help you weigh up the pros and cons of the different treatments available. Your doctor should be able to provide you with information on how treatments work, how effective they are, and what side-effects you may experience. Drug treatment may be extremely effective for some people, others may find talking treatments the best option. Others may find a combination of drug treatment and talking treatments or relaxation training works best for them.

What can I do to help myself?

There are many ways in which you can help yourself cope with anxiety. It is important that you come to understand the nature of your illness, its causes and symptoms. If you can recognise the early signs of a relapse or deterioration in your mental health, you can seek help and treatment before your condition worsens.

When you are feeling anxious, it can be difficult to see beyond the day-to-day problems in life. It can be very difficult finding the energy and motivation to actively try and help yourself. However, if you are able to take an active part in your treatment it should help your situation improve.

Self-help groups
Many people find it helpful to meet other people in a similar position. It can be very useful to share experiences with other people who may be going through the same thing you are. There are opportunities for mutual support, and you may get ideas of what things other people have found helpful to them. Above all, it is an opportunity to help you realise that you are not alone in how you are feeling.

Fighting negative attitudes
Anxiety can cause people to sink into a cycle of negative thinking. The more anxious you become, the less you are able to find the motivation to help you fight the anxiety. It can be extremely helpful if you are able to recognise patterns of negative thinking, challenge these yourself, and try and replace them with more positive, constructive thoughts.

Physical Activity
Many of the physical symptoms of anxiety can be attributed to an excess of hormones, such as adrenalin, in your system. Although it may be difficult finding the motivation to exercise, it can be very therapeutic to take part in physical activities. Jogging, swimming, sports; even brisk walking can help to use up any excess adrenalin.

Care for yourself
When you are feeling anxious it is extremely important that you care for yourself. You will feel better if you are able to eat properly, pay attention to your physical appearance, and don’t abuse alcohol or drugs. Be kind to yourself, allow yourself treats, and try not to cut yourself off from other people.

Complementary therapies
The following are non-medical treatments that some people find helpful, however it is important that you discuss such treatments with your doctor first in case of any interaction with any treatment they have prescribed. Massage can help to alleviate stress and anxiety making make you feel better. Some people benefit from meditation, yoga, homeopathy and acupuncture.

What can friends and family do to help?

Supporting a friend with anxiety can be hard work and frustrating. However, it can also be immensely satisfying and an opportunity to build a closer relationship. Anxiety can make people withdraw from social situations and relationships and make them reluctant to confide in people and ask for help and support. Friends and relatives can be of great help. They can provide emotional and practical support and encourage people to seek appropriate support and treatment. Friends and family can become involved in treatment plans and, above all, make a person feel wanted, needed and loved.

Where can I find help and support?

There is a wide a range of services available that can help provide care, support and information to people experiencing anxiety, their friends, relatives and carers. You may find some of the following useful:

SANEline / SANEmail
1st Floor Cityside House, 40 Adler Street, London, E1 1EE
helpline:0845 767 8000, fax: 020 7375 2162
www.sane.org.uk
SANEline and SANEmail offer emotional support and information to those experiencing mental health problems, their families and carers.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9 – 13 Silver Street, Bury, BL9 0EU
tel.0161 797 4484, fax: 0161 797 2670
email: babcp@babcp.com
web: www.babcp.com
The full directory of psychotherapists is available online.

British Association for Counselling and Psychotherapy (BACP)
BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire, LE17 4HB
tel. 0870 443 5252
email: bacp@bacp.co.uk
web: www.bacp.co.uk
See website or send A5 SAE for details of local practitioners.

British Psychoanalytic Council
West Hill House, 6 Swains Lane, London N6 6QS
tel. 020 7267 3626, fax: 020 7267 4772
email: mail@psychoanalytic-council.org
web: www.bcp.org.uk
A linking body of psychoanalytical psychotherapist societies.

Carers UK
20–25 Glasshouse Yard, London EC1A 4JT
carers line: 0808 808 7777, tel. 020 7490 8818, fax: 020 7490 8824
email: info@carersuk.org
web: www.carersonline.org.uk
Information and advice on all aspects of caring.

First Steps to Freedom
PO Box 476, Newquay, TR7 1WG
helpline: 0845 120 2916
email: first.steps@byconnect.com
web: www.first-steps.org
Information and help for people with anxiety problems, 10am -10pm 7days.

No Panic
93 Brands Farm Way, Randlay, Telford, Shropshire, TF3 2JQ
helpline: 0808 808 0545
email: ceo@nopanic.org.uk
web: www.nopanic.org.uk
Helpline for people experiencing anxiety problems, 10am -10pm 7days.

Rethink
28 Castle Street, Kingston-upon-Thames, Surrey KT1 1SS
tel. 0845 456 0455, advice line: 020 8974 6814
email: advice@rethink.org / info@rethink.org
web: www.rethink.org
Working together to help everyone affected by severe mental illness to recover a better quality of life.

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF
helpline: 08457 90 90 90, fax: 020 8394 8301
email: jo@samaritans.org
web: www.samaritans.org
24-hour telephone helpline offering emotional support for people who are experiencing feelings of distress or despair, including those that may lead to suicide.

United Kingdom Council for Psychotherapy (UKCP)
2nd Floor Edward House, 2 Wakley Street, London, EC1V 7LT
tel. 020 7014 9955, fax: 020 7014 9977
email: ukcp@psychotherapy.org.uk
web: www.psychotherapy.org.uk
Umbrella organisation for psychotherapy in UK. Regional lists of psychotherapists are available free.

About Mental Illness