Anxiety is a major and growing health problem. According to research at Sydney University, 18.5% of women and 10.4% of men will suffer from one anxiety disorder or another at some time in their lives. As well as generalised anxiety disorder (GAD) itself, they may suffer with panic disorder, phobias, or similar conditions. There are estimated to be around 8 million people with anxiety in the UK.
What is anxiety?
Everyone is anxious or stressed at some time, especially faced with a frightening or threatening event, like a visit to the doctor or hospital, or an examination, or a driving test. And there is some evidence that anxiety is a natural response that has evolved to help humans cope with threats. It’s thought to be part of the so-called 'fight or flight response', and serves to prepare the body for action, either to fight the danger or run away, by triggering physiological changes including a tensing of muscles ready for action and a faster heartbeat to get more blood flowing to the brain and muscles.
In most people, the anxiety levels soon drop back to normal, but some men and women have permanently high levels of anxiety. They anticipate problems, run to meet disasters, and worry excessively about most things, including health. For them, that slight chest pain becomes a heart attack, a cough, a sign of lung cancer and a dry eye heralds imminent blindness.
Find out what stress does to the body.
What are the symptoms of anxiety?
Generalised anxiety disorder is usually diagnosed where there has been excessive worrying about everyday problems for at least six months. People with the condition often have an inability to relax, find concentrating difficult, and are easily startled, and they may also experience sleep problems, headaches, trembling, irritability, sweating and breathlessness.
The causes of anxiety are not fully understood, and there are probably a number of factors, including genes and early environment. It has also been suggested that in people with general anxiety, there may be an imbalance in levels of neurotransmitters like serotonin which are involved in mood.
- General anxiety: Exaggerated worry and tension, even when there is little or nothing to provoke it.
- Phobia: intense, irrational fear of something that actually poses little or no threat.
- Obsessive-compulsive disorder: Sufferers have persistent upsetting thoughts or obsessions and use rituals or compulsions to control the anxiety these thoughts produce.
- Social anxiety: overwhelmingly anxiety and excessive self-consciousness in everyday social situations, and an intense, persistent fear of being watched and judged by others.
- Panic Disorder: sudden attacks of terror, with symptoms including pounding heart, sweatiness, weakness, faintness or dizziness.
- Post-traumatic stress disorder: develops after a terrifying ordeal that involved physical harm or the threat of physical harm.
What causes anxiety?
One theory about general anxiety is that feeling anxious may be a learned response, a trait that is picked up early on in life. Families who tend to see the world as a hostile and fearful place, for example, may be more likely to have offspring who are anxious.
It is known that highly anxious men and women tend to pay more attention to negative things than to positive ones. They are the people who believe that every silver lining has a dark cloud, and see half full glasses as half empty.
Can you cure anxiety?
A wide range of treatments are available for anxiety. Most treatments available, and on trial, are either medications, talking therapy or counselling. Drug therapies will not cure anxiety disorders, but can keep symptoms under control, include antidepressants, tranquillisers and beta-blockers.
Of the non-drug treatments, cognitive behavioural therapy (CBT) is one of the most effective with research suggesting that more than half of people with general anxiety can benefit from up to 20 one-hour sessions recommended. It works by helping anxiety sufferers to identify that their worrying is irrational and teaches them to react more positively,
One treatment theory, pioneered by psychologists from Florida and two other US universities, is based on the idea that if anxiety is a learned behaviour, it can be un-learned.
In the research, the psychologists designed a type of therapy for people diagnosed as severe worriers. It involved each individual sitting in front of a computer screen that displayed a series of words on a black screen. Two words at a time were presented for less than a second, one above the other, so that they competed for attention. One of the words was a threatening word and the other was neutral.
The theory was that the eyes of people with high levels of anxiety would focus first on the negative word, and the goal of the therapy was to get them to hone in on the neutral word. To do that, the men and women were told that after the words were displayed, there would be a flashing probe in the space where one of the words had been, and they had to press a button as soon as they spotted it.
The probe almost always appeared where the neutral word had been, and in each session the threat and neutral words appeared in the same position. As a result, the men and women learned to ignore the threat words and focus on the neutral words.
Not only did the anxious people focus on the non-negative words during the test sessions, but there was a remarkable carry over effect on anxiety generally. One week after the last session, various tests for anxiety and depression symptoms in daily life, were carried out, and those who had the active treatment had significantly greater improvement compared with those who had been given a sham therapy.
"The size of the effect suggests that such retraining may have considerable promise in generalised anxiety," say the researchers.
Cognitive behavioural therapy
CBT is one of the most effective treatments for generalised anxiety disorder. The cognitive side involves assessing the reasoning behind people's thinking, on the basis that incorrect thinking results in abnormal reactions. The behavioural therapy is designed to change behaviour.
If CBT or relaxation methods have not worked with you your GP will probably discuss medications that can help the symptoms of anxiety. The medications you are prescribed will depend on your specific symptoms, and the length of time you have to take them can vary. Some are designed for short-term use while others can be taken over a long period, with regular check-ins with your GP. Each medication will have its own list of side effects so check what you can expect before taking them, and if you have any concerns be sure to speak to your GP - do not stop taking medication without discussing with your GP. If your treatment isn't working discuss alternatives with your doctor.
Anxiety medication can include:
- Selective serotonin reuptake inhibitor (SSRI) anti-depressants: a medication that increases the amount of serotonin in the brain, and the most common medication for GAD. Example drugs include sertraline, escitalopram and paroxetine.
- Serotonin and noradrenaline reuptake inhibitor (SNRI) anti-depressants: a medication to increase levels of serotonin and noradrenaline in the brain to lift mood. Examples drugs include venlafaxine and
- Antihistamines: used to treat anxiety in the short-term basis, and work by having a calming effect on the brain, helping to lower anxiety.
- Buspirone: a short-term treatment for generalised anxiety disorder.
- Beta blockers: beta blockers such as propranolol can help with physical symptoms of anxiety including sweating and palpitations.
- Benzodiazepines: Benzodiazepines, such as diazepam, are sedatives that work immediately. They can become addictive, so are prescribed with caution and only for very short lengths of time.
Self-help ways to stop anxiety
If your anxiety is mild and manageable and you do not yet need to consult your GP there are some simple lifestyle changes to help you stop worrying.
Physical activity is a great worry buster, partly because it's hard to worry when you're doing something physical and partly because activity helps release endorphins, natural calming chemicals produced by the brain.
Thirty minutes of exercise a day helps combat stress and release tension and increases levels of the brain mood chemical serotonin.
Learn to relax
If you find relaxing difficult, try to find an absorbing hobby or take up yoga, tai chi or Pilates. Physical relaxation and slow, calm breathing can help: by concentrating on physical relaxation you also allow your mind to relax and let go of what is troubling it. Pick a quiet time of day and find a place where you'll be undisturbed. Sit or lie down and consciously go from your toes to your head first tensing and then relaxing each group of muscles.
Watch your diet
Too much caffeine can increase levels of anxiety, so watch your coffee intake. Alcohol has also been linked to a worsening of anxiety.
Many smokers will smoke to relax, but smoking has actually been linked to a worsening of anxiety. Smoking a cigarette will temporarily calm you, but as soon as the nicotine withdrawal kicks in you will start to get more anxious again. Quit smoking if you're trying to stop feelings of anxiety or worry.
Keep an anxiety diary
Keeping an hourly diary of anxiety levels can help you focus on situations that make you anxious and help you better understand what is triggering your anxiety.
Write down your worries as they occur, noting exactly what you are thinking and, if the same worry recurs, write it down again in the same way.
Doing this will help you put your worries in perspective and see them for the repetitive thoughts they are. As it's a lot more time-consuming to write things down than it is to think about them you could find that eventually worrying becomes more trouble than it's worth.
Try to take your mind off anxiety symptoms and they may often disappear. Research suggests that after focusing on something else for at least three minutes symptoms will begin to reduce.
Take deep breaths
People who become anxious tend to breathe quickly, which can bring on feelings of dizziness and make the anxiety worse. Try to control your breathing.
Create a slot in your day for worrying
Spend ten minutes a couple of times a day when you imagine the worst that could happen and become as anxious as possible. At the end of this time take some deep relaxing breaths and let your worries go.
The idea is that by exposing yourself to a flood of anxious thoughts you 'de-sensitise' yourself until worry becomes boring and fades in significance.
Talk it over
Sharing your worries helps put them into perspective and can often throw a new light on them. Getting someone else's view of a problem can help you work out how to solve it more successfully, especially if your confidant takes an interest in whether you have taken any action.
Positive thinking techniques are the basis of what is known as 'cognitive therapy'. It concentrates on helping you look at any unrealistic ideas you may have that are undermining your confidence and making you feel worried.
Positive thinking can also help to look at the unconscious 'rules for living' that you may have set yourself, such as 'I have to be a perfect mother' or 'I can't be happy unless I succeed at what I do.'
Learning to examine your thoughts in this way and stopping automatic thoughts in their tracks can be of real benefit in combating worry.
Find out more about mental health, including how to tackle insomnia if your worries are keeping you awake.