I hope the following information is useful. It is aimed at anyone who suffers from anxiety and looks into the causes of anxiety, its effects and what to do to reduce it to a manageable level, as well as how to reassure and support friends and relatives with this problem.
What is anxiety?
Anxiety is something we all experience from time to time. Most people can relate to feeling tense, uncertain and, perhaps, fearful at the thought of sitting an exam, going into hospital, attending an interview or starting a new job. You may worry about feeling uncomfortable, appearing foolish or how successful you will be. In turn, these worries can affect your sleep, appetite and ability to concentrate. If everything goes well, the anxiety will go away.
Short-term anxiety can be useful. Feeling nervous before an exam can make you feel more alert, and enhance your performance. However, if the feelings of anxiety overwhelm you, your ability to concentrate and do well may suffer.
The ‘fight or flight’ reflex
Anxiety and fear are actually important for survival because they act as a mechanism to protect the body against stress or danger. Anxiety and fear trigger the release of hormones, such as adrenalin. Adrenalin causes your heart to beat faster to carry blood where it’s most needed. You breathe faster to provide the extra oxygen required for energy. You sweat to prevent overheating. Your mouth may feel dry, as your digestive system slows down to allow more blood to be deflected to your muscles. Your senses become heightened and your brain becomes more alert. These changes enable the body to take action and protect itself in a dangerous situation, either by running away or fighting a foe. It is known as the ‘fight or flight’ reaction. Once the danger has passed, other hormones are released, which may cause you to shake as your muscles start to relax.
The response is useful for protecting you against physical dangers. However, your body reacts in the same way to situations that you find threatening, but which you can’t deal with appropriately by fighting or running away. Situations like this may include public speaking, a driving test, or having an injection.
Why are some people more anxious than others?
Anxiety can be triggered by a number of factors. Something distressing may have happened to you in the past, and because you were unable to deal with the emotions at the time, you may become anxious about encountering the situation again, just in case it stirs up the same feelings of distress.
You may worry about the future. Sometimes, if we feel we are not in control of different aspects of our lives, we can start to feel anxious about events beyond our control, such as the threat of nuclear war, of being attacked, of developing cancer, or of losing a job.
Feeling anxious can also be a learned response – something that you picked up early on in life. Your family may have tended to see the world as a hostile and fearful place, for example. Research suggests that people may even inherit a tendency to be more anxious. We all become anxious under pressure, but one person may succumb more easily than another, because of a mixture of personality, current circumstances and childhood experience.
On a day-to-day basis, caffeine, excess sugar, poor diet, drug misuse, exhaustion, stress and the side effects of certain medication can also cause anxiety.
After a while, people can start to fear the symptoms of anxiety, especially feeling out of control. This sets up a vicious circle. They feel anxious because they dread feeling the symptoms of anxiety, and then they experience those symptoms because they are having anxious thoughts.
What are the effects of anxiety?
Anxiety will have an effect on both the body and the mind:
Increased muscular tension can cause discomfort and headaches.
Breathing rapidly may make you feel light-headed and shaky, and give you pins and needles.
Rising blood pressure can make you more aware of a pounding heart.
Changes to the blood supply affecting the digestive system may also cause nausea and sickness.
The effects on your nervous system may manifest themselves in an urgent need to visit the toilet, and butterfly feelings in the stomach.
The psychological effects of anxiety include:
fear, heightened alertness, being on edge, irritable, and unable to relax or concentrate. You may feel an overwhelming desire to seek the reassurance of others, to be weepy and need reassurance.
The way you think can be affected: you may fear that the worst is going to happen and slot everything that occurs into a pessimistic outlook on life. For example, if a friend is late, you worry that they have had an accident or don’t want to see you, when in fact their train was delayed.
To cope with these feelings and sensations, people may start smoking or drinking too much, or misusing drugs. They may start steering clear of certain situations, and maintain relationships that either support their anxious outlook or help them avoid situations they find distressing.
Sometimes, anxiety can take the form of a panic attack. This is the rapid build-up of overwhelming sensations, such as a pounding (and sometimes irregular) heartbeat, feeling faint, sweating, nausea, chest pains, breathing discomfort, feelings of losing control, shaky limbs and legs turning to jelly. It can make people afraid that they are going mad, blacking out, or having a heart attack. They may be convinced they are going to die in the course of the attack, making this a terrifying experience.
Panic attacks may sometimes occur for no reason, and people may not be able to understand why. They may feel as if their mind has gone totally out of control.
Long-term anxiety is bad for your health. It can weaken your immune system, lowering your resistance to infection. Increased blood pressure can cause heart or kidney problems, and contribute to the chances of having a stroke. You may experience digestive difficulties, along with other health problems.
You may also be depressed. Depression and anxiety often appear together, to the extent that doctors sometimes treat them in the same way.
Impact on work, leisure and relationships
You may find it difficult to hold down a job, develop or maintain good relationships, or simply to enjoy leisure time. Sleep problems may further aggravate anxious feelings and reduce your ability to cope. For some people, anxiety becomes so overwhelming that it takes over their lives. They may experience severe or very frequent panic attacks, for no apparent reason, or have a persistent, ‘free-floating’ sense of anxiety.
Some may develop a phobia about going out and about, or may withdraw from contact with people, even their family and friends. Others have obsessive thoughts or repetitious behaviour, such as endlessly washing their hands.
Problems of this kind are known as panic disorders or anxiety disorders.
Can I learn to manage my anxiety myself?
There are many things you can do to reduce your anxiety to a more manageable level. Taking action may make you feel more anxious at first. Even thinking about anxiety can make it worse. But facing up to anxiety, and how it makes you feel, can be the first step in breaking the cycle of fear and insecurity. It’s important to remember how much better you will feel when you can begin to relax, take control, and lead a fuller life.
Controlling the symptoms
The symptoms of anxiety can be controlled by breathing and relaxation techniques, and by replacing distressing, negative thoughts with positive, peaceful ones. These methods are straightforward and can be learnt from books, the internet, video and audio tapes, through counselling, and attending relaxation classes.
Learning how to handle difficult situations and to stand up for yourself can make you feel more confident and, therefore, more relaxed. Some people find that learning self-defence makes them feel safer.
Complementary therapies can help you to relax, sleep better, and deal with the symptoms of anxiety. Yoga, meditation, aromatherapy, massage, reflexology, herbalism, Bach flower remedies, homeopathy, and hypnotherapy are some of the methods people have found successful.
Many chemists and health shops stock different remedies and may be able to offer advice.
Avoid stimulants, such as coffee, cigarettes and alcohol, which can promote anxiety. Eating a healthy diet and getting plenty of sleep can also make a big difference to your ability to cope with stress.
It can relieve your feelings to talk to a friend or family member about what’s making you anxious. You may find that they have encountered a similar problem and can help talk you through it.
What sort of treatment can I get?
Because of problems of dependency, doctors usually prescribe tranquillisers and sleeping pills only as a temporary measure for severe or disabling anxiety. They are given at the lowest possible dose, for the shortest possible time, and not longer than about four weeks.
The side effects can include feeling sluggish, unable to concentrate, and not caring about anything.
Withdrawal symptoms may occur, if you take them for any length of time. These can seem worse than the original feelings of anxiety. The long-term use of tranquillisers has also been linked with having panic attacks.
Tranquillisers can’t tackle the root cause of the problem, but they can bring some relief, until such time as other forms of treatment can be put in place.
Doctors may also suggest beta-blockers to deal with symptoms such as palpitations, although the success of this treatment is variable.
Talking treatments can help you to understand and deal with the causes of your anxiety and to find strategies for coping. They have proved to have longer-lasting benefits than other treatments for anxiety problems.
There are various different types of counselling and psychotherapy available, in groups or individually. It may be short-term or open-ended and take place between one and four times a week. Some types help with how you are feeling, others look into reasons why you may be experiencing anxiety.
How can friends and family help?
Recognising how you feel when you are anxious can help you to empathise with a friend or relative who is going through a bad patch. People with severe anxiety often feel very negative about themselves. Keep reminding them of their good points.
Being supportive can be a question of finding the right balance. You need to accept the person as they are, and not push them into situations that are beyond them. Yet, at the same time, avoid being too protective, and assist them to overcome small challenges. In this way, they can build up their self-confidence and feel in control.
It may be a good tactic to try and strike a bargain with your friend or relative. If they will agree to go to a relaxation class, for instance, you could promise to travel with them and meet them afterwards.
If someone is distressed, they may need reassurance that it’s OK to cry. Letting out feelings can relieve tension. Laughter is relaxing; helping your friend to have fun may be one of the most useful things you can do for them. They may also need support in finding appropriate channels to express anger, even if this is just bashing a few cushions about.
Some people may be embarrassed at not feeling in control. They may blush or shake, and need reassurance that this is not obvious to others. Sometimes, physical closeness, such as a touch or a hug, can be very comforting. A gentle massage to neck or shoulders may also be soothing.
Look after yourself
Supporting someone else through emotional problems can be very rewarding, but it can also be very frustrating. Look after yourself, or else you are likely to become impatient with them, and tense and irritable yourself. Finding someone you can confide in might be very useful.
If you are living with the person, make sure that you have a break. Their anxiety may stop them doing things, but it shouldn’t stop you, as well. You should not feel guilty doing things on your own. If you are enjoying life, you will find it easier to be loving and supportive. But if your friend feels you are being a martyr, they will feel anxious about spoiling your life.
Affected by Anxiety? Contact Frances for an assessment appointment by using the contact form on this website.