Anxiety can be seen as a customary, yet unpleasant part of life that can affect us all in different ways. If you are suffering from anxiety you may feel irritable, tense, nervous, uptight or wound up. Common in all these complaints is the overwhelming effect of the body producing too much adrenaline. This results in physical symptoms that can affect daily life.
The apprehension of anxiety, which causes palpitations and shaking, creates even more adrenaline, resulting in a vicious circle. For some people anxiety is a temporary state that passes when the source of stress subsides. For others it becomes a long-term condition that affects their lives and those of their loved ones.
It is normal and healthy to feel sad or worried about life and its problems and pressures. But when a worry casts a cloud over everyday life, you may be suffering from anxiety, depression or a mixture of the two.
This fact-sheet explores symptoms, possible causes and the effects of anxiety. It will also look into anxiety disorders and varying kinds of anxiety treatment (including anxiety counselling).
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Symptoms and disorders
If you have symptoms that interfere with your daily activities, then you may have an anxiety disorder. According to Patient.co.uk, approximately one in 20 people have an anxiety disorder. Some sufferers may also have more than one.
Here is a brief overview of the most prevalent anxiety disorders:
Reactions to stress
Anxiety can manifest as a reaction to a stressful situation. These type of stress-related anxiety disorders are classed as ‘reaction disorders’. The three most common are:
Acute reaction to stress
Having an acute reaction to stress means that your symptoms appear within minutes or hours of the stressful experience. Typically, acute reactions in stressful incidents occur after a sudden life crisis such as a bereavement, accident or family problem. In some cases, the symptoms occur before a known event like an interview or an exam – this is called situational anxiety.
When this happens, symptoms tend to settle down quickly. However, in some situations they can last for days or weeks at a time. Other symptoms you might experience include irritability, low mood, poor sleep, wanting to be alone and emotional ups and downs.
An adjustment reaction is similar to an acute reaction. However symptoms tend to develop days or weeks after a stressful event as a reaction. For example you could develop symptoms a few weeks after a divorce, wondering how you are going to cope without your spouse. The symptoms of this are similar to the acute reaction but in some cases can include depression.
Post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) typically follows a serious traumatic event such as a life-threatening incident. Symptoms tend to last for around a month, but can go on for much longer. Anxiety is only one of the symptoms of PTSD. The other main symptoms include:
- Recurring memories, dreams, images, thoughts or flashbacks of the traumatic event.
- A pessimistic outlook on your future. You may start to lose interest in activities you once enjoyed.
- Avoiding places, feelings, people or anything else that may trigger thoughts or memories of the traumatic event.
- Feeling detached from friends and family, feeling emotionally numb.
Phobic anxiety disorders
If you have a phobia of something, you are genuinely fearful of it. This fear is typically disproportionate to the situation. Entering the same vicinity or coming into contact with the feared situation may cause you to feel anxious. In some cases, even thinking of the situation can lead to feelings of anxiety. Hence you may avoid the situation, causing a restriction in your life.
Social anxiety disorder
Social anxiety disorder, or social phobia, is one of the most common phobias. In this instance you become anxious when you think people are judging you, or when you try to figure out what people think of you. It also extends to meeting new people and performing in front of others. You fear that you will act in an embarrassing manner – so much so that other people will think you are crazy, foolish or inadequate. This causes you to avoid such situations as much as possible.
Agoraphobia is perceived as a fear of open spaces and public places, but in reality it is more complex. If you have agoraphobia, you may have a fear of:
- travelling on public transport
- using a lift
- travelling across a bridge
- entering public places
- being in a place where there isn’t an easy exit such as a cinema
- walking through crowds of people.
All of these stem from the underlying fear of help not being instantly available, or if it’s difficult to escape to safety. When you enter a feared place, you can become distressed and anxious. This is why in severe cases, agoraphobics tend to stay in their own home for as long as possible.
More phobias linked to anxiety:
- fear of choking
- fear of being alone
- fear of specific animals
- fear of confined spaces
- fear of injections/needles.
Other anxiety disorders
If you suffer from panic disorder, it means that you have panic attacks on a recurring basis. A panic attack is a sudden, severe attack of fear and anxiety that can occur for no clear reason. The attacks tend to last between five and 10 minutes, but in some instances you can suffer them in waves for up to two hours.
The physical symptoms of a panic attack include:
- heart palpitations
- shortness of breath
- feeling faint
- chest pains
Generalised anxiety disorder
If you suffer from generalised anxiety disorder (GAD) you will feel anxious on most days. It’s a persistent condition where symptoms may come and go. Typically these feelings are related to seemingly minor things such as stress at home or at work. But sometimes you might not even know why you are feeling anxious. If you do have GAD, you will most likely have at least three of the following symptoms:
- easily tired
- on edge/restless
- poor sleep
- muscle tension
- difficulty concentrating.
Obsessive compulsive disorder
Obsessive compulsive disorder comprises of obsessional thoughts followed by compulsive urges.
- Obsessions are recurring urges, thoughts or images that can cause you to become anxious.
- Compulsions are actions or thoughts that you feel the need to do or repeat. A compulsion is typically a response to ease the anxiety that you feel from an obsession.
Relationships can be affected as you withdraw from social activities. If your behaviour is dominated by anxious feelings it can affect your partner, family and colleagues who may sense your rejection.
Anxiety is often accompanied by intense emotional and physical sensations that can convince you that you cannot cope with work, family life or ordinary social contact. Your withdrawal and increasing pre-occupation with anxiety symptoms increases the effects and isolation. Cold sweats, trembling, tingling and palpitations are common symptoms in both anxiety and depression, which often interact. The physical and mental symptoms create a cycle that is easily triggered and may cause you to avoid others.
Anticipating disasters and dwelling on symptoms can dominate the life of an anxious person. This can put pressure on friends and relatives who may themselves feel depleted and drained.
Anxiety feeds on fear and needs to be appropriately and safely confronted with skills and constructive thinking patterns. This is why anxiety counselling is considered an effective form of treatment.
What are the causes?
Causes include medical factors, brain chemistry, environmental factors, substance abuse, genetics, or a combination of these. External pressures typically cause anxiety, but it is possible for you to become anxious with ‘negative self-talk’ – an outlook on life where you expect the worst to happen.
Infections, asthma, anaemia and some heart conditions are all believed to be associated with anxiousness. A number of medically related causes include:
- Side effects from medication.
- Lack of oxygen from a pulmonary embolism or emphysema.
- Stress from a serious illness.
- Symptoms of an illness.
According to research, if you have abnormal levels of certain neurotransmitters in the brain, you may have an increased risk of developing GAD.
When certain neurotransmitters are not working correctly, the brain’s internal network breaks down. This causes the brain to react in inappropriate ways in some situations.
Some environmental factors include:
- Work-related stress.
- Finance and money worries.
- Stress at school.
- Traumatic events such as death of a loved one, a car accident or abuse.
- Relationship problems.
- High-altitude areas.
Alcohol and benzodiazepine dependence are two of the most common substance-related causes of anxiety disorders such as GAD, social phobia and panic disorder.
General causes include:
- Intoxication from an illicit drug such as cocaine.
- Withdrawal from illicit drugs such as heroin, or from prescription drugs like Vicodin.
Some research has suggested that if you have a family history of anxiety, you have a greater chance of developing it yourself.
When is the right time to seek help?
Anxiety is a problem that feeds on itself and is often covered up and dealt with in isolation. Help should be sought as soon as possible. If physical symptoms are severe, consult your GP as a first port of call. Anxiety counselling can help you to face your fears and rebuild self-esteem.
The aim of anxiety treatment is to help reduce symptoms so anxious feelings no longer affect your daily life.
Anxiety counselling is one form of anxiety treatment. It can help by teaching you how to:
- co-manage your life to get back to normal
- define and reframe your most common anxieties
- manage and understand the problem
- manage your life better through meeting your needs
- understand your own limits and triggers
- confront and tolerate your fears
- understand the effects of your self-esteem and expectations
- consider the wider context of your relationships and their effects.
Gaining an understanding of the source of the problem may help you develop a new perspective. Relaxation techniques such as guided fantasy and muscle tension are two techniques that can be used to break the cycle.
Cognitive behavioural therapy has a structured approach to dealing with anxiety in stages. It allows sufferers to look at their own unhealthy thinking and employs graduated exercises in desensitisation and exposure to help people face their fears and anxieties. Psychoanalytic work can look at the origins of the anxiety and offer new perspectives when the time is right.
Mindfulness exercises for anxiety
Mindfulness exercises for anxiety can help you manage symptoms. The aim of mindfulness is to develop your moment-by-moment awareness to be appreciative, self-compassionate and non-judgemental. You will gain greater clarity on what is happening around you, which should help you recognise your anxiety triggers and deal with them effectively.
Medication can be prescribed to help with your anxiety treatment. Common medications include:
- Antidepressants - Even though they are commonly used to treat depression, antidepressants can help reduce your symptoms.
- Benzodiazepines - Benzodiazepines tend to work well to ease symptoms, but they do have serious side effects.
- Beta-blockers - Beta-blockers can help treat some of the physical symptoms such as heart palpitations and trembling.
- Buspirone - This drug is used to treat GAD. It’s an anti-anxiety medicine that isn’t thought to be addictive.
What should I be looking for in a counsellor or psychotherapist?
There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat anxiety. However, the National Institute for Health and Care Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments.
In the first instance, those suffering with anxiety should be offered access to a support group and self-help information recommendations by their doctor. If this doesn't help, or the anxiety is more severe, psychological treatments such as cognitive behavioural therapy and/or applied relaxation are recommended. Further treatment may require medication.
Read the full NICE guidelines:
There are several accredited courses, qualifications and workshops available that can improve a counsellors knowledge of a particular area, so for peace of mind you may wish to check to see if they have had further training in treating anxiety.
What our experts say
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Sophie Coutand-Marin, MBACP, ACTO8th February, 2017
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