Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe.
Everyone has feelings of anxiety at some point in their life – for example, you may feel worried and anxious about sitting an exam, or having a medical test or job interview. During times like these, feeling anxious can be perfectly normal.
However, some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives.
Anxiety is the main symptom of several conditions, including:
If you identify with several of the following signs and symptoms, and they just won’t go away, you may be suffering from an anxiety disorder:
Because anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything.
Despite their different forms, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened.
In addition to the primary symptoms of irrational and excessive fear and worry, other common emotional symptoms of anxiety include:
Anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety involves a wide range of physical symptoms. Because of the numerous physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is discovered.
Common physical symptoms of anxiety include:
Anxiety attacks, also known as panic attacks, are episodes of intense panic or fear. Anxiety attacks usually occur suddenly and without warning. Sometimes there’s an obvious trigger—getting stuck in an elevator, for example, or thinking about the big speech you have to give—but in other cases, the attacks come out of the blue.
Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.
It’s important to seek help if you’re starting to avoid certain situations or places because you’re afraid of having a panic attack. The good news is that panic attacks are highly treatable. In fact, many people are panic free within just 5 to 8 treatment sessions.
Anxiety disorders may be caused by environmental factors, medical factors, genetics, brain chemistry, substance abuse, or a combination of these. It is most commonly triggered by the stress in our lives.
Usually anxiety is a response to outside forces, but it is possible that we make ourselves anxious with "negative self-talk" - a habit of always telling ourselves the worst will happen.
Environmental factors that are known to cause several types of anxiety include:
Anxiety is associated with medical factors such as anemia, asthma, infections, and several heart conditions. Some medically-related causes of anxiety include:
It is estimated that about half of patients who utilize mental health services for anxiety disorders such as GAD, panic disorder, or social phobia are doing so because of alcohol or benzodiazepine dependence. More generally, anxiety is also know to result from:
It has been suggested by some researchers that a family history of anxiety increases the likelihood that a person will develop it. That is, some people may have a genetic predisposition that gives them a greater chance of suffering from anxiety disorders.
Research has shown that people with abnormal levels of certain neurotransmitters in the brain are more likely to suffer from generalized anxiety disorder. When neurotransmitters are not working properly, the brain's internal communication network breaks down, and the brain may react in an inappropriate way in some situations. This can lead to anxiety.
Anxiety disorders are the most common of all mental health problems. Research into these disorders has shown that up to 1 in 4 adults will have an anxiety disorder in their lifetime, and that up to 1 in 10 people will have an anxiety disorder each year.
The most common treatments that your GP might offer you for anxiety and panic disorders are:
The kind of treatment your GP offers you might vary depending on your diagnosis, but ideally they should offer you a talking treatment before prescribing medication (this the recommendation of the National Institute for Health and Care Excellence (NICE), who produce guidelines on best practice in healthcare).
Talking treatments (also known as counselling or therapy), are a process in which you work with a trained therapist to understand the causes of your anxiety, and to find strategies to manage it.
There are lots of different types of talking treatments available, but the most commonly prescribed talking treatment for anxiety is cognitive behavioural therapy (CBT), because there is reliable evidence that it can be effective.
Self-help resources are tools that have been developed by health care professionals for you to use by yourself, and can be helpful in managing anxiety. They can be in the form of:
|Fearfighter is a computer-based CBT (CCBT) programme for treating anxiety, panic and phobias, which is freely available on prescription through the NHS. Some people prefer CCBT to seeing a therapist in person, particularly as a first step.|
To access self-help resources:
Anxiety is very common and many of us overcome it or cope with it without professional help. However, if it is severe or goes on for a long time, anxiety can affect your physical health, and stop you doing the things you want to do. The good news is that there are ways to help yourself.
Someone with troublesome anxiety or a phobia may not talk about their feelings, even with family or close friends. Even so, it is usually obvious that things are not right. The sufferer will tend to look pale and tense, and may easily be startled by normal sounds such as a door-bell ringing or a car's horn. They may be irritable and this can cause arguments with those around them, especially if they don't understand why the person feels that they cannot do certain things. Although friends and family can understand the distress of an anxious person, they can find them difficult to live with, especially if the fear seems unreasonable.
If you have an anxiety problem which just won't go away, you may not ask for help because you worry that people might think that you are "mad". They won't. It's a common problem and it's much better to get help rather than suffer in silence.
Whatever it is that scares you, here are 10 ways to help you cope with your day-to-day fears and anxieties.
It feels impossible to think clearly when you're flooded with fear or anxiety. A racing heart, sweating palms and feeling panicky and confused are the result of adrenalin. So, the first thing to do is take time out so you can physically calm down.
When you're anxious about something – be it work, a relationship or an exam – it can help to think through what the worst end result could be. Even if a presentation, a call or a conversation goes horribly wrong, chances are that you and the world will survive. Sometimes the worst that can happen is a panic attack.
If you start to get a faster heartbeat or sweating palms, the best thing is not to fight it. Stay where you are and simply feel the panic without trying to distract yourself. Placing the palm of your hand on your stomach and breathing slowly and deeply (no more than 12 breaths a minute) helps soothe the body.
It may take up to an hour, but eventually the panic will go away on its own. The goal is to help the mind get used to coping with panic, which takes the fear of fear away.
Avoiding fears only makes them scarier. If you panic one day getting into a lift, it's best to get back into a lift the next day. Stand in the lift and feel the fear until it goes away. Whatever your fear, if you face it, it should start to fade.
Each time fears are embraced, it makes them easier to cope with the next time they strike, until in the end they are no longer a problem. Try imagining the worst thing that can happen – perhaps it's panicking and having a heart attack. Then try to think yourself into having a heart attack. It's just not possible. The fear will run away the more you chase it.
These tips are designed for people who are coping with day-to-day fears and anxieties. If you have been diagnosed with an anxiety-related condition, see our page ongeneralised anxiety disorder.
Fears tend to be much worse than reality. Often, people who have been attacked can't help thinking they're going to be attacked again every time they walk down a dark alley. But the chance that an attack will happen again is actually very low.
Similarly, people sometimes tell themselves they're a failure because they blush when they feel self-conscious. This then makes them more upset. But blushing in stressful situations is normal. By remembering this, the anxiety goes away.
Black-and-white perfectionist thinking such as, "If I'm not the best mum in the world, I'm a failure," or, "My DVDs aren't all facing in the same direction, so my life is a mess," are unrealistic and only set us up for anxiety.
Life is full of stresses, yet many of us feel that our lives must be perfect. Bad days and setbacks will always happen, and it's essential to remember that life is messy.
Take a moment to close your eyes and imagine a place of safety and calm – it could be a picture of you walking on a beautiful beach, or snuggled up in bed with the cat next to you, or a happy memory from childhood. Let the positive feelings soothe you until you feel more relaxed.
Sharing fears takes away a lot of their scariness. If you can't talk to a partner, friend or family member, call a helpline such as the Samaritans (08457 90 90 90, open 24 hours a day). And if your fears aren't going away, ask your GP for help. GPs can refer people for counselling, psychotherapy or online help through an online service calledFearFighter.
A good sleep, a wholesome meal and a walk are often the best cures for anxiety. The easiest way to fall asleep when worries are spiralling through the mind can be to stop trying to nod off. Instead, try to stay awake.
Many people turn to alcohol or drugs to self-treat anxiety with the idea that it will make them feel better, but these only make nervousness worse. On the other hand, eating well will make you feel great physically and mentally.
Finally, give yourself a treat. When you've picked up that spider or made that call you've been dreading, reinforce your success by treating yourself to a candlelit bath, a massage, a country walk, a concert, a meal out, a book, a DVD, or whatever little gift makes you happy.
As part of your treatment, your doctor might offer to prescribe you some medication. There are 4 types of medication which can be helpful in managing anxiety:
According to the National Institute for Health and Care Excellence (NICE) – the organisation that produces health care guidelines – ideally your doctor should offer you other kinds of treatment for anxiety first, before prescribing these drugs.
(See our pages on psychiatric medication for guidance on what to know before taking any medication, your right to refuse, coping with side effects and coming off medication.)
(See our pages on antidepressants for more information on what they are, what to know before taking them, possible side effects and withdrawal. You can also look up detailed information about specific antidepressants in our antidepressants A-Z.)
(See our page on treatments available for phobias for more information about beta-blockers.)
(See our pages on sleeping pills and minor tranquillisers for more information about what they are, how they can help, possible side effects and withdrawal.)
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 (Lyrica).
This drug is an anticonvulsant medication which is normally used to treat epilepsy, but is also licensed to treat anxiety.
0844 477 5774
Support, help and information for those with anxiety disorders.
Helps people to recover from anxiety disorders.
0161 705 4304
Provides details of accredited cognitive behavioural therapy (CBT) therapists.
Provides a register of professional complementary medicine practitioners and training courses.
A supportive online community which provides online peer support for anyone experiencing a mental health problem.
A computer-based CBT (CCBT) programme for treating panic and phobias.
Use the NHS service search to find psychological therapies services near you.
020 7922 7980
Provides a register of practitioners of complementary medicine.
The MHRA is responsible for regulating all medicines and medical devices in the UK.
Information and clinical guidelines on recommended treatments for different conditions, including anxiety disorders.
Provides information, support and advice for those with panic disorder, anxiety, phobias and OCD, including a forum and chat room.
helpline: 0844 967 4848 (10am–10pm)
Provides a helpline, step-by-step programmes, and support for those with anxiety disorders.
Provides self-help therapy groups and support for those with OCD, phobias and related anxiety disorders.
Offers information, support and services for people experiencing drug and alcohol issues, mental health problems and learning disabilities.