Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.
It’s completely normal to feel anxious from time to time – most of us have experienced that unsettling sensation of feeling uptight, scared, or worried in certain situations.
For example, the natural ‘fight or flight’ response, where your body is flooded with adrenaline, is designed to help you react to immediate danger. This surge of adrenaline can make you run faster to escape a threat or spur you into action to avoid risky situations. This type of anxiety is short-lived and tied to specific stressors, such as an important presentation or a moment of physical danger.
However, for some people, anxiety becomes a constant presence, lingering even when there is no clear cause or immediate threat. When anxiety persists like this, it can seep into daily life, affecting relationships, work, physical health, and overall well-being.
This form of chronic anxiety can feel overwhelming, making even basic tasks feel exhausting and draining. Understanding the difference between occasional anxiety and ongoing, severe anxiety is essential to knowing when to seek help and how to manage these feelings effectively.
What is an Anxiety Disorder?
If you feel anxious so often that it interferes with your normal everyday activities, you may be dealing with an anxiety disorder. This could manifest in various ways, such as feeling anxious about minor issues that others might cope with easily, being unable to stop feeling anxious even after the source of stress has passed, or experiencing repeated bouts of anxiety without any clear trigger.
Anxiety disorders can significantly impact daily life, making common tasks feel overwhelming and relationships more challenging to navigate. It’s estimated that over 8 million people in the UK are struggling with an anxiety disorder at any given time, highlighting the prevalence of this issue. This makes anxiety disorders the most common mental health condition in the UK.
Despite these numbers, many people may not seek help due to stigma or a lack of awareness about treatment options, which can include therapy, self-help strategies, and, in some cases, medication. Understanding anxiety disorders is the first step toward addressing the condition and seeking the support needed to improve overall well-being.
What Causes Anxiety Disorders?
Anxiety disorders have a wide variety of causes, which can differ greatly from person to person. Often, several factors combine to make someone more prone to anxiety, and these factors frequently originate in early life. Experiences such as neglect, abuse, or other major stresses and traumas during childhood can have a lasting impact on emotional well-being, increasing vulnerability to anxiety disorders later in life.
Genetics may also play a role, as individuals with a family history of anxiety disorders might be more likely to develop similar conditions. Additionally, environmental factors, such as growing up in a high-stress or unstable environment, can contribute to long-term susceptibility.
In adulthood, one or more significant stressors related to home, work, financial struggles, relationships, or bereavement may act as triggers for anxiety disorders. For some, a combination of smaller, ongoing stressors—such as demanding workloads or feelings of loneliness—can gradually build up and lead to overwhelming anxiety.
It's important to recognize that anxiety disorders are complex, often resulting from a mix of biological, psychological, and environmental influences. Understanding these causes can be a key step toward seeking help and finding effective ways to manage anxiety.
What are the Main Types of Anxiety Disorders?
There are many types of anxiety disorders. While they all involve feeling anxious (to the extent that it interferes with your life), they have different triggers and affect people in different ways.
Generalised Anxiety Disorder
Generalised anxiety disorder or GAD is the most common anxiety disorder. The clue is in the name – you worry about everything. If your partner is out, you may fret that they’ve had an accident; if you go out to the shops, you may be convinced your home is being burgled; if a friend doesn’t return your call immediately, you may fear you’ve done something to offend them.
Going on holiday is usually an excellent form of relaxation, but if you have GAD your time may be ruined by worry about delayed flights, food poisoning, and freak accidents.
In short, GAD affects every aspect of your life, meaning you often find it hard to get to sleep, feel irritable or on edge all the time, get muscle aches or headaches from tension and find it hard to concentrate.
Panic Attacks
Panic attacks are intense episodes of anxiety that can be overwhelming and often include a range of physical symptoms. These symptoms might include a racing heart or palpitations, a choking sensation, shortness of breath, pins and needles in the hands or feet, dry mouth, excessive sweating, and uncontrollable trembling. For many people, these episodes feel sudden and alarming, sometimes leading to a fear of having another attack.
If you experience repeated panic attacks, it may be diagnosed as panic disorder. While some panic attacks are triggered by a major stressful event, they often appear without any clear cause, making them particularly distressing. Over time, the unpredictability of these attacks can create additional anxiety, as individuals may worry about when or where the next one will occur, potentially affecting their daily lives and routines.
Phobias
Phobias are a specific type of anxiety disorder that revolves around an intense, irrational fear of a particular object, situation, or activity. These fears can be so overwhelming that they interfere with daily life, even though the feared object or scenario may pose little to no real danger.
Common examples include a fear of snakes, needles, dentists, or small, enclosed spaces, which is known as claustrophobia. Another well-known phobia is agoraphobia, the fear of situations where escape might be difficult or help unavailable, often involving public spaces like shopping malls, crowded areas, or even open spaces.
Phobias can range from mildly inconvenient to severely debilitating, depending on their intensity and the frequency of exposure to the trigger.
Social Anxiety Disorder
Social anxiety disorder is a condition where anxiety is triggered by fear of how others perceive you. It can make social interactions feel overwhelming, often causing individuals to avoid them altogether. This avoidance can lead to social isolation, which is a common trigger for depression, creating a difficult cycle to break.
People with social anxiety often experience intense fear or self-consciousness in everyday situations, such as meeting new people, speaking in public, or even eating in front of others. It’s sometimes referred to as social phobia because it involves an intense, almost paralyzing fear of specific social circumstances. Understanding and addressing this condition is crucial for improving quality of life and mental well-being.
What Help is Available for Anxiety Disorders?
Talking therapies, such as cognitive behavioural therapy (CBT), are fundamental in treating most anxiety disorders. These therapies focus on uncovering the intricate link between your thoughts, feelings, and behaviours. The aim is to help you understand how negative emotions can trigger a spiral of unhelpful thoughts, leading to anxious behaviours.
By identifying these patterns, you can learn to challenge automatic, negative thoughts and replace them with healthier, more constructive ones. Over time, this process can reduce anxiety and give you greater control over your emotional responses.
Another effective form of talking therapy is behavioural therapy, which targets the behaviours associated with anxiety. For instance, if you have a phobia, behavioural therapy often incorporates a technique called exposure therapy. This involves gradually and safely confronting your fear in a controlled environment to desensitise you.
Take arachnophobia (fear of spiders) as an example. The process might start with your therapist showing you a picture of a harmless spider. Over time, you could progress to being in the same room as a spider and, if you feel ready, even touching one.
By combining these approaches, talking therapies can empower you to break free from the cycle of fear, avoidance, and overwhelming thoughts that anxiety creates. With time, you can build confidence, overcome challenges, and lead a calmer, more fulfilling life.
What help is available for anxiety disorder?
Talking therapy, including CBT (cognitive behavioural therapy), is the mainstay of treatment for most types of anxiety disorders. It aims to help you recognise that how you’re feeling can trigger a train of unhelpful thoughts. Once you recognise this, you can challenge these negative thoughts and replace them with more realistic ones.
Behavioural therapy is a type of talking therapy which specifically aims to change behaviours caused by, or driving, your anxiety disorder. If you have a phobia, it may involve being exposed very gradually to whatever you’re scared of in a safe setting. If you’re scared of spiders, your therapist might start by showing you just a picture of a very small, harmless spider. They give you techniques – relaxation exercises, deep breathing, distraction etc - to help you cope with your anxiety.
Can I get help on the NHS?
You can access talking therapy on the NHS in England without needing a referral from your doctor. This means you can reach out directly to services in your area to start getting support. Simply search the NHS website for ‘find a talking therapies service,’ where you’ll find a directory of options available locally. Talking therapy can help with a range of mental health challenges, including anxiety, depression, stress, and trauma, offering a space to explore your feelings and develop coping strategies.
If your symptoms are severe, your GP may discuss medication as a treatment option. Medications that may be prescribed include:
Antidepressants: These are commonly used for depression but are also effective in treating anxiety disorders, such as generalized anxiety disorder (GAD) or panic disorder. They work by balancing chemicals in the brain to improve mood and reduce anxiety.
Benzodiazepines: These medications can reduce anxiety quickly but carry a high risk of addiction and side effects, so they are now rarely prescribed and mainly used for very short-term relief in extreme cases.
Buspirone: Specifically used for GAD, this medication is an option with less risk of dependency compared to benzodiazepines.
Beta blockers: These target the physical symptoms of anxiety and panic, such as a racing heart or trembling, making them effective for people experiencing frequent panic attacks.
While medication can help manage symptoms, it is important to remember that it is not a substitute for talking therapy. Therapy addresses the root causes of your mental health challenges and can offer a long-term solution to your symptoms by teaching coping techniques, changing negative thought patterns, and improving your overall mental well-being.
Often, a combination of therapy and medication provides the best outcomes, so it’s worth discussing all your options with a healthcare professional.
In conclusion, anxiety disorders can be overwhelming, but with the right strategies and support, they are manageable. Understanding your condition, exploring therapy options, considering medication when appropriate, and practising self-care are all vital steps towards achieving better mental health.
Remember, you are not alone in this journey—professionals, support groups, and loved ones can provide assistance and encouragement. With persistence and the right approach, it’s possible to reduce the impact of anxiety on your life and move towards a healthier, more fulfilling future.