What is anxiety?
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Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future. It's particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life.
Like all animals, human beings have evolved ways to help us protect ourselves from danger. When we feel under threat our bodies react by releasing certain hormones, such as adrenaline and cortisol, which can be helpful.
These hormones:
make us feel more alert, so we can act faster
make our hearts beat faster, quickly sending blood to where it's needed most.
After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to shake.
This is commonly called the 'fight, flight or freeze' response – it's something that happens automatically in our bodies, and we have no control over it.
If you are feeling anxious or experiencing a panic attack right now, see our page on how to manage panic attacks.
What are anxiety disorders?
Anxiety can become a mental health problem if it impacts your ability to live your life as fully as you want to. For example, it may be a problem if:
your feelings of anxiety are very strong or last for a long time
your fears or worries are out of proportion to the situation
you avoid situations that might cause you to feel anxious
your worries feel very distressing or are hard to control
you regularly experience symptoms of anxiety, which could include panic attacks
you find it hard to go about your everyday life or do things you enjoy.
If your symptoms fit a particular set of medical criteria then you might be diagnosed with a particular anxiety disorder. But it's also possible to experience problems with anxiety without having a specific diagnosis.
Some commonly diagnosed anxiety disorders are:
Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person's experiences.
Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia.
Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks.
Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders).
Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you're re-living all the fear and anxiety you experienced at the time of the traumatic events.
Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges.
Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD.
Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance.
Perinatal anxiety or perinatal OCD – some people develop anxiety problems during pregnancy or in the first year after giving birth.
Symptoms of anxiety
Anxiety feels different for everyone. You might experience some of the physical and mental effects listed on this page, as well as effects in other areas of your life.
You might also have experiences or difficulties with anxiety that aren't recognised here.
Effects of anxiety on your body
These can include:
a churning feeling in your stomach
feeling light-headed or dizzy
pins and needles
feeling restless or unable to sit still
headaches, backache or other aches and pains
faster breathing
a fast, thumping or irregular heartbeat
sweating or hot flushes
Sleep problems
grinding your teeth, especially at night
nausea (feeling sick)
needing the toilet more or less often
changes in your sex drive
having panic attacks
Effects of anxiety on your mind
These can include:
feeling tense, nervous or unable to relax
having a sense of dread, or fearing the worst
feeling like the world is speeding up or slowing down
feeling like other people can see you're anxious and are looking at you
feeling like you can't stop worrying, or that bad things will happen if you stop worrying
worrying about anxiety itself, for example worrying about when panic attacks might happen
wanting lots of reassurance from other people or worrying that people are angry or upset with you
worrying that you're losing touch with reality
low mood and depression
rumination – thinking a lot about bad experiences, or thinking over a situation again and again
Depersonalisation – a type of dissociation where you feel disconnected from your mind or body, or like you are a character that you are watching in a film
Derealisation – another type of dissociation where you feel disconnected from the world around you, or like the world isn't real
worrying a lot about things that might happen in the future
Causes of anxiety
Everyone's experience of anxiety is different, so it's hard to know exactly what causes anxiety problems. There are probably lots of factors involved.
Research shows that having a close relative with anxiety problems might increase your chances of experiencing anxiety problems yourself.
At the moment there is not enough evidence to show whether this is because we share some genes that make us more vulnerable to developing anxiety, or because we learn particular ways of thinking and behaving from our parents and other family members as we grow up.
Some things which make anxiety problems more likely to happen are:
Past or childhood experiences
Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma when you're very young is likely to have a particularly big impact. Experiences which can trigger anxiety problems include things like:
physical or emotional abuse
neglect
losing a parent
being bullied or being socially excluded
experiencing racism.
Having parents who don't treat you warmly or are overprotective can also be a factor.
Your current life situation
Current problems in your life can also trigger anxiety. For example:
exhaustion or a build-up of stress
lots of change or uncertainty
feeling under pressure while studying or in work
long working hours
being out of work
money problems
housing problems and homelessness
worrying about the environment or natural disasters (sometimes called climate anxiety or eco-anxiety)
losing someone close to you (sometimes called bereavement)
feeling lonely or isolated
Being abused, bullied or harassed, including experiencing racism.
Big changes to your day-to-day life can be a particular trigger for anxiety, so you may find that you've experienced anxiety problems during the coronavirus pandemic.
Physical or mental health problems
Other health problems can sometimes cause anxiety, or might make it worse. For example:
physical health problems – living with a serious, ongoing or life-threatening physical health condition can sometimes trigger anxiety.
other mental health problems – it's also common to develop anxiety while living with other mental health problems, such as depression.
Drugs and medication
Anxiety can sometimes be a side effect of taking:
some psychiatric medications
some medications for physical health problems
recreational drugs and alcohol
Diet
Some types of food or drink can trigger symptoms of anxiety or panic, or make them worse. These include sugar and caffeine.
Treatment of anxiety
There are various evidence-based treatments that have been found to help with anxiety and panic disorder.
Self-help resources
A self-help resource might be the first treatment option your GP offers you. This is because it's available quite quickly, and there's a chance it could help you to feel better without needing to try other options.
Self-help could be delivered through workbooks or online cognitive behavioural therapy (CBT) programmes such as Bradford District and Craven Talking Therapies.
Talking therapies
If self-help resources aren't likely to help with the anxiety problems you're experiencing, or you've already tried them and they haven't helped, your doctor may offer you a talking treatment. There are two types of talking treatment recommended for anxiety and panic:
Cognitive behavioural therapy (CBT) – this focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour, and teaches you coping skills for dealing with different problems.
Applied relaxation therapy – this involves learning how to relax your muscles in situations where you normally experience anxiety.
Medication
Your doctor might offer to prescribe you medication to help manage your symptoms. Some people find it helpful to try talking therapies and medication at the same time, but medication shouldn't be the only thing you're offered.
Here are some medications you might be offered:
Antidepressants - usually this will be a type called a selective serotonin reuptake inhibitor (SSRI). For some people SSRIs can cause side effects, such as sleep problems or feeling more anxious than you did before. If they don't work, or aren't right for you, you may be offered a different kind.
Pregabalin - 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. This is an antiseizure drug which is normally used to treat epilepsy, a neurological disorder that can cause seizures, but is also licensed to treat anxiety.
Beta-blockers - beta-blockers are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). But they are not psychiatric drugs so they don't reduce any of the psychological symptoms. They may be helpful in certain situations that trigger your phobia.
Benzodiazepine tranquillisers - if you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser. But these drugs can cause unpleasant side effects and can become addictive, so your doctor should only prescribe them at a low dose for a short time, to help you through a crisis period.
Before deciding to take any drug, it's important to make sure you have all the facts you need to make an informed choice.
Tips on managing anxiety
Living with anxiety can be very difficult, but there are steps you can take that might help. This page has some suggestions for you to consider.
Talk to someone you trust
Talking to someone you trust about what's making you anxious could be a relief. It may be that just having someone listen to you and show they care can help in itself. If you aren't able to open up to someone close to you, call Guide-Line who will help you find some support.
Try to manage your worries
Anxiety can make it really hard to stop worrying. You might have worries you can't control. Or you might feel like you need to keep worrying because it feels useful – or that bad things might happen if you stop.
It can be helpful to try different ways of addressing these worries. For example, you could:
Set aside a specific time to focus on your worries – so you can reassure yourself you haven't forgotten to think about them. Some people find it helps to set a timer.
Write down your worries and keep them in a particular place – for example, you could write them in a notebook, or on pieces of paper you put in an envelope or jar.
Look after your physical health
Try to get enough sleep. Sleep can give you the energy to cope with difficult feelings and experiences.
Think about your diet. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels.
Try to do some physical activity. Exercise can be really helpful for your mental wellbeing.
Try breathing exercises
Breathing exercises can help you cope and feel more in control. The NHS has some tips on breathing exercises for stress.
Keep a diary
It might help to make a note of what happens when you get anxious or have a panic attack. This could help you spot patterns in what triggers these experiences for you, or notice early signs that they are beginning to happen.
You could also make a note of what's going well. Living with anxiety can mean you think a lot about things that worry you or are hard to do. It's important to be kind to yourself and notice the good things too.
Try peer support
Peer support brings together people who've had similar experiences to support each other. Many people find it helps them to share ideas about how to stay well, connect with others and feel less alone. Local peer support groups are listed in our services.
Complementary and alternative therapies
You may find that complementary and alternative therapies help you to manage your anxiety.
There are many types that you can try, to see what works for you. These include:
yoga
meditation
aromatherapy
massage
reflexology
herbal treatments
Bach flower remedies
hypnotherapy
Some people find that one or more of these methods can help them to relax or sleep better.
Many chemists and health shops stock different remedies and should be able to offer advice.