Anxiety disorders

Anxiety disorders are conditions in which symptoms of anxiety are so severe, or occur so regularly, they start to interfere with your everyday life.

About anxiety disorders

Anxiety is a feeling of unease. Everybody gets anxious when faced with a stressful situation, for example an exam or interview, or during a worrying time such as illness. It's also normal to feel anxious when you face something difficult or dangerous. Mild anxiety can often be positive and useful, particularly if you’re better at working under pressure.

If you have anxiety that is long-lasting and severe, it can interfere with your everyday activities. This can lead to other mental health problems, such as depression.

Types of anxiety disorder

There are different types of anxiety disorders. Below are some examples.

Phobias

A phobia is when you have a fear that is out of proportion to any real danger. If a phobia interferes with your ability to lead a normal life, then it may be considered an anxiety disorder. Common phobias include fears of heights, spiders, mice, blood, injections or enclosed spaces.

Panic disorder

If you have panic disorder, you can suddenly develop intense periods of fear known as panic attacks. You may find that something triggers your panic attacks, or they may develop for no apparent reason. Panic attacks usually last between five and 20 minutes, but they can last longer.

Obsessive-compulsive disorder

If you have obsessive-compulsive disorder (OCD), you may have repeated obsessions and/or compulsions that make you feel anxious. Obsessions are recurrent ideas that make you feel distressed or anxious, such as thoughts about being contaminated with germs. Compulsions are actions or rituals that you feel necessary to cancel out the obsessions, such as washing your hands. OCD symptoms vary from mild to severe.

Post-traumatic stress disorder

You can develop post-traumatic stress disorder if you have had, or have witnessed, a traumatic event. Post-traumatic stress disorder symptoms include anxiety, which may come and go, and recurring thoughts, memories, images, dreams or distressing 'flashbacks' of the trauma. It may develop years after the traumatic event has occurred.

Generalised anxiety disorder

Anxiety can be a long-term disorder where you feel worried most of the time about things that might go wrong. This is called generalised anxiety disorder. If you have generalised anxiety disorder, you may also have panic attacks and some phobias.

Symptoms of anxiety disorders

Anxiety disorders can cause both psychological and physical symptoms.

If you have an anxiety disorder, your main symptom will be feeling anxious. However, this can lead to other psychological symptoms such as:

• sleeping difficulties (insomnia)
• feeling tired
• being irritable or quick to get angry
• being unable to concentrate
• feeling out of control of your actions, or detached from your surroundings

When you're anxious, you may also have a range of physical symptoms. This is caused by the release of the hormone adrenaline – your body's so-called 'fight or flight' response. Physical symptoms of anxiety include:

• rapid heartbeat or palpitations
• stomach cramps
• diarrhoea
• dry mouth
• shortness of breath
• dizziness
• needing to urinate more often than usual
• feeling of a lump in your throat
• trembling or shaking
• hot or cold sweats
• nausea or sickness
• headaches

These symptoms may be caused by problems other than anxiety disorders. If you have any of these symptoms, speak to your GP for advice.

Causes of anxiety disorders

There are many different causes of anxiety disorders. It may not be clear why you have an anxiety disorder, but you may be more likely to develop one if you:

• go through a stressful, life-changing event such as a bereavement, or witness something traumatic
• have another mental health condition, such as depression or alcohol dependence
• have a physical illness, such as a thyroid disorder
• take illegal substances such as amphetamines, LSD and ecstasy
• are withdrawing from long-term use of some medicines, such as tranquillisers

Some people seem to be born with a tendency to be more anxious than others. This means anxiety disorders may be genetically inherited. Equally, people who aren’t naturally anxious can become so if they are put under intense pressure.

Diagnosis of anxiety disorders

If you think feelings of anxiety are affecting your day-to-day life, see your GP.

Your GP will want to identify what’s causing your anxiety. He or she will ask about your symptoms.

In some circumstances, depending on the severity of your symptoms, your GP may refer you to a counsellor, therapist or psychiatrist for further diagnosis.

Treatment of anxiety disorders

Self-help

There are various lifestyle changes you can make to help reduce feelings of anxiety. Taking part in regular physical activity, staying away from stimulants such as cigarettes and alcohol and eating a healthy diet can help improve your symptoms. Contacting and talking to other people who have anxiety disorders through charities and patient groups can be a good source of support and advice. Your GP may be able to advise you about services available in your area.

Talking therapies

Your GP may refer you to a counsellor or a therapist for treatment.

Talking through your problems with a counsellor may help you to deal better with your anxiety. Counselling may be particularly helpful if you have a panic disorder, social phobia or generalised anxiety disorder, especially in the short term, but it isn’t suitable for everyone. For more information, speak to your GP.

Cognitive behavioural therapy (CBT) is a short-term psychological treatment. It can help you change how you think (‘cognitive’) and what you do (‘behaviour’). As CBT helps to challenge negative thoughts, feelings and behaviour, it’s particularly suitable if you have problems such as phobias or panic attacks.

Medicines

There are a number of different types of medicines that can be used to treat anxiety disorders. Your GP may prescribe you one of the following medicines, depending on how much your anxiety affects you.

• Benzodiazepines. These may be used for the short-term relief of severe anxiety. They aren’t prescribed for long-term use because of the risk of addiction.
• Antidepressants. These can be used on their own for chronic anxiety or in combination with a benzodiazepine.
• Beta-blockers. These may help to reduce some of your physical symptoms, such as rapid heartbeats or palpitations and shaking. However, they don’t help with the psychological symptoms of anxiety.

Always ask your GP for advice, and read the patient information leaflet that comes with your medicine.

Complementary therapies

Some relaxation techniques such as meditation and low impact yoga or t’ai chi exercises may help you to deal with your anxiety. However, there isn’t enough research on these types of therapy to tell if they are effective or not. You should always speak with your GP before you start any complementary therapy courses or treatments.

Video

See our videos about anxiety:

• simple relaxation exercises
• deep breathing exercises for relaxation

Produced by Rebecca Canvin, Bupa Health Information Team, January 2013.

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