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During Mental Health Awareness Week, Stuart Haydock, Bupa UK Organisational Psychologist and resilience expert, will be answering your questions about resilience, via Facebook Live. Join him at 12.30 on Tuesday 9 May 2017.
There are different types of anxiety disorder, some of which we’ve explained here.
A phobia is when you have a fear that’s out of proportion to any real danger. If a phobia interferes with your everyday life, it’s considered to be an anxiety disorder. Common phobias include fears of heights, spiders, mice, blood, injections or enclosed spaces.
If you have panic disorder, you can suddenly have intense periods of fear known as panic attacks. You may find that something triggers these, or they may develop for no apparent reason. Panic attacks usually reach their peak within 10 minutes and can last between 20 and 30 minutes.
If you have obsessive-compulsive disorder (OCD), you may have repeated obsessions or compulsions (or both) that make you feel anxious. Obsessions are ideas you have over and over that make you feel distressed or anxious, such as thoughts about being contaminated with germs. Compulsions are actions or rituals that you feel you have to do, sometimes to cancel out obsessions, such as washing your hands. OCD symptoms can range in how severe they are.
Post-traumatic stress disorder
You can develop this if you have been through 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 weeks, months or even years after the event.
Generalised anxiety disorder
Generalised anxiety is when you feel worried most of the time about things that might go wrong and you can’t control these feelings. These symptoms last a long time (at least six months) and can have a significant impact on your life.
Anxiety disorders can cause both mental (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:
- difficulty sleeping (insomnia)
- feeling tired
- feeling restless
- feeling irritable
- having trouble concentrating
- feeling out of control
- feeling detached from yourself or your surroundings
When you’re anxious, you may also have physical symptoms. This happens when your body releases the hormone adrenaline – described as your body’s ‘fight or flight’ response. Physical symptoms of anxiety include:
- a racing heartbeat (palpitations)
- tension in your muscles, which may be painful
- stomach cramps
- feeling sick
- shortness of breath
- dizziness or feeling faint
- needing to go to the toilet more often than usual
- trembling or shaking
- a headache
- numb or tingling fingers, toes or lips
These symptoms may be caused by problems other than anxiety disorders. If you have any of these symptoms, contact your GP for advice.
If you feel that your feelings of anxiety are affecting your day-to-day life, see your GP.
Your GP will ask you some questions to try to identify what’s causing your anxiety. They will ask about your symptoms and your medical history too.
Depending on what symptoms you have, your GP may want you to have some tests to rule out other conditions.
There are various changes you can make to your life to help reduce your feelings of anxiety. Doing some regular physical activity, cutting down on caffeine and eating a healthy diet can all help. Learning some relaxation techniques or reading self-help books may improve your symptoms too.
It might also help to contact and talk to other people who have anxiety disorders through charities and patient groups. They may be going through something similar to you and be a good source of support and advice. See our Resources section for contact details of these organisations, or ask your GP about services in your local area.
Your GP may refer you to see a counsellor or a therapist for treatment, or direct you to resources you can access yourself.
Talking through your problems with a counsellor may help you to deal better with your anxiety.
Cognitive behavioural therapy (CBT) is a short-term psychological talking treatment. It can help you change how you think and what you do. As CBT helps to challenge negative thoughts, feelings and behaviour, it can be particularly helpful if you have problems such as phobias or panic attacks. You can see a professional trained in CBT or access resources online.
There are different types of medicines used to treat some people with 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, usually for up to a couple of weeks. They aren’t prescribed for longer than this because they can become addictive.
- 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 and shaking but they don’t help with psychological symptoms of anxiety.
Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.
Some relaxation techniques, such as meditation and yoga, or t’ai chi exercises may help you to deal with your anxiety.
Although there isn’t enough research on these types of therapy to tell if they are effective or not, many people do find them helpful. It’s worth talking to people who have tried them as well as your GP to find out more before you try any yourself.
There are many different causes of anxiety disorders. It may not be immediately clear why you have developed one but it may be more likely if you:
- go through a stressful, life-changing event such as a bereavement, or experience 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
Some of us seem to be born with a tendency to be more anxious than others. This means it may be possible to inherit anxiety disorders. Equally, people who aren’t naturally anxious can become so if they are put under intense pressure.
What can I do to help reduce my anxiety?
There are lots of things you can do to help reduce your anxiety. Everyone is different, so it’s important to try different things and see which works best for you.
Taking part in regular physical activity can help you to feel less anxious. When you exercise, your brain releases hormones called endorphins, which can improve how you feel.
Because anxiety disorders often affect sleep, taking steps to improve this may help you feel better. So, for example, cut down as much as you can on alcohol and stimulants, such as coffee. This is particularly worth remembering in the three to six hours before you go to bed.
Even talking to friends or relatives about the things that are making you feel anxious can help. This may encourage you to seek practical advice for your problems if you need to.
Learning to relax in any way that suits you is also important.
How long will it take for medicines or CBT to improve my anxiety disorder?
Medicines and cognitive behavioural therapy (CBT) don’t work instantly. It can take weeks before you notice any improvements from either type of treatment.
If your GP prescribes a medicine for your anxiety, it’s important to keep in mind that it may not work immediately. For example, antidepressants can take about two to four weeks to work.
A course of CBT can last anything from six weeks to six months and usually involve weekly sessions that last up to an hour each. You may have CBT sessions on your own, or with a group of people in a similar situation to you. There are also self-help books and online programmes where you can access CBT. Ask your GP for more information.
What is trichotillomania and how is it treated?
Trichotillomania is a condition in which you have an obsessive urge to pull out your own hair. You can lose a lot of hair, and even go bald. Treatment aims to change behaviour through different methods and may involve cognitive behavioural therapy (CBT).
Trichotillomania usually starts when you’re a child. The main symptom is pulling hair from your scalp and feeling increasingly stressed and anxious. The most effective treatments are those that try different ways of changing your behaviour and habits, based on CBT techniques. Some of these include the following.
- Self-monitoring. You keep a record of when you pull out your hair and learn to recognise the situations that trigger this.
- Competing reaction training. You learn to substitute a different response to pulling out your hair. For example, if you feel the urge to pull your hair out, you lock your arms so it’s impossible to do so.
- Relaxation training. This involves learning to identify when you start to feel tension and do activities to help you relax, such as deep breathing exercises.
For more information about trichotillomania and sources of support, contact your GP.
What treatments can my child get for anxiety?
Children and teenagers can be treated for anxiety with medicines, but it’s usually better to try psychological therapies first.
Some antidepressant medicines can treat anxiety disorders in children and teenagers. For example, some types of selective serotonin re-uptake inhibitors (SSRIs) have been found to help children and young adults deal with obsessive-compulsive disorder (OCD). These medicines are only available on prescription from your GP or specialist and will only be considered after your child has tried other treatments.
Instead of prescribing medicines, your GP or specialist may recommend trying a course of psychotherapy known as cognitive behavioural therapy (CBT). This is a type of talking therapy carried out by a trained professional. CBT can help children and parents understand how the problem developed and what they can do to overcome the anxiety. If you need further information, contact your GP for more advice.
Headspace This tool describes itself as gym membership for your mind using meditation and mindfulness techniques. You can start off with free 10-day introduction to meditation and then choose to subscribe for access to more exercises covering a range of topics. You can use it on your phone or computer, depending on what suits you best. Big White Wall This online, anonymous community provides a secure environment for you to seek help if you’re feeling stressed, anxious or down about anything. You can share stories to get and give advice, find information and do courses to understand better how you’re feeling and make positive change. And trained professionals keep an eye on things 24 hours a day to make sure everyone stays safe and supported. Be Mindful This website-based mindfulness programme is made up of 10 30-minute modules for you to do at your own pace. It teaches mindfulness techniques to help you manage stress or simply to try to live a happier, healthier life. The programme uses audio clips, text-based information and a library of resources and exercises, and you can track your progress as you go along. Mental Health Foundation The Mental Health Foundation is a charity that carries out research and offers information about many areas of mental health.here are lots of suggestions here of things you can do to help yourself if you’re affected by anxiety. If you get panic attacks, you’ll know how alarming they can be, so knowing how to manage them can make all the difference. Try listening to one of the MHF’s podcasts on ways to relax and improve your sense of wellbeing. Mind The charity Mind has information to support people with a mental health condition and those who care for them. As with many of their other topics, their content about anxiety disorders has quotes from people coping with the anxiety or panic attacks, and also a video of people talking about their experiences. Rethink
This charity has support groups, runs campaigns and can direct you to local mental health services, as well as providing information. This factsheet that you can download has comprehensive information about the different types of depression and directs to other, more specific guidance.
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- Anxiety disorders. National Institute for Health and Care Excellence (NICE), February 2014. www.nice.org.uk
- Generalized anxiety disorder. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published June 2013
- Anxiety disorders. Medscape. www.emedicine.medscape.com, published 21 April 2014
- Understanding phobias. Mind. www.mind.org.uk, published 2014
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- Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 13 January 2015
- Krisanaprakornkit T, Sriraj W, Piyavhatkul N, et al. Meditation therapy for anxiety disorders. Cochrane Database of Systematic Reviews 2006, Issue 1. doi:10.1002/14651858.CD004998.pub2
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- Abbott R, Lavretsky H. Tai chi and qigong for the treatment and prevention of mental disorders. Psychiatr Clin North Am 2013; 36(1):109–19. doi:10.1016/j.psc.2013.01.011
- Exercise for stress and anxiety. Anxiety and Depression Association of America. www.adaa.org, accessed 13 January 2015
- Cognitive behavioural therapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, published July 2013
- Trichotillomania. Medscape. www.emedicine.medscape.com, published 15 January 2014
- Expert consensus: treatment guidelines for trichotillomania, skin picking and other body-focused repetitive behaviours. Trichotillomania Learning Centre. www.trich.org, published 2011
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