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Anxiety


Expert reviewers Dr Liz Russell, Consultant Psychiatrist and Dr Melanie Hill, Bupa Clinics GP
Next review due March 2023

Anxiety is a feeling of unease or worry about the future. It’s normal to feel anxious when you face something difficult. It's also normal to become anxious when faced with a stressful situation such as a job interview. Mild anxiety can often be positive and useful, by helping you to stay alert and perform well when you do important tasks. But if your anxiety lasts a long time and is severe, it can interfere with your everyday life.

There are many reasons why people have anxiety. You can get anxiety if you feel you have a lack of control over the future, from a fear of failure, or fear of embarrassment, or even a fear of loss or a fear of illness or death. And it can cause both mental and physical problems.

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If you need help now

This page is designed to provide health information about anxiety. If you need help now, the following helpline is free for you to call and talk to someone.

  • Samaritans
    116 123 (UK and ROI)

Alternatively, follow this link to Mind’s website and click on the yellow ‘I need urgent help’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you need immediate help or are worried about someone, call the emergency services.

How does anxiety feel?

When you are anxious, you may feel worried or stressed about the future. You may also:

  • have difficulty sleeping (insomnia)
  • feel tired
  • feel irritable
  • have trouble concentrating

There are lots of different ways that people can experience anxiety. Your feelings can also be either about something in particular or about life in general. Some people who get anxiety also have depression.

When you have anxiety, there can also be physical changes to your body, which happen when your body releases adrenaline. Adrenaline is a hormone that historically has helped us to ‘fight or flight’ – to either fend off danger or run away from it. In the modern world, we’re much more likely to produce adrenaline in situations where, although you feel anxious, you aren’t actually in physical danger.

Physical anxiety symptoms can include:

  • a racing heartbeat (palpitations)
  • tension in your muscles, which may be painful
  • feeling sick
  • diarrhoea
  • shortness of breath or breathing quickly
  • dizziness or feeling faint
  • needing to go to the toilet to pee more often than usual
  • trembling or shaking
  • sweating
  • a headache
  • numb or tingling fingers, toes or lips
  • occasionally a dry mouth
  • occasionally stomach cramps

These symptoms may also be caused by problems with your physical health. So, contact your GP for advice if you’re concerned.

Anxiety can become a mental health problem when it:

  • doesn’t go away
  • has a very strong mental or physical effect on you
  • happens regularly, perhaps without an obvious reason
  • affects your everyday life – for example, your ability to do your job or socialise
  • prevents you doing things, or makes you avoid situations, that others find manageable

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Types of anxiety disorders

Your GP may diagnose you with a particular anxiety disorder. Some of these are described below. Not everyone who gets anxiety will have one of these disorders, but it’s good to know about them in case they fit with what you’re going through.

Phobias

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. There are many different types of phobia.

  • Specific or ‘simple’ phobias are ones that are caused by a particular thing. Common ones include fears of flying, enclosed spaces, spiders, or going to the dentist.
  • Social phobia is the fear of being judged by others, which leads you to avoid social situations. It’s stronger than just feeling shy around other people.
  • People with agoraphobia often worry about visiting crowded places and travelling on public transport, and they may stay at home to avoid such situations.

You can learn more in our separate topic: Phobias.

Generalised anxiety disorder

Generalised anxiety disorder 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. For more information, see our topic on Generalised anxiety disorder.

Panic disorder

If you have panic disorder, you can suddenly have intense periods of fear known as panic attacks. The sensations of a panic attack vary from person to person and can be both physical and mental. As well as the symptoms of anxiety listed above, you may also feel like you’re choking or having difficulty swallowing, or feel detached from reality. Sometimes symptoms can be so intense that people can think they are having a heart attack. It’s important to remember that although these symptoms are upsetting, they aren’t dangerous and are unlikely to cause any lasting physical harm.

You might find that something triggers your panic attacks, such as them happening at night, 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. Up to a third of people get a panic attack at some point in their life.

Ways to deal with a panic attack include talking therapies or counselling. If you regularly have them, your GP may recommend medication for panic attacks. This could include taking antidepressants or another medicine to improve your mood. Finding ways to feel more relaxed and less anxious in everyday life could help to prevent panic attacks too. See the information above for advice. And learn more about mental health in the workplace:

Other disorders related to anxiety

Some other health conditions overlap with anxiety. These include obsessive-compulsive disorder (OCD), where you may have repeated obsessions or compulsions that make you feel anxious. Another related condition is post-traumatic stress disorder, which you can develop if you’ve been through a traumatic event. Symptoms of anxiety commonly occur with other mental health conditions, such as depression, alcohol and substance misuse, attention deficit hyperactive disorder (ADHD), autism, bipolar disorder, and personality disorder. Sometimes it can be hard to determine which came first. For example, you may feel that alcohol relieves anxiety, but on withdrawal it can cause anxiety.

Reducing anxiety

There are various changes you can make to your life to help reduce your feelings of anxiety.

Do some physical activity

When you exercise, your brain releases hormones called endorphins, which can improve how you feel. Even going for a 15-minute walk can have a positive effect on your mood.

Have less caffeine

If you consume too much caffeine, it can cause or increase feelings of anxiety. If you drink tea or coffee, try switching to decaffeinated versions. Caffeine is also found in chocolate, so it’s a good idea to cut down on that too. It’s best not to drink energy drinks if you’re prone to feeling anxious, as these can contain high amounts of caffeine.

Eat a healthy diet

Make sure you eat and drink often enough throughout the day. Otherwise you may feel tired, dehydrated and worn down, making it more likely that you’ll feel anxious. Healthy foods can improve your mood so make sure you eat a healthy diet.

Relaxation techniques

Various techniques may help you control your thoughts and feel calmer, such as progressive relaxation, meditation, controlled breathing, mindfulness and distraction techniques. Getting enough sleep may also help – for tips see our topic on sleeping well.

For more tips and advice on how to relax your mind, see the article: How to stop worrying: six helpful ideas.

Read self-help books

The best self-help books are often based on the same principles as counselling, so you may find they help. But it’s worth remembering that these books can vary in quality. Try to get recommendations from someone you trust, such as a health professional. Another option is Reading Well, which is a website supported by charities and professional bodies that gives self-help book recommendations.

Talk to friends or relatives

Sharing your worries with someone close to you can help you to feel understood.

Help from your GP and support organisations

If simple measures like these don’t make a difference, speak to your GP for more advice. Your GP may be able to refer you for counselling or psychological therapies, such as cognitive behavioural therapy (CBT). You can learn more about these and how to access treatment in our topic: Talking therapies. In some cases they may recommend taking anxiety medication for a short time.

There are also organisations that can give you advice or support. Try the ones listed in the other helpful websites section below, or ask your GP about services in your local area.



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Related information

    • Overview of anxiety disorders. The MSD Manuals. www.msdmanuals.com, last full review/revision July 2018
    • Anxiety and panic attacks. Mind. www.mind.org.uk, published September 2017
    • Andrews G, Bell C, Boyce P, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Austr N Z J Psychiatry 2018; 52(12):1109–72. www.ranzcp.org
    • Anxiety, panic and phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, published February 2015
    • Anxiety and stress-related disorders. Oxford handbook of psychiatry. Oxford Medicine Online. oxfordmedicine.com, published June 2019
    • Mental health. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Generalised anxiety disorder. BMJ Best Practice. bestpractice.bmj.com, last reviewed October 2019
    • Panic disorders. BMJ Best Practice. bestpractice.bmj.com, last reviewed January 2020
    • Panic disorder. PatientPro. patient.info/doctor, last edited 28 December 2016
    • Recreational drugs and alcohol. Mind. www.mind.org.uk, published November 2016
    • Better mental health for all: a public health approach to mental health improvement. Faculty of Public Health and Mental Health Foundation. www.fph.org.uk, published 2016
    • Herring MP, O'Connor PJ, Dishman RK. The effect of exercise training on anxiety symptoms among patients: a systematic review. Arch Intern Med 2010; 170(4):321–31. doi: 10.1001/archinternmed.2009.530
    • Let’s get physical. The impact of physical activity on wellbeing. Mental Health Foundation. www.mentalhealth.org.uk, published 2013
    • Food and mood. Mind. www.mind.org.uk, published December 2017
    • Healthy hydration guide for adults and teenagers. British Nutrition Foundation. www.nutrition.org.uk, last reviewed August 2018
    • Food and mood. British Dietetic Association. www.bda.uk.com, accessed August 2017
    • Distraction and grounding strategies. Oxford Cognitive Therapy Centre. www.octc.co.uk, published May 2016
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, March 2020
    Expert reviewer Dr Liz Russell, Consultant Psychiatrist and Dr Melanie Hill, Bupa Clinics GP
    Next review due March 2023

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