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Anxiety


Expert reviewer Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due September 2020

Anxiety is a feeling of unease or worry about the future. It’s normal to feel anxious when you face something difficult or dangerous. 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. However, if your anxiety lasts a long time and is severe, it can interfere with your everyday life.

A photo of a boy lying on his bed and looking thoughtful

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 a lot of different ways that people can experience anxiety. The feelings can also either be about something in particular or about life much more generally. Some people who experience anxiety also have depression.

There can also be physical changes to your body when you become anxious. This happens 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, adrenaline is more likely to be produced in situations where, although you feel anxious, you are not actually in physical danger.

The physical symptoms of anxiety can include:

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

These symptoms may also be caused by problems with your physical health. So if you have any of the symptoms above, contact your GP for advice.

Reducing anxiety

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

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.

Having less caffeine

Having too much caffeine can cause or increase feelings of anxiety. If you drink tea or coffee, try switching to decaffeinated options. Remember that caffeine is also found in chocolate, so it’s a good idea to cut down on that too. You should avoid energy drinks if you’re prone to feeling anxious, as these are often highly caffeinated.

Eating 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.

Eating healthy foods can improve your mood. You should try to include the following in your diet:

  • Wholegrain foods, fruit and vegetables will all help keep your blood sugar steady. This is better than eating sugary foods such as biscuits and cakes, which make your blood sugar rise and fall quickly, and can leave you feeling irritable. These foods are also rich in B vitamins, which are good for your brain and may help protect your mental health.
  • Protein keeps you full and helps your brain to keep your emotions under control. Good sources of protein include lean meat, fish, eggs and some green leafy vegetables such as spinach.
  • Healthier unsaturated fats (found in foods like olive oil, nuts, avocado and oily fish) help to keep your brain healthy.

We have more information about having a healthy diet.

Relaxation techniques

Meditating or practising mindfulness may help you control your thoughts and feel calmer. Even small steps can help. That includes things like taking more breaks, spending a few moments focusing on your breathing, and doing creative hobbies.

Reading self-help books

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

Talking 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 psychological therapies or counselling. In some cases they may recommend taking 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.

Anxiety disorders

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

If any of these apply to you, see your GP. They will ask you some questions to try to find out what is causing the anxiety.

Your GP may diagnose you with a particular anxiety disorder. Some of these are described below. Not everyone who experiences 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.

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.

Panic disorder

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.

Other disorders related to anxiety

There are certain other conditions that 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. You can develop post-traumatic stress disorder if you have been through a traumatic event.


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Related information

    • 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 a video of people talking about their experiences.
    • Mental Health Foundation
      The Mental Health Foundation is a charity that carries out research and offers information about many areas of mental health. It also has podcasts about overcoming anxiety and mindfulness.
    • 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.
    • Headspace
      This tool describes itself as gym membership for your mind using meditation and mindfulness techniques. You can start off with free introduction to meditation and then choose to pay 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 Online
      This website-based mindfulness programme is made up of ten 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.
    • Anxiety, Panic and Phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, last updated September 2015
    • Understanding the stress response. Harvard Medical School. www.health.harvard.edu, last updated March 2016
    • Mental health. Oxford Handbook of General Practice (online). Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Let's get physical: the impact of physical activity on wellbeing. Mental Health Foundation, 2013. www.mentalhealth.org.uk
    • Winston AP, Hardwick E, Jaberi N. Neuropsychiatric effects of caffeine. Adv Psychiatr Treat 2005; 11(6):432–39. doi:10.1192/apt.11.6.432
    • ood and mood. Mind. www.mind.org.uk, last updated April 2015
    • Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry 2008; 8(41). doi:10.1186/1471-244X-8–41
    • Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent 2016; 8:35–50. doi:10.2147/CCIDE.S63626
    • BMJ Best Practice. Generalised anxiety disorder. bestpractice.bmj.com, last updated March 2017
    • Anxiety and stress-related disorders. Oxford Handbook of Psychiatry (online). Oxford Medicine Online. oxfordmedicine.com, published March 2013
    • Obsessive-compulsive disorder. NICE Clinical Knowledge Summary. cks.nice.org, last revised July 2013
    • Post-traumatic stress disorder. NICE Clinical Knowledge Summary. cks.nice.org.uk, last revised June 2013
  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, September 2017
    Expert reviewer Dr Rahul Bhattacharya, Consultant Psychiatrist
    Next review due September 2020



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