Anxiety Guide

What is anxiety?

Anxiety is a word we use to describe our feelings when we are frightened. For example, if you are walking down a street and suddenly a vicious dog runs up to you, snarling and baring its teeth, you will almost certainly feel anxious because you are frightened that the dog will attack you. In this example, it is easy to see what has made you anxious, and so you will tend not to worry about it after it is over, because it makes sense and it is quite normal and the anxiety will soon fade away.

However, if you get those feelings of anxiety when nothing frightening has happened, you may worry that there is something wrong with you.

Anxiety can affect people in three ways:

• Physical symptoms (how the body responds)
• Psychological symptoms (what you think and feel)
• Behavioural symptoms (what you actually do when anxious)

 

Physical symptoms of anxiety

There are several physical symptoms of anxiety listed below. You may not experience them all, and of those you do experience, some may be stronger than others.

• Heart racing or palpitations
• Dizziness or light-headedness
• Legs feeling weak or ‘like jelly’
• Stomach churning (butterflies) or feeling sick
• Shakiness, especially hands and arms
• Tingling sensations
• Dry mouth, difficulty swallowing (‘lump in throat’)
• Feeling hot and sweaty, flushed
• Wanting to go to the toilet
• Muscle tension
• Rapid breathing
• Tight chest / chest pain

 

Psychological symptoms of anxiety

Psychological symptoms are what you feel when anxious and what you actually think and say to yourself when anxious. Here is a list of some of the feelings and thoughts you might have:

• Feeling frightened and panicky
• Thinking that you might be losing your mind
• Thinking that you might be having a heart attack
• Feeling that you are losing control
• Worrying that you might faint or be sick
• Thinking you may have a brain tumour
• Worrying that people are looking at you and thinking that you might be acting strangely
• Worrying that you might make a fool or yourself by saying or doing something silly
• Wanting to escape and get to a safe place
• Thinking that you may be having a stroke

You might not experience all these things, or one thought or fear might be particularly strong. There may be other worries that are not above.

 

Behavioural symptoms of anxiety

These include the things you actually do when you are anxious. What you do will depend on the situations you find particularly stressful. Here are a few examples:

• Making excuses to avoid going out or doing something
• Only shopping when its quiet or in small shops
• Crossing the street to avoid people
• Rushing out of places or situations when feeling anxious
• Going to the toilet to escape things
• Not saying anything when with other people
• Using props before you go out – for example having a drink or taking a tablet
• Avoiding going out alone
• In buildings, sitting near doors, at the end of rows or as far back as possible

You may be able to think of other different things that you do. However, you will probably find that whatever it is you do, it comes down to either avoiding situations or escaping from them.

 

The causes of the physical symptoms

Physical symptoms of anxiety reflect how your brain responds to any situation you feel anxious. This response prepares your body for immediate action in the face of danger. What this can look like in reality is the following:

Your heart rate shoots up so that it can pump blood to the muscles in your arms and legs as it is your arms and legs that will get you out of danger

To keep your heart beating fast, you need extra oxygen, therefore you breathe quicker to get the extra energy for the heart.

As more energy is sent to your arms and legs, the muscles are much more tense, more ready to spring into action.

As your arms and legs need extra blood, the blood which usually goes to the stomach area is re-directed away from the stomach and is sent to the arms and legs. This leads to the butterflies feeling in your stomach,

Blood is also re-directed from the brain, which can cause you to feel light-headed and dizzy.

As your heart is pumping blood more quickly around your body, your temperature increases to cool your body down. This causes you to perspire more, which is why you feel hot and sweaty.

 

This Anxiety Response is automatic, you do not ‘consciously’ switch it on. This is because it needs to work immediately when you are aware of any danger.

The reason we all have this anxiety response was in the past it served as a survival mechanism. When people experienced severe danger, such as the threat from wild animals this reponse allowed them to move quickly and were therefore most likely to survive.

You may not face quite so much danger in the shape or wild animals, but you still have the same way or responding to danger and stress, as your ancestors did many years ago.

 

The cause of Psychological Symptoms of Anxiety

If you look back at the list of psychological symptoms, the main feature is a fear of losing control. This is where nearly everyone will tend to think the worst, “I’m having a heart attack!”, “am I going crazy?!”, “am I going to die?” are a few examples of what you might think when you are anxious.

These thoughts themselves can make you feel even more anxious and this leads to a vicious circle – you experience the physical symptoms; you worry that they might mean something is seriously wrong with you; you then feel more anxious so the physical symptoms get worse, and so on.

Sometimes your anxious thoughts and feelings may trigger off the physical symptoms. For example, you are about to go into a shop and suddenly the thought hits you “what if I panic?” This thought will trigger off the panic and the vicious circle will make it worse.

Tip to help: Start to breathe in slowly and deeply. Imagine your lungs filling completely with air to the count of three, hold your breath for the count of two and then exhale fully on the count of three.

 

The cause of Behavioural Symptoms of Anxiety

If you look back at the list of behavioural symptoms you may do one or more of the things that were listed. However, perhaps the most important thing you may do which keeps the anxiety going is avoiding situations.

If you do avoid a situation which makes you feel anxious, it may stop you feeling anxious in the short term, but in the long term it will mean that you will never get a chance to overcome your anxiety and will always feel frightened by that situation.

If you avoid something once, next time it may be even more difficult.

Once you start avoiding one place, you may find yourself avoiding other places too.

 

How can I manage my anxiety?

• Counselling/emotional support
• Self-help
• Prescription medicines (Some anti depressants are also anti-anxiety medicines which target some of the chemicals in your brain that might be causing the anxiety. Other tablets, such as Beta-Blockers, may be prescribed to relieve some of the physical symptoms that anxiety can cause such as rapid heartbeat or sweating).
• Cutting down or avoiding alcohol (alcohol contains depressants and can make you feel worse)
• Cutting down or avoiding cigarettes (the nicotine in cigarettes can make anxiety worse and if your breathing is affected by smoking it increases your anxiety).
• Cutting down or avoiding tea, coffee or cola. (These all contain caffeine which can increase anxiety).

 

Self-help techniques

Learning to relax is a way of helping you to overcome your worries. Try a relaxation tape or online meditation. When teaching yourself to relax, remember to be patient – you may have to practise several times before getting the full benefits.

Breathing too quickly can make you feel more anxious – by concentrating on controlling your breathing, it can help control your anxious thoughts and feelings.

Facing up to your worries – many people find that it is easier to avoid situations that make them anxious rather than deal with them. However, facing your worries can be an important factor in overcoming them. It might seem frightening, but you can practise and learn to deal with them slowly, at a pace which feels comfortable and manageable for you. Practising allows you to gently challenge yourself to gradually build up your confidence and begin to reduce your anxiety.

 

Ways you can help to break the cycle and overcome anxiety

Consider answering the questions below to help you identify your behavioural responses.

• What are your safety behaviours?
• Consider how much they help or hinder you (short-term and long-term)
• Predict what would happen if you got rid of the safety behaviours? (Worst outcome?)
• Work out a plan how to tackle one of your safety behaviours.
• Review it – (how did it go?)

It can also help to:

Set targets – Write a list of objects or situations that make you feel anxious and arrange your list in order of difficulty, with the easiest first

Grade tasks – Starting with the easiest task first, write down ways you could achieve this task. This may involve several small steps of increading difficulty.

Practise tasks – Practice each step as often as you need until you can manage the task without difficulty. Be kind to yourself, even if you find it hard at first. Give yourself encouragement and keep a diary to remind yourself of how well you have done.

 

Remember: it is normal to feel anxious and you will get through it