What is anxiety?

Anxiety is something we all experience from time to time. Most people can relate to feeling tense, uncertain and, perhaps, fearful at the thought of sitting an exam, going into hospital, attending an interview or starting a new job. You may worry about feeling uncomfortable, appearing foolish or how successful you will be. In turn, these worries can affect your sleep, appetite and ability to concentrate. If everything goes well, the anxiety will go away.

This type of short-term anxiety can be useful. Feeling nervous before  an exam can make you feel more alert, and enhance your performance. However, if the feelings of anxiety overwhelm you, your ability to concentrate and do well may suffer.

The 'fight or flight' reflex

Anxiety and fear can protect you from danger. When you feel under threat, anxiety and fear trigger the release of hormones, such as adrenalin. Adrenalin causes your heart to beat faster to carry blood  where it's most needed. You breathe faster to provide the extra oxygen required for energy. You sweat to prevent overheating. Your mouth may feel dry, as your digestive system slows down to allow more blood to be sent to your muscles. Your senses become heightened and your brain becomes more alert.

These changes make your body able to take action and protect you in a  dangerous situation either by running away or fighting. It is known as the 'fight or flight' reflex. Once the danger has passed, other hormones are released, which may cause you to shake as your muscles start to relax.

This response is useful for protecting you against physical dangers; for example, it can help you run away from wild animals, attackers, fires etc   very quickly. The response is not so useful if you want to run away from exams, public speaking, a driving test, or having an injection. This is because, if there is no physical threat, and you have no need to physically run away or fight, the effects of adrenaline subside more slowly, and you may go on feeling agitated for a long time.

Severe anxiety

If the anxiety stays at a high level for a long time, you may feel that it is difficult to deal with everyday life. The anxiety may become severe; you may feel powerless, out of control, as if you are about to die or go mad. Sometimes, if the feelings of fear overwhelm you, you may experience a panic attack.

What is a panic attack?

A panic attack is an exaggeration of the body’s normal response to fear, stress or excitement. It is the rapid build-up of overwhelming sensations, such as a pounding heartbeat, feeling faint, sweating, nausea, chest pains, breathing discomfort, feelings of losing control, shaky limbs and legs turning to jelly. If you experience this, you may fear that you are going mad, blacking out, or having a heart attack. You may be convinced you are going to die in the course of the attack – making this a terrifying experience.

Panic attacks come on very quickly, symptoms usually peaking within 10 minutes. Most panic attacks last for between 5 and 20 minutes. Some people report attacks lasting for up to an hour, but they are likely to be  experiencing one attack after another, or a high level of anxiety after  the initial attack. You may have one or two panic attacks and never  experience another. Or you may have attacks once a month or several  times each week. For some people they seem to come without warning  and strike at random.

I’m walking to the village shop, then the earth shifts to one side, my heart’s hammering as if it will explode, my vision is blurred  and my hands are sticky with sweat. And I’ve no idea why.

Panic attacks can also come in the night and wake you up. These nighttime attacks occur if your brain is on 'high alert' (due to anxiety) and can detect small changes in your body which it then interprets as a sign of danger. Night-time attacks may be particularly frightening, as you may feel confused and are helpless to do anything to spot them coming.

Why do some people feel more anxious than others?

If you worry more than others, it could be because of your personality, current circumstances or your past or childhood experience; it could be a  mixture of these.

Past experiences

If something distressing happened to you in the past, and you were unable to deal with your emotions at the time, you may become anxious  about facing similar situations again in case they stir up the same feelings of distress.

Feeling anxious could also be something you learned early on in life; for example, your family may have tended to see the world as hostile and dangerous and you’ve learned to respond in the same way.

Some theories suggest that you may inherit a tendency to be more anxious, and so it is a part of your personality.

Everyday life and habits

On a day-to-day basis, caffeine, excess sugar, poor diet, drug misuse, exhaustion, stress and the side effects of certain medication can also mimic and trigger symptoms of anxiety.

Fear of losing control

You may worry about the future. Sometimes, if you feel you are not in control of many aspects of your life, you can start to feel anxious about events beyond your control, such as the threat of global warming, of  being attacked, of developing cancer, or of losing a job. 

After a while, you can start to fear the symptoms of anxiety, especially feeling out of control. This sets up a vicious circle. You may feel anxious because you dread feeling the symptoms of anxiety, and then you experience those symptoms because you are having anxious thoughts.

What are the effects of anxiety?

Anxiety can have an effect on both your body and your mind.

Physical effects

Short-term effects:

  • Increased muscular tension can cause discomfort and headaches
  • Rapid breathing may make you feel light-headed and shaky, and give you pins and needles.
  • Rising blood pressure can make you more aware of a pounding heart. 
  • Changes in the blood supply to your digestive system may cause nausea and sickness.   
  • You may feel an urgent need to visit the toilet, and get 'butterflies' in your stomach.                   

Long-term effects:

  • Fear combined with tension and lack of sleep can weaken your immune system, lowering your resistance to infection.
  • Increased blood pressure can cause heart or kidney problems, and contribute to the chances of having a stroke.
  • You may experience digestive difficulties.
  • You may also feel depressed. (See Depression)

Psychological effects

Anxiety can make you more fearful, alert, on edge, irritable, and unable to relax or concentrate. You may feel an overwhelming desire to seek the reassurance of others, to be weepy and dependent. 

The way you think can be affected: if you fear that the worst is going to happen, you may start to see everything negatively and become very pessimistic. For example, if a friend is late, you may imagine and worry  that he or she has had an accident or doesn’t want to see you; even though your friend may simply be late because their train was delayed.

To cope with these feelings and sensations, you may feel tempted to start smoking or drinking too much, or misusing drugs. You may hold on to relationships that either encourage your anxious outlook or help you avoid situations you find distressing – and so stop you dealing with what’s worrying you.

Impact on work, leisure and relationships

If your anxiety is severe, you may find it difficult to hold down a job, develop or maintain good relationships, or simply to enjoy leisure time. Sleep problems may make your anxious feelings even worse and reduce your ability to cope. (See How to cope with sleep problems.)

For some people, anxiety becomes so overwhelming that it takes over their lives. They may experience severe or very frequent panic attacks for no apparent reason, or have a persistent 'free-floating' sense of anxiety. Some people may develop a phobia about going out, or may withdraw from contact with people – even their family and friends. Others have obsessive thoughts or compulsive behaviour, such as endlessly washing their hands.

 
 

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Worry and anxiety self-help tip #1: Create a worry period

It’s tough to be productive in your daily life when anxiety and worry are dominating your thoughts. But what can you do? If you’re like many chronic worriers, your anxious thoughts feel uncontrollable. You’ve tried lots of things, from distracting yourself, reasoning with your worries, and trying to think positive, but nothing seems to work.

Why trying to stop anxious thoughts doesn’t work

Telling yourself to stop worrying doesn’t work—at least not for long. You can distract yourself or suppress anxious thoughts for a moment, but you can’t banish them for good. In fact, trying to do so often makes them stronger and more persistent.

You can test this out for yourself. Close your eyes and picture a pink elephant. Once you can see the pink elephant in your mind, stop thinking about it. Whatever you do, for the next five minutes, don’t think about pink elephants!

How did you do? Did thoughts of pink elephants keep popping in your brain?

“Thought stopping” backfires because it forces you to pay extra attention to the very thought you want to avoid. You always have to be watching for it, and this very emphasis makes it seem even more important.

But that doesn’t mean there’s nothing you can do to control your worry. You just need to try a different approach. This is where the strategy of postponing worrying comes in. Rather than trying to stop or get rid of an anxious thought, give yourself permission to have it, but put off thinking any more about it until later.

Learning to postpone worrying:

  1. Create a “worry period.” Choose a set time and place for worrying. It should be the same every day (e.g. in the living room from 5:00 to 5:20 p.m.) and early enough that it won’t make you anxious right before bedtime. During your worry period, you’re allowed to worry about whatever’s on your mind. The rest of the day, however, is a worry-free zone.
  2. Postpone your worry. If an anxious thought or worry comes into your head during the day, make a brief note of it on paper and postpone it to your worry period. Remind yourself that you’ll have time to think about it later, so there’s no need to worry about it right now. Save it for later and continue to go about your day.
  3. Go over your “worry list” during the worry period. Reflect on the worries you wrote down during the day. If the thoughts are still bothering you, allow yourself to worry about them, but only for the amount of time you’ve specified for your worry period. If the worries don’t seem important any more, cut your worry period short and enjoy the rest of your day.

Postponing worrying is effective because it breaks the habit of dwelling on worries in the present moment. Yet there’s no struggle to suppress the thought or judge it. You simply save it for later. As you develop the ability to postpone your anxious thoughts, you’ll start to realize that you have more control over your worrying than you think.

Worry and anxiety self-help tip #2: Ask yourself if the problem is solvable

Research shows that while you’re worrying, you temporarily feel less anxious. Running over the problem in your head distracts you from your emotions and makes you feel like you’re getting something accomplished. But worrying and problem solving are two very different things.

Problem solving involves evaluating a situation, coming up with concrete steps for dealing with it, and then putting the plan into action. Worrying, on the other hand, rarely leads to solutions. No matter how much time you spend dwelling on worst-case scenarios, you’re no more prepared to deal with them should they actually happen.

Distinguish between solvable and unsolvable worries

If a worry pops into your head, start by asking yourself whether the problem is something you can actually solve. The following questions can help:

  • Is the problem something you’re currently facing, rather than an imaginary what-if?
  • If the problem is an imaginary what-if, how likely is it to happen? Is your concern realistic?
  • Can you do something about the problem or prepare for it, or is it out of your control?

Productive, solvable worries are those you can take action on right away. For example, if you’re worried about your bills, you could call your creditors to see about flexible payment options. Unproductive, unsolvable worries are those for which there is no corresponding action. “What if I get cancer someday?” or “What if my kid gets into an accident?”

If the worry is solvable, start brainstorming. Make a list of all the possible solutions you can think of. Try not to get too hung up on finding the perfect solution. Focus on the things you have the power to change, rather than the circumstances or realities beyond your control. After you’ve evaluated your options, make a plan of action. Once you have a plan and start doing something about the problem, you’ll feel much less worried.

Dealing with unsolvable worries

But what if the worry isn’t something you can solve? If you’re a chronic worrier, the vast majority of your anxious thoughts probably fall in this camp. In such cases, it’s important to tune into your emotions.

As previously mentioned, worrying helps you avoid unpleasant emotions. Worrying keeps you in your head, thinking about how to solve problems rather than allowing yourself to feel the underlying emotions. But you can’t worry your emotions away. While you’re worrying, your feelings are temporarily suppressed, but as soon as you stop, the tension and anxiety bounces back. And then, you start worrying about your feelings, “What’s wrong with me? I shouldn’t feel this way!”

The only way out of this vicious cycle is by learning to embrace your feelings. This may seem scary at first because of negative beliefs you have about emotions. For example, you may believe that you should always be rational and in control, that your feelings should always make sense, or that you shouldn’t feel certain emotions, such as fear or anger.

The truth is that emotions—like life—are messy. They don’t always make sense and they’re not always pleasant. But as long as you can accept your feelings as part of being human, you’ll be able to experience them without becoming overwhelmed and learn how to use them to your advantage. The following tips will help you find a better balance between your intellect and your emotions.

Worry and anxiety self-help tip #3: Accept uncertainty

The inability to tolerate uncertainty plays a huge role in anxiety and worry. Chronic worriers can’t stand doubt or unpredictability. They need to know with 100 percent certainty what’s going to happen. Worrying is seen as a way to predict what the future has in store—a way to prevent unpleasant surprises and control the outcome. The problem is, it doesn’t work.

Thinking about all the things that could go wrong doesn’t make life any more predictable. You may feel safer when you’re worrying, but it’s just an illusion. Focusing on worst-case scenarios won’t keep bad things from happening. It will only keep you from enjoying the good things you have in the present. So if you want to stop worrying, start by tackling your need for certainty and immediate answers.

Challenging intolerance of uncertainty: The key to anxiety relief

Ask yourself the following questions and write down your responses. See if you can come to an understanding of the disadvantages and problems of being intolerant of uncertainty.

  • Is it possible to be certain about everything in life?
  • What are the advantages of requiring certainty, versus the disadvantages? Or, how is needing certainty in life helpful and unhelpful?
  • Do you tend to predict bad things will happen just because they are uncertain? Is this a reasonable thing to do? What is the likelihood of positive or neutral outcomes?
  • Is it possible to live with the small chance that something negative may happen, given its likelihood is very low?

Adapted from: Accepting Uncertainty, Centre for Clinical Interventions

Worry and anxiety self-help tip #4: Challenge anxious thoughts

If you suffer from chronic anxiety and worries, chances are you look at the world in ways that make it seem more dangerous than it really is. For example, you may overestimate the possibility that things will turn out badly, jump immediately to worst-case scenarios, or treat every negative thought as if it were fact. You may also discredit your own ability to handle life’s problems, assuming you’ll fall apart at the first sign of trouble. These irrational, pessimistic attitudes are known as cognitive distortions.

Although cognitive distortions aren’t based on reality, they’re not easy to give up. Often, they’re part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it. In order to break these bad thinking habits and stop the worry and anxiety they bring, you must retrain your brain.

Start by identifying the frightening thought, being as detailed as possible about what scares or worries you. Then, instead of viewing your thoughts as facts, treat them as hypotheses you’re testing out. As you examine and challenge your worries and fears, you’ll develop a more balanced perspective.

Stop worry by questioning the worried thought:

  • What’s the evidence that the thought is true? That it’s not true?
  • Is there a more positive, realistic way of looking at the situation?
  • What’s the probability that what I’m scared of will actually happen?
  • If the probability is low, what are some more likely outcomes?
  • Is the thought helpful? How will worrying about it help me and how will it hurt me?
  • What would I say to a friend who had this worry?
Cognitive Distortions that Add to Anxiety, Worry, and Stress

All-or-nothing thinking - Looking at things in black-or-white categories, with no middle ground. “If I fall short of perfection, I’m a total failure.”

Overgeneralization - Generalizing from a single negative experience, expecting it to hold true forever. “I didn’t get hired for the job. I’ll never get any job.”

The mental filter - Focusing on the negatives while filtering out all the positives. Noticing the one thing that went wrong, rather than all the things that went right.

Diminishing the positive - Coming up with reasons why positive events don’t count. “I did well on the presentation, but that was just dumb luck.”

Jumping to conclusions - Making negative interpretations without actual evidence. You act like a mind reader, “I can tell she secretly hates me.” Or a fortune teller, “I just know something terrible is going to happen.”

Catastrophizing - Expecting the worst-case scenario to happen. “The pilot said we’re in for some turbulence. The plane’s going to crash!”

Emotional reasoning - Believing that the way you feel reflects reality. “I feel frightened right now. That must mean I’m in real physical danger.”

'Shoulds’ and ‘should-nots’ - Holding yourself to a strict list of what you should and shouldn’t do and beating yourself up if you break any of the rules

Labeling - Labeling yourself based on mistakes and perceived shortcomings. “I’m a failure; an idiot; a loser.”

Personalization - Assuming responsibility for things that are outside your control. “It’s my fault my son got in an accident. I should have warned him to drive carefully in the rain.”

Worry and anxiety self-help tip # 5: Be aware of how others affect you

How you feel is affected by the company you keep, whether you’re aware of it or not. Studies show that emotions are contagious. We quickly “catch” moods from other people—even from strangers who never speak a word (e.g. the terrified woman sitting by you on the plane; the fuming man in the checkout line). The people you spend a lot of time with have an even greater impact on your mental state.

  • Keep a worry diary. You may not be aware of how people or situations are affecting you. Maybe this is the way it’s always been in your family, or you’ve been dealing with the stress so long that it feels normal. You may want to keep a worry diary for a week or so. Every time you start to worry, jot down the thought and what triggered it. Over time, you’ll start to see patterns.
  • Spend less time with people who make you anxious. Is there someone in your life who drags you down or always seems to leave you feeling stressed? Think about cutting back on the time you spend with that person or establish healthier relationship boundaries. For example, you might set certain topics off-limits, if you know that talking about them with that person makes you anxious.
  • Choose your confidantes carefully. Know who to talk to about situations that make you anxious. Some people will help you gain perspective, while others will feed into your worries, doubts, and fears.

Worry and anxiety self-help tip #6: Practice mindfulness

Worrying is usually focused on the future—on what might happen and what you’ll do about it. The centuries-old practice of mindfulness can help you break free of your worries by bringing your attention back to the present. In contrast to the previous techniques of challenging your anxious thoughts or postponing them to a worry period, this strategy is based on observing and then letting them go. Together, they can help you identify where your thinking is causing problems, while helping you get in touch with your emotions.

  • Acknowledge and observe your anxious thoughts and feelings. Don’t try to ignore, fight, or control them like you usually would. Instead, simply observe them as if from an outsider’s perspective, without reacting or judging.
  • Let your worries go. Notice that when you don’t try to control the anxious thoughts that pop up, they soon pass, like clouds moving across the sky. It’s only when you engage your worries that you get stuck.
  • Stay focused on the present. Pay attention to the way your body feels, the rhythm of your breathing, your ever-changing emotions, and the thoughts that drift across your mind. If you find yourself getting stuck on a particular thought, bring your attention back to the present moment.

Using mindfulness meditation to stay focused on the 

Use full links and numbers

tel. 07552 877 219
web: anxietycare.org.uk 
Helps people to recover from anxiety disorders.

Anxiety UK 
tel. 08444 775 774
web: anxietyuk.org.uk 
Support, help and information for those with anxiety disorders.

British Association for Behavioural and Cognitive Psychotherapies (BABCP) 
tel. 0161 705 4304
web: babcp.com 
Can provide details of accredited therapists.

British Association for Counselling and Psychotherapy (BACP) 
tel. 01455 883 300 
web: bacp.co.uk
For Information about counselling and therapy. See website or sister website, itsgoodtotalk, for details of local practitioners.

The British Psychological Society
tel. 0116 254 9568
web: bps.org.uk 
Produces a directory of chartered psychologists.

The Complementary Medical Association (CMA)
tel: 0845 129 8434
web: the-cma.org.uk
Has a register of professional practitioners and training courses.

Institute for Complementary and Natural Medicine (ICNM) 
tel. 020 7922 7980
web: icnm.org.uk
Has a register of practitioners.

Mindfulness Based Cognitive Therapy 
web: mbct.co.uk 
Information about the therapy, classes in Mindfulness and training.

NICE (National Institute for Health and Care Excellence)
web: nice.org.uk 
Information and guidelines on recommended treatments for different disorders.

No Panic 
helpline: 0800 138 8889
web: nopanic.org.uk 
Provides a helpline, step-by-step programmes, and support for those with anxiety disorders.

Samaritans 
24-hour helpline: 08457 90 90 90 
email: jo@samaritans.org 
web: samaritans.org
Freepost RSRB-KKBY-CYJK, ChrisPO Box 90 90
Stirling
FK8 2SA
Emotional support for anyone feeling down, experiencing distress or struggling to cope.

UK Council for Psychotherapy (UKCP) 
tel. 020 7014 9955
web: psychotherapy.org.uk 
Has a voluntary register of qualified psychotherapists.

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