Anxiety and anxiety disorders

What is anxiety?

Anxiety is a feeling of unease, such as fear, agitation, edginess or worry. The sense of anxiety can range from mild to severe, and the duration that it's felt varies between people also. We all develop feelings of anxiety at some point in our lives. For example, if we have a job interview, exam, facing confrontation, or even when we're going to the dentist! During times like these, feeling anxious is expected and nothing to worry about. However, sometimes, people find it difficult to control their fears and worry. Their feelings of anxiety are felt more often, perhaps regularly, and can impact their day-to-day lives, causing problems. Indeed, anxiety is a significant symptom of many mental health conditions, such as panic disorder, phobias (such as agoraphobia), post-traumatic stress disorder (PTSD), panic disorder and generalized anxiety disorder (GAD).

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 What causes anxiety?

Sometimes it's very clear what is causing anxiety, and sometimes it isn't so obvious. For example, if you feel anxious due to a specific phobia, you'll usually know what that is. But if you have GAD, it can be difficult to pinpoint particular causes (and often diagnoses). Genetics, brain chemistry, the environment (current life circumstances) and other health conditions could all contribute to the causes of anxiety. Anxiety can also be caused by stress, whether from a stressful work environment or stress due to uncertainty due to finances or relationship issues. Unpredictable events and general uncertainty in the world and for your future can also cause anxiety to rise.

What are the psychological symptoms of anxiety?

The symptoms that arise from anxiety depends on the specific anxiety disorder. However, many of the conditions feature the same symptoms as GAD: a sense of dread, feeling on edge, irritability, problems concentrating, or restlessness. Other typical symptoms are racing thoughts, problems sleeping, changes in appetite, and having trouble concentrating on anything. It is also quite common to find yourself disassociating, which means it feels like you are experiencing what's going on around you from an outside perspective; you're watching it without feeling it. The disassociating can also make it feel like you are not connected to your body in some way.

What are the physical symptoms of anxiety?

There are many possible physical anxiety symptoms that can show up when we are feeling anxious. Some of the most common ones include dizziness, heart racing, trembling, fatigue, muscle aches, pins and needles, dry mouth, sweating, headaches, hot flashes, and shortness of breath. Other typical physical symptoms of anxiety can be muscle tension, chest pain, chills, feeling faint, a sense of numbness or tingling, or having an upsets stomach with diarrhoea or nausea as a result. It's important to try and figure out what the symptoms are in order to try and learn to manage the anxiety when it comes.

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How can I deal with anxiety?

You can deal with GAD through a mixture of psychological treatment – such as CBT cognitive behavioural therapy alongside medication. Exercise, meditation, avoiding coffee and alcohol, sleeping well, eating a healthy diet, and deep breathing are all natural ways you can deal with anxiety and panic attacks. It is also recommended to try and identify the triggers or a specific trauma that set off your anxiety, something that requires a lot of self-reflection and is not always easy. Some people find that yoga, meditation, spending time in nature, and journalling all contribute positively to managing anxiety and coping with it when it occurs.

Is anxiety an emotion or a disorder?

Most people would agree that feeling anxious is an emotive state which, if it becomes severe or starts to have a debilitating effect on normal behaviour, can become a more serious disorder in its own right. In other words, if you happen to feel anxious about something, then you should not immediately jump to the false conclusion that you have a mental health disorder. Worrying or even not being able to sleep because you are agitated about something is a normal part of life that everyone will suffer from occasionally. Indeed, you might even be considered to be emotionally abnormal to an extent if you never worried about anything at all. And yet, anxiety can grow beyond these normal everyday worries and concerns into something much more serious. Accepting worries and moving on from them will help you not to dwell on them to an excessive degree. In this regard, talking therapies and mindfulness techniques can help overcome concerns to not develop into something more serious.

Are anxiety attacks and panic attacks the same?

Although people often refer to anxiety attacks and panic attacks in the same breath, they are not the same, strictly speaking. However, this is very understandable because many of the same feelings and symptoms felt during panic attacks are also felt when anxious feelings start to break out. For example, dizziness, an upturn in your pulse rate and a sense of breathlessness, can be features of both sorts of attack. That said, panic attacks are characterised by other symptoms which are a result of getting stuck in the flight or fight response that most animals feel when threatened. In short, panic attacks will usually be associated with sweating, feeling cold, a sense of morbidity or fear, the clenching of fists and the tightening of stomach muscles. An attack that is more anxious in its nature than derived from fear will not feature so many symptoms because it is more of an emotive response than a physical one. That said, such attacks can be very unpleasant and serious if they occur regularly enough to interfere with daily life.

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Will anxiety go away?

The good news is that feeling anxious is not something that you should expect to have to put up with for the rest of your life. Indeed, being anxious about something or someone is perfectly normal and not, of itself, something to worry about. Usually, feelings surrounding everyday worries will simply dissipate over time. Something that might have made you lose sleep the night before will often go away if you face up to the concern the next day. Maybe you are worried you might have offended or upset someone? If so, face up to this concern by talking to them and apologising, where appropriate. What is harder to say is when longer-term anxious feelings will go away. This is when being worried cannot be pinned down to anything rational. As previously mentioned, certain talking therapies can help to alleviate such worries, as can using mindfulness meditation which tries to separate the individual from their emotions to an extent. When worries are ever-present, seeking professional help can be a positive way forward.

How does anxiety affect daily life?

There are plenty of ways that anxious states take their toll on everyday existence. One of the most common is the loss of sleep. Many people who are worried will also find it hard to drop off at night as their mind is constantly whirling, often focussing and refocussing on some specific issue that is causing concern. This will tend to cause tiredness and irritation the following day, which can, in some cases, also create more worries which then affect the next night's sleep. This is the cyclical nature of anxiety, so you need to break the chain somehow, perhaps by addressing the root cause of the worries or taking time out to relax more fully. Many people report that feeling anxious will make it harder to focus and, in some cases, create problems with recall. Prolonged periods of worry may also have a negative impact on self-esteem, something which, once again, can cause more worries to mount. Finally, some people who are concerned about something they cannot put their finger on will explore it through their subconscious in the form of dreams and even nightmares.

Will anxiety medication help?

As you can see, the build-up of worry that causes more concerns to mount is a vicious circle that tends to get worse before it gets better. To this end, breaking the cycle of anxious feelings is the best approach. Even one good night's sleep or a day spent achieving what you set out to can be a big help in breaking the cycle and starting to feel less anxious. In this regard, anxiety medication can help, but it should never be taken without professional guidance and never as a first resort. For example, it is often better to set aside some time each day for vigorous sports and physical activity. Not only will this release endorphins in your brain that can help to lessen anxiety, but it will help you to get to sleep naturally, feeling more refreshed and less worried in the morning. If this is supported by a talking therapy, such as cognitive behavioural therapy (CBT), then the effects can be even more pronounced, thereby avoiding the need for medication altogether.

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Which medical conditions are associated with anxiety?

Anxious feelings are not felt in a vacuum without a range of other emotions that go with them. Worries over a loved-one will often be mixed in with emotions such as affection, empathy and protectiveness, for example. Moreover, when you are talking about clinical anxiety, there are often associated medical conditions which will also be at play. For example, it has long been known that anxiety-depression is a state that many people who suffer from clinical depression will feel. That said, being anxious does not mean that you will necessarily be depressed. They are associated conditions but not the same thing. Medical professionals have also noted some correlation between anxious emotive states and other conditions, such as COPD and asthma, which negatively impact breathing. In certain cases, conditions that lead to sexual dysfunction will often be accompanied by excessive worrying, too. Furthermore, some conditions associated with brain degeneration - such as Parkinson's disease or geriatric dementia, for example – are also sometimes found to be linked to high levels of nervousness.

What is the difference between short and long-term anxiety?

Whether anxious feelings are present in the short or the long-term, they will often be associated with the same sorts of responses, such as fatigue, dizziness or disorientation, lack of breath and a racing heart rate. However, when this state is sustained for a long time, there can be further problems that will start to develop. Scientists have yet to produce conclusive results in their studies in this field, but a long-term feeling of worry and anxious behaviour may lead to a worsening in immune response. Another thing that is indicative of longer-term states of nervous-anxiety includes susceptibility to migraines and even the increased risk of heart disease. Some studies also suggest that there may be a link to certain gastrointestinal problems. As previously mentioned, feeling anxious is a normal part of life, and it will often go away without causing further worries. Only when it is present for prolonged periods might it lead to these other outcomes, which is why professional medical help should be sought.

How does anxiety affect relationships?

Although very supportive relationships can cope with a degree of worry from either partner, there can be little doubt that it places most romantic relationships under strain. One of the problems associated with anxious behaviour is that it tends to be self-focussed to some degree or other. In turn, this can mean that someone who is worried is more centred on their concerns than that of their partner, which makes sharing and caring within a relationship that much more of a challenge. Understanding that your partner is not being selfish but is suffering from anxious emotions is a key part of getting through such difficult times. Supporting by talking about worries and shifting the focus onto more pleasant of life-affirming things can be a big help in this regard. It can also be the case that worrying about something will lead to indecision. This is normal human behaviour that can seem like a lack of commitment in the setting of relationship. Not being able to commit to something may come from a deeply held concern that has nothing to do with the partner concerned. Nevertheless, it is not always easy to see it that way if you are in a relationship with someone who is anxious a lot of the time.

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Anxiety in summary

Being anxious about something is perfectly normal when you consider that it is an emotive state that is designed to keep us alive. From the earliest days of humankind, people have rightly shown caution about things they don't know about or understand fully in case it might do them harm. Of course, as people now understand the world much better than they ever did before, so it can seem as though there is very little to worry about any more. And yet, even though our understanding of the world around has improved, our control over our deep emotional states have not been able to keep track. In other words, we still feel worried about things whether they are the sort of thing we should be rationally concerned about or not.

In this sense, anxiety is something that we all have to accept as one of the many emotions we will feel as we go through life. It is not something that should concern us too much. However, being anxious about things excessively, especially when a cycle of worrying starts to develop, can be a big problem that needs to be overcome. If anxious behaviour is left unchecked, then it can become a habit which leads to negative mental states and could, in the worst cases, also lead to unwanted physical conditions being more likely to develop.

When anxious emotions are a part of a mental health disorder, such as clinical depression or PTSD, they can also feel much more acute than they otherwise would. It is always helpful to try and keep concerns and worries in perspective and realise that we cannot control every situation so that we can lead worry-free lives. Talking about concerns – real or perceived – with trusted friends or even a trained counsellor will often help alleviate the worst of these emotions and break the cycles of negative thoughts that add to them.

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