Anxiety

Do you feel irritable and nervous or find it difficult to sleep?
Do you avoid certain situations for fear of panicking, or do you have an irrational fear of animals?
These are symptoms of an anxiety disorder. This self help page may help you understand anxiety and how you can overcome it.

Why do we get anxiety?
In the natural world, a physical response to a frightening situation releases adrenaline, which prepares your body for action - the so-called 'fight or flight' response. While this helped our ancestors escape or fight their aggressors, in our modern lives a physical response is rarely necessary and the bodily changes produced are unpleasant.

Who gets anxiety?
We can all suffer stress in certain situations, such as the death of a loved one, divorce or overwork. But some people have an anxious personality and can develop anxiety for no obvious reason.

What are the symptoms of anxiety?
Physical symptoms of anxiety include:

Finding it difficult to breathe
A tight chest
Shaking
Palpitations
A dry mouth
Blurred vision
Feeling sick
Loose bowels
Urinating frequently
Muscle tension
Extreme tiredness
Hot and cold flushes

Psychological symptoms include fear and worry about a situation, or your physical response to a situation. Sufferers commonly feel: 'I'm losing control', 'I'm having a heart attack', or 'I can't cope'. These thoughts make the physical symptoms worse, creating a vicious circle resulting in states of panic. You may want to avoid all situations that make you nervous, which will seriously affect your lifestyle - even leading to a dependence on alcohol or drugs.

What are the different types of anxiety?
Generalised anxiety disorder (GAD) is an extreme form of worry with no apparent cause. GAD sufferers find it hard to relax and sleep, and suffer many physical symptoms.

People with panic disorders have feelings of terror that strike suddenly and repeatedly with no warning. They suffer from a pounding heart, chest pain or shortness of breath, and can even feel that they're suffocating or dying. They may avoid everyday activities such as shopping, driving or, in extreme cases, leaving the house (a condition known as agoraphobia).

Phobic anxiety is a fear of particular situations or objects leading to you avoiding them, which affects 10% of the population. Common phobias are spiders, dogs, heights and injuries involving blood.

Social phobia is an extreme form of shyness where a person's fear of being judged by others leads to them blushing or being sick.

What can I do to avoid anxiety?
There are a number of things that can help you avoid anxiety.

Avoid rushing, trying to do too much, or being too competitive
Allow time for relaxation, hobbies and having fun
Get enough sleep and take regular exercise
Avoid smoking
Limit your intake of caffeine-based drinks and alcohol
Avoid cannabis and other illegal drugs
Make a 'problem list' and try and tackle the things on it one by one, rather than allowing yourself to be overwhelmed
Ask yourself, 'What's the worst thing that can happen? Is it so bad really?'

Relaxation or yoga classes may be helpful, as can anxiety-management groups where you'll meet other sufferers, learn more about anxiety and how to overcome it.

How is anxiety treated?
Contacting your GP is often the easiest way to get help and further treatment. He or she may offer you counselling or refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment.

If you're worried about talking to your GP, consider writing down your concerns and questions, or take a friend or family member with you.

The type of professional support offered will depend upon the services that are available in your area and the arrangements that your primary care trust (PCT) have with other health authorities or private providers. Treatment for stress and anxiety is also available privately through Priory.

When is medication prescribed?
Medication is useful in cases of severe anxiety, panic disorder and depression. The most useful drugs are SSRI anti-depressants - these are non-addictive and only work after several weeks. It is important to take a full course of treatment, which will be nine months or more. Betablockers, such as Proprandol, will reduce the physical symptoms of anxiety. This can be useful in specific situations, like helping someone perform or speak in public. They are also used in longer-term treatment.

For the short-term relief of anxiety, anxiolytics such as diazepamcan be useful, but these are addictive and aren't recommended for long-term use.

What therapy is used to treat anxiety disorders?
Phobias can be treated with behavioural treatments such as exposure, where a person is reintroduced to an object or situation they are afraid of, in carefully graded stages.

With GAD and panic disorder, cognitive behaviour therapy (CBT) is recommended. It looks at thought patterns involved in anxiety, identifies when they've become distorted, then challenges you to think of new ways of looking at your situation.

Psychological therapy is normally offered to outpatients, and usually involves one to two sessions each week for about six to eight weeks.

Self help
Recommended reading
'Overcoming panic' by Derrick Silove (Robinson)
'Overcoming social anxiety' by Gillian Butler (Robinson)
'Overcoming anxiety' by Helen Kennerley (Robinson)

Click here for a free self help leaflet

Finding help
If you feel that you or a close relative are affected by anxiety and would like help or more information, you can ask your GP or contact any of the following organisations:

Triumph over Phobia
0845 600 9601 (www.triumphoverphobia.com)

The Anxiety and Panic Internet Resource
(www.algy.com/anxiety)

Depression Alliance
0845 123 23 20 (www.depressionalliance.org)

NHS Direct
0845 4647 (www.nhsdirect.nhs.uk)

The Samaritans
08457 909090 (www.samaritans.co.uk)

Priory
0845 2 774 679 (www.priorygroup.com)

If you are interested in receiving treatment from us, your GP will be able to refer you.

If you or your relative have private medical insurance, your insurer will probably insist that your GP refers you to us.

Why should I choose Priory?
Our service
At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.

Expertise and innovation
Through our close links with the public and private sectors, we've developed the expertise and innovation to offer consistent and successful treatment. And, as Europe's leading independent provider of specialist mental health, neuro-rehabilitation and special education services, we bring experience and an excellent reputation.

We admit patients 24 hours a day, seven days a week.

Please click here to view a list of the Priory hospitals that can help with anxiety.

This document has been edited by
Dr Paul Dedman MB BCh FRCPsych MRCGP, with the help of The Depression Alliance (www.depressionalliance.org) and Plain English Campaign (www.plainenglish.co.uk)

For more information please download our self-help leaflet by clicking here.