Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

6 min read

It’s completely normal to feel anxious now and again – most of us have experienced that sensation of feeling uptight, scared, and worried now and again. In fact, as many as 3 in 5 people have at least mild symptoms of anxiety.

In some situations, anxiety can help protect us. For instance, the natural ‘fight or flight’ response, where your body is flooded with adrenaline, can allow you to run faster from immediate danger or can prompt you to get yourself out of a risky situation. But for some people, anxiety is constant and isn’t triggered by obvious stress – which means it can have a huge impact on every aspect of life.

What is an anxiety disorder?

If you feel anxious so often that it interferes with your normal everyday activities, you’re likely to have an anxiety disorder. This could be because you feel anxious about minor issues others would cope with fine, or you can’t stop feeling anxious when a source of stress has gone, or you feel repeatedly anxious for no obvious reason.

It’s estimated that over 8 million people in the UK are struggling with an anxiety disorder at any one time – making it the commonest mental health problem.

Rock Tower

What causes anxiety disorders?

Anxiety disorders have a wide variety of causes which are different for everyone. Often multiple factors, often in early life, make you more prone to anxiety. Major stresses and traumas in early life can have a major impact. Later in life, one or more stresses (related to home, work, money, bereavement and more) can trigger an anxiety disorder.

What types of anxiety disorder are there?

There are many types of anxiety disorders. While they all involve feeling anxious (to the extent that it interferes with your life), they have different triggers and affect people in different ways.

  • Generalised anxiety disorder or GAD is the most common anxiety disorder. The clue is in the name – you worry about everything. If your partner is out, you may fret that they’ve had an accident; if you go out to the shops, you may be convinced your home is being burgled; if a friend doesn’t return your call immediately, you may fear you’ve done something to offend them. Going on holiday is usually an excellent form of relaxation, but if you have GAD your time may be ruined by worry about delayed flights, food poisoning, and freak accidents.

In short, GAD affects every aspect of your life, meaning you often find it hard to get to sleep, feel irritable or on edge all the time, get muscle aches or headaches from tension and find it hard to concentrate.

  • Panic attacks are severe episodes of anxiety often accompanied by psychical symptoms – palpitations, choking sensation, shortness of breath, pins and needs, dry mouth, sweatiness, and uncontrollable trembling. If you have repeated panic attacks, it’s called panic disorder. Panic attacks may start with a single major stress, but often come on for no obvious reason.
  • Phobias are a specific type of anxiety disorder, which centre around a single cause. You may be terrified of snakes, injections, dentists, or confined spaces (claustrophobia). Agoraphobia is a fear of being in spaces where you can’t escape – often public spaces.
  • Social anxiety disorder is about anxiety triggered by what others think of you. It can make social interactions a nightmare and often leads to you avoiding social interaction. Unfortunately, social isolation is a frequent trigger for depression and can lead to a vicious cycle. It’s sometimes called social phobia because it involves the terror of a particular circumstance.
Clear waters

What help is available for anxiety disorder?

Talking therapy, including CBT (cognitive behavioural therapy), is the mainstay of treatment for most types of anxiety disorders. It aims to help you recognise that how you’re feeling can trigger a train of unhelpful thoughts. Once you recognise this, you can challenge these negative thoughts and replace them with more realistic ones.

Behavioural therapy is a type of talking therapy which specifically aims to change behaviours caused by, or driving, your anxiety disorder. If you have a phobia, it may involve being exposed very gradually to whatever you’re scared of in a safe setting. If you’re scared of spiders, your therapist might start by showing you just a picture of a very small, harmless spider. They give you techniques – relaxation exercises, deep breathing, distraction etc - to help you cope with your anxiety.

Can I get help on the NHS?

You can access talking therapy on the NHS in England without a referral from your doctor. Search the NHS website for ‘find a talking therapies service’, which will let you see what’s available in your area.

If your symptoms are severe, your GP may recommend medication. Possible treatments include:

  • Antidepressants (some of which have been found to help with anxiety disorders as well as depression)
  • Benzodiazepines to reduce anxiety – however, these carry a high risk of addiction and side effects, so are rarely prescribed today.
  • Buspirone for GAD.
  • Beta blockers to treat the physical symptoms of panic attack.

However, it is important to remember that medication is not a substitute for talking therapy, which can offer a long-term solution to your symptoms.

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