What is Anxiety?
Anxiety is an emotion, characterised by feelings of tension, worried thoughts and physical sensations, such as a racing heart. It is our body’s natural response to stress – known as the fight-flight-freeze response – designed to protect us from danger and react more quickly in emergencies. It is a normal and often healthy emotion, necessary for our survival.
Most of us experience anxiety at times in life, for example if we are starting a new job, moving house or giving an important work presentation. At times like these it is perfectly normal to feel anxious and can even be beneficial, raising our performance levels.
Unfortunately, our bodies are not able to distinguish between a very real and present danger and an imagined or anticipated danger in the future. If the brain believes we have sensed danger (real or imagined), it will automatically set off alarms in the body, triggering the fight-flight-freeze response – and we will feel anxious.
For some people, this response can be heightened and constant, with unpleasant physical symptoms, and be difficult to control. The anxiety can become chronic and irrational and starts to interfere with daily functioning. The mental, physical and emotional symptoms may be so intense that they cause work, family and social difficulties. At this point, a person is suffering from an anxiety disorder.
Anxiety is the main symptom for several disorders, including:
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
- Obsessive compulsive disorder (OCD).
Anxiety disorders alter how we process emotions, with the duration or severity of anxious feelings being out of proportion to the stressor. These days, anxiety disorders tend to revolve around finances, work, family, health or other issues that constantly demand our attention, but do not require the fight-flight-freeze reaction.
Anxiety disorders generally develop out of a combination of biological and psychological factors, activated by (real or imagined) stressful or traumatic events or situations.
What are the Different Types of Anxiety Disorder?
Anxiety is a normal reaction to stress – for example, before a job interview, having a medical procedure or travelling on a plane – where we naturally feel nervous or anxious.
However, when these feelings involve excessive fear or anxiety, are ongoing and persistent, and interfere with our daily life, then we have an anxiety disorder.
The most common types of anxiety disorder include:
A phobia is an extreme fear or anxiety triggered by a particular object, place, situation, activity or animal. We may know our fear is excessive and irrational, but we cannot control or contain it. Common phobias include:
- animals, such as spiders, snakes or rodents
- natural environmental, such as heights, water or germs
- situational, such as going to the dentist, flying or escalators
- body, such as blood, being sick or injections
- sexual, such as sexual acts, fear of nudity or performance anxiety.
With panic disorder we will regularly have panic attacks but without an obvious cause or trigger. The panic attacks can happen suddenly, and feel intense and frightening. This can be a vicious circle as we start to worry about having another panic attack, creating more anxiety. It is common to dissociate during a panic attack. During an attack, several of these symptoms occur in combination:
- chest pain or a sensation that our heart is racing or beating irregularly
- feeling that we might be dying or having a heart attack
- sweating, hot or cold flushes and shivering
- a dry mouth
- shortness of breath or choking sensation
- abdominal pains or nausea
- dizziness or feeling faint
- an overwhelming sense of dread or fear
- numbness or a tingling sensations.
Panic attacks often occur with other mental health disorders, such as depression or PTSD.
Generalised anxiety disorder (GAD)
This is a common, long-term condition that causes persistent and excessive worry about a wide range of different activities and events in our daily lives. As soon as one anxious thought is resolved, another will appear about a different issue. We have no control over these thoughts and they begin to negatively affect our daily life, interfering with work, travel, relationships and other daily functions. We will have ongoing physical symptoms, such as muscle tension, fatigue and problems sleeping. It is common to have other conditions alongside GAD, including other anxiety disorders and depression.
Social anxiety disorder
Also known as social phobia, social anxiety disorder is when we have intense feelings of fear and dread about social situations or public performance. We worry about being embarrassed, rejected, humiliated or ridiculed in social interactions. The feelings can arise before, during or after the event and last for up to six months. We will try to avoid certain situations, for example:
- meeting new people
- speaking in public, or in front of groups of people
- attending parties
- eating or drinking in public.
With social anxiety disorder even though we are often aware that our fears are excessive and unfounded, we still find it impossible to control them.
Post-traumatic stress disorder (PTSD)
If our anxiety symptoms were caused by experiencing or witnessing a traumatic event (such as an car accident, natural disaster or violent attack) we may be diagnosed with PTSD. The symptoms can last for months or years after the event and include flashbacks or nightmares where we relive the fear and anxiety we experienced during the actual event. Symptoms of PTSD fall into four categories:
- intrusive thoughts
- avoiding reminders
- negative thoughts and feelings
- arousal and reactive symptoms.
Obsessive compulsive disorder (OCD)
With OCD our anxiety issues are caused by recurring thoughts, ideas or sensations (obsessions) that drive us to do something repetitively (compulsions). This can include hand washing, cleaning and repeatedly checking on things – and can significantly interfere with our daily activities and social interactions. For people with OCD, thoughts are persistent and unwanted, and not completing compulsive routines / behaviours causes great distress. Related conditions, sharing some features of OCD include:
- body dismorphic disorder
- hoarding disorder
It is very common to have any type of anxiety disorder alongside other mental health issues, such as depression and substance-use disorders. The most effective treatment for those with co-occurring conditions is a dual-diagnosis treatment programme.
What are the Causes of Anxiety Disorders?
The causes of anxiety disorders are still not fully understood, but it is becoming clear that many of these disorders are caused by a combination of factors, including biology, psychology and environmental stressors.
- Life experience
- Substance use
Studies have shown that anxiety disorders run in families, which means they can be inherited from one or both parents. This doesn’t mean we will automatically develop anxiety, but we may have a genetic predisposition towards it.
Anxiety may be linked to underlying health issues for some people, for example heart disease, diabetes, thyroid problems and asthma. Anxiety might also be activated by chemical imbalances in the body, for example as a result of prescription medications, or drug or alcohol misuse.
Traumatic or significant events – such as being bullied, abused or losing a loved one – appear to trigger anxiety disorders in people who already have an inherited susceptibility to anxiety.
Drug or alcohol misuse or withdrawal are known to cause or aggravate anxiety conditions.
Sometimes it is obvious what is causing our anxiety, for example stress at work, moving house or relationship problems. When the problem is resolved our anxiety usually goes away. However, studies have shown that severe or prolonged stress can actually change the balance of chemicals in the brain that control mood. This can contribute to anxiety disorders developing.
It’s important to remember that while we might not be able to identify the specific cause of our anxiety, or change difficult circumstances, we can learn to recognise the signs and symptoms and seek the help and support we need.
What are the Common Symptoms of Anxiety Disorders?
Everyone experiences some symptoms from anxiety, but they tend to be limited in time, and connected to a specific event or situation. The signs and symptoms are short-lived and dissipate quickly after the event or situation is over.
However, for those with an anxiety disorder, these symptoms are more frequent and persistent – and not always connected to anything specific. This can cause distress in a person’s life, to the point that it impacts negatively on their quality of life and day-to-day functioning.
Signs and symptoms will vary depending on the specific type of anxiety disorder, and its severity, but there are some common symptoms across all types, including:
This is how we experience anxiety in our bodies, caused by the physical changes that automatically occur during our evolved fight-flight-freeze response:
- racing or irregular heartbeat / racing pulse
- stomach ache / nausea and / or diarrhea
- sweating / hot and cold flushes
- panic attacks
- faster, heavier breathing / shortness of breath
- muscle tension – causing headaches, back ache, other aches and pains
- light-headed / dizziness / fainting
- feeling extreme fatigue / exhaustion
- changes in patterns of sleeping and eating
- panic attacks.
Prolonged physical symptoms of anxiety can often be mistaken for other medical conditions, such as heart attack or multiple sclerosis (MS).
It is quite common to have thoughts racing through our minds when we feel anxious – commonly referred to as worry. These can often be due to an inaccurate appraisal of an event or situation, where we are overestimating the level of threat and underestimating our ability to cope with it. Symptoms include:
- difficulty concentrating or staying on task
- memory difficulties
- obsessive / uncontrollable over-thinking
- catastrophising / anticipating the worst possible outcomes
- underestimating our ability to cope if something ‘bad’ does happen
- worrying that our anxiety will be obvious to others – fear of being judged
- loss of confidence
- depressive thoughts.
In its most basic form, anxiety is an emotion. It obviously feels like anxiety, but people who are anxious commonly feel a range of other emotions too, including:
- fear or apprehension
- excessive worrying
- feeling overwhelmed
- feeling uneasy, jumpy or on edge.
Many people find these emotional aspects of anxiety the most distressing, even though they often cause the least disruption to our daily functioning.
Our attempts to cope with the unpleasant physical, mental and emotional aspects of anxiety, can result in maladaptive behaviours including:
- avoidance behaviours, such as avoiding situations, people or places that make us feel anxious – or that we fear will trigger anxiety
- safety behaviours, such as becoming overly attached to a safety object (e.g. mobile phone) or person
- increasing inability to fully meet responsibilities at home, work or in the community – or overcompensating for anxiety by working extra hard in these areas
- limiting our daily activities, to reduce the overall level of anxiety – for example, staying at home to feel safer
- over-checking and under-checking, for example, if we are anxious about our weight
- reassurance-seeking behaviours, which can have relationship implications
- unhealthy, risky or self-destructive behaviours, such as using alcohol or drugs to self-medicate the symptoms.
Unfortunately, these coping strategies often make the anxiety worse and only serve to maintain the anxiety disorder.
Can Anxiety Disorders be Treated?
Treating an anxiety disorder usually combines different types of therapy, medication, and lifestyle adjustments. Treatment will be different for each person depending on the type of anxiety disorder they have and the presence of any other, underlying conditions.
Therapies, including Cognitive Behaviour Therapy (CBT), can be helpful as they support us in exploring and adjusting the way we react to stressful life events and triggers, as well as the scale of our responses. They can also help to limit distorted thinking, replace negative thoughts and teach us healthy coping skills.
Medications can also be used to support treatment, including anti-depressants, beta-blockers, and benzodiazepines.
It's important to remember that recovery is a journey, and will take time and persistence. It is helpful to concentrate on learning more about ourselves and developing positive ways to cope, rather than focusing on getting rid of every symptom of our anxiety problem.
Anxiety Disorder Treatment at White River Manor
At White River Manor we provide a holistic treatment programme for anxiety disorders, which is shaped around your personal preferences and therapeutic needs and addresses any co-occurring conditions.
Using a combination of traditional methods, ancient philosophy and cutting-edge science, the team at White River Manor treats the whole person and not just the anxiety disorder, ensuring deep transformational healing and a full recovery.
We understand that recovery is a lifelong pursuit of positive habit building, maintaining mental wellbeing and avoiding triggers, which is why we also include a complete aftercare plan to support you following treatment.
We will be there to guide and support you, and your loved ones, throughout the whole recovery process.