Anxiety disorders, symptoms and treatments

Anxiety is the feeling of worry, fear or panic. It can be caused by a past or upcoming event or the thought of something going wrong. You may feel anxiety when you take an exam, start a new job or if you are in debt. When the situation has passed or been resolved, you may go back to feeling calm and at ease. This is a normal response to a stressful situation. However, if you are experiencing anxiety for an extended period of time, or for no reason in particular, this may be a sign of something more, such as generalised anxiety disorder.

An anxiety disorder, like generalised anxiety disorder, occurs when the feelings of anxiety, fear and worry are excessive and exaggerated. An anxiety disorder can cause you to have racing thoughts and can be brought on in circumstances where no real threat is present. Anxiety disorder is a broad term to cover all types of anxiety.

Social anxiety disorder, also referred to as social phobia, is a type of anxiety disorder that affects people in social situations. You can tell if you are struggling with social anxiety disorder if you regularly experience a feeling of intense fear, worry and unease in situations where you have to interact and communicate with people. You may be constantly overthinking and feeling worried about what other people think of you and fear being rejected, judged or evaluated negatively. Or you may just find social interaction makes you feel anxious without knowing why.

If you are experiencing regular panic attacks with no definite trigger, you may have panic disorder. Panic disorder is characterised by recurrent panic attacks that can occur out of the blue or in a stressful situation. During a panic attack, you may experience symptoms such as an overwhelming sense of dread, excessive sweating, shortness of breath, choking, rapid heart rate, trembling, numbness, nausea and chest pain. It is also common for people with panic disorder to continuously worry about experiencing panic attacks.

You may have heard the term PTSD. PTSD, also known as post-traumatic stress disorder, is an anxiety disorder that can affect anyone who has experienced a traumatic situation. Individuals with PTSD experience increased levels of anxiety following exposure to a terrifying event such as a car crash, house fire, personal assault or any event perceived to be stressful. If you have PTSD you may feel anxiety about the event months or years after it has passed.

Many people have phobias. A phobia is a form of anxiety disorder characterised by an intense or overwhelming fear of a specific thing. It may be an object, place, situation, animal or feeling. This feeling of fear can be disproportionate to the trigger.

People can live with phobias and not experience exposure to their trigger. However, phobias can affect the quality of life for some people, especially if they have multiple phobias. Common phobias include:

Obsessive-compulsive disorder, also known as OCD, is an anxiety disorder that causes an individual to have obsessive thoughts and may engage in compulsive behaviours. If you notice unpleasant or unwanted thoughts repeatedly popping into your mind, you may have OCD. OCD can also cause you to compulsively perform actions repeatedly and feel fear or intense worry if you are unable to carry out this repetitive behaviour. OCD can develop at any age but most commonly arises during early adulthood.

BDD or body dysmorphic disorder is an anxiety disorder that causes you to uncontrollably worry about your appearance. People who experience BDD tend to obsessively worry and focus on what they perceive to be flaws in their body image. They may also engage in compulsive behaviours and routines to curb their worries about their body image. BDD is a serious disorder and can drastically affect the way you live your life. In extreme cases, BDD can lead to eating disorders and self-harm.

This table uses everyday life examples to distinguish between anxiety and an anxiety disorder:

When stress and anxiety occur at the same time for a long period of time, it can lead to adverse effects on both the body and the mind. Although stress and generalised anxiety disorder share a few symptoms and can occur simultaneously, they have a few differences. See the chart below to understand these differences:

The feeling of anxiety is a symptom of different anxiety disorders. Other anxiety disorders include:

Generalised anxiety disorder can affect the way we think and perceive situations. This can affect the way we feel and behave. Signs of generalised anxiety disorder include:

Generalised anxiety disorder is a mental issue and can affect the way you think and perceive situations. It can manifest in physical symptoms such as:

If you suffer from GAD or other anxiety disorders, you may experience anxiety attacks. An anxiety attack can be triggered by a specific event or issue. When this trigger occurs, you may feel fearful and worried. This can cause physical symptoms such as a rapid heart rate, restlessness and a churning sensation in your stomach. An anxiety attack is less severe than a panic attack.

Panic attacks and anxiety attacks share a lot of symptoms, however, during a panic attack, physical symptoms are more intense and can be accompanied by a fear of dying or a sense of detachment from the world (derealisation) or oneself (depersonalisation). An anxiety attack would usually pass once the stressor has been removed whereas a panic attack would usually not be in reaction to a particular stress.

This table shows how emotional symptoms differ between an anxiety attack and a panic attack:

Physical symptoms of a panic attack and anxiety attack include:

Some people may have a genetic predisposition to generalised anxiety disorder. If you have a close family member with GAD, you are more likely to develop it as well. Often, GAD is triggered by both environmental triggers and genetic markers.

Your brain chemistry may be the cause of your generalised anxiety disorder.

The amygdala is the part of the brain that initiates a quick response to danger. When the amygdala is overly sensitive, it can react to situations that aren’t threatening. This can cause an imbalance of brain chemicals like serotonin and noradrenaline. An overly sensitive amygdala can cause anxiety over time because the brain associates fear with situations that are safe.

The way you have been brought up and the experiences you have gone through can contribute to the development of generalised anxiety disorder. Critical or traumatic life experiences such as domestic violence and child abuse can cause a hyperactive anxiety reaction. Your experiences may also cause you to pick up certain behavioural patterns like the inability to handle stressful situations.

People who have a shy personality may be more likely to develop generalised anxiety disorder. Individuals who are often negative and those who tend to be cautious are also more likely to develop GAD.

Factors that may increase your risk of developing generalised anxiety disorder include:

Your GP will be able to diagnose generalised anxiety disorder. To do so, your GP:

Generalised anxiety disorder can be treated in different ways. You can discuss with your GP which method of treatment is right for you. Some treatments include:

You should seek help from a healthcare professional if you notice you have been experiencing symptoms of generalised anxiety disorder over the course of several months.

You should also seek help if you feel your anxiety is preventing you from performing essential daily activities, is causing you to have panic attacks, or is affecting your day to day life.

Cognitive behavioural therapy or CBT is a form of psychotherapy that can be used to treat depression and anxiety disorders such as generalised anxiety disorder.

CBT is the most commonly used therapy for anxiety disorders. It aims to understand the relationship between our thoughts, feelings and behaviours.

CBT is typically carried out with a Psychologist, a High Intensity CBT Therapist or Psychological Wellbeing Practitioner in a clinical setting.

CBT identifies and challenges negative thought patterns and helps you to develop skills to manage symptoms as well as finding new ways to reach realistic and balanced thoughts.

Here’s some tips for managing your anxiety:

Exercise has been shown to reduce symptoms of anxiety. Exercising for 30 minutes, 5 times a week can help you relax and worry less by decreasing your stress hormones. Some exercises that can help ease your anxiety symptoms include:

Smoking can heighten your fight-or-flight response and research has shown that it may increase the risk of anxiety disorders. To reduce your cortisol levels and fight your anxiety, it is a good idea to quit smoking. It may take some time to entirely quit smoking but here are some tips on how to start:

Reduce alcohol intake. You may feel relief from anxiety after having a glass or two of wine but the after-effects can increase symptoms of anxiety. Here are some tips on how to cut down your alcohol intake:

It is a good idea to reduce the amount of coffee and tea you drink regularly. Research has shown a link between caffeine and anxiety disorders. Reducing your intake can ease your symptoms. Try swapping your morning cup of coffee with an herbal tea, decaffeinated drink or hot chocolate.

Meditation has been shown to reduce stress and anxiety levels by calming your mind and allowing you to be more present. There are many apps and podcasts available to teach you relaxation techniques to apply to your everyday life when triggers appear. They can also take you on guided meditations if you’re unsure of how to start.

Eating a healthy balanced diet promotes anxiety relief. Staying healthy and hydrated will alleviate some symptoms of anxiety because artificial foods can cause mood changes and affect blood sugar levels.

You should aim to eat more vegetables, fruits, grains, wholefoods and lean meats. Some foods to incorporate into your diet to ease anxiety include:

A study in the Journal of Clinical Psychopharmacology found that chamomile tea is great for calming nerves and helps to reduce symptoms of anxiety. You can switch out your morning cup of coffee with some chamomile tea.

Passionflower is a herb that can help with generalised anxiety disorder. It is a sedative that can effectively reduce symptoms of anxiety but can also cause drowsiness. You can create a passionflower herbal tea by adding dried passionflower to boiling water. You can also get passionflower capsules and liquid extracts.

Unlike adults who may realise that their behaviour or anxious thoughts are irrational, children may not have this self-awareness. There are some signs you can look out for in your child to see if they might have generalised anxiety disorder:

If you are concerned that your child may have generalised anxiety disorder, it is worth taking them to a GP to get an accurate diagnosis.

Your GP may want to refer your child to a specialist such as a counsellor or therapist. Appropriate medication can also be prescribed by doctors specialised in child mental health.

A diagnosis can be made if one or more GAD symptoms appear on more days than they don’t and if you have noticed these symptoms for at least 6 months. Your GP will ask questions about your child’s history, habits and symptoms to give an accurate diagnosis.

There are some risk factors that can affect whether your child is more likely to develop generalised anxiety disorder, such as:

Treatment for generalised anxiety disorder in kids can be either psychotherapeutic or pharmacological.

Psychotherapeutic treatment can include:

Pharmacological treatment can include:

General anxiety disorder (GAD) can lead to higher cortisol levels. Cortisol is the body’s main stress hormone and can cause depressive symptoms. The increase of cortisol and reduction of serotonin (the “feel-good” hormone) can significantly influence mood and lead to depression. In this way, people with GAD are more likely to have depression or develop depression.

GAD symptoms can leave you feeling helpless, which can contribute to the development of depression. Depression is a mental illness that can leave you with a recurring low mood and sadness, a feeling of hopelessness and helplessness, reduced motivation, low self-esteem and even suicidal thoughts. Some physical symptoms include low energy levels, a reduced sex drive and significant changes in appetite and weight.

You are more at risk of developing GAD due to a history of substance abuse. Similarly, GAD can lead to substance abuse. People with GAD can often feel overwhelmed by their symptoms and turn to substances like alcohol or drugs for relief.

When this happens, an addiction and dependency can form. When drug abuse occurs over a long period of time, this can cause changes to the brain chemistry and can lead to more severe symptoms of GAD.

Generalised anxiety disorder can have an adverse effect on your body. GAD can cause increased levels of stress. Your immune system can be weakened by regular exposure to stress, making you more susceptible to bacterial diseases and viral infections like the flu.

Chronic anxiety can lead to diseases such as heart disease, high blood pressure and diabetes. Extreme cases of GAD can also cause hair loss. This is because stress can initiate Telogen effluvium – a condition where hair follicles go into a resting state and don’t produce new hair strands.

If GAD is left untreated, the symptoms can become overwhelming. This can lead to a feeling of loneliness and isolation when you feel you cannot communicate the symptoms you are experiencing with others.

It may lead you to be fearful or worried about what other people may think of your condition so you retreat from interacting with others. You may also experience excessive amounts of worry about engaging in different activities such as travel and going to events. This can stop you from leaving your house and leads to social isolation.

Fear of flying, otherwise known as flight phobia and aerophobia, is an excessive worry about travelling in an aeroplane. While plane crashes are rare occurrences, they are often widely reported on.

The graphic images accompanied by such coverage is enough to put off many people from getting on an aeroplane. However, this is considered an irrational fear because statistics suggest you are more likely to die in a car crash than a plane crash.

Symptoms of flight phobia include:

A GP will be able to make a formal diagnosis on whether you have a fear of flying and the treatment options available for you. According to Anxiety UK, those affected by flight phobia are likely to have:

Fear of flying is a common symptom of generalised anxiety disorder and simple phobia. While some people are terrified of the plane crashing, others struggle to cope with being in an enclosed space without an escape.

There are a lot of potential causes for having a fear of flying. Some people are afraid of flying because they have never flown before, whereas others have had a negative experience related to flying in the past.

This could be experiencing turbulence during a flight, reading about a recent plane crash in the news or feeling uncomfortable in an enclosed space. Often people have a flying phobia without any specific bad experience or trigger.

If you want to know how to get over fear of flying, there are different treatments available depending on the severity and type of your flight phobia.

Learning the facts If you’re a nervous flyer, understanding how a plane works and the true risks of flying might calm your nerves. Flying statistics suggest that travelling by plane is considerably safer than travelling by car.

Breathing exercises You can try various breathing exercises to calm your nerves while flying.

Personal strategies Personal strategies such as wearing headphones or choosing an aisle seat help many cope with anxiety during a flight.

Fear of flying medication There are medications available to alleviate anxiety from flying.

The best way to deal with fear of flying varies from person to person. Many like to adopt personal coping strategies such as wearing headphones, sitting next to a window or completing a crossword puzzle, whereas others prefer to take medication to calm their nerves. Those with a more extreme fear of flying might need to attend cognitive behavioural therapy (CBT).

Whether or not you need to take drugs to calm your fear of flying depends on the severity and type of your flight phobia. Your doctor will be able to diagnose you and prescribe medication as needed to help you have a comfortable trip.

There are different tablets for fear of flying that you can take. Diazepam (Valium) and Alprazolam (Xanax) are the anti-anxiety medications most commonly prescribed to treat fear of flying.

Medications can have varying effects on different people so there is no definitive drug to treat fear of flying. Your doctor will be able to prescribe you medication that suits your needs.

You can get over a fear of flying by exposing yourself to flights while keeping your anxiety under control. Over time, it is likely that you will be able to experience flying without feeling anxious.

There are a number of charities in the UK that provide advice and support to people with anxiety disorders:

There are apps and mobile games specially designed to relieve anxiety, whether it be through colour, puzzles or guided meditation:

Meditation – The Nothing Technique

Maria Munir is a London based Chartered Counselling Psychologist accredited by the British Psychological Society and The Health and Care Professions Council. Maria has over 15 years of experience working in the NHS as well as the private sector. She has trained in Humanistic, Psychodynamic as well as Cognitive Behavioural Therapies and has been working within Primary Care NHS services for the past 10 years.

She is currently working as a Senior CBT Therapist and Clinical Supervisor and has extensive experience of practicing CBT with clients presenting with mild to moderate and severe depression and anxiety disorders. Maria also uses Eye Movement Desensitisation and Reprocessing for clients with PTSD as well as third wave CBT approaches such Mindfulness and ACT.

Dr Abby Hyams grew up in Manchester and did her medical training in Bristol. She has been a GP for over ten years, many of them as a partner in an NHS practice in Hemel Hempstead. Dr Hyams loves being a GP because the wide spectrum of people she encounters every day.

Ri Adel is an accomplished Senior Clinical Prescribing Pharmacist with advanced assessment skills. She has had 14 years of experience in both hospital and primary care before focusing on mental health. Her primary care experience relates to medicines optimisation of chronic diseases such as asthma, COPD, diabetes, AF, CHD, HT, and epilepsy.

At Medicspot, Ms Adel plays an integral role in clinical governance and ensuring high levels of professionalism. She also has considerable experience within the NHS 111 emergency service and developing previous training material in primary care, including the mental health field.

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medicspot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.