What is Anxiety?

Anxiety is a common, normal human response to stress or perceived threats. However, when anxiety is persistent, overwhelming, or otherwise disruptive in one’s daily life, this can be a sign of an anxiety disorder, wherein anxiety becomes uncontrollable and negatively affects quality of life.

There are a few key defining characteristics of anxiety disorders in the clinical, psychological context:

  • Experiencing worry which is disproportionate to the situation being worried about
  • Avoidance of important activities, such as hobbies, going to work and/or meeting friends, limiting quality of life
  • Physical symptoms such as increased heartrate, insomnia or chest pain.

This article aims to explore the causes and symptoms of anxiety, alongside its clinical subtypes and practical techniques to effectively manage anxiety.

Why do we become anxious?

There are a number of causes, including biological, environmental and psychological factors, which contribute towards causing anxiety:

Biological factors involved in anxiety include imbalances in neurotransmitters (brain chemicals) such as the inhibitory gamma-aminobutyric acid (GABA; a deficiency in its activity can increase anxiety), alongside the excitatory neurotransmitters glutamate, dopamine, and norepinephrine (although important in cognitive function and wakefulness, an excess, or imbalanced activity of, these neurotransmitters can induce anxiety.) Furthermore, a family history of anxiety or related conditions such as PTSD can increase the statistical likelihood of developing anxiety, suggesting a genetic predisposition.

Environmental and social factors, such as living or working in particularly stressful or tense environments, being in psychologically harmful relationship dynamics and a lack of social support or prolonged isolation, can all contribute to the development of anxiety disorders.

Finally, psychological factors such as traumatic or stressful life events (e.g. divorce, passing of a loved one), negative thought patterns and/or low self-esteem, being influenced by the aforementioned factors, can precipitate the emergence of specific symptoms of an anxiety disorder.

Thus, understanding these various contributing factors can help guide personalisation of anxiety disorder treatment.

Common Signs and Symptoms of Anxiety

Everyone experiences anxiety differently. Some common symptoms of anxiety include:

  • Persistent feelings of dread, or despair
  • Avoidance of important life activities (avoidance behaviours) to avoid situations which could provoke anxiety
  • Restlessness, or finding it hard to relax/take rest
  • Insomnia (difficulty sleeping)
  • Physical symptoms, such as:
    • A feeling of chest tightness, or a thumping heart
    • Sweating, shaking and/or breathlessness
    • Digestive issues, such as diarrhea, constipation and/or nausea.
  • Panic attacks, which are episodes of intense anxiety (panic) characterised by severe physical symptoms such as chest pain or dizziness.

Clinical Subtypes of Anxiety

Anxiety is not only one condition, but can be considered an umbrella term for a group of conditions, which are clinically termed ‘anxiety disorders’.

There are a number of common types of anxiety disorders, some of which include:

  1. Social anxiety disorder, or SAD, is characterised by an intense fear of social judgement, including embarrassment, which can make social interactions, including professional/occupational, public (speaking in front of an audience) and/or with one’s own friends, extremely difficult.
  2. Generalised anxiety disorder, or GAD, is defined as persistent fear or dread about different general aspects of daily life, for example concerning finances, health and/or employment; this fear is often disproportionate to the impact/significance of the actual situation.
  3. Specific phobias, such as claustrophobia (a fear of confined, or enclosed spaces), arachnophobia (fear of spiders) and acrophobia (fear of heights) can induce, in those affected by the given phobia, intense fear of the subject of the phobia (a particular phenomenon, object or situation) which often leads to avoidance of this stimulus, in turn negatively affecting quality of life.
  4. Panic disorder is defined by experiencing sudden and recurrent (as opposed to isolated) panic attacks, often alongside a pronounced fear of when the next panic attack will happen – this can also lead to avoidance behaviours, such as not going to work or not meeting with friends to avoid a situation which could lead to a panic attack.

Post-traumatic stress disorder (PTSD), although not specifically an anxiety disorder, involves many hallmarks of anxiety disorder symptoms such as flashbacks, hypervigilance (or heightened anticipation of potential danger/threats) and nightmares; as such, its symptoms overlap with anxiety disorders.

Strategies to Manage Anxiety

With the right tools and support, anxiety is a manageable, treatable condition; there are a number of strategies which have demonstrated clinical efficacy in mitigating anxiety symptoms, consequently increasing quality of life.

Some of these strategies include:

  1. In anxiety therapy, or counselling for anxiety, a therapist offers a secure setting for discussing stressors and creating coping mechanisms; this can include psychotherapeutic modalities such as CBT (cognitive behavioural therapy), which can support individuals to recognise and thereby manage their potentially harmful, or self-limiting, thought patterns.
  2. Exposure therapy, which gradually lessens dread, or fear, of the offending stimulus which originally caused anxiety, via the principle of desensitisation; by controlled exposure to circumstances which cause anxiety, exposure therapy gradually lessens anxiety caused by the offending stimulus, and thereby its potential to induce fear.
  3. Some people may need to take prescribed medication, such as antidepressants and/or anxiolytics, to control their anxiety symptoms.

    When prescribed and supervised by a qualified medical professional, taking antidepressants and anxiolytics as prescribed can aid in re-establishing more healthy neurochemistry and thus lessening the symptoms and intensity of anxiety experienced.

    However, it is important to note that some medicines prescribed for anxiety, such as benzodiazepines, may cause dizziness, drowsiness and/or impaired coordination as adverse effects; if you experience these side effects, avoid driving, operating machinery or performing other tasks which require full concentration until you understand how the medication affects you. Always consult with your doctor about potential side effects of these medicines and potential lifestyle adjustments necessary.

  4. Mental health can be considerably enhanced by engaging in appropriate lifestyle adjustments to manage anxiety and promote wellbeing, and importantly prioritising self-care as an important part of your lifestyle. Some beneficial lifestyle adjustments include the following:
    • A diet balanced between the three major macronutrients (carbohydrates, proteins, fats; balanced diet) promotes both physical and mental well-being. Nuts and fish are good sources of omega-3 fatty acids, which are beneficial for brain function.
    • Mindfulness-based therapy promotes living in the present, lessening fear and overthinking. Thus, mindfulness-based practices such as yoga, meditation, and grounding exercises can help people focus on the here and now, lessening worry.
    • Breathing techniques, such as practicing deep, slow breathing can assist soothe the body when anxiety levels are high.
    • Participating in regular exercise, such as lifting weights or moderate cardio e.g. using a treadmill, can promote not only physical health but also psychological wellbeing: exercise can lead to the release of endorphins, elevating mood and lowering anxiety.
    • Alcohol and caffeine can worsen anxiety symptoms, and it is recommended to limit alcohol and/or caffeine consumption to lessen the incidence of anxiety episodes.
    • In addition, alcohol can interact negatively with prescribed anti-anxiety medications, such as antidepressants and/or anxiolytics; it is recommended to avoid drinking alcohol when taking prescribed anti-anxiety medicines.
    • By speaking with dependable family members or friends, you can establish a support network which reduces feelings of loneliness and isolation, alongside strengthening emotional resilience. Joining support groups may also help you to meet people who have been through similar things.

Anxiety is a difficult, albeit treatable, psychological condition.

By taking proactive measures to manage anxiety symptoms, you can overcome your anxiety and ultimately retake control of your life.

Helping you create change and uncover inner happiness

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