Saunders Clinic

What is anxiety?

Anxiety can very between individuals but tends to be made up of features of altered thoughts, emotions, behaviours and physical sensations. These are described below. Each of these features can influence each other leading to a worsening of the anxiety. Altered Physical Features

Often anxious people are aware of their heart beating harder and faster. Sweatiness and shaking can also occur. Sometimes people feel light-headed, dizzy and nausea as well as a range of other symptoms.

Altered Thoughts

Very often worrying is a feature of anxiety. Here people often become concerned that the worrying will harm them. In panic attacks people often believe they may be at risk of fainting. Sometimes they interpret the heart palpitations as evidence of heart problems and again worry about the risk of ensuing harm or even death.

Altered Behaviours

With anxiety the person may be uneasy, jumpy and restless. They appear to be always on the lookout for possible danger in order to avoid such situations. In panic disorder the panic attacks may happen at any time. In some people, however, they happen only in certain situations such as when there are lots of people around. In this case a panic sufferer may simply avoid these situations and appear on the surface to have few problems in their lives.

While in a panic attack they may lie down, sit or quickly remove themselves from the situation. Others use drugs or alcohol in the hope that this will help. Unfortunately, in the long term they make the anxiety worse.

Altered Emotions

In panic disorder the main emotion is fear. In less severe anxiety people feel worked up and irritable. Unfortunately, in generalised anxiety disorder when the symptoms last for much of an individual’s day people can feel desperate. Sometimes this mood can drop.

Causes

There is no one cause of anxiety disorder. In some cases it appears to run in families. Sometimes it also starts after a big life change such as; bereavement, childbirth, or losing a job. A smaller number of cases are associated with physical or other psychological illnesses. These include depression or thyroid problems. Anxiety can also be a feature of phobias, which are fears of different situations such as types of animals or of crowds.

Consequences

Sufferers begin to avoid those things or places that they associate with their symptoms. This can get worse until it forms a significant part of the persons life. Fear of having a panic attack can be very disabling. Eventually it can prevent people from going about normal work or social activities and can lead to agoraphobia. Less commonly the distress and disablement caused by anxiety may cause periods of depression or drug and alcohol problems.

Treatment

Treatment of anxiety can be by psychological treatments or by using prescribed medications.

Anti depressant medication can be used and have been shown to be effective but unfortunately the anxiety often comes back when the medication is stopped.

Counselling and practical techniques to teach relaxation are found to be helpful by some. Likewise, self-help materials on tapes or in books can teach strategies to help people feel better. The psychological approach with the most evidence of effectiveness for anxiety disorders is Cognitive Behavioural therapy (CBT).

CBT is likely to include:

• Teaching about the nature of anxiety, including the physical symptoms. Any misinterpretations that such symptoms such as palpitations are harmful or dangerous can be corrected.
• Exploring the extreme and unhelpful thoughts that happen particularly when the sufferer is very anxious. Learning techniques to balance out some of these biased thoughts.
• The feature of worry can be explored and techniques tried to lessen the impact of worrying.
• Where many situations are being avoided they will be looked at. The therapy will attempt to reintroduce these into the life of the sufferer. This is done gradually in small steps and only when the client feels ready to try this.
• Sometimes the therapy may include training in relaxation techniques to reduce the physical symptoms of anxiety.
• Where depression has become a feature of the persons problem this can also be treated using CBT.