Anxiety can have a huge impact on a person’s life and the lives of those around them.  Anxiety is a part of everyday life and is usually perfectly normal, however, when anxiety attacks are unexplained or frequent and affecting your life, it maybe time to get help.

The Office for National Statistics estimates that 4.7 per cent of adults experience generalised anxiety disorders not including depression, at any one time and that a further 9.2 per cent have mixed anxiety and depression with these ailments being more common in females than males.

You may also want to read the Panic Attacks section of this website

Help with Anxiety

The National Institute for Clinical Excellence recommends talking therapies such as Counselling or Cognitive Behavioural Therapy (CBT) to help with anxiety.

Your experience of anxiety is unique to You.  In helping You, its likely we’ll look to at short-term emotional regulation as well as looking at the deeper things that may have created and continue to maintain your anxieties.  This may include: –

• Gain awareness of what triggers your anxiety and how to manage them
• Help you gain an understanding of how anxiety affects the body and mind
• Find new coping strategies and mechanisms that fit for You (that are also clinically researched as being viable and helpful coping mechanisms)
• Acknowledging past influences that may have created anxiety or unhelpful beliefs
• Challenge and/or reduce thoughts and behaviours that maintain your anxiety
• Build on what works well for you
• Find longer term coping strategies that fit for you

Please click here for more information about how Counselling and CBT can help with Anxiety.

About Anxiety

Anxiety is a universal human emotion and is experienced in many situations from preparing for a speech to watching a sporting event. As a part of everyday life it can improve motivation and performance by increasing alertness and preparing the body for action.

For many though, the extent to which anxiety affects them can cause problems and can impede their lives from having a mild affect to severe cases where anxiety can be described as ruining their lives and that of others around them. Described as an overwhelming feeling of emotional or mental discomfort or unease, many people can cope with these symptoms as they last for a short time and occur infrequently, thus having no major affect on their lives. It only causes problems if it the anxiety becomes severe and persistent and affects a persons life by manifesting itself as General Anxiety Disorder (GAD), Panic Attacks, Obsessive Compulsive Disorder (OCD), Phobias, Eating Disorders, Substance abuse, Agoraphobia and Social Phobia – these are known as Anxiety Disorders and are detailed below.

Generally when anxiety is talked of, many speak of symptoms such as: –

• Excessive worry and fear of situations and objects
• Unrealistic fear of future situations (fear of fear)
• Disturbed sleep or insomnia
• Fatigue
• Trembling, shakiness, constant fidgeting
• Cold hands or feet as blood is distributed to the major organs
• Pins and needles or tingling sensations
• Upset stomach
• Increased heart rate
• Increased breathing rate
• Feeling of jumpiness/jitteriness
• Apprehension
• Unrealistic worry or fear that something bad may happen to loved ones
• Impatience and irritability
• Lack of attention span; being easily distracted

Panic Attacks – click here

General Anxiety Disorder (GAD)

This is where people worry, have fears or feel anxious about everyday affairs and activities such as being pre-occupied with the welfare of others, constantly worrying about financial matters or having an ongoing fear for the future. GAD is viewed as a long term disorder, whereby you can experience anxiety for months and years and where it becomes part of your accepted everyday life. You may go for long periods without being consumed with worry but may be anxious most of the time. This disorder is often linked with depression.

Common Symptoms: –

• Constant feelings of worry and being anxious
• Feeling of being on edge, shaky and wound up due to high tension levels.

There are numerous causes with each individual having different contributing circumstances and differing symptoms. Commonly though, it be resultant of ongoing periods of stress, inability to cope with life changes or from a single or series of previous traumatic experiences that may be strongly affecting the person.

Obsessive Compulsive Disorder (OCD)

OCD is where you become trapped in a pattern of repeated or ritualistic obsessional thoughts or compulsive behaviours.  The obsessive thoughts often focus on personal safety or the norms of society.  For example, common obsessive fears can be fear of losing control in public, being embarrassed or having fears relating to cleanliness, bacteria and germs.  Often the thoughts drive the behaviour and the classic example of OCD is where you feel everything is dirty and constantly need to clean the immediate environment and/or yourself.

Ritualistic compulsions (i.e. the behaviour) can become a ritualistic coping mechanism to help create a sense of order and live your life as normally as possible.  Common examples are: –

• Cleaning – where any contact or perceived contact with dirt or germs may result in hours of cleaning.
• Checking – ensuring doors and windows are secure and locked, that the oven is turned off, the iron is off etc..
• Repeating behaviour such as saying a loved ones name over and over in a sentence or believing that if you do not turn the light switch on and off 5 times then something bad will happen to the house when you leave.

By engaging in these ritualistic behaviours the need is satisfied at that moment but this reinforces the need to do it again in the future if satisfaction or any sort of gain is derived from this.

Phobias – click here

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Post Traumatic Stress Disorder (PTSD)

PTSD is a set of symptoms that is experienced after involvement in or exposure to a particular experience that caused bodily and/or psychological harm.  This experience may have been life threatening or will have perceived to have been life threatening.  Examples of such experiences can be the victim of a violent crime or involvement in a crime such as being present during an armed robbery, being in a car accident or being involved in military combat.

PTSD can develop when a person experiences an overwhelming trauma which commonly can include serious accidents, disasters, sexual abuse, violent crime, physical abuse, torture, military combat, kidnap and imprisonment.  The traumatic event(s) will have been personally experienced, witnessed, heard about or confronted with in a terrifying manner to the sufferer and will have been involved death or the threat of death, serious injury or the threat of serious injury to themselves or to somebody around them.

The original traumatic stressor will create a response of helplessness, intense fear and horror.  This can result in the re-living of this trauma and its response persistently after the event.

The aftermath of this event can leave a person with difficulties in coping in their everyday life and impairments in how they express themselves emotionally and this can create a hyperarousal state or a disassociative state.

The hyperarousal state is where after the traumatic event, the human self preservation system seems to go on permanent alert as if the danger may return at any moment.  This reaction forms the flight or fight syndrome where a person will constantly be in a state of readiness to either fight the impending perceived danger or flee from it.

During the originating traumatic event, the subconscious mind may feel threatened but will cope with the situation with the aid of the body’s natural flight or fight defence mechanism.  This stimulates the sympathetic nervous system to it’s fullest; alerting all of the sensory systems, secreting stress response hormones into the bloodstream, inhibiting or shutting down somatic systems such as the digestive and immune systems and distributes blood to the bodies critical areas.

The severity of the symptoms are usually more severe when the trauma was unexpected therefore not all war veterans suffer from PSTN in spite of prolonged exposure to violence and combat.

Eating Disorders

Any eating habit that threatens your health or happiness or the health and happiness of those around you can be classed as an eating disorder.  The most common disorders are Anorexia Nervosa and Bulimia Nervosa which are serious mental health conditions.

 – Anorexia Nervosa

90 to 95% of anorexia sufferers are female and this affects approximately 2% with 1% being current sufferers.

Anorexia Nervosa is where eating becomes very distressing and where the sufferer can have a distorted self image and can obsessively and anxiously try to maintain or lose body weight through limiting food and calorie intake, even when they become dangerously thin.  An intense fear of gaining weight is also common as feelings of personal value is felt to be directly related to body shape.

This condition can be fatal through the direct physical loss of weight or through suicide.  Typical symptoms can include –

• Poor circulation
• Hair Loss
• Dehydration
• Fainting
• Dizziness
• Infertility (temporary or permanent)
• Brittle bones
• Low blood pressure
• Poor circulation
• Kidney damage
• Low body temperature

Whilst some of these symptoms will be alleviated upon recovery such as low body temperature or dizziness, others such as kidney damage and brittle bones will have much longer lasting effects.

There can be many potential causes as to why a person becomes anorexic and often it can develop when a person has emotional needs that are not being met.

 – Bulimia Nervosa

This affects you by disrupting the ability to maintain healthy eating patterns and food is approached in a chaotic manner and a cycle of binging and purging is often developed.  Commonly there is a switching between binging and then a state of panic to rid the foods that have been binged on.  The latter is usually fulfilled by vomiting or the use of laxatives.  Some sufferers will fast for long periods after binging rather than purging.

With eating disorders, there can their can be many causes, with no two cases being the same, however, commonly it can be linked to an inability to cope with emotional issues whether they are directly conscious and of present concern or whether they are deeper rooted or suppressed issues.

Bulimia Nervosa can be a physical way of alleviating emotional stress and sufferers have described the feelings of release they felt the first time they began to make themselves vomit.  This is likely to be resultant of the physical action of ridding their body of something.

Common symptoms can include:-

• Tooth decay
• Bowel damage
• Constipation
• Kidney disease
• Heart disease
• Damage to intestines
• Swelling (especially on the extremities)
• Increased hair growth
• Irregular menstruation

Initially, the condition can provide feelings of added control – you suddenly feel you can eat whatever foods you like without putting on weight.  When Bulimia takes hold though, it can eradicate the ability to have any control on what you eat and then all physical and emotional energy is put into food; eating excessively and chaotically or trying to physically rid what has been eaten.  This means that all other areas of your life suffer as there is no energy to cope with anything else.

Many people find it hard to understand why sufferers can be so self destructive but as a serious mental health disorder, often the sufferer will have as much difficulty understanding it as others around them.

Substance Misuse

This is defined as the continual use of any mind altering substance that has an affect on a person’s physical or mental health, or on that of others around them.  Interlinked with anxiety, most forms of substance abuse allow the user to alleviate their own anxiety in some manner usually by providing temporary feelings of escape or increased control although ultimately they are damaging to a person’s health.

Alcohol dependence is the most common form but it also covers – drug abuse (heroin, Cocaine, Cannabis, Hallucinogenics etc), and volatile substances such as solvents and glue.  Excessive caffeine consumption through coffee and other energy drinks and smoking is also included in this section.

The most severe forms of substance misuse can normally be helped through specialist agencies such as for drug rehabilitation and alcohol.

Substance misuse can come about for a number of reasons and can commonly include curiosity, the influences from others/peers or being stressed or unhappy and using substances as a way of coping.  Substances are a very temporary measure to coping as when the effects subside the original stress/problem/unhappiness can become greater as the come down can bring negative side effects which in turn can encourage the user to misuse again and this can be the beginning of a cycle of abuse.

Alcohol Misuse: – As the 3^rd largest health problem in the UK, prolonged and long term drinking can lead to damage of the liver, kidneys, heart and stomach and can lead to drink dependency.  Commonly alcohol misuse is linked with drug use and addiction, relationship problems, problems with the police (e.g through drink driving, public order offences etc), suicide and accidents.

Alcohol is very much interlinked with anxiety and many socially anxious people use alcohol to alleviate their nerves and social inhibitions, however, this is only ever temporary and long term misuse increases anxiety.

Drugs: – These can be catagorised in the following way:-

• Stimulants – such as caffeine, tobacco, amphetamine (speed), MDMA (ecstasy), anabolic steroids, amyl nitrate (poppers), cocaine and crack.   These stimulate the Central Nervous System and increases brain activity so the user feels more confident, alert and awake.  With the exception of caffeine and tobacco, all high doses can lead to anxiety, nervousness and can cause temporary feelings of paranoia.
• Depressants – such as solvents, glues, tamazepam, valium and Librium.  These relax the user by slowing down brain activity reducing tension and anxiety but it also reduces physical performance and self control.
• Analgesics – pain killers such as heroin, opium, other opiates, pethidine and codeine which can emotionally and physically desensitise the user allowing them to feel contentment and warmth.
• Hallucinogenics – such as LSD, acid, magic mushrooms and cannabis which distort the brains perception of sight and sound.

Psychological dependence on drugs can come about when a person relies on drugs to feel less anxious or stressed or to improve their mood.  Physical dependence is develops from the desire to achieve certain physical sensations or by avoiding the physical effects of not taking the drug of choice.  Other signs of dependence include – where drug use is to block out physical and emotional pain, to distance oneself from problems, where drug use affects others around you or where obtaining or taking drugs becomes a significant part of your life.

Food: – See Eating Disorders

Caffeine: – This stimulates the nervous system and can aid concentration and give feelings of added alertness.  It is contained in Tea, Coffee and Chocolate and increases heart beat, blood pressure and makes you pass more water.  Excessive intake can result in stomach pains, anxiety, irritability, headaches and sleeplessness

Nicotine: – Many people smoke as they believe it helps them relax and cope in stressful circumstances, however the dangers of smoking are very well publicised and long term smoking can cause heart disease, cancer and lung disease.  Nicotine is a fast acting drug and the effects are felt very quickly but the concentration levels reduce from the bloodstream just as fast creating the desire for more.  The body’s withdrawal from nicotine is very subtle so often the smoker does not realise they are addicted.  There is no physical pain or great uncomfortability, but feelings of emptiness, hunger or restlessness are common which are easily alleviated within seconds of lighting up.

Theories about the cause of anxiety disorders

Examples of anxiety disorders include – GAD, Obsessive Compulsive Disorder (OCD), Anorexia, Bulimia and Panic Attacks.  There is no single situation or circumstance that causes an anxiety disorder and often it can be resultant of the experiences and environment of the individual. There are many theories speculating possible causes and include it being hereditary, a chemical imbalance in the brain, mental, and emotional issues, personality issues, a stressful lifestyle, trauma and abuse or negative life experiences. There are a number of theories that delve deeper that are put forward by varying published psychologists.

The renowned psychologist Bowlby is best known for his attachment theory. This centres on how infants understand their social world and how the early parent-infant relationship has a major impact on the development of personality. He claimed there are great distinctions between secure and insecurely attached children with securely attached children developing a stronger sense of esteem and insecurely attached children developing beliefs that they are unloved and unwanted which lead to feelings of anger, mistrust and anxiety. Since Bowlby’s research in the 1970’s and 80’s where he proposed that ‘anxiety is the fundamental condition underlying insecure attachment’, studies have been carried out on individuals with anxiety disorders to see if there is a correlation in their attachment style. Two studies found social anxiety disorder to be positively correlated with individuals having an avoidant, anxious or insecure attachment style indicating that the ability of creating a secure attachment between parent and infant can influence the likelihood of the infant to mature to develop an anxiety disorder. The studies did state, however, that some people with social anxiety disorders did exhibit secure attachment styles.

Psychoanalytic Theory (Freudian) suggests that anxiety is rooted in unconscious conflicts experienced in childhood. This could be a conflict of sexual feelings toward their parent of the opposite sex (Oedipus Complex) or could be resultant of problems from an early traumatic experience. The symptoms can be alleviated by identifying and resolving this unconscious inner conflict.

Other theories suggest that anxiety is a learnt response to certain situations or objects and when faced with that stimulus they will look to avoid it. The theory suggests that this learnt response can also be unlearnt.

Chemical imbalances in the brain have also been researched and it is thought that all thoughts and feelings are complex electrochemical exchanges in the central nervous system. Studies indicate that feelings of anxiety and panic are resultant of certain biochemicals therefore the treatment of anxiety should be to correct these imbalances. This does not necessarily mean with the use of medication as biochemical changes can come about through emotional, psychological and behavioural changes.