Anxiety’s a bit like excitement. It is a lot like fear. It is a feeling you get when the person who looks after you suddenly isn’t there. The safety net has gone.

 

This feeling can come on in all sorts of different situations. A person who is under stress may find that she has more and more physical symptoms. She may get headaches, chest pains, feelings of tiredness and tension. She may fear that she is physically ill, that she is going to drop dead of a heart attack. But in fact she is just doing too much. She needs to slow down, relax, take some of the worry from her life. Some people experience real fear in the most unlikely places. Sometimes even when just sitting at home he may find that his heart is pounding, he is sweating, unable to get his breathe and terrified that something dreadful is going to happen.

 

Other times something dreadful has happened. For example, the person may have seen violent death first hand. She may be unable to get the image of it out of her head. She may awake petrified from nightmares. She may be irritable, jumpy, cold and distant with her loved ones.

 

Anxiety appears in many forms. Whenever it comes on, whatever it is called, it is fear. It may seem ridiculous that a person cannot even walk to the end of his road but that is the power of fear. It may be out of proportion but it is paralysing.

 

It doesn’t have to be forever. Anxiety in all forms can be treated.

Anxiety disorders may cause people a number of different physical and psychological problems. Some people suffer from anxiety all of the time – this is called generalised anxiety. For people suffering from panic attacks, the symptoms of anxiety are likely to come out of the blue. Another sort of anxiety disorder is called a phobia, in which people have problems in certain situations. Post-traumatic stress disorder is another form of severe anxiety. The psychological symptoms of anxiety include feelings of dread and irritability, and increased muscle tension and activity of the nervous system. This leads to a variety of physical symptoms such as dry mouth, shortness of breath, dizziness and trembling.

 

Anyone can have feelings of anxiety. These may occur in response to a stressful situation. Sometimes these feelings can be helpful, for example, by increasing a person’s ability to perform in a race. These feelings are normal. Only when the symptoms are more intense or long-lasting do they interfere with a person’s concentration and ability to do routine tasks. People may avoid situations that could provoke feelings of anxiety. This interference with daily living as much as the symptoms themselves may lead a person to seek help.

Anxiety disorders are quite common, affecting 5 per cent of the population at any one time, but many people do not seek help. More women than men are affected. Anxiety disorders often start in the 20s but may begin earlier. Sometimes they occur in older people.

The cause is not always clear. Anxiety disorders are more common in some families, suggesting that genetic factors may be important. These disorders may also develop as a result of emotional or social problems, occasionally starting after a stressful or frightening event. One theory is that some of these problems are caused by ‘faulty’ thinking. For instance, an exaggerated fear that physical symptoms (such as palpitations) together with the feeling of anxiety, will lead to a medical emergency. Someone having these palpitations and feeling his heart beating a little fast may believe that he is going to have a heart attack. This may lead to increasing levels of anxiety, and even more palpitations.

The aim of any treatment is to try and help someone to reduce their symptoms of anxiety to an acceptable level, so that the anxiety no longer interferes with day-to-day living.

 

Health professionals can help by giving a clear explanation of the symptoms. The doctor may point out that physical and psychological feelings are closely related. For example, breathlessness or dizziness can occur in anyone feeling under stress, and do not necessarily mean that there is a serious disease in the rest of the body.

 

Health professionals may also encourage a person to try and identify any social or emotional problems. There are various ways of trying to deal with these, but one helpful approach can be to use problem-

 

solving techniques. These can be complex or as simple as listing the problems and selecting one for action. Different approaches are then looked at, their pros and cons reviewed, and finally the best course of action chosen. Problem solving can be a self-help technique or may form part of a course of therapy sessions, either on a one-to-one basis or in an anxiety management group. It also naturally forms part of relationship based psychotherapy that can sometimes be helpful.

Other approaches to managing anxiety include cognitive and behavioural therapy techniques and relaxation. Sometimes it can be helpful for a friend or relative to get involved in the treatment, perhaps attending some of the therapy sessions and learning about the disorder, and helping with any homework between sessions.

 

Occasionally a doctor will prescribe an antidepressant in combination with non-drug treatments. These drugs can help lower levels of anxiety.

 

Doctors sometimes use minor tranquillisers. These also lower levels of anxiety but are prescribed with caution because of the risk of long-term dependence.

 

The person with anxiety can help himself by learning how to relax, to do things he enjoys and by taking exercise. By learning about his symptoms, he can understand that they are not life-threatening, and this can help.

Public education can help us to have a better understanding of the nature of anxiety disorders. With this understanding should come increased tolerance. We need to recognise that severe anxiety disorders can cause much personal distress and interfere with daily living. People with this disorder and their families need support in seeking help and getting treatment.