Introduction
Anxiety is a normal human feeling. We all experience it when
faced with situations we find threatening or difficult.
People often call this feeling stress but the
word 'stress' can be used to mean two different things - on the one
hand, the things that make us anxious and on the other, our
reaction to them. This makes it a confusing word and so it will not
be used in this leaflet.
When our anxiety is a result of a continuing problem, such as
money difficulties, we call it worry, if it is a
sudden response to an immediate threat, like looking over a cliff
or being confronted with an angry dog, we call it
fear.
Normally, both fear and anxiety can he helpful, helping us to
avoid dangerous situations, making us alert and giving us the
motivation to deal with problems. However, if the feelings become
too strong or go for too long, they can stop us from doing the
things we want to and can make our lives miserable.
A phobia is a fear of particular situations
or things that are not dangerous and which most people do not find
troublesome.
Symptoms
In the mind:
Feeling worried all the time, Feeling tired, Unable to
concentrate, Feeling irritable, Sleeping badly
In the body:
Irregular heartbeats
(palpitations), Sweating, Muscle tension and pains, Breathing
heavily, Dizziness, Faintness, Indigestion, Diarrhoea
These symptoms are easily mistaken by anxious people for
evidence of serious physical illness - their worry about this can
make the symptoms even worse. Sudden unexpected surges of anxiety
are called panic, and usually lead to the person
having to quickly get out of whatever situation they happen to be
in. Anxiety and panic are often accompanied by feelings of
depression, when we feel glum, lose our appetite and see the future
as bleak and hopeless.
Phobias
A person with a phobia has intense symptoms of anxiety, as
described above. But they only arise from time to time in the
particular situations that frighten them. At other times they don't
feel anxious. If you have a phobia of dogs, you will feel OK if
there are no dogs around, if you are scared of heights, you feel OK
at ground level, and if you can't face social situations, you will
feel calm when there are no people around.
A phobia will lead the sufferer to avoid situations in which
they know they will be anxious, but this will actually make the
phobia worse as time goes on. It can also mean that the person's
life becomes increasingly dominated by the precautions they have to
take to avoid the situation they fear. Sufferers usually know that
there is no real danger, they may feel silly about their fear but
they are still unable to control it. A phobia is more likely to go
away if it has started after a distressing or traumatic
event.
Are they common? About one in every ten
people will have troublesome anxiety or phobias at some point in
their lives. However, most will never ask for treatment.
Causes
Some of us seem to be born with a tendency to be anxious -
research suggests that it can be inherited through our genes.
However, even people who are not naturally anxious can become
anxious if they are put under enough pressure.
Sometimes it is obvious what is causing anxiety. When the
problem disappears, so does the anxiety. However, there are some
circumstances that are so upsetting and threatening that the
anxiety they cause can go on long after the event. These are
usually life threatening situations like car crashes, train crashes
or fires. The people involved can feel nervous and anxious for
months or years after the event, even if they have been physically
unharmed. This is part of what we now call
post-traumatic stress disorder.
Sometimes anxiety may be caused by using street drugs like
amphetamines, LSD or Ecstasy. Even the caffeine in coffee can be
enough to make some of us feel uncomfortably anxious!
On the other hand, it may not be clear at all why a particular
person feels anxious, because it is due to a mixture of their
personality, the things that have happened to them, or life-changes
such as pregnancy.
Seeking help
If we are put under a lot of pressure, we may feel anxious and
fearful for much of the time. We usually cope with these feelings
because we know what is causing them and we know when the situation
will end. For instance, most of us will feel very anxious before
taking a driving test, but we can cope because we know that the
feelings will disappear once the test is over.
However, some of us have these feelings for much of the time
without knowing what is causing them, and so not knowing when they
might end. This is much harder to cope with and will usually need
some help from somebody else. People will sometimes not want to ask
for help because they think that people might think that they are
'mad'. In fact, people with anxiety and fears hardly ever have a
serious mental illness. It's much better to get help as soon as you
can rather than suffer in silence.
People with anxiety and phobias may not talk about these
feelings, even with family or close friends. Even so, it is usually
obvious that things are not right. The sufferer will tend to look
pale and tense, and may be easily startled by normal sounds such as
a door-bell ringing or a car's horn. They will tend to be irritable
and this can cause arguments with those close to them, especially
if they do not understand why the sufferer feels that they cannot
do certain things. AIthough friends and family can understand the
distress caused by anxiety, they can find it difficult to live
with, especially if the fears seem unreasonable.
Most children go through times when they feel very frightened
about things. It's a normal part of growing up. For instance,
toddlers get very attached to the people who look after them. If
for any reason they are separated from them, they can become very
anxious or upset. Many children are scared of the dark or of
imaginary monsters. These fears usually disappear as a child grows
older, and they do not usually spoil the child's life or interfere
with their development. Most will feel anxious about important
events like their first day at school, but they stop being
frightened afterwards and are able to get on and enjoy their new
situation.
Teenagers may often be moody. They tend to be worried about
how they look, what other people think of them, how they get on
with people in general, but especially about close relationships
and sex. These worries can usually be dealt with by talking
about them. However, if they are too strong other people may notice
that they are doing badly at school, behaving differently, or
feeling physically unwell. If a child or teenager feels so anxious
or fearful that it is spoiling their life, it's a good thing to ask
the family doctor to look into it.
Helping people with anxiety and phobias
Talking about the problem This can
help when the anxiety comes from recent knocks, like a spouse
leaving, a child becoming ill or losing a job. Who should we talk
to? Try friends or relatives who you trust, whose opinions you
respect, and who are good listeners. They may have had the same
problem themselves, or know someone else who has. As well as having
the chance to talk, we may be able to find out how other people
have coped with a similar problem.
SeIf-help groups These are a good
way of getting in touch with people with similar problems. They
will both be able to understand what you are going through, but may
be able to suggest helpful ways of coping. These groups may be
focussed on anxieties and phobias, or may be made up of people who
have been through similar experiences - women's groups, bereaved
parent's groups, survivors of abuse groups.
Learning to relax It can be a great
help to learn a special way of relaxing, to help us control our
anxiety and tension. We can learn these through groups, through
professionals, but there are several books and videotapes we can
use to teach ourselves (see below). It's a good idea to practice
this regularly, not just when we are in a crisis.
Psychotherapy This is a more
intensive talking treatment which can help us to understand and to
come to terms with reasons for our anxieties that we may not have
recognised ourselves. The treatment can take place in groups or
individually and is usually weekly for several weeks or months.
Psychotherapists may or may not be medically qualified.
If this is not enough, there are several different kinds of
professionals who may be able to help - the family doctor,
psychiatrist, psychologist, social worker, nurse or
counsellor.
Medication Drugs can play a part in
the treatment of some people with anxiety or phobias.
The most common tranquillisers are the
valium-like drugs, the benzodiazepines (most sleeping tablets also
belong to this class of drugs). They are very effective at
relieving anxiety, but we now know that they can be addictive after
only four weeks regular use. When people try to stop taking them
they may experience unpleasant withdrawal symptoms which can go on
for some time. These drugs should be only used for short periods,
perhaps to help during a crisis. They should not be used for
longer-term treatment of anxiety.
Antidepressants can help to relieve anxiety
as well as the depression for which they are usually prescribed.
Some even seem to have a particular effect on individual types of
anxiety. One of the draw-backs is that they usually take 2 to 4
weeks to work and some can cause nausea, drowsiness, dizziness, dry
mouth and constipation. Taking a certain kind of antidepressant,
the MAOIs, may mean that you have to stick to a special diet.
Please see our leaflet on
antidepressants
for more information.
Beta blockers are usually used to treat high
blood pressure. In low doses, they control the physical
shaking of anxiety and can be taken shortly before meeting people
or before speaking in public.
Advice and Information:
- Anxiety UK
(formerly National Phobics Society) Monday to Friday:
9.15 am to 9.00 pm: tel: 08444 775 774; 0161 227 9898; email:
info@anxietyuk.org.uk A
national registered charity formed 30 years ago by a sufferer of
agoraphobia for those affected by anxiety disorders.
- Flying
Without Fear This informative site is filled with
useful tips to help anyone overcome the debilitating fear of
airline travel
- www.destigmatize.org.uk A
new organization working with the National Phobic's Society which
aims to provide information and support for sufferers of anxiety
disorders mainly, but not exclusively, in the Asian
population.
- Triumph
Over Phobia Tel: 0845 600 9601 info@triumphoverphobia.org.uk Triumph
Over Phobia runs a series of self-help groups to help people with
phobia learn to overcome their fears through small interactions
with their phobias. Includes some information on phobias, but the
focus is on the self-help groups.
Further Reading
- Anxiety and Depression: a Practial Guide to
Recovery by Robert Priest (McDonald and Co.)
- Self-Help for your Nerves: Learn to Relax and
Enjoy Life Again by Overcoming Stress and Fear by Claire
Weekes (Angus and Robertson)
- A 2007
survey of self-help books
Audio Tapes/ Cd's
- Coping with Depression, Talking Life Tel: 0151 632
0662 £13.99 for CD or double cassette full version or £8.50
for shorter one cassette version.
- Control your Tension, Lifeskills, Bowman
House, 6 Billetfield, Taunton, Somerset TA1 3NN.
This leaflet was produced by the Royal College of
Psychiatrists' Public Education Editorial Board. 
Series editor: Dr Philip Timms.
© January 2006 Royal College of Psychiatrists.
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