Anxious thoughts and feelings are a normal response to stressful situations. However, anxiety is abnormal if it occurs out of proportion to the stress within a situation or often when there is no apparent reason.
This often has a significant impact on day-to-day living. Anxiety disorders include generalised anxiety disorder (GAD), phobias, and panic disorder. About 1 in 20 people in the UK suffer with an anxiety disorder at any specific time.
Anxiety is the feeling of worry, panic or nervousness that occurs as a reaction to fear or stress, often over an impending event. However, anxiety becomes a problem when this reaction is out of proportion to the stress of a situation and starts to impact day to day life.
Symptoms of anxiety disorders range from mild to severe with severe anxiety sufferers struggling with day-to-day living. Anxiety is a very common psychological disorder, affecting one in four people during their lives.
Many factors contribute to the development of anxiety disorders including both genetic and environmental factors. The following have been shown to increase the risk of developing an anxiety disorder:
Anxiety can affect the body in a number of ways and each person may experience anxiety very differently. Common symptoms of anxiety include:
Generalised anxiety disorder (GAD) is characterised by frequent and uncontrollable worry over a combination of issues and situations. There are both physical and psychological symptoms associated with GAD and it affects the daily lives of those who suffer due to the frequency of the anxious thoughts.
Panic disorder is an anxiety disorder which leads to frequent and unexpected surges of uncontrollable panic, often resulting in a panic attack. The feeling of panic often has no obvious cause or trigger and can occur at any given time. Those who suffer with panic disorder may also experience anxiety around having panic attacks themselves.
Social anxiety disorder is an uncontrollable fear of social settings. Also known as a social phobia, people who suffer with social anxiety disorder often experience extreme feelings of worry before, during and after a social event.
A phobia is characterised by the feeling of an extreme sense of danger stemming from a situation or object. Phobias often lead to physical side effects including sweating and dizziness. People who suffer with phobias tend to take measures to avoid the situation or object the phobia stems from.
Agoraphobia is an extreme fear of settings which don’t have a clear and easily accessed escape route as well as settings where help isn’t readily available should it be needed. People who suffer with agoraphobia often avoid anxiety inducing settings as being in that situation may cause a panic attack.
Separation anxiety disorder (SAD) is an extreme fear of being away from a person or attachment figure. This includes worrying about what could happen during separation as well as fear of events which may lead to the separation. Often triggered by experiences during childhood, SAD is most common in children but can also occur in adults.
Post-traumatic stress disorder (PTSD) is an anxiety disorder stemming from distressing and traumatising past events or situations. People who suffer from PTSD often have graphic and frequent flashbacks to the event or situation, leading to a strong sense of distress.
The most commonly diagnosed anxiety disorder in adults is generalised anxiety disorder (GAD).
Anxiety is diagnosed from speaking to a patient to understand their symptoms in full, however other conditions may mimic anxiety and it is important to rule these out with further tests if suspected.
Questionnaires are a commonly used tool to aid making an anxiety diagnosis. They are also useful in monitoring response to treatment.
Anxiety treatment options are dependent on which anxiety disorder(s) a person experiences and how severely they are affected.
Simple approaches; including exercise, relaxation techniques, improved sleep hygiene, identifying and removing stressors, and spending time with natural support groups (family and friends), can help manage anxiety symptoms and reduce the impact on quality of life.
Some patients will also benefit from an element of psychological therapy, including counselling, cognitive behavioural therapy (CBT), or exposure therapy.
Is there medication for anxiety?
Medication is often prescribed to people suffering with anxiety disorders. Medical management of anxiety primarily involves the use of anti-depressants (e.g. sertraline, fluoxetine) and benzodiazepines (e.g. diazepam). Beta-blockers (e.g. propranolol) can sometimes be useful for controlling symptoms experienced with panic attacks.
Is there medicinal cannabis for anxiety?
Medicinal cannabis may be considered with the aim of reducing the severity of anxiety symptoms and improve quality of life. Medicinal cannabis can only be considered when first line therapies have not achieved adequate benefit. Find out more on prescribing medical cannabis for anxiety here.
High functioning anxiety refers to anxiety symptoms suffered by people who are still able to continue with everyday activities and work, if they so choose. Whilst people who suffer with high functioning anxiety are often confident and outgoing high achievers, they still experience symptoms such as insomnia, overthinking and fear of failure.
Also known as a panic attack, an anxiety attack is a sudden surge of intense fear which develops in a period of up to 10 minutes. Some of the most common symptoms include sweating, inability to breath, dizziness, heart palpitations, shaking and chest pain. When experiencing an anxiety attack, people may feel like they’re going to die or they’ve lost control of their body therefore the episode is usually extremely distressing and scary.
Anxiety can cause the chest to tighten leading to feelings of hyperventilation or an abnormal shortness of breath. Breathing exercises are an effective way to relieve chest tightness; try taking long deep breaths which involve inhaling through your nose for around 10 seconds and exhaling through your mouth for around 10 seconds. Another method to reduce anxiety related chest tightness includes focusing on happy, calming thoughts which take the focus away from the root cause of the panic attack. If anybody is experiencing chest tightness for the first time or is having chest pains that are different from the type of pain associated with their anxiety, they should discuss this with a trained healthcare professional.
There are many ways you can help someone cope with their anxiety. Suffering with anxiety can lead to feelings of loneliness and isolation so knowing how to help someone will certainly be appreciated by the person with anxiety. You could help someone with anxiety by researching treatment options, listening to and reassuring them, be understanding if they cancel or rearrange plans and checking in on them regularly to ensure they’re okay. Not everyone will want to discuss the anxiety they are feeling and if this is the case, respect their decision whilst gently exploring the reason for their decision.
There are several methods to help people deal with anxiety including:
To calm anxiety at night, introducing a daily routine may help as structure helps to focus the mind and ease stress. Include things such as eating times, sleeping times and exercise into your routine and in time, anxious thoughts at night may ease. Reducing tech time and increasing time spent on restful activities such as reading and practising mindfulness is also an effective way to calm anxiety at night as this too will help you manage your thoughts.
If you are a patient or carer seeking an appointment to discuss treatment with medical cannabis, you can complete this form and we can assist you with this.
Eligible patients can provide us with their healthcare records or we can obtain these through your GP. This is to confirm that a patient’s condition has been fully assessed and all other treatment options have been attempted. We will ensure that the primary care provider receives all treatment communication to maintain the highest level of clinical governance.
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