What is the definition of anxiety?

Anxiety is our body’s natural reaction to stress. We’ve all felt a sense of unease or apprehension as we approach difficult situations in our lives. In many cases, this is a useful response. Consider anxiety as our built-in security system, a way of telling us that there is danger up ahead.

But sometimes, feelings of anxiousness can overwhelm us and get in the way of our daily routines. Excessive fear and nervousness, coupled with tangible physical symptoms, can cause great distress and disruption to our lives.

Knowing how to cope with anxiety when it gets like this is not always easy. But there is help available.

We’re going to tackle the causes and various types of anxiety — and then take you through how to find relief.

Causes of anxiety

Anxiety disorders do not stem from one cause. Rather, they result from a complex mix of biological and environmental factors. Your family history, brain chemistry, and life experiences all play a role.

Anxiety disorders can result from:

• Genetic influences. It’s clear that the likelihood of developing anxiety disorders increases if they are present in your immediate family. 

This study, for example, showed how a specific gene known as RBFOX1 plays a role in the development of anxiety disorders. But even while this is a significant finding, the researchers still emphasise that the genetic influence is one part of the puzzle.

• Trauma. Traumatic events in your life can lead to Post-Traumatic Stress Disorder (PTSD), an anxiety disorder that results from having experienced something shocking or threatening, such as car accidents, abuse and assault, or the effects of having gone to war.
• Big life changes. A major career change, losing a loved one or a move to a different city can all bring on anxiety. New parenthood can bring on feelings of anxiety — both for men and for women.

The coronavirus pandemic and anxiety also have important links. We’ve all been subject to a major collective life change since the start of the pandemic, and dealing with this has impacted our mental health.

• Brain functioning. The exact role of brain chemistry in anxiety disorders is still unclear, but it appears to be an important factor. 

This study shows evidence that the amygdala — the part of your brain involved in emotional processing — may play an important role in the regulation of our feelings of anxiety. Another brain structure that could come into play is the hippocampus, which is responsible in part for learning and memory.

Recent developments in neuroscience have given us striking new insights into what might happen in our brains when anxiety affects our mental health. This overview in the American Journal of Psychiatry offers a compelling argument for our need to bring the treatment of anxiety disorders in line with the progress being made in the science of brain imaging. Hopefully, in years to come, we will know much more than we do now and be able to access even better treatment options.

• Other health conditions. Physical conditions such as heart conditions, brain tumours, and thyroid problems can be at the root of some anxiety disorders. 

Types of anxiety disorders and their symptoms

Anxiety disorders can lead to avoiding work commitments and/or social engagements and, as a result, disrupt your life.

You might experience:

Generalized Anxiety Disorder (GAD)

GAD is characterised by feelings of excessive worry and tension for an extended period that is not specifically linked to an identifiable threat.

These feelings are not only around when you have a big job interview coming up or you’re concerned for the health and well-being of a family member — the negative thoughts and feelings are simply there. It’s common, affecting about 5% of the UK population and affects women slightly more than men.

Symptoms include:

• Excessive worry and feelings of anxiousness
• Imagining the worst-case scenario for situations in your life
• Extreme indecision
• Restlessness and feeling permanently on edge
• Difficulty concentrating
• Exhaustion
• Muscle tension and aches
• Sleep disruption
• Trembling and sweating
• Digestive trouble like nausea and diarrhoea

Panic Disorder

Panic disorders stem from having frequent panic attacks. Panic attacks last for a few minutes, or longer in some cases. They involve a serious fear that disaster is going to strike, even if there is no danger around. For many sufferers of panic attacks, it can feel as though they are having a heart attack.

Those who suffer from panic disorders may also be in a state of fear that the next panic attack is about to happen. This can be seriously debilitating as it may prevent normal daily activities such as going to work, socialising and even going into public spaces.

Symptoms of a panic attack include:

• Fear of losing control or even dying
• Feeling separated from what is happening around you
• Heart pounding
• Chest pain
• Stomach pain
• A feeling like you are choking
• Sweating and chills
• Trembling
• Trouble breathing
• Dizziness
• Nausea

Phobias

Phobias are a serious fear of specific objects, animals, people, activities or situations, even if they are not specifically threatening. They can cause great distress and lead people to avoid situations they feel might trigger their anxiety.

Specific phobias can range from fear of being in situations from which you cannot escape (agoraphobia) to a fear of germs (mysophobia). According to this study, fears involving animals and heights are the most common.

Social Anxiety Disorder

For sufferers of social anxiety disorder, social engagement causes a significant amount of anxiousness. A person with social anxiety disorder might avoid social interaction in fear of being rejected, judged, or belittled. It can get in the way of daily functioning and be a great source of distress for those who struggle with it.

Treatment of anxiety disorders

So how do we cope with anxiety disorder?

Luckily, there is help available in various forms. Because there is no one experience of anxiety, there is no one treatment. You might find that a combination of these options work to improve your mental health and well-being.

Medication

Anti-anxiety medications help many people struggling with anxiety disorders. These will need to be prescribed by your doctor and require follow-up appointments to monitor the effects of the medication.

Anti-anxiety medication may cause side effects, including feelings of agitation, digestive trouble, headaches, and dizziness. It’s important to work with your doctor to adjust your medication program if need be.

The most common types of anti-anxiety medications are:

• Selective serotonin reuptake inhibitors (SSRIs). Regularly used as a treatment for depression, SSRIs help to increase your levels of serotonin — a hormone that helps stabilise mood and promotes feelings of well-being.
• Serotonin and noradrenaline reuptake inhibitors (SNRIs). Also an antidepressant, this type of medication increases your supplies of both serotonin and noradrenaline — a neurotransmitter that helps regulate your “flight or fight” response and respond to danger.
• Pregabalin. If antidepressants aren’t working, you may be prescribed pregabalin, a medication that is also used to treat epilepsy that has shown to be effective as a treatment.
• Benzodiazepines. If you are suffering from a severe case of anxiety, you might be prescribed benzodiazepines for short-term use. This medication is a type of sedative and can’t be taken on a long-term basis. 

Talk therapy

Talk therapy — also called psychotherapy — can be a very effective treatment for some anxiety disorders. One of the most widely used types of talk therapy for this purpose is Cognitive Behavioural Therapy (CBT). Through discussion with a mental health professional, you can gain insight into your negative thoughts so that you can develop skills to cope with them.

Support groups may be an effective treatment for a range of anxiety disorders. Researchers are continuing to find new ways to support patients in this format. 

But while CBT has proven to be helpful, some anxiety disorders like social anxiety disorder (SAD) and panic disorder may require other forms of treatment, such as medication.

Lifestyle strategies

• Try grounding techniques. As the name suggests, grounding techniques can help ground you in the present moment and bring you back from racing thoughts. Your senses can play a huge role in anchoring you in this way.

A useful strategy to help with anxiety attacks is the 5-4-3-2-1 technique.

Acknowledge:

• FIVE things you can see, for example window, tree, cellphone, cushion, cup
• FOUR things you can touch, for example, shirt, hair, socks, table
• THREE things you can hear, for example traffic, the neighbour’s music, fan
• TWO things you can smell, for example coffee, cologne
• ONE thing you can taste, for example, the garlic from your lunch
• Move. Regular exercise helps to both reduce and stave off anxiety symptoms. Exercising in nature — or “green” exercise — could have profound effects.

And if it feels overwhelming, start small. Just 15 minutes of regular exercise can help have benefits and help you build up a routine.

It’s important that exercise as a treatment for anxiety is not as effective as medication.

• Hit the pause button. If you are feeling overwhelmed, taking a break can help stave off a breakdown. For some, this can be as simple as a walk around the block or a chat with a friend.
• Focus on what you put into your body. This means nutritious, regular meals and limiting the amount of alcohol, caffeine, and processed food that you consume. 
• Prioritise sleep. Factor getting enough sleep into your daily schedule. Sleep and mental health issues have a complicated relationship with one another — one causing the other causing the other. So, it may not be that easy to get sleep if you are already struggling with anxiety symptoms. 

But what you can do is try your best to practice sleep hygiene by going to bed at the same time every night in a dark room with no devices to distract you.

• Try relaxation technique. Ancient practises such as yoga and meditation are getting renewed attention in terms of how they may contribute to our mental health. 

While the research is still ongoing, meditation may offer our brains the opportunity to grow new neurons and form new connections and, in doing so, help keep symptoms of anxiety disorders at bay.

• Take deep breaths. This simple and effective tool can really help. Breathing and mental health issues have a strong link. A simple series of intentional inhales and exhales can do wonders.

One option is the 4-7-8 breathing technique, where you inhale for four seconds, hold for seven seconds, and exhale for eight.

• Do things you love. Involving yourself in activities that you really enjoy can seriously help reduce stress. Play that instrument, paint that picture, row that canoe, climb that mountain, volunteer with a local organisation. Make time for the things that matter. Better yet? Do them with others. 
• Be gentle with yourself. There are some things you can control, others you can’t. You’re doing your best. 

Key Takeaways

There are various causes of anxiety and different ways that it manifests. The most common forms are GAD, panic disorders, phobias, and social anxiety. Because experiences vary, so do the treatments needed to respond to them.

The bottom line is, no matter where you are in your life, there is help available. You can find coping strategies that are appropriate for you. And you don’t have to do it alone.

FAQs

What is the 3 3 3 rule for anxiety?

This technique has proven to be effective for quieting anxious thoughts. A strategy with similar principles to the 5-4-3-2-1 strategy we have discussed, the 3-3-3 rule requires naming three things that you can see, then three things that you can hear, and then moving three parts of your body.

What is the most important tip for coping with anxiety?

The most important piece of advice is that no two struggles are the same. The unique combination of strategies that you need to cope with anxiety is not the same as what others might need. Getting to know yourself, your triggers, and what helps you in times of need will make it possible to live with anxiety disorders.

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.