What is Anxiety?
Anxiety is an emotion that causes us to feel a sense of unease, worry or fear. It is normal to experience anxiety at times, however, it can become problematic if we start to experience it for prolonged periods or if it starts to impact on day to day functioning. There are many different types of anxiety disorder and this article will give a brief overview of some of the most common ones. Treatment is available for all of the anxiety disorders outlined and at Brighter Minds, we want to help you overcome anxiety.
Generalised Anxiety Disorder
Generalised Anxiety Disorder (GAD) is characterised by long-term worry about different things rather than one thing in particular. For example, if you have GAD, you may find that you worry about things such as work, finances, health, making mistakes, or upcoming events. When one anxiety trigger or worry is resolved, the focus tends to move onto the next one and you may therefore find it hard to remember a recent time where you felt relaxed or were not worrying about something. Symptoms of GAD typically involve feeling nervous, anxious and on edge which can make it difficult to switch off, relax or concentrate on things. You may also feel irritable, have difficulties sleeping and feel tired.
If you have GAD, you are likely to feel uncomfortable with uncertainty and want to feel a sense of control over things. You may try to achieve this by planning excessively, trying to predict and prepare for all possible outcomes, researching things in detail before carrying out a task or activity, or avoiding things that you don't feel you have certainty about or control over.
GAD is a common condition that is estimated to affect roughly 5% of the population in the UK. However, people can often believe the anxiety they feel to be part of their personality (being a ‘worrier’) rather than signs of an anxiety disorder and it is therefore possible that this figure is under-represented.
Health anxiety is characterised by excessive preoccupation and worry about your health. This may be related to a specific illness, such as cancer, or the illness may change depending on the presence and perception of different symptoms. For example, you may worry that a mole is a sign of skin cancer, that a headache is a sign of a brain tumour or that an increased heart rate is a sign of cardiovascular problems.
If you have health anxiety, you will likely pay excessive attention to bodily sensations and check for and monitor signs of illness. You may try to manage anxiety by seeking reassurance by researching the condition you are worried about or seeking medical advice. Alternatively, you may try to manage the anxiety by avoiding anything health related, including TV shows, news stories, or healthcare appointments and professionals. Anxiety itself can result in a number of physical symptoms that can exacerbate health anxiety as these symptoms may also be interpreted as an indication of physical illness.
Social anxiety can also be known as social phobia and involves a long-term fear of social situations. The anxiety caused by interactions with others can have a significant impact on lifestyle and day to day functioning. Some of the signs of social anxiety can include feeling overly concerned about what others think of you; feeling fearful of being watched, judged or criticised; having low self-esteem and confidence; worrying significantly about social situations and interactions with others.
Social anxiety triggers can vary and may include things like:
· Speaking to a shop assistant or bus driver
· Making eye contact
· Making a phone call
· Sending a text or email
· Attending work meetings
· Meeting new people
· Attending social events such as weddings or birthday parties
After a social interaction, you may find yourself replaying events and conversations and feeling concerned that you have done or said something that made you look bad in some way. For example, you may repeatedly re-read an email you have already sent to check for mistakes or anything that could be interpreted negatively about you or you may try to recall the details of a conversation to see if you could have unintentionally said something to cause offense or embarrassment. You may try to gain anxiety relief by avoiding or limiting social situations. However, this creates a vicious cycle that maintains the problem.
It is not unusual for people with social anxiety to also suffer with other mental health difficulties such as generalised anxiety and depression.
Obsessive-Compulsive Disorder (OCD) involves obsessive thoughts that cause anxiety and compulsive behaviours that are believed to alleviate this anxiety. An obsession may be a thought, image or urge that is unwanted. They are often described as intrusive in that they occur unintentionally and are often recurrent. Obsessions can cause you to feel distressing emotions such as anxiety, shame and disgust, depending on their nature. A compulsion is a behaviour that is believed to be necessary to alleviate these feelings to offer temporary anxiety relief. This may be a visible behaviour such as washing, cleaning or checking things. Or it may be a mental act such as counting, replaying a situation, or mentally repeating a word or phrase.
OCD can be very distressing due to the lack of control felt about the intrusive nature of obsessions and what this is perceived to mean. Some people may feel too embarrassed or ashamed to talk about their obsessions. However, OCD usually requires treatment in order for improvements to be made. The most effective treatment for OCD is CBT which includes Exposure Response Prevention (ERP) and medication. ERP involves being gradually exposed to anxiety triggers and not using compulsions to manage anxiety. This helps you learn that you can cope with anxiety, and that the anxiety reduces with time without the need for compulsions.
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after a traumatic experience. PTSD is often associated with veterans, however, it can develop from other traumatic events such as abuse, assault, accidents or injuries. Symptoms of PTSD include re-experiencing the event through flashbacks and nightmares. This is different to recalling the event as a memory. If you have PTSD, in re-experiencing, you feel as though you are experiencing the event as if it is happening. You may also experience associated physical sensations such as pain, sweating or crying.
PTSD can result in hyperarousal which is an increased state of alertness that can result in you feeling under threat and on edge, in the absence of any current danger. You may find you startle easily in response to unexpected sounds or physical contact. Hyperarousal can result in hypervigilance which is where an increased amount of attention is paid to identifying potential threats in order to improve the ability to respond to or escape from them. This can affect your ability to relax, impact sleep, cause irritation and feelings of anger.
People with PTSD may also suffer with other problems such as depression, substance use or relationship difficulties. CBT can help people overcome PTSD by providing treatment for flashbacks and nightmares, supporting with processing the trauma and so finding a meaningful way forwards.
A phobia is an overwhelming fear of something specific. Some common examples of phobias include spiders, heights, vomit and needles. A phobia is more severe than fear and involves an excessive sense of perceived danger in response to the trigger which can result in debilitating distress. It is possible for people with phobias to maintain their lives without distress unless there is risk of coming into contact with the trigger. Someone with a needle phobia, for example, may not be affected by this day to day but may become extremely anxious if they need a blood test or if they are unexpectedly exposed to a scene on a TV show that involves a needle. Other people may feel anticipatory anxiety about the possibility of being exposed to the trigger. In this case, someone else with a needle phobia may actively avoid any TV programmes or films that have a health theme in case they include a scene with a needle because the possibility of this evokes anxiety.
Panic disorder involves the experience of acute anxiety, stress or fear that comes on unexpectedly. This can result in a panic attack. Symptoms of a panic attack can include:
· Heart palpitations
· Shortness of breath
· Chest pain
· Blurred vision
· Pins and needles
· A physical urge to go to the toilet
· An acute fear of death
· A feeling of dread
Panic attacks pass, however, these symptoms can feel very frightening and are often misinterpreted as symptoms of a serious medical problem such as a heart attack which can cause further distress. If you have had a panic attack, you may worry about it happening again. This may lead to worry, anxiety or avoidance of certain things you may associate with the experience. For example, if you experience a panic attack in a shopping centre, you may feel very anxious about going back to the same shopping centre and so start to avoid it. You may generalise this to all shopping centres and start to avoid them and other public places too. This can sometimes result in further problems such as generalised anxiety, agoraphobia and depression.
There are different types of eating disorder including anorexia, bulimia and binge-eating. Eating disorders involve a dysfunctional relationship with food and body image. Eating disorders may involve eating too much, too little or going between the two extremes. There is often a preoccupation with body image, shape, size and weight. This may include body dysmorphia disorder which involves excessive concern over an aspect of your body that would either not be noticeable to others or where your perception of your body differs significantly from how it is perceived objectively.
Eating disorders can have a significant impact on physical health and the body’s ability to function normally. Depending on the chronicity and severity of the eating disorder, specialist treatment through an eating disorder service may be required. In cases of very low Body Mass Index (BMI), a hospital admission may be required.
COVID and Anxiety
It is likely that we have all experienced a degree of anxiety about the pandemic at some point. However, we are seeing an increase in people experiencing difficulties with anxiety. This may be in relation to uncertainties about the future, feeling a lack of control, feeling concerned about the risks of having and passing on coronavirus or a number of other factors.
It is normal to feel anxious during a pandemic, however, if the level of anxiety you are experiencing is impacting your day to day life or if you identify with the descriptions in this article, you may wish to consider speaking with a professional about the support that may be helpful for you.
How Brighter Minds can Help with Anxiety
It’s really important to know that there is support and treatment for anxiety disorders. Brighter Minds offer Cognitive Behavioural Therapy (CBT) which is the psychological therapy recommended by the National Institute for Health and Care and Excellence (NICE) for the anxiety disorders outlined in this article. CBT works by helping us understand the role that our thoughts and behaviour play in the development and maintenance of anxiety disorders. We can then identify and change unhelpful patterns of thoughts and behaviour in order to break negative cycles and manage anxiety symptoms to improve mental health and wellbeing. You can find out more about CBT in our article, What to Expect from Cognitive Behavioural Therapy (CBT).
If you're looking for help with anxiety and wants some practical CBT techniques and exercise to improve anxiety symptoms, we're here to help. You can book an initial consultation online to get started right now.
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