I recently “outed” myself as having anxiety, a condition that is just part of my make-up (would anyone choose to have this condition?). I used to be very embarrassed that I had the condition, but mustered the courage to realise that there’s no shame in having it. But it’s a common enough condition, and I want to talk more about it here.
Anxiety is an entirely normal emotion that everyone experiences from time to time, such as in the run up to exams or a job interview. But when anxiety becomes much more severe, it can take over parts of your consciousness and begin to interfere with everyday life.
Conditions under the anxiety umbrella include:
- Social anxiety
- Generalised Anxiety Disorder (GAD)
- Panic Disorder
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
Recognising that you have might have one of these is the first step – because you can then do something about it. There are a lot of symptoms and signs that we can use to recognise the difference between normal anxiety and one of these heightened senses.
For people with an anxiety disorder, feelings like stress, panic, and worry are longer lasting, more extreme, and far harder to control. Symptoms may also include feeling restless or agitated, panic attacks, having trouble concentrating or sleeping, sweating, shortness of breath, dizziness, and heart palpitations.
Putting it another way, anxiety can feel like a spotlight in your mind shining on your deepest fears or worries all the time. Dealing with anxiety can be intense, and the impact can be debilitating. It can stop people living the life they want – whether that means not being able to work, see friends or, in the most severe cases, even leave the house.
Excessive worry is the inherent core of generalised anxiety disorder (GAD). But what constitutes “too much” worry? In the case of GAD, it means having persistent anxious thoughts most of the time, on any subject you could potentially imagine.
The precise causes of these inter-related mental health issues aren’t fully understood as yet, although medical researchers think that there’s a probably a combination of several factors playing a role:
- Over-activity in areas of the brain involved in emotions and behaviour.
- An imbalance of two particular brain chemicals involved in the control and regulation of mood.
- Your genes; you’re five times more likely to develop GAD if you have a close relative with the condition.
- Having a history of stressful or traumatic experiences, such as domestic violence, child abuse, or bullying.
- Having a painful long-term health condition, such as arthritis.
- Having a history of drug or alcohol misuse.
All that said, many people develop GAD for no apparent reason. Interestingly, slightly more women are affected than men, and the condition is more common in people from the ages of 35 to 59.
But more importantly, it’s important to realise that anxiety can be managed. When I tried CBT therapy back in 2015, I wasn’t fully able to absorb all the lessons, but I did find that a weekly mindfulness meditation with a couple of friends really helped.
But there are so many different options for support and self-care that there’s something out there for everyone.
Talking it through. Although it can be difficult to open up, it often helps talking to friends, family, or someone who has had a similar experience. Although you might feel embarrassed or afraid to discuss your feelings with others, so many people want to help those they care about, and are willing to listen, even if they can’t come up with any suggestions. Sharing can be a way to cope with a problem, and being listened to can help you feel supported. I opened up to a friend recently for the first time – I’d never done it before – and it felt really liberating. I actually found that, when I started talking, I couldn’t stop, but once it was all out, I felt so much better knowing that someone else knew. Everyone who reads these blogs know, so the cat’s out the bag now.
Face your fear. By breaking the cycle of constantly avoiding situations that make you anxious, you are less likely to stop doing the things you want, or need, to do. The chances are the reality of the situation won’t be as bad as you expect, making you better equipped to manage, and reduce, your anxiety.
Know yourself. Make a note of when you feel anxious, what happens, and the potential triggers. By acknowledging these and arming yourself with tips to deal with these triggers, you will be better prepared in anxiety-inducing situations.
Exercise. Even small increases in physical activity levels can trigger brain chemicals that improve your mood, well-being, and stress levels. This can act as a prevention and treatment for anxiety as well as lead to improved body-image, self-esteem and self-worth.
Healthy eating. Eat lots of fruit and vegetables and try to avoid too much sugar. Very sweet foods cause an initial sugar ‘rush,’ followed by a sharp dip in blood sugar levels which can give you anxious feelings. Caffeine can also increase anxiety levels, so try to avoid drinking too much tea or coffee as well.
Mindfulness focuses you on changing the relationship between you and your thoughts. Meditation can help people be ‘mindful’ of their thoughts and break out of a pattern of negative thinking, so it’s more than just sitting and trying to not to think about whatever is worrying you. Mark Williams, professor of clinical psychology at the Oxford Mindfulness Centre, says “An important part of mindfulness is reconnecting with our bodies and the sensations they experience. This means waking up to the sights, sounds, smells, and tastes of the present moment.”
Breathing helps you take some time out. It sounds obvious, but focusing on your breathing can help calm you down. My friend and expert hypnotherapist Barbara Neill argues that, by focusing on your breathing, it’s easier to ignore any bad thoughts trying to creep their way into your subconscious.
Find a distraction. Perhaps you have a favourite podcast that you enjoy listening to, or a favourite Youtuber. When you feel anxious, put said podcast or video on in the background of whatever you’re doing.
Baby steps. Try dealing with the problems that make you anxious one step at a time. Often when you suffer from an anxiety disorder, even something seemingly simple such as making a phone call or going to meet a friend can seem like a huge task. Break it down into small steps.
All of these are things we can do for ourselves, but there will be times when professional help is needed, entirely appropriate, and absolutely fine to try.
Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. The basic premise is that our thoughts – not external events – affect the way we feel. In other words, it’s not the situation you’re in, but your perception of the situation. “Thought challenging” is where you challenge the negative thinking patterns that contribute to your anxiety, replacing them with more positive, realistic thoughts. This involves three steps:
- Identifying your negative thoughts. With anxiety disorders, situations are perceived as more dangerous than they really are. To someone with a germ phobia, for example, shaking another person’s hand can seem life threatening. Although you may easily see that this is an irrational fear, identifying your own irrational, scary thoughts can be very difficult. One strategy is to ask yourself what you were thinking when you started feeling anxious.
- Challenging your negative thoughts. In the second step, you will need to evaluate your anxiety-provoking thoughts. This involves questioning the evidence for your frightening thoughts, analysing unhelpful beliefs, and testing out the reality of negative predictions. Strategies for challenging negative thoughts include conducting experiments, weighing the pros and cons of worrying or avoiding the thing you fear, and determining the realistic chances that what you’re anxious about will actually happen.
- Replacing negative thoughts with realistic thoughts. Once you’ve identified the irrational predictions and negative distortions in your anxious thoughts, you can replace them with new thoughts that are more accurate and positive. Your therapist may also help you come up with realistic, calming statements you can say to yourself when you’re facing or anticipating a situation that normally sends your anxiety levels soaring.
Medication is used to provide short-term help, rather than as a cure for anxiety problems. Drugs may be most useful when they are combined with other treatments or support, such as talking therapies. If psychological treatment doesn’t help, or you’d prefer not to try them, you’ll usually be offered medication.
In most cases, the first medication you’ll be offered will be a type of anti-depressant called a selective serotonin reuptake inhibitor (SSRI). This works by increasing the level of a chemical called serotonin in your brain, and they can be taken on a long-term basis. But, as with all antidepressants, they can take several weeks to start working. You’ll usually be started on a low dose, which is gradually increased as your body adjusts to the medicine.
If SSRIs don’t help ease your anxiety, you may be prescribed a different type of anti-depressant known as a serotonin and noradrenaline reuptake inhibitor (SNRI). This type of medicine increases the amount of serotonin and noradrenaline in your brain.
Benzodiazepines (like diazepam) are a type of sedative that may sometimes be used as a short-term treatment during a particularly severe period of anxiety, because they help ease the symptoms within 30 to 90 minutes of taking the medication.
An anxious mind is a strong, powerful mind, as anyone who has tried to rationalise themselves out of anxiety will tell you. An anxious mind can outrun, out-power, and outwit rationality and logic any day of the week. What if you could harness the strength and power of that fiercely protective mind and use it to work for you instead of against you?
But what if we could harness the strength and power of that fiercely protective mind, and use it to work for us instead of against us? Mindfulness works to build and strengthen a brain against anxiety, but there are aspects of mindfulness that can be used in the midst of anxiety to find calm. With practice, they can be called on at will to turn down the volume on anxious thoughts and feelings.
Changing your mindset involves small, repeated steps. Each step builds on the one before it, and this takes time. That’s okay though – there’s no hurry. Remember, your mind has been doing what it’s doing for a lifetime, and it will take time to unlearn its habits. But the anxiety will fade in time, and you will feel better for it.