Stress, Anxiety and Depression
There are over 100 symptoms of anxiety. Each person has a unique chemical make up so the type, number, intensity, and frequency of anxiety symptoms will vary from person to person. For example, one person may have just one mild anxiety symptom, whereas another may have all anxiety symptoms and to great severity.
What is anxiety?
- Anxiety is ‘being afraid’ and occurs as a result of perceived danger. This in turn activates a self- protection mechanism to alert us to and protect us from this perceived danger. Hence the body reacts and produces the symptoms of stress, as described in the ‘Stress’ section of this leaflet.
- Anxiety is a needed protection mechanism.
- Anxiety turns into a disorder when a person becomes physically, psychologically or emotionally symptomatic, fearful or distraught because of it. If it does become a disorder, it can be reversed.
- Anxiety is not something which is genetically inherited or an illness which can be contracted.
Essentially people with anxiety live more stressfully and fearfully than others and as a result the body produces symptoms of stress or ‘anxiety symptoms’.
The National Institute of Mental Health lists the six main categories of anxiety disorder as:
- Panic Attack Disorder (Anxiety Attack Disorder, Anxiety Attacks, Panic Attacks)
- Generalised Anxiety Disorder (GAD)
- Obsessive-Compulsive disorder
- Social Anxiety Disorder
- Post-Traumatic Stress Disorder
According to NHS Choices, if you are anxious as a result of a phobia or because of panic disorder, you will usually know what the cause is. For example, if you have claustrophobia (a fear of enclosed spaces), you know that being confined in a small space will trigger your anxiety.
However, if you have GAD, what you are feeling anxious about may not always be clear. Not knowing what triggers your anxiety can intensify your anxiety and you may start to worry that there will be no solution.
Anxiety conditions can generally be divided into two main categories:
- Circumstantial anxiety – this is when symptoms appear because of acute stressful events, circumstances or emotions. Examples include a relationship difficulty, job loss or job promotion, illness or death of a loved one, or heavy workload. A build up of stress often comes before an anxiety condition, most early stress conditions fall within this category. Once the event, circumstance, or emotion has passed, with sufficient self-help materials, rest, and time, most anxiety conditions in this category resolve on their own.
- Chronic anxiety – this is when the symptoms come and go over an extended period of time, months to a year or more. Examples include, where the symptoms come and go at different stages of life or remain as a background throughout someone’s life. Chronic anxiety also has a deep-seated fear component. Many feel that they live in fear whenever their “episodes of illness” appear. Others may have it as a constant companion as they journey through life. Episodes can last a few weeks to many years. Some can remain constant throughout their life.
Within these two categories there are four types of anxiety:
Spontaneous anxiety or panic – anxiety or panic that occurs regardless of where a person is.
Situational or phobic anxiety or panic – anxiety or panic that occurs because of a particular situation or location.
Anticipatory anxiety or panic – anxiety or panic that occurs because of a thought that something “might” happen or a situation that “might” occur.
Involuntary anxiety or panic – anxiety or panic that occurs involuntarily, by itself, or “out of the blue” that hasn’t been preceded by spontaneous, situational, or anticipatory anxiety.
Symptoms of anxiety
General anxiety disorder can cause physical and psychological symptoms. They often develop slowly and vary in severity from person to person.
Psychological symptoms include:
- a change in behaviour and the way you think and feel about things
- a sense of dread
- feeling constantly ‘on edge’
- difficulty concentrating
- easily distracted.
These symptoms may cause people to withdraw from social contact [visiting family and friends] to avoid the feelings of worry or dread. It may be difficult and stressful to go to work and sick leave may be necessary. However, these actions can cause even more worry and add to the feeling of lack of self-esteem.
There are over 100 symptoms which include:
- drowsiness and tiredness
- pins and needles
- irregular heartbeat (palpitations)
- muscle aches and tension
- dry mouth
- excessive sweating
- shortness of breath
- stomach ache
- excessive thirst
- frequent urinating
- painful or missed periods
- difficulty falling or staying asleep (insomnia)
Many people can achieve some form of anxiety and symptom reduction on their own although the results may be temporary.
There are two main forms of treatment for generalised anxiety disorder:
- psychological therapy – this is often prescribed before medication. The main form is psychological treatment is cognitive behavioural therapy [CBT]. Evidence suggests that about 50% of people who have CBT recover and many others obtain some benefit. CBT mainly focuses on the problems that you are experiencing in the present, rather than events from the past. It teaches you new skills and helps you to understand how to react more positively to situations that would usually cause you anxiety. The National Institute for Health and Clinical Excellence [NICE] recommends that you should have a total of 16 to 20 hours of CBT over a period of four months. Your treatment will usually involve a weekly one- to two-hour session.
- medication – usually antidepressants. NICE  says that you have the right to make informed decisions about their treatment and antidepressants are one option but decisions about their use need to be based on a shared problem assessment and a care plan that accounts for your preferences.
Depending on the circumstances, one of these treatments or a combination of both may be beneficial. No single treatment is best for everyone although there is evidence that psychological treatments last the longest.
Your GP should discuss all your treatment choices with you before you begin any form of treatment giving you the advantages and disadvantages of all and at the same time, discuss any possible risks or side effects. You can then make a decision with your GP about which treatment is most suitable for you, taking into account your circumstances and preferences. For example, some people may prefer psychological treatment such as counseling, in preference to treatment with antidepressants.
Exercise – it is well worth remembering that physical activity helps to relieve anxiety.