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Anxiety

Introduction

Anxiety is a normal part of life. It affects us all to varying degrees and we all experience feelings of anxiety at some point in our lives. For example, we may feel anxious about an exam, job interview, or approaching hand-in date. Feeling anxious is perfectly normal. Sometimes the thoughts and feelings associated with anxiety can be used positively to motivate us into action. However, when the frequency and severity of anxiety becomes extreme and very difficult to manage, this can negatively impact on our lives and we could be said to be ‘suffering with anxiety’; sometimes this may be given a clinical label where it is known as Generalised Anxiety Disorder (GAD) if the symptoms persist more days than not for at least six months. With such a condition feelings of anxiety are more constant and often affect daily life significantly.

Whereas stress may come and go as the external factors causing it change (be it a work, relationship or academic issues, etc.) anxiety is something that can persist even when external factors seem calm.

When we struggle to manage our anxious feelings we tend to imagine that things in life are worse than they really are (catastrophizing) and this can prevent us from confronting our fears. What is important is the recognition that anxiety is normal. It has a neurobiological origin formed in our early childhood development, perhaps when we were distressed by separation from our figure of security (often a parent). As adults it can be experienced as a response to trauma. Human evolution equipped us with an internal alarm system designed to protect us from danger. This system would make us hyper-alert by giving us a boost of adrenaline that would increase the heart rate and boost the amount of oxygen going to our limbs so we were better able to fight or run from danger. This is known as the “fight or flight” response. The “butterflies in the stomach” feeling that many associate with anxiety is this mechanism kicking in, but instead of being used to avoid immediate danger, it is often wrongly and inappropriately activated in a person during normal, everyday situations when stress or anxiety has built up, often unknowingly.

Sometimes there is an identifiable cause for anxiety; a traumatic incident, lots of cumulative stressors or a significant life event (e.g. a bereavement or serious illness). However, sometimes there doesn’t appear to be an identifiable cause for anxiety and this itself can cause distress. One way of thinking about anxiety is to imagine shaking a can of fizzy pop. If we keep experiencing stressors (or continually shaking the can), over time it will need to release. This can be a good way of looking at anxiety as it explains why sometimes it can seem to come out of the blue with no significant trigger. However, what has happened is that the trigger was just a very small stressor but collectively they join to make the drink explode.

Symptoms of anxiety

Symptoms are often a combination of physical, psychological and behavioural indicators.

Common physical symptoms of anxiety are: 

  • Increased heart rate
  • Increased muscle tension
  • A tingling sensation in the hands and feet
  • Hyperventilation (over breathing)
  • Dizziness
  • Difficulty in breathing/shortness of breath
  • Feeling sick
  • Tightness in the stomach/butterflies
  • Headaches
  • Increased perspiration
  • Dry mouth
  • Shaking
  • Palpitations

Common psychological symptoms (or thoughts we experience during periods of anxiety) are:

  • Thinking that you may lose control
  • Feeling keyed up/on edge
  • Ruminating – going over and over the same thoughts
  • Thinking that you may have a heart attack or faint
  • An acute sense that people are looking at you and observing your anxiety
  • Feeling detached from your environment and the people around you
  • Wanting to run away/escape from the situation
  • Feeling edgy and hypersensitive to embarrassment/shame

Behavioural Responses

Most commonly, we respond to anxiety by trying to avoid its cause, as this brings the most immediate relief and sense of security. This isn’t always possible and is only a short term solution. This means that whilst it may seem like avoidance is the best thing to do at the time, you never get to find out whether your fear about the situation and what might happen is actually true.

  • Avoidance
  • Excessive checking
  • Social distress
  • Urge to escape uncomfortable situations
  • Difficulty relaxing
Managing Anxiety

Although when we’re anxious it is tempting to reach for some immediate comfort – maybe by eating comfort food, drinking alcohol or putting off doing something (procrastinating) and doing something less anxiety provoking instead, it is important to manage anxiety in as healthy a way as possible to combat it. Try to:

Exercise

Regular exercise will help combat stress and release tension. It also encourages your brain to release the chemical serotonin, which can improve your mood.

Aim to do at least 15 minutes of moderate exercise every day. Going for a brisk walk is a good example, or jumping on the spot for a high intensity shake out of tension and anxiety.

Relaxation

As well as getting regular exercise, learning how to relax is important. You may find relaxation and breathing exercises helpful, or you may prefer activities such as meditation, Yoga or Pilates to help you unwind.

Diet

Changing your diet may help ease your symptoms. Too much caffeine can make you more anxious than normal. This is because caffeine can disrupt your sleep and also speed up your heart rate. If you are tired, you are less likely to be able to manage your anxious feelings.

Smoking and drinking

Smoking and alcohol have been shown to make feelings of anxiety worse. Drink alcohol in moderation and, if you smoke, try to give up. You can get free help giving up smoking from the NHS.

Counselling

The very process of naming your anxiety and exploring its symptoms, roots and causes through talking or writing helps to relieve the symptoms. Communicating and being open acts as release and can empower you to understand what might be behind the cause of the anxiety. It can provide you with useful resources and coping strategies for managing anxiety.

Support

The University Counselling Service is available for face-to-face counselling, email counselling and a range of workshops. Medical support can be obtained through your GP.

Resources

Change the way you feel by changing the way you think is a free E-book containing strategies and exercises to help challenge negative thought patterns and behaviours: https://www.crcpress.com/go/change_the_way_you_feel_by_changing_the_way_you_think_freebook?&utm_medium=email&utm_source=ExactTarget&utm_campaign=161004547_1556941

SAM is a self-help app, developed at UWE, to help you understand, monitor and manage your anxiety in a range of situations. The app will allow you to viusalise your anxiety profile over time, discover and apply self-help techniques including multimedia and mini-games, share anonymous advice and ratings with the user community (the "social cloud"). Sam is free to download to your Android or iPhone: http://sam-app.org.uk/ 

Mindshift App is available on both itunes and google play is CBT in your pocket. It helps you stop avoiding anxiety and face it!

https://www.headspace.com/headspace-meditation-app free for 10 days

http://www.dwmh.nhs.uk/wellmind/ App for stress anxiety and depression

Information sourced from https://www.anxietyuk.org.uk/

http://www.nhs.uk/Conditions/Anxiety/Pages/self-help.aspx

http://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/

http://www.moodjuice.scot.nhs.uk/anxiety.asp

http://www.time-to-change.org.uk/category/blog/anxiety

'It gets brighter' - information and videos on dealing with mental health difficulties: http://www.itgetsbrighter.org/

https://www.youtube.com/watch?v=oco9Ad-Gd5U&feature=youtu.be video on experiences of anxiety - with thanks to NUI Galway (please note that resources referred to in this video are not available to students and staff at Warwick)

Article from the Boar on mental health and support http://theboar.org/2015/10/13/lets-talk-about-mental-health/

Self Help Resources

http://www2.warwick.ac.uk/services/counselling/student/selfhelp

http://www.patient.co.uk/health/Relaxation-Exercises.htm

http://helpguide.org/mental/stress_relief_meditation_yoga_relaxation.htm

Coventry and Warwickshire NHS trust has a number of self-help apps available to download http://www.covwarkpt.nhs.uk/dont_panic/pages/default.aspx

Guided self help booklet on anxiety http://www.ntw.nhs.uk/pic/selfhelp/

https://www.futurelearn.com/courses/anxiety-depression-and-cbt free online course on anxiety, depression and CBT

The University of Warwick cannot be responsible for the content of other websites

The following references are available from the University Library either in hard copy, CD or eBooks. Most are readily available to buy either in bookshops or over the internet. There are also a limited number of books in the Learning Grid and the Bio-med Grid:

Title Author Publisher/Format
Fear: The Friend of Exceptional people: Techniques in Controlling Fear. Geoff Thompson Ebook
Overcoming Anxiety, Panic and Depression: New Ways to Regain Your Confidence James Gardner, Arthur H Bell Ebook
Conquering Fear Rowe Mind
How to Cope with Panic Attacks Teevan and Gorman Mind
How to Stop Worrying Flory Mind
The Anxiety and Phobia Workbook Bourne, Edmund J New Harbinger Publications
When Panic Attacks (Book and CD) Aine Tubridy Newleaf
Overcoming Anxiety (CBT) Helen Kennerley Robinson
Overcoming Panic (CBT) Derrick Silove & V Manicavasagar Robinson
Coping with Anxiety and Depression Trickett Sheldon Press
Don’t Panic Wilson, Robert R Harper Perennial
Panic Attacks Christine Ingham Thursons
The Worry Cure, Stop Worrying and Start Living Leahy Piatkus
Understanding Panic Attacks and Overcoming Fear Baker Lion

Further Reading

Free Yourself From Anxiety: A self-help guide to overcoming anxiety disorders, by Emma Fletcher and Martha Langley

50 Things You Can Do To Manage Anxiety by Wendy Green

Overcoming Social Anxiety & Shyness by Gillian Butler

Mindfulness: A practical guide to finding peace in a frantic world by Prof Mark Williams and Dr Danny Penman

Anxiety: A Very Short Introduction (Very Short Introductions) by Daniel Freeman and Jason Freeman

Relaxation Techniques for a Healthy Life: Ultimate Guide to Reduce Stress and Anxiety by Anna Rowe and Val Clews