• Anxiety is normal - our brains are wired to be alert to danger.
• Feelings of anxiety can help us prepare, focus and protect ourselves.
• However, where these feelings persist and disrupt your daily life, they can be harmful and may indicate that you have an anxiety disorder.
• Symptoms can include dizziness, sweating, shortness of breath, palpitations, nausea, indecisiveness, irritability, distress and avoidance of situations or places.
• There are many treatment options available. Always speak to your GP in the first instance.

What is an anxiety disorder?

Anxiety is when you feel worried, tense or fearful, especially about things that are about to happen or which you think may occur in the future. Most people feel anxious at times. It is an entirely normal response to specific situations, such as feeling worried about a work situation or facing a significant event. However, if your anxiety becomes long-lasting or intense, it can start to interfere with your daily life, and you should seek help.

Anxiety disorders are common and can vary from mild general symptoms to intense symptoms of a panic attack. It is estimated that 284 million people worldwide have had an anxiety disorder at some point in their lives, which is about 4% of the global population (GBD Results Tool, 2019). The overall prevalence of mental ill-health, including anxiety disorders, in Northern Ireland is around 25% higher than in England or Scotland.

What are the symptoms of an anxiety disorder?

Everyone’s experience is different, and therefore not everyone with an anxiety disorder will have the same symptoms.

Some of the most common symptoms are:

• Thoughts – premonitions of bad things, uncontrollable overthinking, confusion, lack of concentration.
• Feelings – fear, worry, nervousness, agitation, irritability.
• Physical – headaches, muscle/chest pain, sweating, tingling, numbness, shaking, dizziness, changes in appetite, rapid or shallow breathing, rapid heartbeat or palpitations, dry mouth, nausea, vomiting, diarrhoea.
• Behaviour – avoidance of places, people or situations, not going out, obsessive or compulsive behaviour, increased use of alcohol or drugs.

What causes anxiety disorders?

When you become aware of a potential threat or danger, your brain responds by setting off its panic button. It releases hormones that prepare your body to react with the fight, flight, or freeze response. For example, when a car sounds its horn to prevent you from walking out in front of it, your brain responds, and you move out of the way.

Sometimes, these potential threats or dangers are imagined. For example, you might feel anxious thinking about speaking in front of a large group of people, despite no physical risk being present.

Usually, when the threat or danger has passed, the body returns to a normal state reasonably quickly.

However, if you have an anxiety disorder, your body may remain in a state of high alert, and you might find it difficult to switch off these bodily responses.

Depression and anxiety

These commonly go hand-in-hand. When you are depressed, you often worry about the future and have a mixture of anxiety and depression. If you have been experiencing high stress levels over a long period, it may lead to depression.

How is an anxiety disorder diagnosed?

It is essential to see your GP if you think you are experiencing an anxiety disorder. They will be able to start the diagnosis process and advise on an appropriate course of action. The GP may ask you about your psychological and physical symptoms, worries and emotions, and personal life. Your GP must understand your symptoms and circumstances so the correct diagnosis can be made. Your GP may also carry out some tests to rule out other conditions that could be causing your symptoms. These include hyperthyroidism, specific cardiac disorders or side effects of drugs, including prescription and non-prescription.

Treatment

Treatment for anxiety may involve self-help, talking therapies and medication. Once a diagnosis has been made, your GP will talk you through the different options that might work for you. Some of these include:

Self-help

It is important to try self-help techniques to help you relax and manage your symptoms better. Finding what's suitable for you might take some practice!

You can find more information about mindfulness through our mindfulness programmes.

For more self-help information, click here.

Talking Therapies

Cognitive behavioural therapy (CBT) has been proven to be effective for anxiety disorders in both the short and the long term. CBT helps you to understand the links between your thoughts, feelings and behaviours. It helps you find ways to overcome your anxiety by challenging negative thoughts and engaging in helpful behaviours. Other talking therapies such as counselling, psychoanalytical and psychodynamic therapies and guided self-help are also available.

Medication

Your GP may prescribe anti-anxiety medication for the short term to help you in a crisis. Modern antidepressants, such as SSRI’s and beta-blockers, are also very effective for specific anxiety disorders, particularly if you also have depression. It is essential to take all medication as prescribed. Anti-anxiety medication, in particular, is highly addictive and should only be taken for a short time.

Antidepressants are not addictive, but stopping them suddenly or too soon may cause a relapse. Therefore, you should take them for at least six months after you feel better, and you should gradually reduce your dosage in consultation with your GP. They can have side effects, which usually disappear or are tolerable, although you should always tell your GP about them. Antidepressants can also react with other medications, but your GP will talk you through this.