Understanding Anxiety - A Comprehensive Guide From The Independent Pharmacy

Anxiety is a natural response to unknown or worrying situations. Most of the time, you’ll probably be able to cope with short periods of mild anxiety. Sometimes however, anxiety can become constant, or become so intense that it impacts your daily life.

If you have this type of anxiety disorder, you may find you have trouble concentrating, difficulty sleeping or feel irritable or overwhelmed. You may also lose your appetite and experience heart palpitations. This could make it difficult to work and carry out essential daily tasks.

If you experience anxiety, it’s important to know that there is help and support available. You could try therapy, or you could talk to a doctor about using a medication for anxiety such as propranolol.

In this guide, we take a look at the different types of anxiety disorders, their symptoms and the support that’s available to help you stay in control of your mental health.

Get Support For Anxiety

What Is Anxiety?

Anxiety is an extremely common condition. Around one in 10 people in the UK are living with an anxiety disorder at any one time. In fact, along with depression, anxiety is one of the most common mental health issues in the world.

Like fear, anxiety is part of your ‘fight or flight’ response. This means that, when you feel you’re in a potentially dangerous or highly stressful situation, your body will prepare you to either flee or stand your ground.

During this response, your brain will produce extra cortisol and adrenaline. These hormones may make your heart beat faster, cause your blood pressure to go up and make you feel ‘on edge’.

If you have an anxiety disorder and are persistently anxious, you may be exposed to high levels of cortisol and adrenaline. This could disrupt almost all of your body’s processes and could put you at risk of a number of mental health issues.

It's normal to feel anxious about certain things, such as a driving test, job interview, presentation or stressful work situation. However, if you feel anxious about everyday social situations, find yourself obsessing over events that are unlikely to occur, or are finding it hard to work or carry out essential daily tasks, it could be a sign that you have an anxiety disorder.

Causes Of Anxiety

Everyone responds to stressful, traumatic and challenging situations differently, and there are many events and triggers that could lead to anxiety.

You may find your anxiety symptoms are caused by health worries, childhood trauma, addiction issues, work difficulties or problems at home. Feeling socially isolated could make anxiety worse, and you may also feel anxious about money, rent and other common financial challenges.

Women are almost twice as likely to experience anxiety as men, and those aged 18 to 24 are more likely to live with anxiety than any other age group. It’s also possible that your genetics or brain chemistry could make you more likely to experience anxiety.

Often, you may not be sure exactly what has caused your anxiety. It could be one specific factor, or it could be a number of things combined that are making you feel overwhelmed.

Common Symptoms Of Anxiety

The symptoms of anxiety can be very varied. You may experience psychological anxiety symptoms such as problems with concentration, racing thoughts and an overwhelming feeling of doom. These feelings may be intense and could interfere with your daily life.

Because your body releases adrenaline and cortisol in response to your anxiety, you may experience a number of physical symptoms as well as psychological changes. For example, you may have heart palpitations, breathing difficulties, dizziness and nausea.

These symptoms are commonly associated with generalised anxiety disorders (GAD). If you have another type of anxiety, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) or a phobia, your symptoms may be slightly different.

If you’re not sure what’s behind your anxiety, speaking to a doctor, therapist or healthcare professional could help.

Physical Symptoms Of Anxiety

Your anxiety disorder may trigger the ‘fight or flight’ response. During this response, your body will release adrenaline and cortisol, two hormones that help you feel more alert and give you more energy. Persistent anxiety can cause an excess of these hormones. This could result in a number of physical symptoms including:

• heart palpitations
• sweating
• breathing difficulties
• dizziness
• nausea
• muscle tension
• sleep problems
• trembling

For many people, the physical symptoms of anxiety are just as challenging as the psychological ones. Going out for a walk or run, doing breathing exercises and practicing mindfulness could help you to cope with these common anxiety symptoms.

Psychological Anxiety Symptoms

Anxiety disorders could have a real impact on your mental health. It may be difficult to push your anxious thoughts aside, and you may find you struggle to think of anything else. This can result in a number of psychological symptoms including:

• persistent worry
• racing thoughts
• concentration issues
• irritability
• feeling overwhelmed
• fear
• sense of doom
• rumination (thinking a lot about specific issues)

If you’re currently struggling with any of the physical or psychological symptoms of anxiety, there is help and support available. You could reach out to specialist groups like the Samaritans, Mind, Shout or Young Minds, or speak to your GP about anxiety management strategies.

The Five Main Types Of Anxiety Disorders

Everyone experiences anxiety differently. The exact situations, thoughts or events that trigger your anxiety will be unique to you, as will the way your mind and body respond to these stresses.

However, while everyone’s experience of anxiety is unique, the disorder can be roughly split into five different types. These are:

• generalised anxiety disorder (GAD)
• panic disorder
• social anxiety disorder
• obsessive-compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)

Generalised Anxiety Disorder (GAD)

General anxiety disorder, or GAD, is characterised by excessive, ongoing anxiety that’s difficult to control. No one’s sure why GAD may develop, but it could happen when you can’t cope with your internal stress, or it could be a side effect of a medication or the result of an addiction issue.

You can develop GAD as a child or an adult. It may appear with other mental health issues, like mood disorders and other types of anxiety, but it can also occur by itself.

Because GAD is a generalised disorder, it can be difficult to distinguish. The most common symptoms of GAD are:

• persistent worry
• overthinking plans and solutions to potential worst-case scenarios
• seeing danger in situations or events that are generally safe (such as travelling on public transport or being in crowded spaces)
• difficulty coping with uncertainty
• difficulty making decisions because you’re afraid to make the ‘wrong’ decision
• inability to relax
• difficulty concentrating
• fatigue
• muscle tension
• trouble sleeping
• sweating
• nausea
• diarrhoea
• irritability

Panic Disorder

Panic disorder is a type of anxiety disorder that causes you to have sudden episodes of fear or panic. This sudden anxiety could cause you to have a panic attack. A panic attack is an episode of intense fear that triggers a severe physical reaction to a situation that’s not really dangerous.

Common symptoms of a panic attack include:

• a racing heartbeat
• feeling faint
• sweating
• nausea
• chest pain
• shortness of breath
• trembling
• hot flushes
• chills
• shaky limbs
• dizziness
• dry mouth
• feeling like you’re not in control

Because panic attacks come on suddenly and can be very intense, they can be a little scary. You may feel confused about what’s happening to you and this could make you feel even more anxious.

Generally, panic attacks last between five and 20 minutes, but they can last up to an hour. The number of panic attacks you have will depend on how severe your disorder is and how your anxiety treatment is managed.

Social Anxiety Disorder

It’s normal to feel nervous about some social situations, such as going on a date, giving a presentation or meeting a new group of people. However, If you have social anxiety disorder (also known as social phobia), social situations may cause you significant anxiety.

You may feel an intense fear of being judged, feel very self-conscious, or experience embarrassment over small, insignificant events. This could cause you to avoid these situations and you may find your phobia disrupts your social life and leaves you feeling isolated.

Symptoms of social anxiety disorder include:

• fear of situations where you worry you’ll be judged
• worrying about embarrassing or humiliating yourself
• fear of talking to strangers
• fear that others will notice your anxiety
• avoiding social interactions because of anxiety
• avoiding social situations where you may be the centre of attention
• overthinking social situations when you get home
• expecting the worst possible consequences from social situations

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety that causes persistent unwanted thoughts and repetitive, compulsive behaviours. These thoughts and behaviours could get in the way of your daily life and cause you additional anxiety and distress.

OCD often centres around certain themes. For example, you may be very concerned about becoming contaminated by germs, or you may become obsessed with the idea of getting burgled or accidentally hurting someone else.

Examples of common OCD obsessions include:

• fear of being contaminated by germs
• worrying you haven’t locked the door or turned off the oven
• stress when objects aren’t orderly or facing a certain way
• intrusive thoughts about hurting others
• worry that you’ll act in an inappropriate way

These obsessions could result in compulsions such as:

• washing your hands repetitively
• checking doors are locked over and over again
• checking the oven over and over again
• silently repeating a word or phrase
• arranging items to be more ordered or all facing the same way

There’s a common misconception that we can all be ‘a little OCD’. However, while a lot of people may carry out some of these behaviours occasionally, people with OCD feel an intense compulsion to complete their rituals. Their obsessions often impact their daily lives, and they may find OCD begins to dominate their thought processes.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder, or PTSD, is a mental health condition that is triggered by an extremely stressful or scary event. You can develop PTSD whether you witnessed the event or were involved with it directly.

Common symptoms of PTSD include:

• flashbacks
• nightmares
• severe anxiety attacks
• uncontrollable thoughts about the event
• being easily frightened or startled
• being overly aware of danger
• self-destructive behaviours, such as excessive drinking

If you have PTSD, you may try to avoid places or situations that could be triggering. You may not want to talk about the trauma that caused your PTSD, and you may also feel emotionally numb or uninterested in activities you once enjoyed.

Everyone’s experience of PTSD is different. If you’re struggling with the symptoms of PTSD, or any other type of anxiety disorder, contact your GP or another healthcare professional.

Situational Anxiety vs. Anxiety Disorders

As well as anxiety disorders, you may also experience situational anxiety. Situational anxiety is different from an anxiety disorder because it’s normally related to a specific event, like a meeting, interview or presentation. Though it can be intense, it typically passes quickly once the triggering event is over.

Often, situational anxiety can be treated with medication such as propranolol. This could ease the symptoms of your anxiety and help you cope better with your anxious feelings.

It’s possible to experience both situational anxiety and an anxiety disorder at the same time. In fact, you may be more likely to have situational anxiety if you tend to be more anxious in general.

How Anxiety Affects Daily Life

Whether you have situational anxiety, or an anxiety disorder, you may find your symptoms impact your daily life. Fatigue, obsessive thoughts, compulsive behaviours and an overwhelming sense of doom may make it difficult to manage everything from work and study to essential daily tasks.

It's very common for people with anxiety to avoid any situations they feel will trigger their symptoms. For example, you may not want to go to social situations that you fear could increase your anxiety, avoid meetings or presentations at work, or stop leaving the house altogether.

More often than not, avoidance reinforces anxiety and makes symptoms worse long term. You could also find that you become isolated from friends and family.

It's also possible to have high-functioning anxiety. This is where you appear to function well from the outside, but experience obsessive thoughts and persistent worry on the inside.

Anxiety In Special Populations

Anxiety can affect anyone. It’s not limited to one group or sector of society and can develop at any point in your life. Anxiety could be triggered by hormonal changes or changes in your circumstances, or it could develop without any obvious cause.

Anxiety In Children And Teenagers

Often, young people with anxiety will have emotional outburst and tantrums. This is because they’re struggling to cope with the feelings they’re experiencing.

Children and teenagers may also find it hard to concentrate at school and their academic performance could slip. They may eat less than usual, be more clingy with a parent or loved one, or complain of tummy aches and feeling unwell.

Just like with adults, there can be lots of triggers of anxiety in children. Some of the most common are:

• parents fighting
• moving house or school
• exams
• bullying
• ill health of a loved one
• emotional or physical abuse

If you’re a child or teenager with anxiety, or you want to support a young person you think may have anxiety, speak to your GP about therapeutic options and support services. You could also get in touch with specialist organisations like Young Minds.

Anxiety In Relationships

It’s fairly common to feel some level of anxiety in a relationship, especially when the relationship is new. Even if everything is going well, you may worry that something will go wrong or have a feeling that something isn’t right.

If you have relationship anxiety, you may need constant reassurance from your partner or doubt their feelings towards you. You may also look for problems where there aren’t any, or feel a constant fear of abandonment.

This type of anxiety could have a negative impact on your relationships. Talking openly and honestly with your partner, identifying your triggers, and prioritising your own wellbeing could help you to cope with your anxious feelings.

If you think your partner may have relationship anxiety, it’s important to find ways to support them while maintaining your boundaries. Going to therapy could help you both better understand the anxiety and its impact.

Anxiety During Pregnancy And Postpartum

It’s very common to feel anxious during pregnancy and shortly after the birth of a child. The hormones that are surging through your body could affect your mental health, and you may also worry about your physical health, the health of your baby and their general wellbeing.

Though it may be difficult, it’s a good idea to get out and about and socialise with other people. Getting regular exercise, sleeping well and practicing mindfulness could all help you to cope with anxiety during pregnancy and postpartum.

When To Seek Help For Anxiety

One of the main signs that it’s time to seek help is when your anxiety is interfering with your everyday life. For example, if your performance at work has dropped because you can’t concentrate, are tired or are avoiding certain situations, then it’s probably a good idea to seek help.

Also, if you find you’re struggling to engage with your family, feel distracted or are regularly avoiding social situations, it could be time to speak to a professional.

You should also consider professional support if you have severe physical symptoms of anxiety. For example, if you’re struggling to sleep, find it difficult to eat, are nauseous or are experiencing any other physical effects that are interrupting your daily life, it may be time to seek help.

It’s important to remember that getting professional support shows strength, not weakness. It can be very difficult to acknowledge anxiety. So, if you’re considering seeking help, you should feel proud of yourself.

Diagnosing Anxiety Disorders

Generally, anxiety disorders will be diagnosed by your GP. They’ll talk to you about your feelings and symptoms to try to find the best treatment path for you.

When you meet with your doctor, it’s important that you’re as honest as possible about your symptoms. Though it may be difficult to talk about your anxieties, the more information you can give your doctor, the more accurate their diagnosis will be.

In some cases, a doctor may carry out a physical examination and they may also run blood tests. This is to check that your anxiety isn’t a symptom of another condition.

Your doctor may send you for a psychological assessment. This will allow a specialist to evaluate your symptoms and suggest possible treatment options.

Self-Help Strategies For Managing Anxiety

Although severe anxiety is often treated with medication, there are a number of other ways to manage anxiety. Many of these techniques can be done at home, with or without the support of a professional.

Learning some self-help strategies for managing anxiety could ease your symptoms and help you to feel more in control of your mental health.

Lifestyle Changes

Making positive lifestyle changes could have a real and profound effect on your mental health. Exercise in particular has been shown to help ease the symptoms of anxiety and depression. Even small amounts of physical activity can be helpful. So, if you don’t feel you could cope with a run or workout, try to go for a walk or do some other gentle exercise for around 10 to 15 minutes.

Eating well can also help to improve your mental health. Try to fill your diet with fruit, vegetables, whole grains, fish and lean meats, and where possible, avoid caffeine and alcohol. While it may be hard to look after yourself when you’re feeling anxious, improving your diet could have a real impact on the way you feel.

Getting adequate sleep may also help ease your anxiety. Although it can be hard to sleep when you’re feeling anxious, resting as much as possible could help you cope better with your symptoms.

Mindfulness And Relaxation Techniques

Practicing mindfulness and relaxation techniques could help you to feel calmer and more in control of your anxiety. Taking deep, deliberate breaths could help to ground you and make you feel more connected to the present.

Learning meditation techniques, and practicing muscle relaxation, could help take your mind off of your anxious thoughts and make you feel calmer.

Cognitive Strategies

Your mind is a very powerful thing. And, as well as making you feel anxious, it can be used to help calm you.

There are a number of cognitive strategies you can use to help control your thoughts and your symptoms. For example, you could ‘examine the evidence’. This involves thinking logically about anxiety-producing events and considering what could realistically happen in these situations.

You could also try ‘worry postponement’. This is where you limit your period of worry to a set time every day. This may help you to reduce the amount of time you spend feeling anxious and, again, could make you feel more in control.

Professional Treatment Options For Anxiety

If you feel self-help hasn’t worked, or you’d just like some extra support coping with your anxiety, it may be worth looking into professional treatment options.

Psychological Therapies

There are a few different types of psychological therapies that are used to treat anxiety. The most common are:

• cognitive behavioural therapy (CBT)
• exposure therapy
• acceptance and commitment therapy (ACT)
• mindfulness

When CBT is used to treat anxiety, problems are broken down into five main areas: situations, thoughts, emotions, physical feelings and actions. This could help you to make sense of your anxieties and give you a very structured approach to coping with anxious feelings.

Exposure therapy is often used to treat phobias and other situational anxieties. As the name suggests, it involves slow, gradual exposure to the focus of your anxiety. It’s thought that, by confronting your fear, you’ll see that it’s not as bad as you expected and the anxiety will ease.

ACT involves accepting your fears, anxieties and emotions rather than avoiding them. This type of therapy aims to help you tolerate discomfort without letting it overwhelm you.

Mindfulness is closely related to meditation. It involves paying attention to what’s going on inside and outside of yourself moment by moment. The therapy teaches you to be aware of your senses and could also make you more conscious of your thoughts and their patterns. Practicing mindfulness could help you to calm and ground yourself in situations where you often become anxious.

Medication Options

If your anxiety is severe or is having a significant impact on your life, your doctor may prescribe you anxiety medication. Often, propranolol and other beta blockers for anxiety are used to help ease the body’s fight or flight response. Beta blockers could help to reduce symptoms like a racing heart, sweating and shaking.

Selective Serotonin Reuptake Inhibitors (SSRIs) are another common treatment option for anxiety. Also used as antidepressants, they may help you sleep and ease symptoms like headaches and muscle tension.

You may also be prescribed Serotonin and Norepinephrine Reuptake Inhibitors, also called SNRIs. These may increase the production of brain chemicals that help regulate your mood and stress response, possibly easing the symptoms of anxiety.

Benzodiazepines, such Alprazolam (Xanax) and Diazepam (Valium) are also used to treat anxiety. They enhance the activity of a chemical in your brain that helps you to feel calm and may also make you feel drowsy, making it easier for you to fall asleep.

Combined Approaches

Often, doctors will use a combination of these techniques to help you manage anxiety. Using medication and therapy together could have a powerful effect on your stress levels. What’s more, as well as helping you to feel calmer now, it could give you the tools you need to effectively self-manage your symptoms in the future.

Propranolol For Anxiety: How It Works

Propranolol belongs to a group of medicines known as beta blockers. Beta blockers can be used to treat a number of conditions including cardiovascular disease, high blood pressure and migraine.

It’s also commonly used to treat anxiety. Propranolol could help you manage anxiety by slowing down your heart rate and easing symptoms such as sweating, flushing, fast breathing (hyperventilating) and trembling.

Propranolol is generally used for situational anxiety rather than generalised anxiety. You may be prescribed Propranolol if you’re feeling very anxious about a presentation, meeting, social event or exam.

In most cases, your doctor will start you on 40mg of Propranolol once per day. Depending on how you respond to the medication, this could be increased to 40mg three times per day. You’ll usually begin to feel the effects of Propranolol within 30 to 60 minutes of taking your dose.

Side Effects And Considerations With Propranolol

Like all medications, Propranolol could cause side effects in some people. In most cases, these side effects will be mild and may ease as your body adjusts to the medication.

The most common side effects of Propranolol are:

• feeling tired
• cold fingers or toes
• difficulty sleeping
• headaches
• feeling sick
• stomach pain

There are some medications that could affect the way Propranolol works, so it’s essential to tell your doctor about all the medicines you take during your consultation.

If you have asthma, diabetes or a heart condition, it’s essential you tell your doctor during your consultation as Propranolol may not be safe for you to take.

Drinking alcohol when taking Propranolol could increase the blood-pressure lowering effect of the medication. This could make you feel dizzy or lightheaded. If possible, avoid drinking alcohol when taking Propranolol, especially in the first few days after you start treatment.

Propranolol, like other beta blockers, isn’t typically addictive. However, it’s usually recommended that you only take Propranolol for a short period to avoid any dependency issues.

Supporting Someone With Anxiety

Supporting someone who is experiencing anxiety can be difficult. It’s hard to see someone you care about suffering, and you may struggle to know what to say or how best to support them.

Often, one of the best things you can do is listen without judgement. Try not to dismiss their feelings and don’t put pressure on them to do things they’re uncomfortable with.

You may feel like you want to come up with practical solutions to their worries and could feel hurt if your suggestions are dismissed. If this happens, it’s important to remember that anxiety isn’t rational and your loved one will be experiencing a range of physical and psychological symptoms that could feel overwhelming.

Educating yourself about anxiety could help you better understand their condition and allow you to offer a good level of support. If possible, encourage your loved one to get professional help. Speaking to a doctor, therapist or other healthcare professional could help them begin to gain control of their anxiety.

When supporting someone with anxiety, it’s important to maintain your boundaries and look after your own mental health. If you feel your mental health is suffering, you could also consider speaking to a doctor or therapist.

Living Well With Anxiety

Though anxiety can bring a lot of challenges, and there may be times when you really struggle with your mental health, it is possible to live well with anxiety. By building a toolkit of coping techniques, learning to recognise the warning signs and seeking support when necessary, you could find a way to manage your anxiety and prevent it from negatively impacting your life.

If you’re currently experiencing anxiety, remember to be kind to yourself. With the right treatment and the right support, you could learn to manage your anxiety and live the life you really want.

It is essential that you speak to a licensed medical professional before starting any anxiety medication. They can provide personalised, expert guidance, assess potential risks and ensure that your chosen treatment is safe and suitable for your health needs.

Anxiety is incredibly common and comes in a lot of different forms. You may feel situational anxiety or generalised anxiety. Your anxiety may be triggered by a stressful or traumatic life event, or it could develop without any obvious cause.

Whatever type of anxiety you’re living with, remember that help and support is available. Organisations such as Young Minds, the Samaritans, Mind and the NHS can help you find a range of treatment options to ease your symptoms and help you manage your mental health.

Sources:

https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/anxiety-disorder-signs/

https://www.youngminds.org.uk/

https://giveusashout.org/

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

https://www.samaritans.org/

https://www.anxietyuk.org.uk/

https://www.mind.org.uk/

https://www.hopkinsmedicine.org/health/conditions-and-diseases/generalized-anxiety-disorder

https://www.mentalhealth.org.uk/explore-mental-health/statistics/anxiety-statistics

https://www.healthline.com/health/anxiety/anxiety-avoidance

https://www.verywellmind.com/what-is-situational-anxiety-5088417