Anxiety refers to feelings of worry, nervousness, or a sense of apprehension, typically about an upcoming event where the outcome is uncertain, or where the person feels he or she might not be up to the task. Anxiety is commonly experienced in high pressure situations, for example, when you are about to make a speech or sit an exam.
Anxious feelings are usually accompanied by physical sensations such as a churning stomach, light headedness, and a racing heart. These are all normal reactions to these types of situations.
Although the experience of anxiety will vary from person to person, feeling stressed, worried and having anxious thoughts are common symptoms. Other common symptoms of anxiety include:
- Difficulty concentrating
- Rapid heartbeat
- Trembling or shaking
- Feeling light-headed or faint
- Numbness or tingling sensations
- Upset stomach or nausea
- Avoidance, or wanting to avoid what is causing the anxiety.
While anxiety is considered a natural and short-lived reaction to a stressful situation, for some people anxious thoughts, feelings, or physical symptoms can become severe and upsetting, return repeatedly, continue over a period of time, and interrupt their daily lives. Where there is a cluster of anxiety symptoms that are severe and persist over time, it is typically considered an anxiety disorder.
Anxiety disorders are the most common type of mental disorder diagnosed in Australia. There are a number of anxiety disorders, including:
Generalised anxiety disorder
Generalised anxiety disorder (GAD) is characterised by persistent and excessive worry, often about daily situations like work, family or health. This worry is difficult to control and interferes with the person’s day-to-day life and relationships.
People with specific phobia experience extreme anxiety and fear of particular objects or situations. Common phobias include fear of flying, fear of spiders and other animals, and fear of injections.
Panic disorder is characterised by the experience of repeat and unexpected panic attacks - sudden surges of overwhelming fear and anxiety and physical symptoms such as chest pain, heart palpitations, dizziness and breathlessness. In panic disorder, these panic attacks come ‘out of the blue’ with no apparent trigger.
Agoraphobia involves intense anxiety in the context or anticipation of a variety of situations such as using public transportation, being in open spaces, being in closed spaces such as in a cinema, being in crowds, or being outside of the home alone.
Obsessive compulsive disorder (OCD)
People with OCD have recurring, persistent, and distressing thoughts, images or impulses, known as obsessions (e.g. a fear of catching germs), or feel compelled to carry out certain repetitive behaviours, rituals, or mental acts, known as compulsions (e.g. hand-washing). Some people with OCD have both obsessions and compulsions. These thoughts and acts can take over a person's life and while people with OCD usually know that their obsessions and compulsions are an over-reaction, they feel they are unable to stop them.
Social anxiety disorder
In social anxiety disorder the person has severe anxiety about being criticised or negatively evaluated by others. This leads to the person avoiding social events and other public situations for fear of doing something that leads to embarrassment or humiliation.
Whilst there is no single known cause for any of the anxiety disorders, there are a number of risk factors or triggers that may contribute. These differ between the different anxiety disorders too. In general, however, the following factors may play a role:
Certain anxiety disorders appear to have a genetic component, with some anxiety disorders running in families.
Some anxiety disorders might have a basis in how the brain processes and responds to stress, and how the body releases stress hormones, such as adrenalin. Sensitivity to your own body’s physical responses, such as increased heart rate might also increase the risk of developing an anxiety disorder.
Patterns of thinking characterised by anticipating the worst, persistent negative self-talk, difficulty accepting uncertainty, and low self-esteem are linked to anxiety.
Unhelpful coping strategies, such as a tendency to avoid situations that cause anxiety rather than facing such situations, increase the risk for developing an anxiety disorder.
Stressful life events
Stressful events such as a marriage breakdown, work or school deadlines, and financial hardship can act as a trigger for anxiety. Early life stress and trauma can also increase the likelihood of developing an anxiety disorder later in life.
Cognitive behaviour therapy (CBT) has been found to be the most effective treatment for anxiety disorders. CBT is a type of therapy that helps a person to change unhelpful thoughts and behaviours which can contribute to anxiety, and build skills to manage it. CBT for anxiety combines some of the following strategies:
Feelings of anxiety sometimes stem from a person’s negative or unhelpful thoughts. Cognitive restructuring is a technique used by psychologists to help a person to challenge negative thoughts and develop more helpful and constructive ways of thinking.
Effectively solving day-to-day problems helps people to feel more confident tackling life’s challenges, and can decrease general anxiety. Structured problem solving involves identifying the problem, developing a range of potential solutions, selecting one to test out, implementing the solution, and evaluating its helpfulness.
Exposure therapy is an effective approach to addressing specific fears, such as those experienced in specific phobia or social anxiety disorder. In exposure therapy, the psychologist guides the person through a series of real or imaginary scenarios to confront specific fears. Through this gradual process, the person learns to cope more effectively with these fears, and with practice, the anxious response naturally decreases.
Learning a form of relaxation, such as meditation or progressive muscle relaxation, and practising it regularly, has been found to effectively reduce anxiety.
In addition to CBT, other effective approaches include:
In mindfulness-based therapy, distress about the experience of anxiety, rather than anxiety itself, is the focus. The psychologist assists the person to focus on the bodily sensations and thoughts that arise when he or she is anxious, and instead of avoiding, withdrawing or fighting against these symptoms, he or she remains present and aware of them. As a result, the person becomes more open to and accepting of the thoughts and sensations associated with anxiety and less overwhelmed by them, and better able to engage more fully with life.
Making positive changes to a person’s lifestyle can help lower stress and anxiety. This includes getting regular exercise, reducing alcohol and caffeine use, engaging in enjoyable activities, improving time-management skills, and having adequate sleep.