Dealing with Anxiety

What is anxiety?

In Australia each year, around 14% of adults are affected by some form of anxiety disorder. The majority of these are women.

Most of us feel anxious from time to time. It could be in the lead up to a big event or as a result of stress. In most cases, the feeling goes away relatively quickly but when it lingers for days, weeks or longer and interferes with our daily lives then it can become a problem.

You may feel very tense, nervous, irritable or generally wound up. These feelings trigger the body’s ‘fight or flight’ response and it produces increased adrenaline in the face of perceived danger. You could start to feel physical symptoms such as palpitations, rapid breathing and shaking which in turn create more adrenaline.

Usually, these feelings and symptoms go away but sometimes they hang around and put extra stress on the mind and body. They can also occur at the same time as depression although the two are separate conditions.

Common anxiety symptoms

Some symptoms may be mild. You might only feel a tightening of the muscles or ‘butterflies’ in your stomach. However sometimes they can be completely debilitating and interfere with your activities. Other symptoms can include (but are not limited to):

• A pounding heart
• A sense of panic
• Increased sweating
• Irrational fears
• Excessive worrying
• Feeling dizzy or shaky
• Intense nausea
• A sense of choking
• A tightened chest and constricted breathing

Most common types of anxiety

Anxiety is a broad term that manifests in many forms. These can be grouped into three main categories:

• Phobias
• Panic disorder
• Generalised anxiety disorder

Phobias

Phobias are intense or irrational fears of everyday situations or objects. They can occur as a result of past traumas but are generally totally disproportionate to the current situation. In their extreme forms they cause people to avoid any situations where they are likely to come into contact with the source of the fear. This can have a very limiting effect on daily life.

Social anxiety disorder or social phobia is common form of anxiety. Sufferers worry obsessively about other people’s opinions of them. They fear being judged or embarrassed so they avoid situations such as public presentations or meeting new people. They have low self-esteem and this is can cause others to perceive them as eccentric or inadequate.

Agoraphobia is the fear of open or public places. These could include lifts, public transport, shopping centres, cinemas, bridges or crowds. The fear triggers a sense almost like a physical but invisible force surrounding and suffocating you until you can no longer focus or breathe easily and you start to panic.

Underlying this fear is one of not having help or a safe exit at close hand. Avoidance of so many triggers can sometimes lead sufferers of this condition to gradually stop leaving their house.

There are many other types of phobia. The more common ones include:

• Fear of confined spaces (Claustrophobia)
• Fear of needles (Trypanophobia)
• Fear of heights (Acrophobia)
• Fear of spiders (Aracnophobia)
• Fear of being alone (Monophobia)

Panic disorder

Panic and anxiety are natural responses to stressful or dangerous situations. For thousands of years our instincts have served us by warning us something bad might happen soon. When we get anxious - particularly when something has caught us by surprise – our body reacts in a number of ways.
For example, we can experience:

• Rapid breathing
• Heart palpitations
• Heavy sweating
• Muscle tension

Generally, these symptoms disappear quickly and are a reaction to a specific situation. Panic attacks occur suddenly and with no obvious trigger. They can be quite severe and disabling but generally only last 5 to 20 minutes. Statistics vary but it is estimated up to 10% of the population will have a few panic attacks at some stage throughout their life.

Panic Disorder is the term used when a person has recurring and disabling panic attacks. Some people may experience one every few months and others may have them several times a week. Because the attacks can seem to come ‘out of nowhere’ and develop rapidly they can be frightening. Attacks can occur while driving, while out with friends or even when a person is asleep.

Sufferers often live in constant fear of when and where the next attack will happen. This fear can be so intense that it has a strong negative impact on the person’s life. They may stop doing certain activities, give up work or potentially become housebound in an attempt to avoid having a panic attack in public.

Panic Disorder is believed to affect up to 5% of Australians including more women than men. Onset generally starts around the early to mid 20’s but can occur at any age (even in children).

Generalised anxiety disorder

Generalised Anxiety Disorder is a form of anxiety along with phobias and Post Traumatic Stress Disorder. While anxiety is associated with a number of mental health issues, GAD is a recognised condition in its own right.

We all feel anxious at times but it is usually related to a specific cause or concern such as an upcoming exam or worrying about finances. The feeling normally passes once the situation has been resolved. However for some people, the feeling of anxiety has no specific trigger and it can persist for days on end. Sometimes it doesn’t go away at all.

Determining when an anxiety is ‘normal’ and when it becomes a ‘disorder’ can be difficult. Some people may simply have an anxious nature when others are quite relaxed about things. When the level of anxiety starts to have a negative impact on a person’s behaviour and daily life then it becomes a problem that needs to be dealt with.

Generalised Anxiety Disorder is believed to affect around 4% of the population and is slightly more prevalent in women than men.

Real life repercussions of anxiety

By its very nature, anxiety can make you withdrawn or self-obsessed. When this happens, it often has a substantial flow-on effect to those around you. They have to deal with your changes in mood or your compulsions.

If you have a strong phobia they may have modify their own activities to accommodate you. For example they may need to drive you on a different road to avoid a tunnel or do the presentation at work so you don’t have to get up in front of everyone. When your phobias occur at work they could make others lose confidence in you or decrease your chances of getting a promotion. They may even cause you to lose your job.

Those that love you will generally support you as much as they can and be happy to step in and do things for you. However, if your anxiety often makes you irritable, moody or angry there may come a point that they can’t cope with you anymore. This can be very distressing for everyone, especially if it is an ongoing problem. In some cases it can be the cause of a complete relationship breakdown such as divorce and have lasting consequences.

On a personal level, severe anxiety that remains unaddressed can lead to substantial depression and suicidal thoughts. It becomes a downward spiral that feeds on fear and is very difficult for someone to overcome it on their own. Addressing the root of the initial fear and changing your thinking patterns with the help of an experienced counsellor is a very effective form of treatment.

Possible causes for anxiety

The causes of anxiety are not fully understood, however we do know that there are several major factors that can trigger anxiety disorders. Often our anxiety is a result of a combination of these factors. They include:

• Substance abuse
• Medical factors
• Brain chemistry and genetics
• Environmental factors

Substance abuse

The two most common causes of substance abuse are alcohol and benzodiazepine dependence. They can trigger social phobia, panic disorder and GAD. Being regularly intoxicated with illicit drugs such as cocaine or withdrawing from drugs like heroin or some prescription drugs can also result in major anxiety disorders.

Medical factors

Some medical conditions and medications can also cause anxiety. Conditions include asthma, anaemia, some infections and heart conditions and also a lack of oxygen from things like emphysema or a pulmonary embolism.

The stress caused by chronic or painful conditions is certainly a major trigger of anxiety. Dealing with severe symptoms can be quite traumatic in itself, but add in the worry about the future, the grief from losing your old way of life and having to deal with a whole new world of doctors, drugs and hospitals and it can all get very overpowering.

Brain chemistry and genetics

Research is increasingly showing that a change in brain chemistry can increase your risk of developing GAD. The neurotransmitters (or chemical messengers) in the brain can sometimes misfire or go the wrong way causing the body’s communication network to break down. This can sometimes cause the brain to react inappropriately. For example, feelings and fears could be intensified or addictions could be harder to resist.

There is also a lot of research to suggest that genetic factors can pre-dispose us to some forms of anxiety. If you have a history of anxiety disorders in your family you can be more at risk of developing one yourself, however it usually takes one or more other factors to trigger your anxiety.

Environmental factors

Not all anxiety triggers are internal; there are many external or environmental factors that also come into play. These can include financial worries, pressure from deadlines or exams, traumatic events, issues at work or relationship problems. When we are anxious in one area of our lives it can often cause us to be stressed in other areas at the same time so they have a cumulative or snowball effect.

When is the right time to seek help?

It is a big step to decide to seek professional help. Sometimes it takes someone around you to voice their concern or you may reach the point when you can no longer cope.

Consider how your stress levels affect you and those around you every day. Have you made changes to your routine? Is it affecting your relationships? Do you feel anxious on a regular basis?

As soon as you are aware that you may have a problem with anxiety, rather than try and deal with it on your own, it is a good idea to talk to your GP and tell them what has been going on. Sometimes this might be all you need but often, to treat your anxiety effectively and to help you get back on track, your GP will refer you to an appropriate mental health care professional.

What therapy or treatment options are available?

There are a number of treatment options you can choose from depending on your needs and preferences. The aim of all these treatments is to provide you with support and to give you the tools and resources to manage or overcome your symptoms and to get on with your life. The main forms of anxiety treatment are:

• Counselling
• Cognitive Behaviour Therapy (CBT)
• Mindfulness
• Medication

Counselling

Professional counselling is a highly effective way to treat anxiety. Understanding the source of your anxiety is the starting point as you may not be aware of it yourself. Your counsellor will work with you to explore all the likely triggers and see how they affect your thoughts and actions. While this can be confronting at first, by discussing the issues in a calm and safe environment you will be shown ways to overcome your fears at your own pace.

Through this process you will learn to look at your issues from a fresh perspective. Once you have addressed the initial fear you will soon begin to see how it has affected other areas of your life such as your relationships and in some cases sparked other anxieties. You may be taught techniques such as guided relaxation to help you gain control and break the anxiety cycle.

Cognitive Behavioural Therapy (CBT)

CBT is often used in combination with other forms of counselling. It is a structured technique that allows the sufferer to deal with their anxiety in stages. You might discover unhealthy thought patterns or subconscious actions. CBT then helps you to explore ways that you can overcome them by breaking them down into tangible chunks.

If your anxiety is a phobia then a CBT approach would be to employ graduated exercises in exposure and desensitisation to help you face the source of your fear.

Mindfulness

Mindfulness techniques have been increasingly used in counselling sessions and also in dedicated classes. The aim is to help you develop a detailed awareness of yourself and everything around you in an appreciative and non-judgemental way. This improved mental clarity will help you to acknowledge your anxiety triggers and manage them appropriately.

Medication

There are a number of medications that are used to help treat anxiety. Your GP or other qualified mental health care practitioner will assess your situation with you and discuss the pros and cons of this type of therapy. If appropriate, you may be prescribed drugs like:

• Antidepressants – These effectively treat a wide range of mental health conditions including anxiety.
• Beta-blockers – Some physical symptoms such as heart palpitations may respond to beta-blockers.
• Benzodiazepines – These can work well to reduce symptoms however they may have strong side effects.
• Buspirone – This is an anti-anxiety drug often used to treat GAD.

What should I look for in a mental health service provider?

There are a wide variety of people who offer mental health services. The generic term ‘Counsellor’ is used to describe various professionals such as psychologists, psychiatrists, social workers or occupational counsellors. Counsellors generally discuss your particular issues and work with you to find ways to address and overcome them. Most have undertaken years of study or additional professional development in their chosen fields however anybody can call themselves a ‘counsellor’. Also, some highly qualified counsellors may not necessarily have training in specific mental health conditions such as anxiety

You may want to ask your counsellor about their type and level of qualifications or see if they are registered in Australia with a professional society or state body. Only certain kinds of practitioners can be registered with Medicare and process Medicare rebates, however most private health insurance companies in Australia have some provision for mental health care cover as part of their ‘extras’ packages.

Where can I find help near me?

Our directory lists hundreds of psychotherapists, psychologists, counsellors and other therapists from around Australia. These mental health experts offer counselling over the phone and online in addition to one-on-one consultations. Many also offer workshops and seminars. 

Enter your postcode or suburb into our search box to see a comprehensive list of the health care professionals near you.