Anxiety: Causes, Symptoms and When to see your Doctor

Anxiety disorders are common with around 1 in 20 people suffering from them. That is one person on the bus. They can also occur alongside other mental health conditions and can sometimes happen ahead of a depressive episode.

There’s no exact cause for an anxiety disorder and anyone can suffer, but it’s more common in people who have gone through difficult or traumatic life events in the past, or who are currently facing or living in difficult life circumstances.

It can also be more common if you have a relative – such as a parent, brother or sister - with an anxiety disorder or if you’re living with a medical condition or other mental health conditions. Some medications can cause anxiety as a side effect, and anxiety can be worsened by smoking or a high caffeine or alcohol intake or use of street or party drugs.

The Impact of Anxiety on Daily Life

Anxiety can have a significant impact on nearly every aspect of a person's life, from work and social relationships to personal well-being and physical health. For many individuals suffering from anxiety disorders, even routine tasks can become overwhelming. The constant worry and sense of dread can interfere with one's ability to concentrate, perform at work or school, and maintain healthy relationships.

Workplace performance can be particularly affected by anxiety. Tasks that once seemed simple may now feel insurmountable. Individuals may find it hard to meet deadlines, collaborate with colleagues, or engage in work-related social interactions, all of which can lead to increased stress and feelings of inadequacy. For some, anxiety can lead to an avoidance of work altogether, which might result in absenteeism or reduced productivity.

Social anxiety can also lead to isolation. Those with this condition often feel an intense fear of being judged, rejected, or scrutinised in social settings, whether it be in a group conversation, at a family gathering, or during a social event. This avoidance can have long-term effects on relationships, as individuals may withdraw from friends or family, fearing the discomfort and anxiety that social situations provoke. Over time, this can exacerbate feelings of loneliness and reduce social support, further contributing to mental distress.

Anxiety can also manifest physically in ways that affect your general health. People with chronic anxiety may experience frequent headaches, digestive issues, and sleep disturbances. The ongoing tension that anxiety creates in the body can also lead to muscle aches and fatigue. For those who already have underlying health conditions, anxiety can make symptoms worse and complicate treatment.

Recognising the far-reaching impact of anxiety on various facets of life is crucial in addressing the disorder. Seeking appropriate treatment and implementing lifestyle changes to manage anxiety can lead to improved overall functioning and quality of life.

Managing anxiety often involves adopting lifestyle changes that help to reduce stress, improve overall health, and promote a sense of calm. While medications and therapies can be effective, certain habits can provide significant relief and support long-term recovery. Some of these lifestyle changes include:

1. Regular Physical Activity

Exercise is one of the most effective ways to reduce anxiety. Physical activity increases the production of endorphins, the body's natural "feel-good" chemicals, which can help improve mood and reduce stress. Whether it's walking, running, swimming, or yoga, engaging in regular exercise can help alleviate both the physical and psychological symptoms of anxiety.

2. Healthy Eating Habits

What we eat has a direct impact on our mental health. A diet high in processed foods and caffeine can exacerbate anxiety symptoms, while a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help improve mood stability. Staying hydrated and limiting alcohol intake is also crucial, as dehydration and alcohol can contribute to anxiety and disrupt sleep patterns.

3. Sleep Hygiene

Adequate rest is essential for both physical and mental well-being. Poor sleep can worsen anxiety, leading to a vicious cycle of restlessness and increased worry. Establishing a healthy sleep routine - such as going to bed at the same time each night, avoiding screens before bed, and creating a relaxing bedtime environment - can help improve the quality of sleep and reduce symptoms of anxiety.

4. Mindfulness and Relaxation Techniques

Mindfulness practices, such as deep breathing exercises, meditation, or progressive muscle relaxation, can be incredibly beneficial for managing anxiety. These practices encourage focusing on the present moment and help individuals break free from the cycle of anxious thoughts. Mindfulness has been shown to lower stress levels, reduce emotional reactivity, and promote a state of calm. Taking a few minutes each day to practise mindfulness can help individuals manage anxiety more effectively over time.

5. Limiting Stressful Triggers

Identifying and avoiding triggers that provoke anxiety is an essential part of managing the condition. While some stressors are unavoidable, individuals can take steps to limit exposure to situations or activities that exacerbate their anxiety. This may involve setting boundaries in relationships, managing work demands, or learning to say no when necessary. Recognising personal triggers and taking proactive steps to reduce them can help prevent the onset of anxiety.

6. Social Support and Communication

Talking to friends, family, or a therapist can offer relief and help individuals feel less isolated. Expressing your feelings and concerns openly with someone you trust can reduce the mental burden of anxiety. In addition, connecting with others who experience anxiety through support groups or online communities can provide mutual understanding and encouragement.

Making small adjustments to daily routines and habits can have a positive impact on anxiety levels. While lifestyle changes alone may not eliminate anxiety, they can support other treatments and play a key role in long-term mental health management.

The role of therapy in treating anxiety

For individuals suffering from persistent anxiety that interferes with daily functioning, therapy can play a pivotal role in helping manage symptoms and improve quality of life. Several therapeutic approaches have been shown to be effective in treating anxiety disorders, with the most commonly used being Cognitive Behavioural Therapy (CBT) and Exposure Therapy.

Cognitive Behavioural Therapy (CBT)

CBT is one of the most widely used therapies for anxiety and involves working with a therapist to identify and challenge negative thought patterns that contribute to anxiety. The goal of CBT is to help individuals recognise how distorted thoughts influence their emotions and behaviours, allowing them to develop healthier ways of thinking and coping. For example, a person with social anxiety may be encouraged to confront their fears and test their assumptions about how others perceive them. Over time, this can lead to a reduction in anxious thoughts and an increase in confidence.

CBT is typically delivered in a structured, time-limited format, often spanning several weeks or months. It is considered an evidence-based treatment with proven effectiveness for a range of anxiety disorders, including generalised anxiety disorder, panic disorder, and social anxiety disorder.

Exposure Therapy

Exposure therapy is a type of CBT that involves gradual and controlled exposure to situations or objects that trigger anxiety. The aim is to desensitise the individual to these triggers by reducing the response to fear over time. For example, someone who fears flying may begin by visualising a flight, then gradually move on to watching videos of planes before eventually taking a short flight. The process allows individuals to confront their fears in a safe and supportive environment, helping them to build confidence and resilience.

Other Forms of Therapy

In addition to CBT and exposure therapy, other therapeutic approaches may be helpful for anxiety, such as:

• Acceptance and Commitment Therapy (ACT)
  • This approach encourages individuals to accept difficult emotions and commit to actions aligned with their values, even in the presence of anxiety.
• Mindfulness-Based Stress Reduction (MBSR)
  • This program teaches individuals mindfulness techniques to manage stress and anxiety, fostering awareness and acceptance of the present moment.
• Psychodynamic Therapy
  • This therapy explores how past experiences and unconscious conflicts may contribute to current anxiety, helping individuals gain insight into their emotional struggles.

Therapy can provide individuals with the tools and strategies needed to manage anxiety and lead a more balanced, fulfilling life. For many, it is an essential component of a comprehensive treatment plan that may also include medication, lifestyle changes, and support from family and friends. If you're struggling with anxiety, reaching out for professional help can be a key step in your journey toward feeling better.

You should see your doctor if you have severe or prolonged anxiety symptoms (lasting a month or more) or if it is affecting your day-to-day life. Sometimes anxiety can occur alongside depression – you should seek urgent medical attention if you have any thoughts to harm yourself by booking an urgent doctor's appointment, calling 111 or 999 if out of hours.

The doctor will ask about your medical history and current symptoms. They may ask you questions from a screening questionnaire that can help with diagnosing an anxiety disorder. If the doctor feels it is necessary, they may also do some blood tests as some medical conditions can contribute to symptoms of anxiety.

If your anxiety is mild the doctor may discuss any relevant lifestyle changes and then monitor how you progress. They may also refer you to talking therapy or cognitive behavioural therapy (CBT), which aims to help you learn about your thoughts, how they affect you, make you feel, and how to process and adapt those thoughts. The doctor or psychologist will keep an eye on how you are doing and whether these interventions are helping.

If you have prolonged or severe anxiety the doctor may prescribe you a medication such as an antidepressant to help with symptoms, or recommend you see a clinical psychologist or mental health nurse who can help you explore the anxiety and methods to help control it. There are a variety of medications that can help with anxiety and the doctor will discuss the options with you.

Your fitness to work will depend on the severity of your anxiety and your doctor will assess this with you.