What is anxiety?
When you are anxious you feel fearful and tense. In addition you may also have one or more unpleasant physical symptoms. For example: a fast heart rate, palpitations, feeling sick, shaking (tremor), sweating, dry mouth, chest pain, headaches, fast breathing. The physical symptoms are partly caused by the brain which sends lots of messages down nerves to various parts of the body when we are anxious. The nerve messages tend to make the heart, lungs, and other parts of the body work faster. In addition, you release stress hormones (such as adrenaline) into the bloodstream when you are anxious. These can also act on the heart, muscles and other parts of the body to cause symptoms.
Anxiety is normal in stressful situations, and can even be helpful. For example, most people will be anxious when threatened by an aggressive person. The burst of adrenaline and nerve impulses which we have in response to stressful situations can encourage a 'fight or flight' response. Some people are more prone to normal anxieties. For example, some people are more anxious before examinations than others. Anxiety is abnormal if it:
Is out of proportion to the stressful situation, or
Persists when a stressful situation has gone, or the stress is minor, or
Appears for no apparent reason when there is no stressful situation.
What are anxiety disorders?
There are various conditions (disorders) where anxiety is a main symptom. This page is about generalised anxiety disorder (GAD). There are other separate pages for other types of anxiety disorders such as panic , phobias, post-traumatic stress disorder, obsessive compulsive disorder(OCD).
What is generalised anxiety disorder?
If you have generalised anxiety disorder (GAD) you have a lot of anxiety (feeling fearful, worried and tense) on most days. The condition persists long-term. Some of the physical symptoms of anxiety (detailed above) may come and go. Your anxiety tends to be about various stresses at home or work, often about quite minor things. Sometimes you do not know why you are anxious.
It can be difficult to tell the difference between normal mild anxiety in someone with an anxious personality, and someone with GAD. As a rule, symptoms of GAD cause you distress and affect your day-to-day activities. In addition, you will usually have some of the following symptoms:
Feeling restless, on edge, irritable, muscle tension, or keyed up a lot of the time.
Difficulty concentrating and your mind going blank quite often.
Poor sleep (insomnia). Usually it is difficulty in getting off to sleep.
You do not have GAD if your anxiety is about one specific thing. For example, if your anxiety is usually caused by fear of one thing then you are more likely to have a phobia.
Who gets generalised anxiety disorder?
GAD develops in about 1 in 50 people at some stage in life. Twice as many women as men are affected. It usually first develops in your 20s and is less common in older people.
What is the outlook (prognosis)?
Without treatment, GAD tends to persist throughout life. It is relatively mild in some cases, but for some it can be very disabling. The results from one clinic showed that at the end of twelve years 4 out of 10 people had recovered. The outlook was worse for people who had more than one anxiety disorder.
The severity of symptoms tends to wax and wane with some good spells, and some not so good spells. Symptoms may flare up and become worse for a while during periods of major life stresses. For example, if you lose your job, or split up with your partner.
People with GAD are more likely than average to smoke heavily, drink too much alcohol, and take street drugs. Each of these things may ease anxiety symptoms in the short-term. However, addiction to nicotine, alcohol or drugs makes things worse in the long-term, and can greatly affect your general health and wellbeing.
Talking to a counsellor can help in many ways, including helping you understand what may be causing your anxiety, and teaching you coping techniques. There are many types of talking therapies available, though the most commonly prescribed is cognitive behavioural therapy (CBT).
CBT seeks to help you manage problems by enabling you to recognise how your thoughts affect both your feeling and behaviour. CBT combines two approaches; examining your thoughts and the way you behave. This helps to break any overwhelming problems down into smaller, more manageable tasks.