What is anxiety?

Everyone experiences anxiety from time to time. Normal worry can be motivating — it can help you with things such as getting to work on time or studying for a test. But in some people, anxious feelings don’t go away and are out of proportion to the situation.

High levels of anxiety affect your ability to: concentrate, sleep and carry out ordinary tasks.

What are anxiety disorders?

Anxiety disorders are the most common group of mental health conditions in Australia. They affect 1 in 4 Australians at some stage in their life.

Having an anxiety disorder is not just a matter of feeling too anxious. People with anxiety disorders have ongoing fears that cause distress and stop you from doing things you want to and should be doing.

Types of anxiety disorders include:

• Generalised anxiety disorder: excessive, uncontrollable worry about everyday issues such as health, work or finances.
• Social phobia or social anxiety disorder: a disorder that causes people to avoid social or performance situations for fear of being embarrassed or rejected.
• Panic disorder: regular panic attacks, which are sudden intense episodes of fear, worry about more attacks and avoiding situations where panic attacks may happen.
• Agoraphobia: avoiding certain situations due to fear of having a panic attack. Agoraphobia is often associated with panic disorder.
• Specific phobias: fears that only apply to one particular situation, such as a fear of: animals, insects, places or people. For example, claustrophobia is a fear of enclosed or confined spaces.
• Obsessive compulsive disorder (OCD): unwanted thoughts and impulses (obsessions), causing repetitive, routine behaviours as a way of coping with anxiety.
• Post-traumatic stress disorder (PTSD): when feelings of fear do not fade after experiencing a traumatic life event. It involves upsetting memories, flashbacks, nightmares and difficulties sleeping.

What are the symptoms of anxiety disorders?

One of the main symptoms of anxiety disorders is having difficulty managing your fears and worries. You might become overwhelmed by your anxious thoughts.

Anxiety may cause you to feel:

• apprehensive or powerless
• like something bad is about to happen
• like you’re in danger
• like your mind is racing

It may also cause difficulty concentrating and memory problems.

People who have an anxiety disorder may avoid situations that make them feel anxious. This can affect your everyday life. You might excessively worry about the past, present or future and have trouble thinking about anything else.

Each type of anxiety disorder has different specific symptoms.

What are the physical symptoms?

There are some physical symptoms that can affect people with anxiety such as:

• panic attacks — sudden, intense episodes of fear
• shortness of breath
• dizziness
• a racing or pounding heart
• sweating
• problems sleeping
• a churning stomach or ’butterflies in the stomach’
• ‘pins and needles’
• feeling lightheaded
• trembling
• feeling very thirsty

What causes anxiety?

The causes of anxiety are not fully understood. Nor are the reasons why anxiety affects some people to the point where it interferes with their lives.

A range of factors are thought to contribute to anxiety disorders.

Most anxious people probably have genes that make them more likely to develop an anxiety disorder. Females are more likely to develop an anxiety disorder than males.

Risk factors for anxiety disorders include the following.

• Family history — you are more likely to develop an anxiety disorder if you have family members with mental health conditions.
• Having another mental health disorder.
• Ongoing stressful situations, such as: problems at work, unstable housing, family or relationship breakdown and grief.
• Any kind of abuse (such as physical, sexual, verbal or domestic abuse).
• Life-threatening events.
• Pregnancy and childbirth (for the pregnant person or their partner).
• Physical health issues such as thyroid problems and other chronic (ongoing) conditions.
• Substance use — particularly cannabis, amphetamines, alcohol and sedatives.
• Withdrawing from drugs and alcohol.
• Having a certain personality type, such as: being a perfectionist, having low self-esteem or needing to be in control.

Everyone is different and often a combination of factors contributes to developing an anxiety disorder.

When should I see my doctor?

If your anxiety symptoms are affecting your everyday life, talk to a doctor or a mental healthcare professional. Getting professional help can support you in managing anxiety and reduce its effects on your life and wellbeing.

It might help you to write down your symptoms in the time leading up to your appointment. This may make it easier to explain to a doctor or mental health professional what you're going through.

How is anxiety diagnosed?

Your doctor will ask you about your symptoms and how they affect your daily life. They may use a detailed questionnaire to do this. The more detailed your answers about what you're experiencing, the better.

You may be diagnosed with an anxiety disorder if your symptoms are affecting your ability to function. This might be at: work, school or socially.

Your doctor may suggest tests to rule out some other conditions.

Your doctor will diagnose the type of anxiety disorder you have based on recognised criteria. The criteria are listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). This is a handbook used by health professionals to help identify and diagnose mental illness.

How is anxiety treated?

Treatment options for anxiety disorders include:

• lifestyle measures, such as regular physical activity
• psychological therapy
• medicines

Your doctor will talk with you about your treatment options and what may be best for your situation. They will consider:

• the type of anxiety disorder you have
• how severe your condition is
• your treatment preferences

People involved in your care might include: your doctor, a psychiatrist or a psychologist, mental health nurse or other type of counsellor.

Treatment for anxiety can take time. A good support network makes the process easier.

Lifestyle measures

A healthy lifestyle can help you manage your anxiety disorder.

• Make sure you exercise regularly. Even a 10-minute short walk can help to improve how you feel. If you have not exercised in a long time, check with your doctor about what is safe for you.
• Cut down on caffeine, which can increase anxiety and alter sleep patterns in some people. Avoid tea, coffee, cola, energy drinks and chocolate, especially after 6pm.
• Limit how much alcohol, cigarettes and drugs you use. You can call the Quitline on: 13 7848 or call the National Alcohol and Other Drug Hotline on: 1800 250 015 for confidential advice.
• Make healthy eating choices.
• Get enough sleep.

Some additional things you can do to help manage your anxiety include the following.

• Take time for yourself. Try to get involved in activities and pastimes you previously enjoyed — even if you don't feel like it to start with.
• Use relaxation techniques, such as mindfulness and meditation.
• Use distraction techniques, such as counting backwards from 10. This will help you to stay in the present moment. It will help stop you thinking of terrible things that might happen in the future.
• Breathing can help with your physical symptoms. Controlled breathing exercises can reduce the risk of symptoms worsening into a panic attack. Slowly take breaths in and out.
• Learn how to change your ‘self-talk’ or inner thought patterns (a mental health professional can help you do this).
• Tackle small tasks that you may have been avoiding. This will help you to feel better about yourself.

You can find more anxiety management strategies on the Beyond Blue website.

Psychological therapy

Anxiety may be treated by using different therapies, including cognitive behaviour therapy (CBT). CBT is designed to change problematic thinking patterns that cause anxiety.

Behaviour therapy is a part of CBT that includes ‘desensitisation’. Desensitisation is a method of slowly exposing you to feared situations to reduce the anxiety that comes with them.

Other types of therapy for anxiety may include:

• interpersonal therapy (focusing on relationships)
• acceptance and commitment therapy (such as mindfulness)
• narrative therapy (understanding the stories you use to describe your life)

Medicine

Medicine such as antidepressants may be recommended for some people. Medicines can be used in combination with the strategies and treatments described above.

Online support tools

Online tools may be suitable if you have mild to moderate anxiety. There is a range of different programs, most of which are backed up by: phone, email, text or web chat support from a mental health specialist.

These online therapies can be particularly helpful if you are living in a rural and remote area. Access to health professionals may be more difficult in these areas.

Resources and support

Resources and support are available through Beyond Blue and the Black Dog Institute. Support groups through these organisations provide opportunities to talk with other people who have similar experiences.

Support, information and counselling for new and expecting parents is available through: the Perinatal Anxiety and Depression Australia (PANDA) website and the PANDA National Helpline (1300 726 306).

Online support for anxiety is also available from:

• NewAccess
• ReachOut NextStep
• The BRAVE Program — an interactive, online program for treating and preventing anxiety in children and teenagers
• e-couch
• MindSpot Clinic
• Moodgym
• myCompass, Black Dog Institute

You can find other digital resources from the Head to Health website.