What is anxiety?
It's quite normal to feel afraid from time to time. We're probably all familiar with the 'butterflies' and shakiness that accompany feelings of fear. Most of us will feel a little afraid if we hear a strange noise outside the house at night, for example.
Fear passes quickly when we realise there's no threat. For example, if I go downstairs and discover the noise was caused by a cat knocking the bin over, my fear passes quickly.
Anxiety is a little different. We feel anxious when there's no real danger or threat. The feelings in the body are very similar, but feelings of anxiety are prolonged or disproportionate to the level of the threat.
For example, I might not be able to sleep, fearing I haven't locked all the doors. I might get up to check them several times, even though I remember locking them.
Sometimes we can become so anxious that we start avoiding things. Some people develop a phobia, or have to perform certain rituals such as counting or cleaning which can stop them getting on with day-to-day life.
When fear is very intense, when it goes on for too long or when it stops us getting on with life, we may have an anxiety disorder.
There are a number of different anxiety disorders. They include:
We'll look at each of these in turn a little later.
What causes anxiety?
We don't know for sure, but it's likely to be a combination of things. Our genes, our experiences and our outlook on life all play a part. Sometimes anxiety is triggered by things that happen to us, this is often stress or a trauma of some kind. Some people seem to be more prone to anxiety than others.
Am I anxious?
To check if you might have anxiety, have a look at these two questions. They are from a questionnaire called the GAD-2. It's designed to measure generalised anxiety, the most common anxiety disorder.
Over the last two weeks, how often have you been bothered by any of the following problems?
Add up your scores for the two questions. Your score will be between 0 and 6. If your score is 3 or more, you might have generalised anxiety and you should seek medical advice.
If you score less than three on the GAD-2 scale, but still think you may have an anxiety disorder, ask yourself:
'Do I find myself avoiding places or activities and does this cause me problems?'
If you answer 'yes' to this question, an anxiety disorder is likely and you should take the issue further with a qualified health professional.
These questions won't give you a diagnosis - that's something only a qualified health professional can do - but it will give you a better idea about your symptoms. Don't worry about the privacy of your results, we don't store them anywhere so they are confidential to you.
There are different types of panic disorder. People with panic disorder suffer from relatively brief but intense attacks of intense fear and apprehension, often accompanied by shaking, dizziness, shortness of breath and nausea.
Panic attacks often start and stop fairly quickly, though some people do find they can last for several hours. Sometimes they start in response to a trigger - a thought or a memory. Sometimes they just seem to come 'out of the blue'.
People with panic disorder often worry about future panic attacks and may go out of their way to avoid situations or places in which they think they'll panic. Quite often panic attacks are associated with pains in the chest, so people with panic disorder might think there's something seriously wrong with them and may be hard to convince otherwise.
Understandably, this can lead to people becoming very conscious of bodily changes. This 'hypervigilance' can itself lead to further panic, when normal sensations are mistaken for the signs of something worse.
People with obsessive-compulsive disorder (OCD) have upsetting intrusive thoughts or images (obsessions) and often feel the urge to perform specific acts or rituals (compulsions) which help them feel safer or less tense. A smaller number of people have obsessions without compulsions (known colloquially as 'Pure O') or compulsions without obsessions.
Often people with OCD 'know' the compulsions have no logical base, but knowing this does not make things any easier. Some people find that, without treatment, compulsions can get worse over time, and may take up many hours of a sufferer's day.
Post-traumatic stress disorder (PTSD) results from either one or several traumatic experience(s). This can be an extreme situation, such as war, natural disaster, rape, abuse or a serious accident. It can also result from long term exposure to stress, for example, soldiers who could endure individual battles but are 'worn down' by continuous combat.
Common symptoms include being tense, alert and 'on guard' all the time, flashbacks (intrusive re-living of memories), avoiding people or situations, anxiety, anger and depression.
Generalised Anxiety Disorder (GAD)
People with GAD feel anxious for much of the time, rather than feeling anxious about specific events or situations. GAD can cause both psychological and physical symptoms. These vary from person to person, but often include feeling tense, restless and worried, with trouble concentrating and sleeping. People with GAD can feel irritable and tired a lot of the time. For a diagnosis of GAD, the above symptoms must have continued for several months.
About 1 person in 10 is thought to suffer from one or more phobias. For people with a phobia, anxiety is triggered by a specific object, event or situation.
Sufferers typically anticipate terrifying consequences from encountering the object of their fear, which can be anything from an animal to a location to a particular situation.
Sufferers often understand that their fear is not proportional to the potential danger but don't find knowing this helps. Avoiding the object of our fear fuels the phobia. Treatment for phobias usually involves gradually exposing ourselves to the feared object or situation, until anxiety diminishes.