WHAT IS ANXIETY?

Anxiety disorders are one of the most common psychological problems, significantly affecting between 15-30% of Australians. Anxiety affects people of all ages (from very young children through to the elderly) and from all cultural backgrounds. Anxiety is a normal reaction. Mild levels of anxiety can even be helpful in some situations. Unfortunately, anxiety can become a problem if it is occurring  too often, is excessive, or begins to interfere in the things you want to do, or need to do.   

CAUSES OF ANXIETY

Many people want to know why they are so anxious. There are a number of common reasons:

• Trauma: Some people become anxious after experiencing a particularly frightening event

• Biology: Some people are born with an anxious personality. They may have inherited a tendency to be anxious from their parents (just like inheriting their parent's eye colour, or height).

• Learning: People can learn to be anxious by watching how to act, behave and think from family members, teachers, or friends. 

• Avoidance:  Avoiding things that you are afraid of feels good in the short-term, but in the long-term it simply makes anxiety worse. If you avoid such situations, you never get the chance to face and conquer your fears, and develop necessary coping skills.

COMMON TYPES OF ANXIETY

Social Anxiety: Fear of social situations (feeling self-conscious, worrying about what others think, etc). People with social phobia have difficulty speaking or doing things in front of others.

Generalised Anxiety Disorder: Excessive and uncontrollable worry about everyday things. 

Panic Attacks/Panic Disorder: Physical symptoms of anxiety (e.g., pounding heart, shaking, sweating) that occur 'out of the blue'. Worry about getting panic attacks and avoiding places where panic attacks are likely or difficult (e.g., crowded places). 

Phobias: Being fearful of a specific object or situation (e.g., snakes, germs, buttons, heights, small spaces). People tend to panic when faced with these things and want to avoid them. 

Obsessive Compulsive Disorder (OCD):  Repetitive thoughts (e.g., that you have germs on you, or that you forgot to lock the door or that you might harm someone) and repetitive behaviours (e.g., checking things repeatedly, touching or rubbing things in a particular way, doing things in a special order or manner). 

PTSD: Experiencing a traumatic event (e.g., being in an accident, being attacked, etc) and afterwards getting physical symptoms of anxiety when things remind you of the event, avoiding things that remind you of the event. People commonly have bad dreams or thoughts and memories of the trauma that intrude into their mind. If this goes on for more than a few weeks and causes problems in your life, it is PTSD and there is help available.

THE FIGHT/FLIGHT RESPONSE

The physical symptoms of anxiety are caused by the ‘fight or flight’ response, which is the body’s automatic alarm system. When we encounter something that frightens us, our body reacts to prepare us to act quickly and escape danger, or defend ourselves...in other words to fight or flee! 

The physical changes in the ‘fight or flight’ response include:

• Breathing speeds up to increase oxygen available to the muscles, experienced as breathlessness, or feeling of being smothered. Tense, fast breathing can also lead to a sensation of 'pins and needles' and faintness (although these are harmless).

• Heart rate increases so that oxygen and nutrients are pumped more quickly to the body,  experienced as heart palpitations and/or chest pain.

• Blood is pumped to the leg and arm muscles, and away from areas that are not being used.

• Muscles become tense, and ready to act quickly. Over time, muscles can become chronically tense and sore.

• Sweating increases to cool the body.

• Blood vessels close to the skin expand, causing chills, hot flushes and blushing.

• Digestion is put on hold, causing feelings of nausea or 'butterflies' in the stomach.

• Bowel and bladder muscles tighten, creating the sensation of needing to go to the toilet.

• Many people also experience trembling or shaking, dizziness, and feeling as though things are ‘unreal’.

The fight/flight response is useful when we are faced with an extreme event, but it is a nuisance when you are about to give a speech, or when you are worried about something unpleasant that happened to you earlier in the day. Whatever the trigger, the fight/flight response is a sign that you are feeling anxious and need to do something to calm down. The fight/flight response can be managed using simple techniques such as relaxation, slow breathing, and addressing the source of the anxiety in terms of your anxious thoughts. 

ANXIETY TREATMENT

Research trials have shown Cognitive Behaviour Therapy (CBT) is the most effective type of psychotherapy for anxiety disorders. CBT emphasises the importance of 'cognition' (what we think and feel), and 'behaviour' (what we do), in determining how anxious we feel. CBT assumes that the way you think can influence how you feel and behave, and vice versa. Anxiety treatment therefore focuses on identifying and challenging negative and unrealistic thoughts that create anxiety. Therapy also focuses on identifying unhelpful behaviours that maintain fears, and gradually replacing them with behaviours that help to overcome anxiety. CBT is a short-term therapy aimed at teaching people skills to self-manage anxiety. The average number of sessions clients attend is around 12. CBT is more effective than medication in the long-term and more effective than other kinds of psychotherapy.  Treatment has long-term benefits, with most individuals reporting improved anxiety 1 to 4 years after completing treatment (this period varies with the research studies conducted. The benefits are often life-long). 

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