What is anxiety?

Anxiety is a normal and healthy response to danger and threat. It focuses body and mind on dealing with a problem - the body gets ready for action ('fight or flight') and the brain focuses on thinking through every possible escape route or dangerous scenario.

The flow of adrenaline into the bloodstream helps us run faster and think our way out of a tricky situation more quickly. This is useful when there is a life-threatening danger to deal with, but can be unhelpful when there is less threat. When we are anxious we feel wound up, nervous, worried and tense. We may go over a problem in our minds until we come up with a solution. Feelings can range from being a bit uneasy to a continuing sense of dread, or feeling panicky and frightened.

How does anxiety affect us?

Anxiety functions similarly to physical pain, calling attention to danger or risk. However, the complex mixture of physical sensations, thoughts and actions means we can exaggerate the potential danger and feel tense and anxious even though we are not currently under threat.

Anxiety has been described as the equation

Recognising anxiety

Anxiety can affect us primarily in three ways:

• Physical effects: Racing or pounding heart, sweating, breathlessness, dizziness, shaking or trembling, chest pain or tightness, nausea and stomach pain.
• Thoughts: Thoughts are often repetitive, with a fixed view of a situation that may bear little relation to reality. Thoughts often escalate, eg. from "Oh no, a traffic jam, I'll be late for my meeting," to "And if I'm late I might miss this sale, disappoint everyone and be fired."
• Behaviour: Anxiety affects how we behave and what we feel able or unable to do, eg. avoid situations.

Panic attacks

Feelings of severe anxiety that start and finish quite suddenly are called panic attacks. The uncomfortable physical symptoms of intense anxiety can make people feel they are about to die, collapse or lose control of their minds, and these frightening thoughts in turn intensify the panic. Panic attacks are common, with one in 10 people having at least one attack during their lives.

Getting help

Sometimes people need more help to manage anxiety. Adults and children who are constantly anxious may have trouble with sleeping, concentration, feel restless or irritable and fatigued. For some, anxiety causes such sustained discomfort and disruption to their everyday life that it is called an 'anxiety disorder'.

There are a number of diagnoses of anxiety disorders including generalised anxiety, agoraphobia, social phobia, panic disorder, obsessive compulsive disorder and post-traumatic stress disorder. Symptoms may vary but they all have in common persistent feelings of high anxiety, causing discomfort and disruption to everyday living. If you experience this level of anxiety constantly you should consult your GP or health service.

Managing anxiety and panic

• Have a physical check-up to make sure there is not another physical cause for your symptoms. Your doctor may refer you for specialist help
• Avoid substances that aggravate anxiety and panic. These include caffeine, alcohol and cannabis.
• Learn to breathe more slowly and deeply when anxious. Breathe with the bottom of your lungs rather than from the top, ie. when you breathe in your stomach goes out, not your ribs. Learning meditation can help with breathing.
• Stay active - walk, jog, swim, garden or do regular exercise that you enjoy.
• Relax regularly. Try a relaxation CD or yoga. Sleep is the most important relaxation, so try to establish a regular sleep routine.
• If you experience a panic attack, remember it is anxiety that causes the awful feelings. If you do nothing, the attack won't harm you it will pass. If you find yourself thinking catastrophic thoughts such as "I'm dying," remind yourself this is not true. Remember that you have survived previous attacks.
• If you can, you should resist leaving places or situations because of panic attacks. If you leave or avoid places you will find it increasingly hard to return there.
• Cognitive-behavioural therapy (CBT) is a psychological therapy that largely focuses on overcoming unhelpful beliefs and has been proven to work well with anxiety and panic.
• Self-help books are usually based on cognitive techniques. Support groups and talking to other people who managed anxiety and panic can be useful.
• Your doctor may prescribe medication, including tranquillisers or antidepressants, mostly in conjunction with other strategies for managing anxiety. 
• Tell family, whanau, friends or workmates you trust about your experience. You will feel more comfortable if they know you might have to stop to 'wait out' a panic attack.

Shrink your worries

For day-to day anxieties, the following can help:

• Question
  Is it really a problem?
• Talk it out
  Share with someone you trust.
• Write it out
  Put it on paper. It's easier to see it in perspective.
• Shrug it off
  Raise your shoulders, and then drop them. Relax your whole body.
• Breathe it away
  Inhale deeply; exhale with a sigh a few times. Let your tension go as you breathe.
• Set an 'appointment with worry'
  Give yourself 15 minutes to concentrate on your worry, then firmly leave it behind.
• Work it off
  Do something physical. Give your tension an outlet.
• Laugh it off
  Look for some humour in the situation.
• Distance it
  Imagine it a few years from now. How much will it matter then?
• Balance it
  Find a good side as well as the bad.
• Exaggerate it
  Picture the worst that can really happen. How likely is it?
• Hold it
  Say 'stop', pause and steady your thoughts. Now take a fresh look.
• Plan for it
  Get up earlier to prepare to face it.
• Make it positive
  Surround yourself with joyful colours, sounds and use your strengths.

Resources

The Mental Health Foundation has a number of books and videos on stress and relaxation for purchase or loan. There is also a relaxation CD available to buy.

Original material provided by the Mental Health Foundation of New Zealand, 2003. Edited by everybody, June 2005.