Unit 3: Understanding Anxiety

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Table of contents

1. Introduction

2. Learning Outcomes

3. Understanding the Term 'Anxiety'

4. Understanding the Term 'Panic Attack'

5. The Possible Causes of Anxiety

6. Situations Where Individuals May Experience Anxiety

7. The Feelings an Individual May Have When Experiencing Anxiety

8. How Anxiety Can Affect an Individual

9. Ways in Which an Individual’s Anxiety May Affect Others

10. The Cycle of Negative Thinking

11. How an Individual’s Personality and Outlook on Life Could help

or Hinder Anxiety

12. Examples of Self-help for Anxiety

13. The Enjoyable Activities That May Help an Individual Manage

Their Anxiety

14. The Local Resources and Treatments Available to Individuals

Experiencing Anxiety Problems

15. Unit Summary

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INTRODUCTION

In this unit you will gain an understanding of anxiety, the causes of anxiety and how it affects the individual and others. You will also gain an understanding of ways in which anxiety can be managed.

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LEARNING OUTCOMES

This unit will teach you to:

Understand the terms 'anxiety' and 'panic attack'

Understand the possible causes of anxiety

Understand how anxiety can affect the individual and others

Understand how different ways of thinking and behaving can

affect anxiety

Understand how anxiety may be managed

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UNDERSTANDING THE TERM 'ANXIETY'

Like related conditions such as stress, anxiety can be a very debilitating condition that can overcome people and result in major changes to their lifestyle, their health and possibly even their personality. However, unlike stress, which is difficult to define and therefore diagnose, anxiety does have a definition that is used when ascertaining if people have the condition.

ANXIETY IS DEfiNED AS "AN UNCOMFORTABLE FEELING OF NERVOUSNESS OR WORRY ABOUT SOMETHING THAT IS HAPPENING OR MIGHT HAPPEN IN THE FUTURE"

Ongoing anxiety, which is normally the most common form of anxiety that individuals will be affected by, can lead to other conditions and so it is vital that anyone who believes that they may be experiencing a period of anxiety knows what their symptoms are and can, therefore, seek appropriate support and treatment.

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UNDERSTANDING THE TERM 'PANIC ATTACK'

A PANIC ATTACK IS DEfiNED AS “A SUDDEN PERIOD OF SEVERE ANXIETY IN WHICH YOUR HEART BEATS FAST, YOU HAVE TROUBLE BREATHING AND YOU FEEL AS IF SOMETHING VERY BAD IS GOING TO HAPPEN.”

One in four people within the United Kingdom experience some sort of mental health issue every year and it is likely that many of these individuals will have had either an acute (short-term) or chronic (long-term) phase of panic attacks.

A panic attack can be a terrifying experience for someone because the symptoms it provokes makes them believe that they are about to die; this adds to the distress and so heightens the emotions that are being felt. Symptoms can also mimic other serious health incidents such as a heart attack, making the panic attack worse.

The symptoms of a panic attack are very varied and include the following:

Racing heart

Trembling

Sweating

A feeling of being detached from reality

A ringing in the ears

Dizziness

Feeling like you are choking

A sense of impending doom or death

Numbness

Chest pain

Uncontrollable crying or even screaming

Fear of losing control

The symptoms of a panic attack occur because the body goes into ‘fight or flight’ mode in response to either a real, or imagined, subconscious stressor. The body perceives danger and so readies itself to either fight what it believes is threatening it or to flee from it by flooding it with adrenaline. Most individuals find that panic attacks can occur when they do not expect them and this is what can make them so frightening. Some even experience an attack whilst sleeping and these can be the most distressing type of them all.

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Even though a panic attack can be terrifying, it is not fatal and it will not cause the individual to ‘go mad’ as they might fear they are doing when it is taking place. An attack can last anything from a few seconds up to approximately thirty minutes, but panic cannot last forever and so, eventually, the symptoms will ease because anxiety levels are not infinite and must peak before re-tuning to some level of eventual normality – knowing this is how many people cope with panic attacks.

The causes of panic attacks are greatly debated but are directly linked to the causes of anxiety, which will be discussed in more detail in the next section.

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THE POSSIBLE CAUSES OF ANXIETY

Causes of anxiety are varied and, as such, can be organised into several

categories:

Biological

Life experiences

Physical

Personal

These causes need not be felt individually, indeed it is highly likely that an individual goes through periods of anxiety because of a number of causes, some of which may be linked and some of which may not.

BIOLOGICAL CAUSES

Genetic causes for any illness, either mental or physical, have been debated for a long time. Some illnesses are certainly linked to genetics, whereas a genetic link with others is more difficult to identify. However, research has indicated that if an individual has parents who have issues with anxiety, then that individual will be more susceptible to have anxiety issues themselves. It is thought that the link may not be entirely due to genetics as the individual may have ‘learnt’ anxiety symptoms from their parents rather than inheriting them.

LIFE EXPERIENCE CAUSES

Childhood trauma, such as abuse, neglect or being involved in a distressing incident like an accident, can be a significant factor in determining whether someone develops anxiety issues either at the time or later in life. Some individuals will repress painful childhood memories and as they get older their behaviour becomes subconsciously motivated by those memories, and this can lead to anxiety. They may not even realise the cause of this anxiety when it occurs later in life.

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Adult trauma can also be a cause of anxiety and this may not necessarily be due to abuse or neglect but something such as bereavement or a divorce, both of which can cause a huge upheaval in someone’s life. Often, when an event is taking place, an individual is too consumed by it to notice the effects that it is having on them. However, once the event has ended, the effects can result in anxiety because the individual is not prepared to deal with the overwhelming emotions that they are feeling or the readjustment required after the trauma has occurred.

Relationships can cause anxiety, especially if the individual feels as though they have no control over their involvement within it. For example, someone may live with a domineering partner who decides everything on behalf of them both. This can lead to a lack of confidence and self-esteem, both major factors in the development of anxiety.

Relationships with friends can also be a cause of anxiety if one friend feels as though others take advantage of them or individuals are continually let down by others. This can lead to feelings of worthlessness if someone assumes that no one wants to spend time with them. For someone who is already susceptible to anxiety, this can cause further problems.

Unemployment can be a major event in someone’s life and often leads to other causes of anxiety, which work together and make someone feel as though they cannot cope with everything that is being thrown at them. Unemployment can cause stress in the short-term if someone has lost their job, but this can have knock-on long-term effects such as financial instability and possible issues with debt. Often, financial issues can impact relationships and so it is unsurprising that when combined, all of these factors can lead to anxiety.

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PHYSICAL CAUSES

Drugs, both prescription and illegal, can cause anxiety, dependent upon the body’s reaction to them. Someone who has started a new course of prescription drugs will often find that one of the side effects is anxiety. This is usually due to the fact that many types of medication will alter the way in which the brain chemistry is balanced. Someone who starts a new course of medication should monitor any side effects carefully, especially if the drugs have been prescribed to alleviate the symptoms of a mental health issue.

Illegal drugs can often cause extreme mood disturbances, paranoia and panic, which can be difficult to cope with if someone has a dependence on the drug despite the negative effects that it has on them. Often people take illegal drugs to counteract some form of negativity in their life. This can lead an individual into a cycle where they take the drug, become anxious and so take more of the drug to help them feel less anxious, only to find that their anxiousness is made worse once the effects of the drug have worn off.

Blood sugar instability can cause anxiety because it involves some of the symptoms associated with a panic attack, such as trembling, sweating and dizziness. Anyone who has issues with panic or anxiety may well be unaware that they have a physical condition, such as hypoglycaemia or diabetes, because they simply put the symptoms down as part of their problem with anxiety.

Chronic pain has associations with anxiety due to the overall impact it has on someone’s well-being. If someone knows that they are going to be in pain, this can cause them anxiety because they know how much it is going to hurt. This can serve to make both the anxiety and the pain worse because mental and physical health issues are often made worse by each other.

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PERSONAL CAUSES

Someone’s personality, in particular their thinking styles, can determine whether or not they are more likely to be affected by anxiety. Someone who has a positive pattern of thought can usually see the good in any situation and is therefore more likely to feel less overwhelmed and more able to cope in stressful situations. On the other hand, someone who has a negative thinking pattern, will almost always assume the worst and this will lead them to believe that something terrible will happen. As we have already discussed, this is a key factor of anxiety and will make someone more likely to believe they cannot cope.

Being overwhelmed and having no time for yourself can also lead to anxiety because the individual will feel as though everything is getting on top of them and they cannot see a way to deal with it. Everyone needs time for themselves but very busy lifestyles can inhibit this, and when someone also feels as though they need to have everything in order all of the time, this leaves little opportunity to do something which may alleviate stress, such as indulging in a favourite pastime or hobby, which, we will see in a later section, can be extremely beneficial.

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SITUATIONS WHERE INDIVIDUALS MAY EXPERIENCE ANXIETY

Problems with anxiety can be made worse because an individual will actively seek ways of avoiding the things that cause them anxiety. This can lead into a negative cycle because the cause of the anxiety is never confronted, which means that it can never be managed or resolved.

PHOBIAS

The situations in which someone may experience anxiety will very much depend on the individual themselves; however, there are common situations that are known to produce anxiety in many people. Firstly, someone may have a phobia, and being confronted by the source of that phobia can induce extreme feelings of anxiety. For example, a common fear that people have is of heights (known as ‘acrophobia’), and when someone experiences a situation where they are not firmly rooted on the ground, it can cause anxiety that can be mild to extreme, depending on the impact that the phobia has.

CROWDED PLACES

Another common fear for individuals who have anxiety is going to a crowded place. When the fight or flight instinct kicks in, often people feel as though they need to escape. Going somewhere that is crowded might make this difficult, and so individuals who have anxiety avoid places where there are a lot of other people. This can negatively impact their social lives because many enjoyable activities involve going to places where there are other people, such as concerts, festivals, shopping malls, cinemas and theatres.

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NEW PLACES OR SITUATIONS

Going to new places or being involved in a new situation can be anxiety

provoking but not just on the day that the new event occurs. Many

individuals will experience anxiety leading up to the event and,

sometimes, this will lead to them cancelling it if they can, for fear that

they will embarrass themselves or have a panic attack. This behaviour is

not useful because the individual does not confront their anxiety and continues to avoid it whenever they can.

MEETING NEW PEOPLE

New people can be a source of anxiety because many individuals who

experience meeting new people fear judgement by others. The thought of

speaking to someone new can cause paralysing anxiety even for

someone who regularly speaks with friends and colleagues during the

course of a normal day. Meeting new people can also occur when going

to public places, and so avoiding leaving the house can sometimes result from someone’s fear of embarrassing themselves in front of others.

PUBLIC TRANSPORT

Avoiding public transport can occur as a mixture of agoraphobia and a

fear of crowded places. When someone has anxiety, they are constantly

on guard waiting for something terrible to happen. They often indulge in

something known as ‘catastrophising’, which means that in any situation

where there is a chance that something can go wrong they will always

assume the worst. Therefore, on public transport they may feel like they

need to escape if they fear that something is about to happen. However,

this is not easy when they are on a moving train or bus and so this will

lead to feelings of anxiety and panic; the individual may even have a

panic attack or fear that they are about to, something which will almost always lead to the attack occurring.

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A PLACE ASSOCIATED WITH A PAINFUL OR TRAUMATIC MEMORY

A place that someone associates with a painful or traumatic memory will mean that an individual will avoid that situation because it is directly associated with anxiety and trauma. For example, if someone was mugged whilst they were out shopping, they will likely avoid the street where it happened. They may even avoid going out at the same time or even with the person they were with when it happened.

If the experience was especially traumatic, such as being violently attacked or being caught up in some form of terrorism, then this can lead to something known as ‘post- traumatic stress disorder’ where a person relives the event over and over again, especially if they encounter something that reminds them of when it happened, such as a location, person or even a smell.

When anxiety reaches a point where someone is afraid to go outside, this is known as ‘agoraphobia’, which is a very serious condition that has life-changing effects on an individual’s ability to live normally. Sometimes, an individual may even have to have a carer to help them get through the day as there are so many situations that they feel they cannot cope with. Some people who have agoraphobia and have not sought help or help for them has not been successful, have not left their homes for months, even years.

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THE FEELINGS AN INDIVIDUAL MAY HAVE WHEN

EXPERIENCING ANXIETY

Anxiety can provoke many feelings and, as might be expected, none of them are likely to be positive. When someone first experiences anxiety, especially if this is in the form of a panic attack, then they are very likely to feel fear. This may be due to the fact that they do not know what is happening to them, they feel that the symptoms they are experiencing are indicative of a major physical problem or that they are completely at the mercy of what is happening and are powerless to stop it. Fear can be a crippling emotion as well as leading to further anxiety, which makes the problem worse.

Fear is also an issue in determining whether or not an individual will continue to experience anxiety in the future. Those who fear future panic attacks find that they are thinking about them more often. When someone thinks about panicking and fears that it will happen to them, this makes them anxious and raises the likelihood of a panic attack occurring.

Someone who is experiencing anxiety for the first time can also feel shock. Since many painful memories can be repressed, someone may be feeling anxious but cannot figure out why. This is far more difficult to cope with than when the stressor is known. For example, if someone goes into fight or flight mode because they have just narrowly avoided falling into a hole they can see what has caused the reaction and can match it to how they are feeling. Compare that with someone who is sitting at home watching their favorite TV show and suddenly, from

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nowhere, begins to panic. They know what is happening to them but cannot figure out why and this can be shocking for someone who is usually in control of their feelings and is normally able to respond accordingly.

Many individuals will avoid certain situations, because when they are feeling anxious, they are also feeling embarrassment because they are struggling to cope with what is happening to them. People who have tendencies towards anxiety are often perfectionists and do not deal well with what they perceive as others viewing it as a weakness. They may also feel embarrassed because they do not want to bring embarrassment for other people.

This can be especially difficult for parents who feel the need to hide their condition from their children, as they are too ashamed to let them know about it or they fear that their children will be made fun of because of it.

One of the biggest symptoms of anxiety is an overall feeling that the person has somehow become detached from reality and that somehow they are losing control of themselves. They may begin to shout and scream or behave in a way that is not socially acceptable in public. This is another key reason as to why some individuals will completely avoid situations where they feel that they might become anxious and begin to panic. The feeling of losing control can be extremely frightening and this is what gives someone the impression that they are ‘going mad’. Often individuals will not seek help for anxiety and panic because they are afraid that the doctor, or other health professional, may seek to hospitalise them or take their children from their care.

Wanting to run is symptomatic of the fight or flight experience because this is an evolutionary response from times when humans would regularly encounter life-threatening situations from animals or from other humans. However, in today’s society, this response is not quite so useful, especially when an individual encounters it at an inopportune moment, such as in the middle of a meeting or when out on a date. The feeling of wanting to escape can induce further anxiety and often turns into a panic attack because the adrenaline flooding the body cannot be burnt off by the means for which it is meant, i.e. running.

Someone who experiences anxiety on an ongoing basis, such as always having an impending sense of dread, will usually also feel tense and irritable because of the way that they feel. Being on edge all of the time can result in someone snapping at others for the slightest thing and this can be distressing for family and friends because it may be at odds with how they behaved prior to being diagnosed with anxiety issues. Being tense can also lead to physical aches and pains, as well as making someone have digestion problems and headaches.

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HOW ANXIETY CAN AFFECT AN INDIVIDUAL

The effects of anxiety can be broken down into three categories:

Behavioural

Physical

Psychological

BEHAVIOURAL EFFECTS

Anxiety can be a very isolating condition and, because of this, one of the major effects that it has on someone is that they do not want to go out or socialise in any way at all. Avoiding situations can mean that someone’s behaviour changes in order to avoid what it is that they fear will bring them anxiety – this is known as developing ‘avoidant behaviours’. These types of behaviour include typical anxiety behaviours as well. A few examples are:

Avoiding people or places

Staying at home

Going to certain places at certain times, such as when there are less

people

Only going out when accompanied by someone else

Leaving early or ‘escaping’ unnoticed

Using ‘coping mechanisms’ if the person actually has to go out,

such as holding a drink, smoking more, planning an escape,

getting drunk or taking medication beforehand

Going through these types of behaviours will make the individual feel

better at the time, and because of this, the behaviour will likely be

repeated. However, in the long run the anxiety will certainly not improve

because it is not being acknowledged or dealt with in a positive way.

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PHYSICAL EFFECTS

Physical effects on someone can vary in accordance with the severity

and longevity of their anxiety. Anxiety is directly linked to stress and so

the physical effects of both are the same. We have already gone through

what these physical effects are in Unit 2 of this course. However, we will

go through them again now that we are discussing them in terms of

anxiety.

Exposure to ongoing anxiety can have a negative impact on an

individual’s immune system. Too much of the hormone cortisol, which is

released when someone undergoes anxiety, causes it to become less

functional and this can leave an individual more vulnerable to infections

and other illnesses.

Also, too much anxiety means that an individual’s stomach cannot digest

food properly because the regulation of this function is impaired. Chronic

anxiety can have long-term effects on an individual’s intestines, causing

them to experience bloating, heartburn and in extreme circumstances

even loss of bowel control.

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An individual’s brain is affected by anxiety because ongoing exposure to

stressful situations can impair memory and other cognitive functions.

Individuals also have difficulty with focus and concentration, both of

which are regulated in specific areas of the brain that are affected by

anxiety.

People who experience anxiety are also more likely to have heart

problems than those people who do not experience it. This is due to the

fact that anxiety elevates blood pressure, causing a narrowing of the

arteries and a constriction in the way blood can flow effectively around

the body, which can lead to a heart attack or stroke.

Individuals who are susceptible to anxiety often report feelings of

constant tension, and this can affect their muscles, which are always

being tightened. This is why many people who are undergoing anxiety

are said to have ‘knots’ in their muscles – this is due to the fact that they

are tense almost all of the time. This tension can lead to headaches, stiff

shoulders, neck pain and migraines.

Finally, when the body undergoes stress and anxiety, the adrenal

system compensates for this by releasing excess amounts of cortisol. As

well as affecting the immune system, too much cortisol can lead the liver

to produce more glucose because it is reacting to the ‘fight or flight’

response being triggered. For most individuals, extra glucose will not be

problematic because the body can easily reabsorb it. However, for those

already at risk of diabetes, the extra glucose may cause serious health

issues.

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PSYCHOLOGICAL EFFECTS

Anxiety can also cause harmful psychological effects. As we have already

mentioned, anxiety is directly linked to stress and depression. When

someone is unable to cope with their anxiety and they begin to isolate

themselves, this isolation can lead to depression. A negative cycle will

begin to develop that can be very difficult for an individual to break.

Fatigue is a harmful condition that further risks an individual becoming

isolated. When an individual has anxiety, their mind and body are

constantly tense and never given the chance to fully relax. This can

cause them to feel very tired, which will result in a lack of productivity

and social activity. Anxiety is also strongly linked to a number of panic

disorders which can have a dramatic effect on the way an individual

lives their lives.

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WAYS IN WHICH AN INDIVIDUAL’S ANXIETY MAY AFFECT OTHERS

Anxiety, whilst being a very isolating condition, can undoubtedly have an

effect on the people around the individual who is currently experiencing

it. One major factor that comes about due to anxiety is relationship

issues. This can usually be because the individual is reluctant to attend

social events because they are afraid of what may happen to them whilst

they are there. This may not only cause arguments within the relationship

but can also cause partners to become disconnected from each other,

especially if one continues to socialise despite the other’s reluctance to

do so.

Many people who have anxiety will rely on their partner to help and

support them more, and the partner may even end up taking on more

domestic tasks because the individual does not feel well enough to do

them or because they involve leaving the house, something that they feel

they cannot do. Many partners will enable the individual to come to terms

with their condition and help them through it. Some, however, will

struggle to understand it because anxiety does not present itself in the

same way as a physical illness and they may then lack empathy towards

the individual due to not being able to ‘see’ the condition. This lack of

empathy may make the individual feel even more isolated and

unsupported.

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If someone’s anxiety is especially severe and they develop a condition

such as agoraphobia alongside it, then someone close to them may end

up becoming an informal carer. An informal carer assists the person

who feels that they can no longer cope alone with their daily activities.

This can put a huge strain on the person who has become the carer

because it will impact heavily upon their own life, especially if they have

been reluctant to take on the caring responsibility and have done so just

because they felt that they had to. This can cause strain in the

relationship they have with the individual who has anxiety, which may

then become a source of further anxiety for both people involved.

Missing work can also be a by-product of anxiety, especially if work is

the source of the anxiety in the first place. In 2014/15, almost ten million

working days were lost due to anxiety and stress-related conditions

(HSE, 2015), which reflects how much of an effect the condition has on

someone’s ability to attend work. Even if the individual is able to attend

work, anxiety has an effect on someone’s ability to concentrate and so

they may not be able to do their job effectively – something that may

cause further anxiety if they believe that this will be noticed by

colleagues or managers.

Although there is no scientific evidence to support the claim, many

researchers believe that anxiety behaviours may be passed on to

children via learnt behaviour. What this means is that the individual

who has anxiety may behave in certain ways and may exhibit certain

symptoms and that any children who witness these on a regular basis will

learn them and then repeat them themselves when they are older. Since

parents are usually the most prominent role model in a child’s life, there

is certainly reason to argue that this might in fact be the case and goes

some way in explaining why anxiety tends to run in families.

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THE CYCLE OF NEGATIVE THINKING

Some people are more predisposed than others to a certain way of thinking, which increases their risk of becoming anxious. The cycle of negative thinking is what happens when someone cannot break their thought patterns and always assume the worst in a situation. To better understand how it works, have a look at the illustration below. It has been drawn up by the mental health charity Mind to highlight what happens during a negative thinking cycle and how difficult it can be to break the cycle without receiving help.

The bottom illustration of the cycle of negative thinking starts with the feeling of anxiety at the top; however, not everyone will start a cycle of anxiety at this stage; people can dip in and out of the cycle and go back and forth between its stages at any time. Let’s look at a case study and apply it to the ‘anxious’ example above.

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CASE STUDY – BECKY

Becky has had issues with anxiety for the last six months. She is really embarrassed by this because, from the outside, everyone perceives her as ‘having it altogether’ and not having any worries about why she might be anxious. What people do not realise is that Becky grew up with an abusive father who would regularly beat her and her two sisters, often for no reason whatsoever.

At age 26, Becky thought she had resolved the issues she had with him because the two of them have had no contact since Becky left home for university eight years ago. However, she feels like her abusive past might be something to do with her current anxiety problems but she is reluctant to seek help because she fears that this would be seen as a sign of weakness, and she prides herself on being the best she can at everything.

Becky has recently started to decline invitations to go out because she is afraid that in a social situation she will not be able to hide her anxiety. However, her best friend has just got engaged and she feels that she cannot miss the party that is being thrown for her friend and her new fiancé. A week before the party, Becky begins to wake up in the night, feeling nauseated and dizzy. She knows that this is because of the upcoming party and tries her best to calm herself and think rationally about what might happen.

However, she convinces herself that she cannot go, she is afraid that everyone will look at her and judge her and that she will start to panic and be unable to escape from the room. Just thinking about it makes Becky feel sick. So, on the evening of the party, she phones her friend and tells her that she does not feel well and won’t be able to attend. As soon as the phone call is made, she instantly feels better and begins to relax.

After five minutes though, she begins to feel guilty about what she has done. She fears that no one will invite her to places anymore and that they will all judge her for not attending. This makes Becky start to feel anxious again and she wonders how she can avoid seeing them in the future so she does not have to explain herself. She then sits and worries about what is wrong with her that she cannot face her friends who she has known for many years. This feeds into her anxiety and, before long, she can feel herself beginning to panic.

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Hopefully, the case study above makes it clear how easy it can be to get stuck in the cycle of anxiety and panic. In this instance, it would seem that Becky’s past is influencing her current behaviour. She may now have negative thinking patterns as a coping mechanism to try and deal with how she was treated as a child – by fearing the worst, someone can be pleasantly surprised when it does not happen, although this is a very unhealthy outlook to have on life in general.

Becky’s cycle of anxiety would almost certainly have to be broken with professional help because she is now at the point where the thought of going out is making her anxious and so she is developing avoidant behaviours to cope with her feelings. As she is also thinking about avoiding her friends altogether, she is at risk of isolation, which can be a key determinant in an individual developing other mental health problems such as depression.

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HOW AN INDIVIDUAL’S PERSONALITY AND

OUTLOOK ON LIFE COULD HELP OR HINDER

ANXIETY

Personality types and their link to an individual’s ability to cope with stress and anxiety have been subject to much research to try and ascertain why some people appear to have no ill effects from stressful situations, whilst others cannot cope and find themselves subjected to ongoing issues.

Research carried out in the 1960s by Friedman and Rosenman concluded that everyone’s personality can be grouped into one of two types – ‘A’ and ‘B’. Some of the questions that the participants in the study were asked included:

Do you feel guilty if you use spare time to relax?

Do you need to win in order to derive enjoyment from games and

sports?

Do you generally move, walk and eat rapidly?

Do you often try to do more than one thing at a time?

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Those people who were found to have a type A personality exhibited the

following characteristics:

Ambitious

Rigidly organised

Sensitive

Impatient

Anxious

Proactive

Workaholic

High achievers

Competitive

Whereas someone with a type B personality exhibited these

characteristics:

Steady workers

Flexible

Even-tempered

Expressive/creative

Relaxed

Reflective

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Hopefully, it is clear that if someone falls into the type A category of

personality types then they are much more likely to have periods of

stress and anxiety than those people who are type B. Type A

personalities are usually very high achievers and get great satisfaction

from organising and managing projects. They are extremely competitive

and feel as though they have to be good at everything they try. It is little

wonder then that this personality type is far more susceptible to stress

and anxiety. They have an ‘all or nothing’ attitude and do not really

tend to relax much – something which is key in reducing the chances

of anxiety from occurring.

Type B personalities are far more laid back and, as such, far less likely

to experience stress and anxiety. They are much less worried about

failure and are not competitive, choosing instead to enjoy their

achievements when they have them and learn from their mistakes when

they are not successful.

The researchers also found that more than twice as many type A people

as type B people developed coronary heart disease. When the figures

were adjusted to take into account other factors that might cause ill

health, such as smoking habits and diet, it still emerged that type A

people were nearly twice as likely to develop heart disease as type B

people.

When following up their original study findings, the researchers

discovered that eight years later, 257 of the 3157 participants had

developed coronary heart disease, of which 70% were type A

personalities.

It was also concluded that type A personalities make individuals more

susceptible to other stress-related illness like high blood pressure.

It is sometimes difficult to place people accurately into one of the two

categories but most people will show characteristics that favour one of

them more than the other. If an individual knows about their

personality type, this may act as an alert for them to watch out for

signs of anxiety; if they know that they are going to behave in a

manner that might make it more likely, then they will be in a better

position to manage it more successfully.

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EXAMPLES OF SELF-HELP FOR ANXIETY

Self-help for stress and anxiety related conditions is becoming more and more popular as health professionals urge individuals to manage their own conditions rather than relying on medical interventions.

One of the most effective ways that someone can manage their anxiety is to understand more about it, especially if they are also experiencing panic attacks which they are finding very distressing. Understanding what happens to the body during a period of anxiety can actually have a calming effect because the ‘unknown’ of the situation is removed and the knowledge that is gained can actually reduce levels of anxiety.

Knowing the triggers of anxiety can also help but this does not mean that an individual should avoid them, as never dealing with the situation can make the condition worse. Instead, if an individual knows what a trigger for their anxiety is and chooses to face that trigger, they can prepare themselves for what will happen and be able to rationalise the experience rather than suffer through it. This is not something that everyone will be able to do right away, but when someone is ready to face their anxiety trigger then they will do so much more successfully if they are prepared.

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Breathing exercises can be very useful as they can reduce the symptoms of anxiety or panic by starting an individual’s parasympathetic nervous system, which reverses the effects of the fight or flight instinct. Breathing is often erratic and shallow when someone is experiencing anxiety, and if the breathing can be brought under control then the individual is far more likely to relax and therefore less likely to have a panic attack.

A healthy diet can make someone feel better in general and this can increase their overall sense of well-being. When someone feels as though they are healthy this means that they are far more likely to be able to cope with stressful situations as they will feel more agile and alert. A good diet consists of a good mix of protein, carbohydrates, fats, vitamins and minerals and individuals who are susceptible to stress would be advised to learn as much as they can about a healthy diet.

Avoiding certain substances such as caffeine, alcohol and cigarettes can help because all of these act as a stimulant that can cause someone’s heart to beat faster, which may be mistaken for the signs of anxiety. If an individual cannot cut them out altogether then reducing them as far as possible is highly advised. For alcohol, this will mean no more than the advised 14 units of alcohol per week for both men and women, which should be spread over three or more days, rather than all being drunk in one day.

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Studies have indicated that when an individual stops smoking, their anxiety levels are reduced considerably; this is in contrast to the popular belief that smoking helps to calm someone’s nerves.

If someone is taking a new course of medication then this may cause symptoms of anxiety. Therefore, checking the potential side effects can help to stop some causes of anxiety that may have been triggered by certain types of medication that may have been taken for a completely different reason.

One of the hardest aspects that many individuals find with anxiety and other stress-related illnesses is explaining to others how they are feeling. This is because they do not want to be judged or seen as weak or possibly even patronised or snubbed by people. However, if someone can explain to those who are close to them how they feel and what effects their anxiety is having on them, they may well find that people are sympathetic. If an individual speaks about how they feel to the people who are close to them then it will enable those people to better understand why the individual may not want to go out one day or why they appear to be sometimes acting in a manner which is out of character. This knowledge of how the individual is feeling will help avoid breakdowns in relationships that are due to a lack of communication and understanding.

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THE ENJOYABLE ACTIVITIES THAT MAY HELP AN

INDIVIDUAL MANAGE THEIR ANXIETY

It can sometimes be difficult for individuals who have anxiety to find something that is enjoyable to them. This is because their condition puts them constantly on edge and, as a result, they find it hard to relax enough to enjoy activities that may have previously brought them great pleasure. However, if they can find a way to indulge in an activity then there are several which may be of great use in helping them reduce their anxiety, if only for a short time:

Mindfulness, including Pilates and yoga: Being mindful means that someone is able to ‘switch off’ and enable their mind to clear and be at peace. This is not easy for people who are disposed to anxiety because their minds are often full of worries about their life. However, breathing techniques can be learnt that will increase their level of relaxation and possibly also allow them to leave their worries to one side, even if this is only for a brief period of time each day. Pilates and yoga actively promote relaxation and stress reduction so these are ideal activities in helping someone reduce their anxiety.

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Hobbies: A hobby can act as a distraction from anxiety and it can also bring enjoyment and fulfilment to someone’s life. A hobby also enables someone to have feelings of satisfaction that they are doing something that may make a difference to their own or someone else’s life. Hobbies help people to feel happy and this can be very influential to someone’s overall well-being.

Volunteering: Sometimes people feel anxious because their confidence and self- esteem is low. By volunteering they are helping others and this can bring great feelings of satisfaction, increasing self-worth and making someone feel as though they are making a real difference to someone else’s life. Like a hobby, it is also a good distraction away from whatever is causing the stress and gives the individual the opportunity for valuable time spent with others, reducing the likelihood of isolation.

Having a bath: Something as simple as running a warm bath and filling it with bubbles can have a very soothing and comforting effect on someone who is feeling anxious. Having some tranquil music on in the background can also help to divert their mind from anxious thoughts which may otherwise present themselves in a quiet room.

Massage: Whilst not scientifically proven to reduce anxiety, a massage will almost certainly enable someone to relax for a period of time and, if done regularly, may decrease someone’s overall anxiety levels. Massages help anxiety because they ease the muscular tensions that someone may have in certain parts of their body, usually their neck and shoulders. It is also thought to help increase levels of the hormone ‘serotonin’ which makes people feel happier and more uplifted.

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THE LOCAL RESOURCES AND TREATMENTS

AVAILABLE TO INDIVIDUALS EXPERIENCING

ANXIETY PROBLEMS

The local resources and treatments available for individuals experiencing anxiety problems are very similar to where an individual would go when experiencing stress-related problems. We discussed these back in Unit 2 but we will go over them again for anxiety.

An individual’s GP or another health professional will be an excellent source of support for someone who is finding one or more aspects of their life to be stressful. GPs can refer individuals for counselling or they can prescribe medication that they think might be useful in the interim to help control their levels of anxiety.

Counsellors and therapists are specialists in stress-related conditions and speaking to one of these professionals can be very useful for any individual. Not only will a counsellor be able to assist them to get better in the present but they will also help guide them to prevent a reoccurrence of the condition in the future. It is believed that the most effective type of therapy for anxiety and stress-related conditions is CBT – cognitive behavioral therapy. This works by enabling the individual to look at their thinking patterns and readjust them so that they do not automatically fear the worst. It teaches them to self- question in times where they may catastrophize. For example, if an individual is walking home and can see smoke in the air, many people prone to anxiety will immediately ‘predict’ that their house is on fire. CBT will enable the individual to ask themselves how likely this situation actually is. This makes them reassess their thinking patterns and enables them to calm themselves down.

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Medication is sometimes offered to individuals whose anxiety may be affecting their ability to carry out their normal day-to-day activities. The most common type of medication that is prescribed to help anxiety is some form of anti- depressant. These usually work by increasing the amount of serotonin available in the brain. Serotonin is a ‘feel good’ hormone and its reduction is thought to be directly linked to low mood and depression. The most common type of antidepressants are SSRIs – selective serotonin reuptake inhibitors – which stop too much serotonin being reabsorbed so more is available in the brain. These in turn will lift or maintain a person’s mood and can help with anxiety and panic disorders.

Sleeping pills and tranquillisers are almost exclusively used for severe anxiety and related insomnia. They work by making users feel calmer and less anxious and to help break a pattern of not sleeping in the hope that a normal pattern can be returned to. These are, however, not usually prescribed for long-term usage as they can become addictive.

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Health centres often have walk-in appointments where individuals can attend to discuss any problems that they are having with anxiety. Professionals will be on hand to assist in giving advice about the issue, possibly pointing them in the direction of a GP appointment or for ways in which they can reduce their stress levels. Many health centres are able to offer discounted memberships at local gyms where individuals can attend to improve their confidence and self-esteem or possibly partake in lessons such as yoga and Pilates, which are known to be beneficial at reducing levels of stress and anxiety.

Community groups provide excellent peer support where individuals can attend and discuss their anxiety with people who are going through, or have previously gone through, the same thing, and so can empathise fully with what the individual is feeling. It is very gratifying for individuals to know that they are not the only ones who have experienced periods of stress because, as we have already discussed, it can be a very isolating condition which many people are embarrassed to admit that they have.

A community group not only provides emotional support but is another very good way of ensuring that someone continues to socialise on some level. This helps to prevent them from being vulnerable to withdrawal from social situations, which people who do experience stress can find very daunting.

Online forums provide exactly the same kind of support as community groups but are better for individuals who cannot currently face the prospect of meeting with other people. To someone who has never suffered stress or anxiety, it may be difficult for them to understand how simply going out and speaking to people can cause more issues. However, for those people who do have these conditions, even the simplest of day-to-day tasks can sometimes feel insurmountable so any kind of help to keep them in contact with other people will be beneficial.

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UNIT SUMMARY

In this unit we have discussed what is meant by the terms ‘anxiety’ and

‘panic attack’ whilst strongly reiterating throughout the link between

anxiety and stress. We have explored how an individual may feel when

experiencing an episode of anxiety, some of the common triggers that

may cause these episodes to occur and the behavioural, physical and

psychological effects that it can have on an individual. We have also

looked at the effect that anxiety has on the people who are close to the

individual suffering with this condition and the impact that it can have on

their relationships. The cycle of negative thinking is a big aspect of

anxiety and we have discussed ways in which an individual can break

out of this cycle to help them live a more stress-free and anxiety-free life.