Stress and Anxiety

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Anxiety is a feeling of unease, such as worry, nervousness or fear about something with an uncertain outcome. It can be experienced as either mild or severe.

Everyone has feelings of anxiety at some point in their life, it is a normal emotion. For example, many people feel worried and anxious about sitting exams or having a medical test or job interview.

However, for some people it is very hard to control worries and the feelings of anxiety can be more constant and often impact on day to day life.

How common is anxiety?


GAD affects about 1 in 20 adults in Britain. Slightly more women are affected than men, and the condition is most common in people in their 20s.

Symptoms of Anxiety

There are many possible symptoms of general anxiety, and how severe they are varies from person to person. Some people have only one or two symptoms, while others have many more.

Anxiety can affect you physically and mentally.

Psychological symptoms of anxiety

Anxiety can cause a change in your behaviour and the way you think and feel about things. Psychological symptoms of anxiety include:

  • restlessness
  • a sense of dread
  • feeling constantly “on edge”
  • difficulty concentrating
  • irritability
  • impatience
  • being easily distracted
  • fear of losing control
  • fear of fainting
  • fear of dying

Your symptoms may cause you to withdraw from social contact (seeing your family and friends) to avoid feelings of worry and dread. You may also find going to work difficult and stressful and may take time off sick. These actions can make you worry even more about yourself and lower your self-esteem.

Physical symptoms of anxiety

The physical symptoms of anxiety can include:

  • dizziness
  • drowsiness and tiredness
  • pins and needles
  • irregular heartbeat (palpitations)
  • muscle aches and tension
  • dry mouth
  • excessive sweating
  • shortness of breath
  • stomach ache
  • nausea
  • diarrhoea
  • headache
  • excessive thirst
  • frequent urinating
  • painful or missed periods
  • difficulty falling or staying asleep (insomnia)

Types of Anxiety

Anxiety can be one of the main symptoms of a number of other types of problem:

Generalised anxiety disorder (GAD)

GAD is a long-term condition which causes you to feel anxious about a wide range of situations and issues, rather than one specific event.

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. GAD can cause both psychological (thoughts and feelings) and physical symptoms. These vary from person to person, but can include feeling irritable or worried and having trouble concentrating or sleeping.

If you have GAD, what you are feeling anxious about may not always be clear. Not knowing what triggers your anxiety can intensify your anxiety and you may start to worry that there will be no solution.



What is stress?

Stress is a normal physical response to events that make you feel threatened in some way. When you sense danger, whether it’s real or imagined, the body’s defences are triggered into a rapid, automatic process known as the “fight-or-flight-or-freeze” reaction, or the stress response.

The stress response is the body’s way of protecting you. When working properly, it helps you stay focused, energetic, and alert. In emergency situations, stress can save your life, giving you extra strength to defend yourself, for example, or making you respond quickly, such as slamming on the brakes to avoid an accident.

The stress response also helps you rise to meet challenges. Stress is what keeps you on your toes during a presentation at work, sharpens your concentration when you’re attempting the game-winning throw, or drives you to study for an exam when you’d rather be watching TV.

But beyond a certain point, stress stops being helpful and starts causing major damage to your health, your mood, your productivity, your relationships, and your quality of life.

Recognising stress

It’s important to learn how to recognise when your stress levels are out of control. The most dangerous thing about stress is how easily it can creep up on you. You get used to it. It starts to feel familiar, even normal. You don’t notice how much it’s affecting you.

The signs and symptoms of stress overload can be almost anything. Stress affects the mind, body, and behaviour in many ways, and everyone experiences stress differently. Not only can overwhelming stress lead to serious mental and physical health problems, it can also impact on your relationships at home, at work, and with friends.

There are some common warning signs and symptoms of stress; these can also be caused by other psychological or medical problems. If you’re experiencing any of the warning signs of stress, it’s important to talk to your GP who can help you determine whether or not your symptoms are stress-related.

Stress Warning Signs


Physical Symptoms

  • Aches and pains
  • Diarrhoea or constipation
  • Nausea, dizziness
  • Chest pain, rapid heartbeat
  • Loss of sex drive
  • Frequent colds


Cognitive Symptoms

  • Memory problems
  • Inability to concentrate
  • Poor judgment
  • Seeing only the negative
  • Anxious or racing thoughts
  • Constant worrying

Panic Disorder


A panic attack occurs when your body experiences a rush of intense anxiety psychological and physical symptoms, including an overwhelming sense of fear, apprehension and anxiety. Panic attacks can be very frightening and distressing. The symptoms often occur suddenly and without warning.

Panic disorder is where you have recurring and regular panic attacks, often for no obvious reason.

Everyone experiences feelings of anxiety and panic at certain times during their lifetime. It is a perfectly natural response, particularly when you are in a dangerous or stressful situation. However, for people with panic disorder, feelings of anxiety, stress and panic occur regularly and at any time.

How common is Panic Disorder?

At least one person in 10 experiences occasional panic attacks, which are usually triggered by a stressful event. In the UK, approximately one person in 100 has panic disorder. Most people first develop the disorder when they are in their twenties. The condition is approximately twice as common in women as it is in men.

The number of panic attacks that you have will depend on the severity of your condition. Some people may have one or two attacks each month, while others may have several attacks a week.

Recognising Panic

The physical symptoms of a panic attack are unpleasant, and they can also be accompanied by thoughts of fear and terror. For this reason, people with panic disorder start to fear the next attack, which creates a cycle of living in ‘fear of fear’ and adds to the sense of panic.

Sometimes, the symptoms of a panic attack can be so intense they can make you feel like you are having a heart attack.

However, it is important to be aware that symptoms such as a racing heartbeat, or shortness of breath, will not result in you having a heart attack. Also, although a panic attack can often be frightening, it will not cause you any physical harm. People who have had panic disorder for some time usually learn to recognise this ‘heart attack sensation’, and become more aware of how to control their symptoms.

The symptoms of a panic attack usually peak within 10 minutes, with most attacks lasting for between 5 and 20 minutes. Some panic attacks have been reported to have lasted up to an hour. However, it is likely that the reason for this is due to one attack occurring straight after another, or high levels of anxiety being felt after the first attack.

During a panic attack your symptoms can feel so intense and out of your control that you may feel detached from the situation, your body and your surroundings. It can almost feel as if you are an observer, making the situation seem very unreal. This sense of detachment is known as depersonalisation and it can make the experience more confusing and disorientating.

What causes Panic Disorder?

As with many mental health conditions, the exact cause of panic disorder is not fully understood. It is thought that panic disorder is probably caused by a combination of physical and psychological factors.

These factors can include traumatic life experiences; possible genetic links; the balance of neurotransmitters, the chemicals that occur naturally in the brain; increased sensitivity to carbon dioxide; catastrophic thinking.

Regardless of the cause, psychological treatments for panic are helpful as they teach people how to manage the symptoms, reducing the fear of the panic and making them less likely to happen again.


A phobia is a persistent and overwhelming fear of an object, place, situation, feeling or animal. The fear can be incapacitating and if severe then a person might try to organise their life so that they do not have to face the thing that they fear. If this is not possible, then they can suffer considerable distress.

A phobia is more than just a fear. The strength of the fear is usually disproportional to the actual danger posed, and they are very often recognised as something that is irrational.

Post-Traumatic Stress Disorder


Anxiety can have a big impact on day to day life, making it difficult to carry out everyday tasks. However, there are several different types of treatment that can help the psychological and physical symptoms of anxiety. These include psychological therapy and medication. Depending on your circumstances, you may benefit from one of these types of treatment or a combination of the two, although people are generally advised to try psychological treatment first as the benefits have been generally been found to last the longest.

Cognitive Therapy

The main type of psychological treatment for anxiety is cognitive behavioural therapy (CBT). Research suggests that around half of people who have CBT recover from anxiety and many others get some benefit.

CBT works by helping you identify unhelpful and unrealistic beliefs and behavioural patterns. We will work together with you to find ways to change your behaviour and replace unhelpful beliefs with more realistic and balanced ones. We will teach you new skills and help you understand how to react differently to situations that would usually cause you stress and anxiety.

Applied relaxation

Applied relaxation is an alternative type of psychological treatment.

Applied relaxation focuses on relaxing your muscles in a particular way during situations that usually cause anxiety; it involves learning how to relax your muscles and practising relaxing your muscles in situations that make you anxious.


Mindfulness is another useful therapy in which you are taught techniques to help you manage anxiety in different ways, helping reduce the physical symptoms and also to take a different approach to the unhelpful thoughts and behaviours.

Medication for anxiety

Your GP can prescribe a variety of different types of medication to treat anxiety. Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods. Depending on your symptoms, you may require medicine to treat your physical symptoms as well as your psychological ones.

If you are considering taking medication for anxiety, your GP should discuss the different options with you in detail, including the different types of medication, length of treatment, side effects and possible interactions with other medicines before you start a course of treatment.

There are also many things you can do to ease the symptoms of anxiety yourself and there are a number of different self-help websites. Some sources of helpful information include:

Self-help booklet produced by Northumberland, Tyne and Wear NHS Trust: Anxiety

Mind: A mental health charity offering support and resources to people to help them manage difficulties associated with mental health.

ReThink: An organisation who challenge attitudes and aim to help people living with mental health conditions like depression and more to recover a better quality of life.


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