What is anxiety?

Many people across the UK are struggling with mental health disorders including anxiety and depression. According to the mental health charity Mind, 1 in 4 people will experience a mental health problem each year in England. In any given week, 8% of the population are struggling with mixed anxiety and depression, 6% have a generalised anxiety disorder and 4% have post-traumatic stress disorder.

Worry, concern and anxious thoughts are all perfectly normal and natural. Everybody worries during their life about both things that they can control and things that they can’t control. However, people with anxiety disorders, such as generalised anxiety, tend to have excessive, exaggerated worry about everyday life events, sometimes with no obvious reasons for that worry. People struggling with anxiety generally always expect disaster and can’t stop worrying about issues such as health, money, family, work, or school.

The cognitive behavioural therapy (CBT) view of anxiety is that it is our thoughts that affect the way that we feel. Therefore, if we have worrying or anxious thoughts, we are going to feel anxious. Then, because we feel anxious, our behaviour changes and we end up doing things that strengthen and maintain our anxious feelings. This leads to more worry and anxiety. As the picture below shows, our thoughts, feelings and behaviours are all interlinked.

Symptoms of anxiety

If you have anxiety you know how uncomfortable it can be. Many of the symptoms of anxiety are as a result of the fight or flight response kicking in when our mind thinks we are in danger (not just physical danger, but also danger to our self-esteem, ego or sense of being etc). The fight or flight response is really helpful when our life is genuinely in danger (such as when we are trying to get out of a house fire), but is unhelpful if all we are dealing with is sitting an exam or having relationship issues. Anxiety, worry, and the physical symptoms associated with it can cause significant distress or impairment in social, occupational, or other important areas of life.

The symptoms of anxiety include:

Excessive anxiety and worry (apprehensive thoughts) about a number of events or activities (such as work or school performance).
Feelings of restlessness or being on edge.
Feeling tired, fatigued or exhausted
Difficulty concentrating
Feelings of Irritability or anger
Muscle tension, especially in the neck and shoulders
Sleep problems including difficulty falling or staying asleep, or unsatisfactory sleep
Headaches and migraines
Feeling hot and sweating
Feeling sick, nauseous, indigestion, upset stomach, IBS
Being easily startled
Trembling and shaky
Shortness of breath or a feeling of not getting enough air in the lungs
Heart racing or palpitations
Butterflies in the stomach

The nature of anxiety

Our understanding of anxiety has developed over the last few years. So, what we know about anxiety is:

Anxiety is hard-wired by evolution as a response to perceived danger. The fight or flight response is present in humans and animals to protect them from danger. A part of the brain called the amygdala, which emerged about 150 million years ago, takes over when we assess that we are in danger.
Anxiety represents the malfunction of a normal fear response. The fight or flight response is really useful, it can help to keep us alive. If a car came rushing towards you, the fight or flight response would help you to jump out of the way. However, because we have minds that are always thinking and planning for the future, the fight or flight response is activated when we are not in any danger. That means we can think about anxiety as being a false alarm.
Anxiety involves the anticipation of danger, pain, or catastrophe. Because anxiety is driven by worry, people with anxiety tend to focus on what could go wrong, rather than what could go right. So, they anticipate terrible things happening to them, such as making a fool of themselves at a party, or their plane crashing, or having developing an illness. Unfortunately, they confuse their thoughts with reality, and they allow their thoughts to hook them in and jerk them around.

The causes of anxiety

There are a number of different causes of anxiety:

1. Genetics and biology play a significant role in the development of anxiety. Some people’s genetic make-up makes there sympathetic nervous system (the parts of the body responsible for the fight or flight response) more sensitive. So, if mum or dad were anxious people, we are likely to struggle with anxiety. However, although some people are predisposed to be anxious, that doesn’t mean that it is predetermined and other factors might influence the likelihood of struggling with anxiety.

2. Painful or traumatic experience plays a significant role in the development of anxiety. We know that early life experiences, such as facing traumatic situations such as child abuse, or even life events such as our parents divorcing or having a childhood illness can increase the chances of developing anxiety as an adult.

3. The self-perception of inefficacy plays a significant role in the development of anxiety. Self-efficacy can be defined as personal beliefs in one’s capabilities. Self-efficacy beliefs determine how people feel, think, motivate themselves and behave. Research shows that there is a link between having a low belief in our abilities and poor mental health.

4. Research suggests that individuals with generalised anxiety engage in chronic worry because they prefer to experience a sustained state of distress as a way to be emotionally prepared for the worst possible outcome to various events. This could be because the shift from “things are going really well in my life” to “things are going badly in my life” is too emotionally painful for some people.

What maintains anxiety?

Although many clients want to know how to get rid of anxiety, there are some things that people do that actually makes their anxiety hang around.

1. There is the avoidance of the feared situation, object, thought, or feeling. We know that avoidance maintains anxiety. Clients who are scared of spiders try their best to avoid being with spiders, or when they see a spider they run away. Their minds then learn that if they avoid spiders they don’t get those uncomfortable feelings called anxiety. However, learning to confront your fears (sometimes called exposure) is one of the best ways to overcome anxiety and fears.

2. There is a continuation of the underlying problems, whether they are unconscious conflicts, a persistent habit or a dysfunctional belief. Basically, if you keep doing what you’ve always done, you are are going to get what you’ve always got. To overcome anxiety you need to start doing something different, whether that’s changing habits, learning new coping strategies, or tackling the problems in your life.

3. There is obsessive self-focused attention. People with anxiety tend to be very focused on themselves, on their thoughts, feelings and sensations. Learning to shift your attention away from yourself and onto the world around you, can be very helpful in reducing anxiety.

What helps with anxiety?

There are a few approaches that can help with anxiety. Sometimes it can take some time to find the best approach for you, so it is worth looking around at all your options and talking to different specialists before making a decision.

Medication – For most people who go to their doctors with anxiety, medication is one of the first options available to them. One of the most common types of medication currently prescribed for anxiety are selective serotonin reuptake inhibitors (SSRIs), such as Prozac. If you have anxiety is it worth talking to your GP about your options.

Person-Centred Counselling – Counselling is available for anxiety both on the NHS and privately. Counselling is an opportunity to talk through your fears and worries in a safe environment with an experienced and qualified counsellor. Counselling can take place from a few weeks to many years depending on the severity of your anxiety.

Cognitive Behavioural Therapy (CBT) – CBT is an evidence-based approach for helping with anxiety that is offered through the NHS, or you can pay for private sessions. CBT tends to take less time than counselling and is focused on helping clients to think about their thoughts in a different way. CBT can be very effective but doesn’t suit everyone.

Mindfulness – Mindfulness involves learning to be more present, and to not get hooked up in thinking. It can be offered in group sessions or one to one. Recent research is very supportive of mindfulness for anxiety.

Hypnotherapy – Hypnotherapy is one of the most researched approaches to helping people with anxiety and the research which supports its use goes back almost 150 years. Hypnosis for anxiety can take many different approaches but usually involves creating a state of focused attention and then giving positive suggestions that can help a client feel calmer, more relaxed and more positive about the future.

Acceptance and Commitment Therapy (ACT) – ACT is a relatively new approach to treating anxiety, that involves learning to be present (rather than getting caught up in thoughts), opening up to difficult thoughts and feelings (rather than struggling with them) and doing what matters (rather than living on auto-pilot).

Eye Movement and Desensitisation Reprocessing (EMDR) – EMDR was developed to help people struggling with post-traumatic stress disorder. It involves the use of exposing a client to difficult memories combined with focusing on bi-lateral movements, either with the hand or a light box. EMDR is now being used to help a wider range of anxiety disorders.

What is hypno-ACT for anxiety?

As an anxiety coach, based in Wigan, Greater Manchester, I have developed a new way of helping people with anxiety. It takes the best of hypnosis, ACT, mindfulness, CBT and EMDR to create a treatment that is effective for a wide range of anxiety disorders.

If you are interested in finding out more about hypno-ACT just click on the link.

What is anxiety