Anxiety: Symptoms, Types and Ways to Cope

Everyone feels anxious sometimes, before an exam, a job interview or a hospital result. That kind of anxiety is normal and can even help you focus. But when worry becomes constant, out of proportion and starts affecting your work, relationships or sleep, it may be an anxiety disorder: one of the most common mental health conditions in the world.

Symptoms

Anxiety affects both mind and body.

Emotional and mental symptoms

• persistent worry that's hard to switch off
• restlessness or feeling "on edge"
• irritability
• trouble concentrating, or your mind going blank
• a sense of dread or that something bad will happen

Physical symptoms

• a racing or pounding heart
• breathlessness or a tight chest
• sweating, trembling or dizziness
• stomach upset, nausea or frequent urge to use the toilet
• muscle tension and headaches
• difficulty falling or staying asleep

Because the physical symptoms can be intense, many people first visit a doctor fearing a heart or stomach problem. It's sensible to rule these out, and equally important to consider anxiety once tests are normal.

Types of anxiety disorders

• Generalised anxiety disorder (GAD): excessive worry about many everyday things on most days for at least six months.
• Panic disorder: repeated, sudden panic attacks (waves of intense fear with physical symptoms that peak within minutes) and fear of having another.
• Social anxiety disorder: intense fear of being judged or embarrassed in social situations.
• Specific phobias: extreme fear of particular things or situations, such as heights, needles or flying.
• Health anxiety: persistent worry about having a serious illness.

What causes anxiety?

There's no single cause. Contributing factors include family history, stressful or traumatic life events, long term stress at work or home, other health conditions (including thyroid problems), and substances such as caffeine, alcohol or some medicines.

Self help strategies

1. Breathe slowly. Breathe in through your nose for 4 seconds and out through your mouth for 6 seconds, for 2 to 5 minutes. Longer out breaths calm the nervous system.
2. Move your body. Regular aerobic exercise (even a brisk 30 minute walk) reduces anxiety over time.
3. Cut back on caffeine. Strong tea, coffee and energy drinks can trigger palpitations and jitteriness.
4. Protect your sleep. See how much sleep you need.
5. Notice and question anxious thoughts. Ask: "What's the evidence? What would I tell a friend in this situation?"
6. Schedule "worry time." Postpone worries to a fixed 15 minute slot each day instead of carrying them all day.
7. Stay connected. Talking to someone you trust helps, and isolation makes anxiety worse.
8. Limit alcohol. It may feel calming at first but worsens anxiety the next day.

Treatment

• Cognitive behavioural therapy (CBT) is the best studied talk therapy for anxiety. It teaches you to recognise and change unhelpful thinking patterns and to gradually face feared situations.
• Medicines such as SSRIs (for example sertraline or escitalopram) are effective for many anxiety disorders. They take a few weeks to work and should be started and stopped under medical supervision.
• Sleeping pills and tranquillisers (benzodiazepines) may be used briefly in some cases but can cause dependence.

Where to get help in India

• Tele MANAS: call 14416 or 1800 891 4416: free, confidential, 24×7, in multiple Indian languages.
• Your family doctor can assess you and refer you to a psychiatrist or psychologist.

If you are having thoughts of harming yourself, please reach out now: call 14416 or 112, or go to the nearest emergency department.

Not sure whether you're anxious, burnt out or depressed? Read burnout vs depression.