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Anxiety

Anxiety is a normal human emotion. However, some people feel worried or anxious so often that it interferes with their day-to-day life.

Key points

  1. Experiencing some anxiety is normal, but if it is so strong that it interferes with you being able to carry out your normal day-to-day life, it is considered to be an anxiety disorder.
  2. Anxiety disorders range from generalised anxiety disorder through to panic disorder, agoraphobia, specific phobias and social anxiety disorder
  3. Anxiety disorders are very common. Approximately 1 in 4 New Zealanders will be affected by an anxiety disorder at some stage in their lives. At any one time, 15% of the population will be affected.
  4. Although it may sometimes feel like anxiety controls you, there are things you can do to manage and even overcome an anxiety disorder.
  5. The key things you can do are to take good care of yourself through a healthy lifestyle, get help and support, and learn about anxiety and techniques for managing it.
anxiety

What is an anxiety disorder?

Anxiety is a normal human emotion. Most people experience some anxiety when facing a new, unknown situation, a stressful event happens or something goes wrong in their life. However, some people find themselves worrying or feeling anxious so often that it interferes with their day-to-day life. This is a sign that you have an anxiety disorder.

Anxiety disorders are very common. Approximately 1 in 4 New Zealanders will be affected by an anxiety disorder at some stage in their lives. At any one time, 15% of the population will be affected. The types of anxiety disorders include:

  • separation anxiety disorder
  • selective mutism (not speaking)
  • specific phobia (spiders, heights, flying, receiving an injection, etc)
  • social anxiety disorder (social phobia)
  • panic disorder
  • agoraphobia (fear of situations where escape might be difficult or embarrassing in the event of anxiety or other incapacitating symptoms).
  • generalised anxiety disorder
  • substance/medication-induced anxiety disorder
  • anxiety disorder due to another medical condition.

Anxiety self-assessment

You can take a test to assess your anxiety (GAD 7). The test is available in multiple languages. Its aim is to give you a general idea about your level of anxiety rather than provide a formal diagnosis. For example, if you score about 10 on this test, it suggests you might have a moderate level of anxiety and that it would be a good idea to talk to someone who can confirm a diagnosis and help you to manage it.

What are the symptoms of an anxiety disorder?

Generalised anxiety disorder is the most common type of anxiety disorder. This is when you are extremely worried about things or overwhelmed with anxiety and fear – even when there is little or no reason to worry about these things.

Generalised anxiety disorder has a range of psychological and physical symptoms, such as:

  • restlessness
  • a sense of dread
  • feeling constantly "on edge" or irritable
  • difficulty concentrating
  • impatience
  • being easily distracted
  • dizziness
  • irregular heartbeat (palpitations)
  • dry mouth or excessive sweating
  • shortness of breath
  • nausea and or stomach ache
  • a headache
  • poor sleep
  • painful or missed periods.

Symptoms can come on gradually or build up quickly. As anxiety increases, it can lead to changes in your behaviour. You may find yourself withdrawing from social contact and not wanting to see your family and friends to avoid feelings of worry and dread.

You can also find yourself needing more 'sick' days and having low self-esteem. With a generalised anxiety disorder, it can be hard to know what the cause is or why certain things trigger you to worry.

Often people with anxiety can be at risk of also having depression

What is the treatment for an anxiety disorder?

Generalised anxiety disorder can be treated. There is a range of treatments available, including talking therapy, self-care, learning anxiety management techniques and medication. The first step is to talk with your GP who will discuss these with you and together you can decide which is best for you. Your doctor may refer you to a mental health specialist for talking therapy. 

Medication

Depending on how severe your anxiety is, your doctor may prescribe medication for anxiety. Medication is best used together with other therapies, such as cognitive behavioural therapy (CBT). Medication helps to alleviate symptoms but addressing the underlying issue (either through self-help or therapy) is usually needed to produce long-lasting change.

Antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs) have been found to be effective in managing panic disorder, social anxiety disorder and generalised anxiety disorder. Examples of SSRIs include citalopram, escitalopram, fluoxetine, paroxetine, sertraline. In some people, venlafaxine may be used for panic disorder.

When starting these medications, your doctor will start you on a low dose and, if needed, will increase your dose slowly. This allows your body to get used to the medicine and reduces side effects. You must keep taking your medication every day – not just when you feel anxious.

It may take 4 to 6 weeks to notice the full benefits of the medication. These medications may initially make your symptoms appear worse before you notice an improvement. Other side effects include nausea (feeling sick), headache, sleep problems and sexual problems. Read more about SSRIs and venlafaxine.

Other antidepressants such as tricyclic antidepressants, may be used if SSRIs or venlafaxine are unsuitable or have not been successful. Read more about antidepressants.

Techniques for managing anxiety

You can learn some new skills that make a big difference in how well you manage your anxiety. Instead of the anxiety controlling you and what you do, you can take charge. Things you can do to break out of the cycle of anxiety include:

  • understanding anxiety
  • accepting and tolerating normal anxiety (and knowing when yours isn't)
  • taking small steps towards doing the things you are worried about coping with, instead of avoiding them
  • learning mindfulness
  • taking good care of your self each day
  • dealing with issues that need addressing 
  • getting personal and professional support.

Read about tips for managing anxiety. See also anxiety apps and e-learning programmes.

Self-care

The choices you make every day of how much you move, what you eat, how much sleep you get, whether you take time to relax and whether you smoke or drink are all important to reducing anxiety.

Exercise

Regular exercise, particularly aerobic exercise, such as walking, swimming or running, is an excellent antidote to stress and tension. Bodies are designed to move, not sit most of the day. Being active for 30 minutes a day or more is one of the best things you can do to improve your mental and physical health. Exercise encourages your brain to release the chemical serotonin, which can improve your mood and make you feel calmer.

Diet

Too much caffeine, sugar or fast food can upset the balance in your body and mind that helps you feel well. Caffeine and energy drinks can disrupt sleep, speed up your heartbeat and increase anxiety. Try eating regular meals, a healthy breakfast, more fruit and vegetables and less processed foods. Find out more about healthy eating basics.

Sleep

While anxiety can affect your sleep, not getting enough sleep can also contribute to making you more anxious. Make sleep a priority. Follow our sleep tips to help with this.

Relaxation

Taking time each day to relax helps to reduce anxiety. Learn relaxation and breathing exercises or try yoga, pilates or tai chi. Spend time outside in nature. Do things that you enjoy, make you feel comfortable or lift your mood. Learn more about looking after your mental health

Smoking and alcohol

Smoking and alcohol have been shown to make feelings of anxiety worse. Aim to reduce your drinking to no more than 1 or 2 drinks per day or avoid it completely. If you smoke, stop! Talk with your doctor/nurse or ring QuitLine for advice, support and nicotine replacement therapy.

Support

Build your support network – a few people you can go to when things are tough. There are also a range of support organisations. Some offer face-to-face meetings where you can talk about your difficulties and problems with other people. Many provide support and guidance over the phone or by email.

Ask your GP about local support groups for anxiety in your area or contact one of these support groups.

Learn more

Anxiety depression.org.nz
Anxiety NZ Trust
 
Anxiety The Lowdown, NZ
Anxiety Mental Health Foundation, NZ
CALM website The University of Auckland, NZ
Anxiety self-help resources Centre for Clinical Interventions, Australia
Anxiety Health Translations Directory, Australia
What is anxiety & the effects on mental health Headspace, Australia
Generalised anxiety disorder in adults NHS Choices, UK, 2018
How dogs can help with mental health – mind boosting benefits of dog ownership UK, 2018
The Big Feels Club Articles and podcasts about life + feelings
Mental Wealth NZ

References

  1. Te rau hinengaro: The New Zealand mental health survey Ministry of Health, NZ, 2006
  2. How does anxiety affect sleep? National Sleep Foundation, US
  3. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder 2018


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Source: Health Navigator