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Anxiety causes and treatments

What is 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.

Panic attacks

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.

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.

Man experiencing a panic attack

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.

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.

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.

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.

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.


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.

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.

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.

Getting Anxiety in Crowded Places

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 favourite TV show and suddenly, from 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.

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.

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.

Chronic anxiety

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.

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.

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.

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.

 Th 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 Cycle of Negative Thinking

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.

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.

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?

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

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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