Anxiety

What is Anxiety?

Anxiety is the mind and body's response to perceived threat or uncertainty. In appropriate doses it is adaptive and protective, but when it becomes persistent, disproportionate, or interferes with daily life, it warrants attention.

Anxiety disorders include generalised anxiety disorder (GAD), panic disorder, social anxiety, health anxiety, and phobias. Each has its own particular features, but all share the experience of excessive fear or worry that causes distress or limits functioning.

Anxiety is highly treatable — most people experience significant improvement with the right approach, and many recover fully.

Signs and symptoms

Anxiety can present very differently from person to person, but common signs include:

• Persistent worry or dread that is difficult to control
• Restlessness, feeling on edge, or unable to relax
• Difficulty concentrating
• Irritability
• Muscle tension
• Fatigue
• Disrupted sleep
• Physical symptoms including racing heart, shortness of breath, dizziness, and digestive upset
• Avoiding situations that trigger anxiety

In panic disorder, sudden intense episodes of fear with physical symptoms (panic attacks) are the key feature. In social anxiety, fear centres on social situations and evaluation by others.

How therapy can help

CBT is the most evidenced psychological treatment for anxiety, addressing the thought patterns and behaviours that maintain it. It is recommended by NICE as a first-line treatment for most anxiety disorders.

Mindfulness-based approaches have strong evidence, particularly for generalised anxiety and recurrent worry. Mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) both reduce anxiety symptoms and build long-term resilience.

Other approaches with good evidence for anxiety include:

• Hypnotherapy — highly effective for anxiety at all levels, using suggestion and relaxation to retrain the anxiety response
• EMDR — particularly where anxiety is rooted in past difficult experiences or trauma
• EFT and TRE — address the physiological dimension of anxiety stored in the body
• Acupuncture — used as an adjunct for anxiety management
• Yoga therapy and exercise — both have evidence for reducing anxiety symptoms

Seeking help

Anxiety that is significantly affecting daily functioning, relationships, or quality of life warrants professional support. A GP is a useful first contact, particularly if physical symptoms need investigation.

NHS talking therapies (IAPT) provide CBT and other evidence-based treatments. If anxiety is accompanied by depression, alcohol or substance use, or thoughts of self-harm, seek support promptly.

Therapies that may help with Anxiety