anxiety; panic; fear; worry; depression; stress; compulsive; obsessive; phobia; agoraphobia; post; traumatic; attack; trauma;
Anxiety is a normal feeling that people have when they are faced with something that could be dangerous, difficult, embarrassing or stressful. Exams, job interviews, talking in front of a group, learning a new skill (such as driving), all make people feel anxious. Your pulse rate might go up and you may have butterflies in your stomach.
Feeling anxious at these times is normal, and can actually be helpful because it motivates you to focus. But people who suffer from strong anxiety find these feelings interfere with lots of normal daily things, like shopping, meeting with friends, going to the movies… lots of stuff.
When you are in a situation where you feel threatened or uncomfortable, you experience things like:
- your heart beats faster
- your breathing speeds up
- your palms sweat
- your muscles tighten
- your stomach tightens
- you feel like going to the toilet.
These are all signs of the 'fight or flight' response. This response has been around for a long time and was helpful when humans had to avoid large predators. Now it is helpful to get you motivated and take action (fight) or walk away (flight).
So just like anger, (see our topic Manageing the anger in your life), normal daily anxiety is actually helpful. It keeps you thinking about and acting on things that are going on around you.
Sometimes people's fight or flight response becomes stronger. This can be due to many factors and is usually due to a number of them together. Things like:
- violence and abuse
- trauma, like being in a car accident
- relationship problems
- feelings of isolation
- brain chemistry.
If you would like to talk to someone about anxiety see the resources section below.
Anxiety disorders are when anxious feelings are present much of the time, even when there is no obvious cause for them. A person may be continually uncomfortable and tense. Anxiety disorders are likely to be diagnosed when the anxiety and feelings of panic get in the way of normal life and stop people doing what they want to do.
The feelings that go with high levels of anxiety are divided into several different patterns or 'types'. A diagnosis of one of the types of disorder can help work out the most useful way of trying to manage the anxiety.
You can find out more about anxiety disorders on the Beyondblue website
What causes anxiety disorders?
The causes vary and it's not always easy to work out. Some things that are known to contribute to whether a person has an anxiety disorder are:
- Heredity: anxiety disorders tend to 'run in families' which may be due to genetics, and may be because a child learns anxious behaviours from their family.
- Personality: people who are easily upset, very sensitive and emotional, who are shy and inhibited as children are more likely to develop an anxiety disorder.
- Biochemical differences within the brain may play a part.
The main symptom is excessive and persistent worry, causing feelings of being keyed up all the time, being easily tired, having difficulty concentrating, irritability, muscle tension and sleep problems. Young people may worry about school or sport performance, such as exams, so much that they are not able to do well.
There is more about this on the Reachout Australia site
People can experience panic in situations where most people would not be afraid. They can have many physical symptoms such as feeling faint or dizzy, blushing, having a rapid heart rate, difficulty breathing, sweating, abdominal pain (or diarrhoea) and chest pain. With this goes a fear that the attack will lead to death or totally losing control.
When the panic has gone, there is an ongoing fear that the panic will come back. Fear of panic can lead them to stop doing things that might trigger a panic attack, such as going outside or going to certain places where they have had a panic attack. Young people who get panic attacks may have had trouble with fear when they were away from their parents when they were younger (separation anxiety).
Agoraphobia is fear of experiencing a difficult or embarrassing situation from which the person cannot escape. People with agoraphobia are very worried that they will have a panic attack in situations where they feel trapped or insecure, such as crowded places, lifts and public transport. A person may be confined to their own home, or maybe only a couple of rooms in the home. While they may have panic attacks, it is the fear of having a panic attack which limits their life so much.
People with agoraphobia are often very aware of feelings in their body, such as their pulse rate or of breathing, that when they need to do something which pushes up their heart rate (such as climbing stairs) they can think this is due to panic rather than being aware that this is a normal response.
There is more about agoraphobia on the Better Health Channel website (Victoria)
This type of anxiety disorder is more of a problem for children and younger people. They may feel extremely distressed when left at school or kindy. Sometimes they feel very scared that someone close to them (like their parent) might leave or be killed in a car accident or murdered or kidnapped. They may show their anxiety by crying and clinging or physical symptoms such as tummy pain, and they often have nightmares about separation. These children may refuse to go to school because their anxiety is causing them to feel unwell.
- There is more about this in the topic 'Separation anxiety' on the Parenting and Child Health part of this site.
Phobias are intense fears about things or situations that then interfere with life. Most people are fearful about some things, like spiders and snakes, or new activities like starting a new job. Someone who has a phobia about spiders will feel fine when there are no spiders, but they can become extremely distressed and may have a panic attack when they see a spider. Fear of having a panic attack might then stop them from doing anything where they might see a spider.
People with social phobia fear that other people will judge everything that they do negatively so that they either try to make sure that everything that they do in front of someone else is perfect or they avoid contact with others. Young people with social phobia may refuse to go to school or to talk with people of the opposite sex.
Young people with this disorder have constant unwanted thoughts which they try to suppress, or they have to perform rituals like putting things straight, washing their hands, checking locks or pulling hair out, to control the thoughts. The rituals usually take a lot of time and they interfere with everyday life. People with obsessive-compulsive disorder are often really embarrassed by their disorder and try to keep it a secret even from their families.
People who have experienced a major trauma such as war, major motor vehicle accident, torture or personal violence such as rape may continue to feel extreme fear long after the event happened. They may have distressing memories that keep coming back, dreams, flashbacks or fear triggered by something that reminds them of the event.
Dealing with an anxiety disorder
Often people who have an anxiety disorder are very reluctant to seek help because they are embarrassed. They may feel that they will be judged as unworthy. They may not have developed good skills at talking about their feelings because they have been shy or have avoided being with others.
Seeking and accepting help can make a lot of difference. You could talk to someone on the phone, go to your doctor, or meet with a counsellor.
Learning more about anxiety disorders can give you greater understanding, but this will probably not be enough to help you manage the feelings you have.
There are many different things that may be helpful.
- Counselling. See the topic 'Counselling'.
- Cognitive behaviour therapy: learning new ways of interpreting feelings and different ways of thinking about behaviour.
- Behaviour therapy, which may include progressively coming to terms with a fear.
- Family therapy may be useful depending on what the difficulties are.
- Changes in the environment, such as changes at school.
- Relaxation techniques. See the topic 'Stress - learning to relax'.
- Exercise. Check out 'Exercise'.
- Doing things which you enjoy will be helpful as extra things which help you understand your body and your feelings better.
- Sometimes medication can make a difference, but medications which lower anxious feelings without looking at what is going on underneath the behaviour may not be helpful in the long run. Antidepressant medications can be useful.
What to do if you think your friend may have an anxiety disorder
Remember that your friend cannot just choose to be less anxious. Saying things like 'don't worry so much' and 'you don't have to be perfect' will not be useful.
Encourage your friend seek help just as they would for a physical problem, such as asthma or a broken bone.
Maybe you could read this topic with them, or encourage them to read some other topics.
- ACEDA (Panic and Anxiety, Obsessive Compulsive and Eating Disorder Association)
589 South Road, Everard Part 5035, 8297 4011
- The Second Story Youth Health Service (TSS)
- Central: 57 Hyde St, Adelaide
- South: 50a Beach Rd, Christies Beach
- North: 6 Gillingham Rd, Elizabeth
- West: 51 Bower St, Woodville
- Youth Healthline 1300 13 17 19
9am to 5pm Monday to Friday
Australian Department of Health and Aging 'National Mental Health Strategy'
Ellis P M and Smith D A R. 'Treating depression: The beyondblue guidelines for treating depression in primary care'. Medical Journal of Australia.
James A, Soler A and Weatherall R. 'Cognitive behavioural therapy for anxiety disorders in children and adolescents'. Cochrane Database of Systematic Reviews, 2005; (4). Art. No.: CD004690. DOI: 10.1002/14651858.CD004690.pub2.
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).