What is anxiety?

Anxiety refers to feelings of worry, nervousness, or a sense of apprehension, typically about an upcoming event where the outcome is uncertain, or where the person feels he or she might not be up to the task. Anxiety is commonly experienced in high pressure situations, for example, prior to a making a speech or sitting an exam. Feelings of anxiety can also arise following a stressful event, like an accident where the person is left feeling shaken. Anxious feelings are usually accompanied by physical sensations such as a churning stomach, light headedness, and a racing heart.

Signs and symptoms

Although the experience of anxiety will vary from person to person, feeling stressed, worried, and having anxious thoughts are common symptoms. Other common symptoms of anxiety include:

  • Difficulty concentrating
  • Restlessness
  • Avoidance behaviour
  • Rapid heartbeat
  • Trembling or shaking
  • Feeling lightheaded or faint
  • Numbness or tingling sensations
  • Upset stomach or nausea
  • Sweating.

Anxiety disorders

While anxiety is considered a natural reaction to a stressful situation, for some people anxious thoughts, feelings, or physical symptoms can become severe and upsetting, interfering with their ability to go about their daily lives.Where symptoms of anxiety occur frequently, occur over a period of time, and interfere with daily life, it is typically considered an anxiety disorder.

Anxiety disorders are the most common type of mental disorders diagnosed in Australia. There are a number of different types of anxiety disorder, including:

Generalised Anxiety Disorder  (GAD)

GAD is characterised by persistent and excessive worry, often about daily situations like work, family or health. This worry is difficult to control and interferes the person’s day-to-day life and relationships.

 

Specific phobia

People with a specific phobia experience extreme anxiety and fear of particular objects or situations. Common phobias include fear of flying, fear of spiders and other animals, and fear of injections.

 

Panic Disorder

Panic Disorder is characterised by the experience of repeat panic attacks - sudden surges of overwhelming fear and anxiety and physical symptoms such as chest pain, heart palpitations, dizziness, and breathlessness.

 

Agoraphobia

Agoraphobia involves intense anxiety following exposure to, or anticipation of, a variety of situations such as public transportation, open spaces, crowds, or being outside of the home alone.

 

Obsessive Compulsive Disorder (OCD)

Individuals with OCD have recurring, persistent, and distressing thoughts, images or impulses, known as obsessions (e.g. a fear of catching germs), or feel compelled to carry out certain repetitive behaviours, rituals, or mental acts, known as compulsions (e.g. hand-washing). These thoughts and acts can take over a person's life and while people with OCD usually know that their obsessions and compulsions are an over-reaction, they are unable to stop them.

 

Social Anxiety Disorder

In social anxiety disorder the person has severe anxiety about being criticised or negatively evaluated by others. This leads to the person avoiding social events and other public situations for fear of doing something that leads to embarrassment or humiliation.

 

Post-Traumatic Stress Disorder (PTSD)

PTSD refers to a set of symptoms that can occur after exposure to a frightening and traumatic event. Symptoms include a sense of reliving the traumatic event (through ‘flashbacks’ or nightmares), avoidance of places, people, or activities which remind the person of the event, feeling numb or detached from others, having negative thoughts about oneself and the world, feeling irritable, angry, or wound up, and having trouble sleeping.

What causes anxiety disorders?

Whilst there is no single known cause of anxiety disorders, there are a number of risk factors or triggers that may contribute. These differ between the different anxiety disorders too. In general, the following factors may play a role:

  • Genes: certainanxiety disorders appear to have a genetic component, with some anxiety disorders running in families.
  • Physical health: Poor physical health can increase a person’s vulnerability to developing symptoms of anxiety.
  • Thinking style: patterns of thinking characterised by anticipating the worst, persistent negative self-talk, low self-esteem, and unhelpful coping strategies (e.g., avoidance) are linked to problem anxiety.
  • Stress: stressful eventssuch as a marriage breakdown, work or school deadlines, financial hardship can act as a trigger for anxiety.

Treatments that work

Cognitive-behaviour therapy (CBT) has been found to be the most effective treatment for anxiety disorders. CBT is a type of psychotherapy that helps an individual to change unhelpful thoughts and behaviours which can contribute to anxiety.  CBT combines some of the following strategies for identifying and challenging unhelpful thoughts:

Problem solving

Problem-solving skills can help a person cope with situations or thoughts that are making them stressed or anxious. Structured problem solving involves identifying the problem, developing and selecting a solution to the problem, implementing the solution, and evaluating its helpfulness.

 

Exposure therapy

In exposure therapy the psychologist guides the person through a series of real or imaginary scenarios to confront specific fears. Through a gradual process of exposure, the person learns to cope more effectively with these fears, and with practice, the anxious response naturally decreases.

 

Cognitive restructuring

Feelings of anxiety sometimes stem from an individual’s negative or unhelpful thoughts. Cognitive restructuring is a technique used by psychologists to help a person to challenge negative thoughts and develop more helpful and constructive ways of thinking.

 

Mindfulness

In mindfulness-based therapy, distress about the experience of anxiety, rather than anxiety itself, is the focus. As such, the psychologist assists the person to focus on the bodily sensations and thoughts that arise when he or she is anxious, and instead of avoiding, withdrawing or fighting against these symptoms, he or she remains present and aware of them. As a result, the person becomes more open and accepting of the thoughts and sensations associated with anxiety and less overwhelmed by them, enabling them to engage more fully with life.

 

Relaxation

Many individuals who experience high levels of anxiety often report that they have trouble relaxing. Learning a form of relaxation, such as meditation or progressive muscle relaxation, and practicing it regularly, has been found to be an effective treatment for anxiety.

 

In addition to the above psychological techniques, making simple changes to a person’s lifestyle can help lower stress and anxiety. Including regular exercise, lowering or eliminating alcohol and caffeine, engaging in enjoyable activities, improving time-management skills, and having adequate sleep can help to lower anxiety.

How a psychologist can help

Through discussion with the client and the possible use of questionnaires, the psychologist develops an understanding of the potential factors that might be contributing to the client’s anxiety. A treatment plan is then developed by the psychologist together with the person. For anxiety disorders, this can involve CBT, mindfulness, exposure therapy, relaxation and other helpful strategies.

The psychologist might also assist the person to address any lifestyle factors which may increase his or her capacity to better manage difficulties, and reduce symptoms of anxiety. They may also suggest involving a supportive family member or friend to assist in the understanding of the person’s situation and to support treatment.

When to seek professional help

If anxiety is affecting a person’s work, school, home life, or relationships, psychological assistance should be considered. The APS Find a Psychologist service can be used to locate a psychologist in your local area: call 1800 333 497 or visit www.findapsychologist.org.au. A GP can also organise a referral to registered psychologist under the Better Access to Mental Health Care items.

More information

The Australian Psychological Society

Australia’s largest professional association for psychologists
www.psychology.org.au

beyondblue

Provides information on anxiety, depression, and related disorders
www.beyondblue.org.au

headspace

Australia’s National Youth Mental Health Foundation, providing assistance for individuals aged 12-25
www.headspace.org.au

Lifeline

A 24-hour counselling, suicide prevention and mental health support service
Telephone: 13 11 14
www.lifeline.org.au

This page was last updated 16 Jul 2015

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