The Independent Pharmacy

Your Guide to Understanding & Managing Your Anxiety

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 24 Oct 2023

The term anxiety is often used to describe feelings of unease, fear, and worry. Feelings of anxiety can manifest with unpleasant mental and physical symptoms.

We have all experienced anxiety at some point in our lives. It’s perfectly natural to feel tense or nervous at the thought of a stressful event or a big decision — especially if the consequences could have a significant impact on your life. Below is a list of common situations that will likely cause feelings of anxiety:

  • Sitting an exam
  • Being interviewed
  • Receiving bad medical news
  • Moving away from home
  • Getting married or divorced
  • Public speaking/performing
  • Starting a new job.

What causes anxiety?

It isn’t always known why some people experience anxiety more than others. For some, it is directly related to a stressful situation unfolding in their lives. For others, it is an ongoing mental health problem that’s difficult to pin down to any specific issue or event.

Things that can lead to anxiety include:

  • Lifestyle & environment — exhaustion, stress, working long hours, money issues or housing problems can all lead to anxiety
  • Past experiences — a distressing incident from your past can leave you feeling anxious in similar situations
  • Diet — drinking too much caffeine or eating too much sugar can affect your mood and trigger your anxiety
  • Physical health — long-term health issues or chronic pain is likely to affect your mental wellbeing, which can lead to anxiety for some people
  • Medication — certain prescription medicines and recreational drugs can trigger feelings of anxiety as a side effect
  • Genetics — there is some evidence that suggests people can inherit a genetic tendency for anxiety.

Everybody is different. Some people are just more prone to worry than others. Your anxiety could come down to a number of different triggers, including a mixture of a genetic disposition coupled with environmental factors.

The symptoms of anxiety

Anxiety can have lots of symptoms - ranging from the physical to the psychological. Different people experience anxiety in different ways. Below are some of the common symptoms of anxiety:

Physical symptoms

  • Nausea
  • Lightheadedness
  • Dizziness
  • Tense muscles
  • Headaches
  • Pins and needles
  • Excessive sweating
  • Trouble sleeping
  • More frequent need for the toilet
  • Stomach-churning
  • Rapid breathing
  • Raised heart rate.

Psychological symptoms

  • Feeling nervous and tense
  • Distorted perception of time
  • Your mind is flooded with thoughts
  • Feeling restless and unable to concentrate
  • Having feelings of dread and fearing the worst
  • Focusing on the negative and rethinking a situation over and over again
  • Feeling numb
  • Feeling as those others can see your anxiety and are staring at you
  • Feeling restless with an inability to concentrate.

If your anxiety is a long-term issue, you will likely experience additional effects both mentally and physically, such as:

  • Sleeping problems
  • Depression
  • Lowered immune system
  • Substance misuse (alcohol, smoking, drugs)
  • A change in your libido.

The types of anxiety

There are several disorders that cause anxiety, or that include anxiety-like symptoms. The most common ones are:

  • General anxiety disorder (GAD) — this relates to the sufferer feeling anxious in the long-term, without anything specifically happening in their life to be anxious about. The symptoms and possible causes of GAD are numerous, which can lead to a very broad diagnosis. One person’s experience of GAD can greatly differ from another's
  • Obsessive-compulsive disorder (OCD) — this is where your anxiety leads you to experience obsessions and compulsions. Obsessions can manifest as unwelcome thoughts, urges or images that occur repeatedly in your mind. Compulsions lead the sufferer to perform repetitive activities, which they feel they have to do
  • Panic disorder — this disorder leads to panic attacks, which can be sudden and unpredictable. Panic attacks are exaggerations of the body’s normal response to stressful or fearful stimuli. It causes overwhelming physical sensations, such as a pounding heartbeat, excessive sweating, nausea chest pains, feeling faint, shaking, breathing difficulties
  • Post-traumatic stress disorder (PTSD) — this is where strong feelings of anxiety are experienced after witnessing something extremely traumatic. This can lead to flashbacks and nightmares, which can give the sufferer the sense that they are reliving the event. Some people may suffer PTSD after events that weren’t particularly traumatic or dramatic in themselves, and it can take many years to manifest
  • Phobias — a phobia is an irrational intense fear of something. It is irrational because the object of the phobia is unlikely to actually cause any harm. Phobias can apply to specific objects or situations, such as spiders or confined spaces.

Situational anxiety

Situational anxiety is often mistaken for generalised anxiety disorder. However, these conditions are quite different. Everyone feels anxiety — it is a perfectly normal emotional response in certain situations. However, for some, this response can become overwhelming. This is known as situational anxiety.

Situational anxiety always relates to a specific situation rather than being a more generalised form of anxiety. Common situations that can cause situational anxiety include:

  • Sitting exams
  • Public speaking
  • Performing in front of others
  • Social interactions
  • Interviews
  • Presentations
  • Being in a busy crowd.

It is quite normal for all of us to feel a level of anxiety in these situations. However, for those who suffer from situational anxiety, their levels of anxiety become too high to control. Common symptoms of situational anxiety include:

  • Heart palpitations
  • Dry mouth
  • Excessive sweating
  • Trembling/shaking
  • Feeling sick
  • Stomach ache
  • Headache.

Managing situational anxiety

Physical symptoms of situational anxiety can be managed with a class of medicines called beta-blockers. The most commonly prescribed beta-blocker for situational anxiety is Propranolol. This medicine can help treat the physical symptoms of situational anxiety, such as palpitations, a rapid heartbeat, and tremors.

Propranolol can also be useful for certain phobias. For example, someone who has a fear of flying may find Propranolol helps calm them down before a flight.

It is important to recognise that Propranolol should only be used on a short-term basis. If you’re finding a need to use a beta-blocker regularly, your anxiety is probably more generalised than it is situational. If this is the case, you should speak to your GP regarding which treatment options would be appropriate for you.

It is important to note that Propranolol is not a psychiatric medicine. It will only act to relieve the physical symptoms, and will not reduce any of the underlying psychological issues.

Anxiety going forward

A natural response to anxiety is to avoid the triggering factors. The thought of confronting these issues can lead to increased levels of anxiety. Although it can be difficult, facing up to your anxiety issues can be the first step towards breaking the cycle of insecurity and fear.

Some helpful methods for tackling anxiety are listed below:

  • Talking to someone you trust — talking to a trusted individual can certainly help, even if only to show that others care about you. Talking through things can be hugely beneficial
  • Breathing exercises — many people find breathing exercises useful. Always take extra time to inhale and exhale steadily. It sounds like such a simple thing, but it is often overlooked — especially during a panic attack
  • Try adjusting your focus — try to distract yourself from your anxiety by focusing on something else. Distract yourself by looking at a picture or find something familiar and comforting to distract you
  • Listen to music — listening to music that you find enjoyable or calming can help relieve your anxiety. Perhaps make some playlists of your favourite tracks, so when anxiety strikes you can try and lose yourself in the music instead
  • Exercise — physical activity is a great way to manage anxiety and stress. Going for a walk or a run will give you an opportunity to think things over away from your everyday stresses
  • Keeping a diary — writing down what happens each time you experience an episode of anxiety can help you identify the triggers. Recording these episodes can provide a means for finding solutions to future episodes
  • Healthy diet and lifestyle — try to avoid stimulants such as coffee, alcohol, and cigarettes. Find natural healthy ways to combat your anxiety, including a balanced diet, meditation and exercise
  • Support groups — finding a support group to share your experiences and concerns can be very comforting. Just knowing you are not alone can be a source of strength for many.

Take charge of your anxiety

Anxiety is a normal human reaction. It can sometimes be difficult to know when this natural reaction is becoming a problem for you. If you find your anxiety is overwhelming and it is affecting your everyday life, it is probably worth thinking about ways to address your issues and what types of treatments and services are available to you.

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