The Independent Pharmacy

What Is Anxiety? An Overview of Anxiety

Scott McDougall
Scott McDougall
MPharm GPhC 2079324
Director & Registered Manager

Anxiety is often used to describe feelings of unease, worry and fear. You may have heard of the term ‘anxiety’ in relation to mental health and wellbeing. But exactly what is anxiety?

It’s helpful to learn more about anxiety and other mental health problems, especially if you’re going through a difficult time and experiencing some challenging feelings, or trying to support someone who is.

That’s why we’ve created the mental health information page below — to give you a comprehensive overview of anxiety, and exactly what people mean when they talk about it.

In the guide below, we’ll be providing a general overview of anxiety, including how to tell if you have anxiety, how it makes you feel, and what you should do if you think you have anxiety.

Read on to find out more.

What is anxiety?

Anxiety is what we feel when we are worried, tense, nervous or afraid of something.

Anxiety is a natural, if unpleasant, human response to stresses or potential threats. We all experience these feelings at some point in our lives and it’s perfectly natural to do so, especially if you’re nervous about something, like an important job interview or a big decision. Anxiety usually settles once the stressful situation has passed.

But sometimes, these feelings don’t go away, or they feel very strong and they make our lives extremely difficult, causing us to avoid situations or stop us from enjoying the things we normally would. They can manifest in unpleasant mental and physical symptoms which could be distressing and hard to control. If this is the case, then you may have a type of mental health problem that we call anxiety.

Anxiety is an umbrella term: there are a few different types of anxiety, each with varying symptoms and defining characteristics. Sometimes, anxiety can be felt in reference to specific stressful external events, such as presentations or exams. This is known as situational anxiety. In situational anxiety, the symptoms of anxiety are normally limited to a specific situation and aren’t triggered by other parts of their life. When anxiety symptoms spread into other parts of your life, it could be an anxiety disorder such as generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

You can learn more about the most common types of anxiety disorders on our ‘5 Main Types of Anxiety’ page.

What is depression?

You’ve probably heard of depression — depression is one of the most common mental health problems alongside anxiety. In fact, lots of people experience depression over the course of their lives, and there’s a chance that you may know someone who is affected by depression.

Depression is a low mood that lasts for a long time. We all feel low at times, but these feelings will usually pass; if they don’t, then you may have depression.

Depression can make you feel deeply unhappy and hopeless, affecting your everyday life to the point where it is hard or impossible to have fun, enjoy the things you used to, or complete everyday tasks. The symptoms of depression can sometimes overlap with the symptoms of anxiety.

You can learn more about depression — including symptoms, causes and treatments — on our Mental Health Disorders page.

What is anxiety and depression?

Although depression is a different mental health problem to anxiety, the terms are often used alongside each other.

In fact, a lot of people who have depression will also experience anxiety too. Approximately half of people with generalised anxiety disorder (GAD) will also have depression. This is what we mean when we say ‘anxiety and depression’. This is sometimes also called ‘mixed anxiety and depressive disorder’ (MADD).

Mixed anxiety and depression is the most common mental disorder in Britain, with 7.8% of people meeting criteria for diagnosis.

How to tell if you have anxiety

Okay, so now we know what anxiety is. But how do you know if you have anxiety?

It can be hard to know the difference between normal feelings of anxiousness or stress and an anxiety disorder that may need a bit of extra attention and support to treat. Mental health problems like anxiety can often creep up on you gradually, making it harder to notice or recognise symptoms initially.

Here are some indications that your feelings of anxiety may be a mental health problem:

  • Your feelings of anxiety are very intense and hard to control
  • These feelings last for a long time — such as months, rather than a few weeks
  • Your feelings of anxiety make you very upset and distressed
  • You know that your worries and fears are disproportionate to the situation
  • You are experiencing the physical and psychological symptoms of anxiety
  • You find it difficult to do the things you normally do in life
  • You don’t enjoy the things that you used to do
  • You find yourself avoiding situations that you think might make you anxious

If some of these sound familiar, then you may have an anxiety disorder.

It’s also helpful to know what the symptoms of anxiety are. We’ll go into those in more detail below.

What are the symptoms of anxiety?

Anxiety can be experienced through a number of different physical and psychological symptoms.

Anxiety symptoms vary from person to person, so your experience of anxiety may be different from what other people experience.

These symptoms may also change depending on the anxiety disorder you have. We’ve listed the most common symptoms of the five main types of anxiety disorders here.

However, here are some of the more common physical symptoms of anxiety:

  • Heart palpitations, fluttering or pounding heart
  • Nausea (your stomach may feel like it is churning or like you have butterflies)
  • Lightheadedness
  • Dizziness
  • Headaches
  • Sweating
  • Hot flushes
  • Trouble sleeping
  • Restlessness
  • Teeth grinding (particularly at night)
  • Blurry vision
  • Loss of libido
  • Tense or achy muscles
  • Pins and needles
  • Panic attacks

Here are some common psychological (mental) symptoms:

  • Feeling on-edge and tense a lot of the time
  • Feeling overwhelmed
  • Feeling like you can’t stop worrying
  • Feeling very upset or tearful
  • Feeling numb or disconnected (this is known as dissociation)
  • Inability to concentrate
  • Being unable to relax
  • Intrusive thoughts
  • Obsessive thoughts
  • Having feelings of dread and fearing the worst
  • Fixating on the negative
  • Rethinking a situation over and over again
  • Wanting lots of reassurance

How to tell if you have situational anxiety

Many people experience anxiety on a regular basis - it is the body's response to a stressful situation. It is not uncommon to experience the symptoms of anxiety before a stressful situation, like an interview, presentation, speech, or exam.

Feeling anxiety before and during these situations is completely normal. However, some people may experience more severe symptoms in these situations than others. If you find that your symptoms of anxiety mean that you struggle to do these kinds of activities, you may suffer from situational anxiety.

In situational anxiety, the psychological and physiological symptoms of anxiety are confined to the event itself, and does not affect your day-to-day life. If your symptoms of anxiety start to apply to a wide range of situations, occur most days and you feel that you struggle to relax, it is likely that you are suffering from an anxiety disorder, such as GAD.

How to tell if you have social anxiety

Social anxiety — also known as social phobia — is a particular type of anxiety disorder which causes the sufferer to have an intense fear or dread of social situations.

We all feel nervous or shy at times, particularly when we are faced with a social situation that we are uncomfortable with. This could be a date, a presentation at work, or going to a party.

However, for some people, these feelings of anxiety either before, during or after a social situation can be overwhelming and extremely distressing.

Social anxiety is not just ‘shyness’ — it’s a long-term and overwhelming fear of social situations that can have a big impact on someone’s life. It can cause such strong fear and worry that it can affect everyday activities, self-esteem and confidence, relationships, friendships and work or school life.

Here are some indications that you may have social anxiety:

  • You avoid situations or activities that make you nervous or anxious
  • You worry about social situations such as parties, meeting friends, meeting strangers, or eating and drinking in public
  • You worry about performance situations like as interviews, presentations, public speaking
  • Simple everyday activities such as shopping, going to the bank, going to the doctor or answering the phone can seem overwhelming
  • You find it difficult to do things when others are watching, and feel like you're being watched and judged all the time
  • You worry about being criticised a lot
  • You worry that something you do or say will be embarrassing
  • You experience symptoms of social anxiety (more on those below)

People with social anxiety don’t find all of these situations a problem — it could just be certain ones. If any of the above stops you from doing normal everyday things, performing to the best of your ability, or you feel like you’re unable to cope in certain situations, then you may have social anxiety.

It’s also helpful to know the physical and psychological symptoms of social anxiety. You can find out more about those in the section below.

What are the symptoms of social anxiety?

People can experience lots of different symptoms of social anxiety.

However, there are some more common physical symptoms of social anxiety that people generally experience (this could be before or during a triggering social situation):

  • A rapid or pounding heartbeat
  • Dizziness
  • Lightheadedness
  • Blushing
  • Trembling
  • Excessive sweating
  • Stuttering or stumbling over your words
  • Speaking with a shaky voice
  • Inability to catch your breath
  • Feeling like your mind has gone blank
  • Feeling sick
  • Stomach problems (like diarrhoea)
  • An ‘out-of-body’ sensation
  • Muscle tension

Here are some common psychological (mental) symptoms:

  • Feeling on-edge and tense
  • Feeling anxious, worried or scared about the situation
  • Feeling embarrassed
  • Feeling like everyone is watching you
  • Feeling judged
  • Worrying that someone will criticise you
  • Worrying that you’re going to say or do the wrong thing
  • Worrying that you will offend someone
  • Rethinking a social situation over and over after it has happened

Many people with social anxiety also have other mental health issues, such as generalised anxiety disorder or panic disorder.

What to do if you think you have anxiety

Feelings of anxiety at certain times are completely normal. However, if you’ve read all of the information above and you think you have anxiety — and that it is affecting your daily life or causing you distress — then it’s a good idea to visit your GP or self-refer for psychological therapy (CBT).

Your GP is there to help you with your mental health as well as your physical health. They will do an assessment and will ask you some questions about the symptoms you’re experiencing, as well as finding out more about your mental wellbeing, worries and fears.

From there, they’ll be able to make a diagnosis, offer support and suggest next steps like treatments.

There are a few different treatments that can help with anxiety symptoms:

  • Self-help resources: this might be the first treatment option your doctor offers you. This might be a workbook to work through, or a computer-based or app-based CBT programme for treating anxiety and panic attacks (like Headspace). You might work through this on your own.
  • Talking treatments such as cognitive behavioural therapy (CBT): CBT focuses on how your thoughts and beliefs affect your feelings and behaviour, teaching you coping skills that can help you manage your problems. You can find talking therapies like CBT on the NHS that can be done remotely and you don't require a referral from your GP. Alternatively, charities like Anxiety UK offer access to different types of talking therapy.
  • Medications such as beta-blockers or a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be recommended by your GP. These different types of medication are prescription-only and can help you to manage your symptoms. They are normally offered alongside talking treatments.

Your GP should explain your treatment options to you, and you can decide together which options might suit you best.

What medication can I take for anxiety?

As we’ve mentioned above, in terms of medication for anxiety, there are two main options:

  • Beta-blockers (like propranolol): beta-blockers are used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors. This is why they can be used for situational or performance anxiety as well. They don’t reduce any of the psychological symptoms of anxiety, which is why it is normally recommended that you have talking therapy as well.
  • Antidepressants: this will usually be a type called selective serotonin reuptake inhibitors (SSRIs). SSRIs work by boosting the serotonin (a neurotransmitter) in your brain, which can regulate and lift your mood.

These different types of medication are prescription-only and can help to manage your symptoms.

Summary

Anxiety is what we feel when we are worried, tense, nervous or afraid. It is a natural human response to stresses or potential threats and it will usually pass.

If these feelings don’t go away, or they feel very strong and are difficult to cope with, then anxiety can become a mental health problem. If you are experiencing this then you may be diagnosed with an anxiety disorder.

Anxiety is an umbrella term; there are a few different types of anxiety disorder, each with varying symptoms and defining characteristics, including social anxiety, which we have covered above.

Sometimes, people with anxiety will also experience depression — roughly 50% of people with generalised anxiety disorder (GAD) have depression too. Mixed anxiety and depression is the most common mental disorder in Britain.

If you think you have anxiety and you need help, there is plenty of support you can get and treatments that will reduce your symptoms.

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Scott McDougall

Authored by

Scott McDougall
Scott McDougall
MPharm
2079324
Director & Registered Manager

Scott is one of the two founders of The Independent Pharmacy. He is a registered pharmacist and the registered manager of our service with the CQC.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.