Anxiety is what someone feels when they are worried, tense, or afraid. It can be mild or severe. People experience anxiety as thoughts, feelings, and physical sensations.1
If you are struggling with anxiety, speak to a health care professional who will be able to provide any help and support you may need.
Read on to find out more about what anxiety is, the symptoms, and how it can be managed and treated.
Anxiety is the body’s natural response to a potentially dangerous or challenging situation. It is a feeling of unease, worry, fear or dread about what is going to happen. It is entirely normal to feel anxious from time to time, and it can even be beneficial. Anxiety can help us prepare for specific situations, making sure we pay attention and stay alert to any dangers.2
However, some people find it hard to control their anxiety. High levels of anxiety maintained over a long time that impact normal, day-to-day activities could mean someone has an anxiety disorder.3
Everyone experiences anxiety in different ways. However, anxiety disorders are different from normal feelings of nervousness and stress and involve excessive anxiety or fear.1
The most frequently diagnosed anxiety disorders include generalised anxiety disorder, panic disorder, phobias, and social anxiety disorder (social phobia) and post-traumatic stress disorder (PTSD).3
Some people with anxiety disorders are affected by more than one anxiety or psychiatric disorder at a time (known as ‘comorbidity’). For example, generalised anxiety disorder can be associated with other psychiatric conditions including depression or major depressive disorder (MDD), bipolar disorder (BD), and substance use disorder (SUD).8
Statistics show that anxiety disorders are prevalent across the globe. The World Health Organization estimates that around 284 million people (3.8% of the world’s population) have experienced an anxiety disorder. About 63% (179 million) are female, compared with 105 million males.9
According to the Institute for Health Metrics and Evaluation (IHME), more than one in six people (nearly 84 million people) across the EU had a mental health problem in 2016. Across EU countries, the most common mental disorder is anxiety disorder, with an estimated 25 million people (equating to 5.4% of the population) living with anxiety disorders.10
Everyone experiences anxiety differently. The physical and mental effects can vary from one person to the next.
The body reacts to anxiety in a particular way, releasing stress hormones such as adrenaline and cortisol. These hormones put someone experiencing anxiety into a high-alert state in which they look for potential threats and activate their fight-or-flight responses1. As a result, some common symptoms of anxiety include1,11 :
The early signs of anxiety are sometimes not obvious and often develop slowly over time. The symptoms vary from person to person. One of the most common early signs of anxiety is excessive worrying about everyday situations. Symptoms sometimes start in childhood or the teenage years and continue into adulthood.12
Many different situations or experiences can bring on anxiety. Sometimes it can be challenging to know what is causing the anxiety, and this can result in further stress or upset.
Anyone can get anxiety, although recent research found that women are almost twice as likely to be affected by anxiety as men. Additionally, people under the age of 35 are disproportionately affected by anxiety disorders.13
Anxiety is not a life-threatening condition. However, research published in The British Journal of Psychiatry shows that anxiety disorders can significantly increase the risk of death. Comorbidity (when two disorders are experienced at the same time) of anxiety disorders and depression plays a key part in the increased mortality risk.14
Anxiety is not a simple diagnosis; it can sometimes be difficult for doctors to diagnose whether a person has an anxiety disorder or another mental health condition, such as depression.15
There are no laboratory tests to diagnose anxiety. If a doctor cannot find any medical reason for certain physical and mental symptoms, they may make a referral to a mental health specialist, such as a psychiatrist or psychologist.
A mental health specialist will ask further questions about symptoms, feelings and emotions, and make a clinical assessment using questionnaires to gauge anxiety levels. Some examples of anxiety assessment questionnaires include the Hamilton anxiety rating scale (HAM-A)16, or the Beck Anxiety Inventory (BAI)17, which measures the severity of anxiety in adults and adolescents.
Treatment and medication for anxiety can relieve the symptoms and make the condition easier to live with.
Several therapies and medications can be helpful for anxiety. People with anxiety may benefit most from a combination of therapy and medication to control their symptoms.
Doctors use a range of medications to help people manage their anxiety symptoms. However, medication should not be the only treatment option offered. Instead, doctors often need to work with individuals to find the right medication, dosage, and therapy that works best.
Some medications are only used on a short-term basis, while others can be prescribed for more extended periods.
Depending on the person’s symptoms, medication may treat the physical symptoms of anxiety and the psychological effects.
Some of the most commonly prescribed medications to treat anxiety include:
Several psychological therapies (psychotherapy) can be useful in treating anxiety, including:
It is vital that anyone whose anxiety is affecting their daily life gets medical advice early to prevent their condition from worsening.
People with a suspected anxiety disorder should be offered psychological intervention as a first line treatment.21
A qualified mental health professional who knows how to treat anxiety effectively will help individuals learn critical coping strategies to deal with their anxiety disorder.
People with anxiety should try to eat a regular, healthy, well-balanced diet. It is also vital to eat regularly and avoid skipping meals, which may result in the blood sugar dropping, making people feel ‘jittery’ or on edge and worsening the underlying anxiety.22
Eating foods rich in complex carbohydrates, such as whole grains – for example, oatmeal, quinoa, and wholegrain bread and cereals – is thought to increase the amount of serotonin in the brain, which has a calming effect.23
Alcohol and caffeine should be limited or avoided. Both can make people feel on edge or nervous and can interfere with sleep patterns.23
There is no way to accurately predict what will cause someone to develop problems with anxiety. However, steps can be taken to reduce the impact of related symptoms12:
Research is continuing into anxiety, the potential risks for developing anxiety disorders, and effective treatment options. There have been significant advances in understanding the parts of the brain involved with experiencing fear and anxiety. For example, scientists have found that the amygdala region of the brain appears to be involved processing information about fear and danger. People with anxiety disorders seem to have a more reactive amygdala.26
Another critical study has looked at how a receptor involved in the brain’s reward system may be a target for treating anhedonia (lack of pleasure), a symptom of several anxiety disorders. This research has significant implications for the development of medications to target specific areas of the brain and will hopefully lead to more informative clinical trials in the future.27
One area of research that has seen significant progress is the role that genetics play in anxiety. Current research is looking at how genes and environments might work together to contribute to the development of anxiety disorders.28 For example, a child with a genetic predisposition to being shy and sensitive might become a target for bullies. In turn, being bullied (an environmental factor) might increase their anxiety levels.
Research is continuing into treatment options for anxiety. The current medications available to help people suffering from anxiety disorders have not changed significantly over the past 50 years29. They are not effective for all patients, and some are known to have potential side effects and safety concerns (for example, a risk of abuse and dependency). Scientists are now working to develop new medicines that could replace current anti-anxiety drugs, and there are currently 12 new medications that are being trialled in anxiety patients.29
There is optimism in the scientific community that more advances are on the horizon. The future treatment for people suffering from anxiety will look very different from today’s care.