General questions about anxiety disorders
Physiological symptoms of anxiety are similar to excitement, such as rapid heart beat, sweaty hands, hot flushes etc this is because in both cases our nervous system is playing a major role. The biggest difference are the feelings themselves, for example with anxiety provoking situations you may feel out of control and challenged which could lead to avoidance, whereas excitement is generally associated with positive emotions and anticipation of pleasure.
Research indicates that people are more likely to experience an anxiety disorder if they have:
- Family history of mental health disorders
- Other mental health conditions such as depression, bipolar disorder, or an anxiety disorder
- Chronic medical conditions such as thyroid disorder, diabetes or heart disease
- Experienced traumatic events, life events or periods of stress
- Issues with alcohol or substance use
Studies have also shown that women are twice as likely to develop an anxiety disorder, whilst LGBTQIA+ people are one and a half times more likely to develop an anxiety disorder.
All of us will experience anxiety throughout our lives and many of the symptoms of anxiety disorders are common during anxiety provoking or stress inducing situations. However, if you feel that your anxiety is impacting on your daily life or causing you distress you should seek help from your GP. It can be difficult to know whether to reach out for support and when, but the sooner you do the better because the process for diagnosis can take time. Your GP will possibly conduct other medical assessments to rule out any physiological health needs prior to making any referrals to mental health professionals.
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There are numerous types of anxiety disorders, with common physical symptoms experienced across many of them. Diagnosing which anxiety disorder you might have is usually conducted by a mental health specialist who will ask a series of questions in order to ascertain which criteria best fits the symptoms you describe experiencing. It is advisable to see your doctor first, so they can rule out any physical reasons for your symptoms and they can refer you to a mental health specialist.
Using other methods to diagnose which anxiety disorder you might have is not advisable and isn’t considered a formal diagnosis.
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Anxiety disorders can be developed at any age, although research suggests that it is less common as people age, however there are numerous other factors to consider. Ageing brings with it numerous other stressors that could contribute to developing a mental health disorder such as loss of a loved one, ill health, limited mobility, isolation, financial insecurity, menopause etc. Additionally, older people may be reluctant to seek help for numerous reasons.
Research has indicated that the most common anxiety disorder in older adults is Generalised Anxiety Disorder (GAD), especially in older women.
It is possible and common to have co-occurring mental health disorders, for example, those living with Generalised Anxiety Disorder (GAD) are at greater risk of developing depression. Co-occurring mental health disorders can compound one another by triggering or making worse the symptoms of one another. Seeking support sooner may reduce the chances of developing co-occurring mental health disorders.
There are two main treatment options considered for anxiety disorders – talking therapy and medication, and sometimes these are combined for greater beneficial effect.
You should consult with your GP about possible treatment options and plans as these will vary from person to person. Other factors they will consider will be your age, severity, duration etc as well as other considerations such as interactions with medications, side effects etc. Your personal preferences are important too, so that should be something to ensure your GP understands when you consult with them about your treatment options.
For each type of anxiety disorder there are different effective treatments so again this is to be considered alongside your diagnosis. Cognitive Behavioural Therapy (CBT) is the most widely used therapy for anxiety disorders and is regarded as highly effective. However, this type of therapy might not suit everyone as there are distinct differences across the psychotherapeutic approaches. There are also differences in the delivery and length of treatment programmes, for example, CBT can be offered as online course, a limited number of sessions or for longer. There are numerous aspects to talking therapies that can determine its effectiveness, not least of all the individual’s experience of them.
Medication has also proven to be effective in the reduction and therefore control of the symptoms experienced with an anxiety disorder both on their own and combined with another form of treatment such as talking therapies. Medication can be used both in the short and long-term management of the disorder. Discussions with your GP will help to ascertain which medication might be suitable for you, as well as the strength and possible duration.
In the simplest sense, medication is often regarded as treating the symptoms, whilst talking therapies such as CBT helps someone to understand their thoughts and behaviours to develop different ways of thinking and coping.
Choosing the right treatment for an anxiety disorder is not an easy process as there are numerous options and factors to consider. Talking with a medical professional such as your GP or mental health clinician will help you to understand both the short-term and long-term effects of each option. Throughout the course of your treatment, it can also be modified and changed in consultation with a medical professional to find what works best for you. It is likely that regardless of which treatment option you proceed with, it will take time i.e., up to a month or more to really see and feel the benefits.
Most anxiety disorders are considered long-term conditions which can be treated and recovered from. People’s experiences vary, so whilst some may experience bouts of symptoms short-term, others can experience years living with the condition. However, it is important to remember that it is possible to live a full life with an anxiety disorder and there are numerous treatment and support options available such as medication, talking therapies etc.
Research would suggest that Generalised Anxiety Disorder (GAD) is the most likely anxiety disorder to continue into old age. The prevalence for an anxiety disorder beyond 65 years of age is at the lowest of all ages which does suggest that anxiety disorders are likely to not persist into senior years.
Everyone living with an anxiety disorder has their own unique journey and it affects people differently. Similarly, each person’s recovery will be unique and what helps and works for one person won’t necessarily be the same for others. Recovery is therefore unique to the individual.
As with all mental health conditions there are numerous treatment options available that could help you to live a full life such as:
- Talking therapies i.e., cognitive behavioural therapy (CBT), psychoanalytic therapy, exposure therapy etc
- Medication i.e., benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) or beta-blockers.
These treatments, on their own or combined, can help people to manage their symptoms. There are also various complementary therapies and self-help techniques and tools too. It may take months or sometimes years to fully minimise and manage symptoms but everyone will find different ways of adapting and coping.
Recovery rate statistics vary for each anxiety disorder and of course depending on the age of onset, diagnosis and treatment recovery rates will vary further. Research would suggest that Generalised Anxiety Disorder (GAD) has upwards of a 40% chance of recovery following treatment.
It is advisable to seek help as soon as you suspect you may have an anxiety disorder so that potential treatment can commence.
The short answer is yes, although the relationship between alcohol and mental health is complex. Alcohol is a depressant and affects both your body and brain. People can also use alcohol to ‘self-medicate’ for the initial relaxing effect, however this can often lead to negative consequences in both the short and long-term.
People who drink alcohol are more likely to develop mental health problems, whilst those living with severe mental illness are more likely to develop problems with alcohol.
If you are taking medication, whether for a physical or mental health condition, you should check with a medical professional, GP or pharmacist whether you can drink alcohol whilst taking a prescription.
Some people do find it is better to not drink alcohol as this often makes their symptoms worse but it is an individual’s choice.
Find out more about the relationship between alcohol and mental health
Anxiety disorders are the most prevalent mental health disorders, estimated to affect 5-19% of young people in the UK. Research indicates that young people between the ages of 16-19 are more likely to have experienced some form of anxiety, with the least likely being over 70 years of age. Other research has indicated that prevalence is higher during midlife. The likely age of onset also varies across each anxiety condition and of course further complicated by the fact that many may go undiagnosed for various reasons into adulthood, thereby skewing the statistics further.
Anxiety is a common symptom experienced by women going through the perimenopause and menopause, regardless of whether they have experienced anxiety before or live with an anxiety disorder. Some women who already have a diagnosed mental health condition such as an anxiety or depressive disorder can report this time of their lives as being challenging as the physiological changes impact upon their psychological wellbeing.
Leading up to the menopause a woman’s hormone levels fluctuate which often leads to numerous physical and emotional changes and symptoms. The main hormones fluctuating during this time, oestrogen and progesterone, disrupts not only a woman’s reproductive system but also the delicate biochemical balance throughout the body; impacting on the regulation of mood hormones such as serotonin and dopamine. These hormonal changes in your brain often lead to mood changes and it can be hard to define whether this is a symptom of the perimenopause or a symptom of an underlying mental health disorder such as depression or anxiety.
You are recommended to seek help from your GP as they can conduct various tests to rule out and identify any physical causes, whilst suggesting appropriate treatment such as Hormone Replacement Therapy (HRT).
Find out more information about menopause and mental health
Both anxiety and depression are a common premenstrual syndrome (PMS) in women that are often experienced weeks before a period. Research indicates that anxiety affects around 30-80% of people who have periods. The severity of PMS symptoms vary, with some experiencing little to no physical or mental symptoms. Others who develop severe symptoms may have premenstrual dysphoric disorder (PMDD). Whilst it is less common, it can have a serious impact on your life due to the intensity of the physical and mental symptoms experienced.
Additionally, increased levels of anxiety can affect your menstrual cycle. Extended periods of anxiety and stress can affect your hormones, which in turns affects your ovulation and therefore your period. Periods can be late and even stop for one or two months. However, if you are experiencing irregularities in your period you are advised to contact your GP to ensure there aren’t other factors affecting your menstruation.
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Genetics play a crucial role in the likelihood of experiencing a mental health disorder such as anxiety and depression but it is not the only factor of consideration. Even if no one in your family has experienced an anxiety disorder it doesn’t necessarily mean that you won’t. A complex interplay of other factors can increase your likelihood of experiencing an anxiety disorder such as physical ill health, environment, experiences, lifestyle etc.
Trauma is a very broad concept that not only includes a wide range of experiences, but these can also be experienced for a short duration, recurrent or a series of events built up over time. Experiencing severe trauma is thought to lead to 1 in 3 people developing Post Traumatic Stress Disorder (PTSD). It isn’t fully known why some people who have experienced trauma go onto develop PTSD whilst others don’t. There are numerous other factors of consideration such as whether the individual has experienced another mental health condition such as anxiety or depression.
Find out more information about post traumatic stress disorder
An anxiety disorder can be developed at any age, however research has indicated that people under the age of 35 are at greatest risk of developing an anxiety disorder. There are numerous other factors to consider in the development of an anxiety disorder which would impact on the likelihood such as family history, gender, environment, experiences etc.
The average age of onset varies with each type of anxiety disorder but in the main onset ranges from early adolescence into young adulthood approximately 11 years of age. Specific phobias and separation anxiety disorder are thought to be the earliest onset (pre-teens) whilst Generalised Anxiety Disorder (GAD) is thought to be the latest onset, commonly in people aged 35-55.
Prevalence rates decreases in age once people are into their 50’s and 60’s and are at the lowest in the elderly, over 65’s.
Questions about panic, panic attacks and panic disorder
People sometimes use the terms anxiety and panic attack interchangeably but they are very different. Whilst there are similarities in symptoms such as rapid heartbeat, tightened breathing and feeling of unease, they differ in intensity, duration and causation.
Panic attacks vary in terms of length, but the majority last between 5 minutes to 20 minutes. Some have reported panic attacks lasting for up to an hour, and you can experience a series of panic attacks after one another. If you experience repeated and multiple panic attacks you might have a panic disorder or generalised anxiety disorder – speak to your GP or the NHS and they can support you to receive help and a diagnosis.
Panic attacks can be extremely frightening and distressing but it is important to remember they are not dangerous. Panic attacks are not life threatening and whilst some of the symptoms might make you feel like you are having a heart attack your life is not in danger. Panic attacks usually subside after 5 minutes. It is important to not ignore panic attacks if you are experiencing them on a regular basis or if they are impacting on your quality of life. Contact your GP so that you can access the support you need from a mental health professional.
Whilst some of the symptoms of a panic attack can mimic the symptoms of a heart attack the two are very different.
Physiologically, panic attacks happen when stress hormones trigger your fight, flight or freeze response which elevates your heart rate. A heart attack happens when there is insufficient blood flow bringing much needed oxygen to your heart.
It is important to know that panic attacks are not life threatening – unlike heart attacks which are considered a medical emergency.
If you are unsure which you might be experiencing generally the following applies:
- Onset: Panic attacks can happen at anytime whether resting or sleeping, whereas heart attacks tend to develop after a period of exertion.
- Duration: Once a panic attack subsides, after several minutes (up to an hour) you tend to feel immediately better, whereas with heart attacks the pain tends to intensify.
- Location: Intense pain during a heart attack can be felt in your chest, arm, shoulders, neck and/or jaw and whilst the pain may move and vary in intensity it doesn’t go away; whereas panic attacks subside eventually.
- Pain characteristics: Heart attacks are associated with the feeling that your chest is being squeezed whereas panic attacks are more sharp or stabbing pains.
If you have a family history of heart conditions, it is advisable as a precaution to seek medical attention if you are unsure whether you are experiencing a panic attack or heart attack.
People living with an anxiety disorder or depression may have a higher risk of developing heart problems so if you are experiencing chest pain or symptoms of a heart attack do seek medical advice from your GP.
It is common for people experiencing panic attacks to become fearful of another attack due to their intensity and sudden onset. This can lead to modifying behaviours such as avoidance of an anxiety provoking situation which in the long-term could be unhelpful depending on the impact to your daily life. The intensity of a panic attack brings various distressing physical changes and emotional responses, but it is important to remember that you are not in danger and the panic attack will gradually cease.
Not everyone who experiences a panic attack will go on to develop a panic disorder. However, if you have regular or recurring panic attacks and worry about having another panic attack you are more likely to be diagnosed with a panic disorder. If you are uncertain whether your panic attacks could be a panic disorder do seek help from your doctor.
Find out more information about panic disorder
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