This guide is written by Dr Susannah Ward, a Physician of Rehabilitation Medicine with a special interest in wellbeing and lifestyle health working in Newcastle NSW. She founded Ataraxia Collective offering talks, workshops, a blog and wellness retreats. She enjoys medical writing with several publications on health professional wellness and is currently a board director at Mood Active.
What is anxiety?
Anxiety is the experience of excessive and difficult to control worry.
It is generally considered an unwanted and unpleasant experience.
It is a normal human response to threat that serves to motivate action and problem solve potential danger.
When anxiety is chronic and disruptive to a person’s function it is viewed as a disorder.
What are the signs and symptoms of anxiety?
Different anxiety disorders have different syndromes.
Anxiety may manifest as physical sensations in the body, an awareness of the emotion of fear, intrusive negative thoughts/beliefs as well as behavioural urges to act to lessen the worry.
You may feel:
- nervous, frightened or panicked
- like you’re going crazy, dissociated or dethatched
- palpitations, stomach butterflies
- physical tension
You may notice thoughts like:
- ‘this is a disaster’
- ‘I can’t do this’
- ‘I not coping’
- ‘everyone thinks I’m a failure.’
- ‘it is never going to work.’
- ‘something bad will happen.’
You may experience:
- increased urges to engage in avoidant and escapist behaviours, such as drug and alcohol use or excessive eating and spending
- changes in appetite, sleep
- reduced mood and vitality
- reduced concentration/work performance
- brain/head fog
What causes anxiety?
Well this is the million-dollar question & one that is difficult to answer.
A person’s anxiety can be an appropriate and expected response to a potential threat.
It is an evolutionary advantage to be able to mount an anxiety response that leads to productive reaction.
It’s entirely useful to have some anxiety before a deadline to steer you into action.
Anxiety a survival mechanism involving the autonomic nervous system and brain that results in a stress response and, hopefully, adaptive behavioural change.
There are many factors that may exacerbate anxiety and cause an anxiety disorder.
People respond differently to stressful triggers based off their biology, conditioning, traits and resources.
Sufferers may have a genetic predisposition or personality traits that leave them vulnerable to developing anxiety disorders, such as perfectionism and unrelenting standards.
A stressful environment with a lack of resources and supports to cope also contributes to the aetiology of a disorder.
Poor self-care plays a role in the onset of anxiety disorders and can make existing illness worse.
A lack of self-mastery skills, like mindfulness, relaxation techniques and problem-solving skills may mean a person is more susceptible to maladaptive behaviours to cope, like excessive alcohol use.
When should I see my doctor?
As mentioned some anxiety can be functional and motivate task completion e.g. anxiety to get up early to finish an assignment before the due date.
But if you find your anxiety is actually interfering with your function and impeding useful behaviour it is time to acknowledge the problem and address it.
If anxiety is negatively impacting your wellbeing see your GP and seek expert help.
- Do I feel distressed by my anxiety?
- Is my anxiety getting in the way of living freely and fully?
- Is my anxiety getting in the way of being and doing the things I wish to do for myself and others?
How is anxiety diagnosed?
General practitioners (GP) are trained to diagnose anxiety and mental ill health.
They will take a history and usually use a validated screening tool, such as the K10 or DASS to assess your situation and mental health.
They may also complete a physical examination and order some tests to exclude other causes or contributors.
Each anxiety disorder has its own symptoms and signs and diagnostic criteria.
In certain circumstances your GP may want to refer you to a Specialist Psychiatrist for a formal diagnosis to direct the best evidence-based treatment for your situation and ultimately to support you back to a state of optimal wellbeing.
Your doctor will take into account the severity of your condition and any secondary issues that may be problematic for you.
Your diagnosis will help your doctor to prescribe the appropriate care you need to be well.
What are the treatments for anxiety?
If you are in an unsafe environment or at risk of harm it is a matter of urgency to address this as a priority.
A GP or your local emergency department can help you to stay safe.
There are also many hotlines and supports online available for times of crisis, such as Lifeline.
There are many non-pharmacological treatments for anxiety, such as lifestyle measures and psychological therapies.
Lifestyle measures include ensuring you are getting sufficient nutrition, hydration, physical movement, sleep, downtime and partaking in some enjoyable activities.
In mild cases non-pharmacological measures may be sufficient as treatment, such as exercise.
GPs can organise mental health care plans for subsidised sessions with a clinical psychologist.
There are many psychological therapies used for anxiety including Mindfulness-Based Stress Reduction, Acceptance Commitment Therapy, Cognitive Behavioural Therapy and Exposure Therapy.
If your anxiety stems from past trauma then therapies targeted to trauma may be useful, such as Eye Movement Desensitization and Reprocessing.
If your anxiety has contributed to an eating disorder or addiction then therapy may be targeted at these issues.
Depending on your diagnosis and the severity of your condition, prescription medication may also be recommended.
If you have moderate to severe anxiety than prescription medication is likely to be necessary.
Anti-depressants and other prescribed medicines may enhance a person’s ability to partake and engage with non-pharmacological approaches.
Supplements, such as St John’s Wart, Camomile and Magnesium are examples of alternative medications that some alternative health practitioners prescribe.
There are also many herbal.
Please ensure your GP is aware of any non-prescribed medications that you wish to take to avoid complications and drug interactions.
Can an anxiety disorder be prevented?
In some instances, disorders of anxiety can be prevented or at least minimised.
- The first step is to acknowledge your vulnerability and to commit to addressing it so it does not get worse or cause secondary problems like avoidant self-destructive habits.
- Speak up and reach out for help to trusted friends and family. Check in with your GP.
- Aim to meet your unique wellbeing needs as best you can. This might look like prioritising a yoga class once a week or scheduling in a massage to destress.
- Learn skills and strategies you can use and put in place to cope with your stress. This may mean reading self-help or taking up a new distracting and adaptive hobby like sewing.
- Trouble shoot any contributing problems in your life. If your finances are a significant factor in your distress seek professional advice from an accountant or advisor.
- Be self-compassionate and remember that as humans we are all vulnerable to anxiety. The more connected and supported you feel to others the more likely you are to self-care and cope.
Allow your trusted friends and family to support you through this challenging time.
Here at Mood Active, we know the powerful effects of physical movement on mood.
Not only does daily exercise help to prevent mental illness onset, it prevents illness getting worse and plays a role in recovery.
We highly recommend regular and consistent physical movement!
Get outside and move your body in this beautiful world we live in.
Set your brain chemistry in a good place with the Endorphins released by exercise.
You need not push yourself to exhaustion.
A simple morning stretch or walk is all you may need to feel inspired, empowered and ready to face your day.
What are anxiety disorders?
An anxiety disorder is when anxiety causes distress and dysfunction in your life.
It happens with unrelenting and chronic anxiety and when people have maladaptive coping mechanisms or develop harmful behaviours to avoid their condition.
What are the types of anxiety disorders?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the diagnostic manual that doctors use for diagnosis of mental health issues.
The DSM-5 classifies anxiety into separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder (social phobia), panic disorder, agoraphobia, generalized anxiety disorder, substance/medication-induced anxiety disorder, and anxiety disorder due to another medical condition.
What is a panic attack?
A panic attack is defined as a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes:
- palpitations, pounding heart or accelerated heart rate
- trembling or shaking
- sensations of shortness of breath or smothering
- feeling of choking
- chest pain or discomfort
- nausea or abdominal distress
- feeling dizzy, unsteady, light-headed or faint
- derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
- fear of losing control or going crazy
- fear of dying
- paraesthesia (numbness or tingling sensations)
- chills or hot flushes
Are there tests that diagnose anxiety?
An anxiety disorder is diagnosed through history, examination and may need certain investigations.
Commonly used screening tools in Australia are the DASS and K10.
They are validated and standardised questions around your inner world experiences, mood and coping mechanisms.
They can be used along with the DSM criteria for diagnosis.
What natural remedies are used for anxiety?
The best natural remedy for anxiety is really good self-care and living a healthy and balanced lifestyle.
Daily movement, sound nutrition, sufficient rest and ensuring your unique needs are being met on a regular basis are great natural remedies to keep anxiety at bay.
Work out what you need to do for yourself to feel grounded and well even during times of stress and crisis.
Time spent in nature can be soothing. Being around animals and loved ones can be calming.
Having connection to community and being of service can be inspiring.
Expressing your unique self through creative acts and cultivating your sense of spirituality are all entirely natural and effective ways of managing anxiety.
Acquiring and drawing on adaptive coping tools to cope is a wonderful natural remedy for anxiety.
If your mind is racing try some mindfulness and CBT.
If your body is tense and stressed try some relaxation.
If you feel overwhelmed by a situation use problem solving techniques and get the expert help you need.
Meditation and massage may help reduce held physical tension.
Self-expression, like journaling or psychotherapy is likely to bring to light unhelpful patterns of thinking and being so you can learn and change.
Energetic release like dance and movement may help shift emotions and mind states.
Create your own toolkit of natural remedies that work uniquely for you.
If you are looking for herbal remedies or non-prescription pharmaceuticals I suggest seeing a qualified and registered alternative healer for guidance but always involve your GP so they are aware of any potential side effects and medication interactions.
Is anxiety the same as depression?
Disorders of anxiety are distinct from those of depression.
However they can manifest in similar ways, can occur together or lead to one another.
Some people may have an underlying depression masked by their anxiety and others may develop depression following prolonged anxiety.
People with anxiety disorders are at greater risk of developing depression.
Almost half of people suffering major depression also have significant and chronic anxiety.
People who feel anxious are often easily triggered to feel sad and vice versa.
Post-traumatic stress disorder (PTSD) is a particular risk factor for depression.
People may have a genetic and personality disposition for anxiety and depression.
Typical worriers and deep thinkers are vulnerable to these conditions and those with a harsh inner critic.
Depression also has a variety of subtypes, such as Major Depression.
Depression is characterised by a persistent low mood and negative world view and often without an apparent reason.
A person suffering depression is likely to chronically feel sad, low in vitality and willingness.
Their concentration and performance may be hindered and their function affected.
Like anxiety disorders, disorders of depression may manifest as negative thoughts, unpleasant sensory and body experiences and changes in function like poor sleep.
Is anxiety caused by stress?
Stress or short-term anxiety is usually a response to an external issue, such as a work-related incident.
Chronic stress may lead to an anxiety disorder, where the anxiety is persistent, excessive and may occur without an obvious external trigger or cause of stress.
Stress experienced early in life is a risk factor for developing anxiety conditions.
The neurological, physiological and psychological underpinnings of stress and anxiety states are similar.
Some research suggests stress states alter the brain making anxiety conditions more likely through neuroplastic mechanisms.
Is anxiety caused by alcohol?
Alcohol changes neurochemistry making your brain prone to a depressed state.
Serotonin is a neurotransmitter known to play a role in mood disorders and is depleted with excessive and chronic alcohol intake.
Can foods treat anxiety?
Eating a balanced diet of mainly plants and unprocessed wholefoods will certainly help your health, mood and wellbeing.
When you eat well you have better sleep, performance and you feel better.
If you have good rest and feel energised you are more likely to other things that are also good for you.
Eating well can be the gateway to a virtuous path of self-care.
Although using diet alone is unlikely to manage anxiety conditions it can certainly help prevent them getting worse.
When you lack nutrients and take a poor diet you are less likely to have the vitality to make the most of each day.
Your brain will lack the ingredients it needs to function optimally and keep you feeling well.
If you are not sure what foods to eat or whether your diet is optimal to help combat anxiety then consider seeing a dietician or doing further online research into good mood foods.
Sources of Omega 3 fats like salmon and antioxidants like blueberries may be just what you need to increase in your diet to help your mind and body find balance.
Conclusion – How mood active can help
Come find your tribe of like-minded souls who recognise the endless benefits of exercise and social connection to lift your mood.
Mood active offers casual/drop in classes, social gatherings, 4 week and 8 week programs.
Interested in learning more?