Anxiety Disorders

Woman with anxiety

We live in a time of high stress. Many people are without work, others live in fear of their livelihoods and the global economy is rarely out of the news.

The television is full of warnings about terrorism, war, global warming and increased crime and unrest in our schools and town centres. Hope and optimism seem in short supply. It's little wonder that many of us feel stressed and anxious!

In America, the National Institute of Mental Health Survey (2008) tells us that approximately 40 million Americans suffer from an anxiety disorder - close to one fifth of the adult population.1 The total population of people in the US with mental health problems was estimated to be almost 58 million people - close to the entire population of the UK!2

In the UK, the Office of National Statistics (2000) 3 found 1 in 6 people had a diagnosable mental health problem, the most common being anxiety and depression. More recent surveys put the figure even higher. Estimates vary, but many people think that one or two people out of every three will suffer from anxiety or depression at some time in their lives.

Do you think you might suffer from anxiety? Try the following two quick questions (together they form the GAD-2).

Over the last two weeks, how often have you been bothered by the following problems ...

  1. Feeling nervous, anxious or on edge?
  2. Not being able to stop or control worrying?

There are four possible responses

  • Not at all (score 0)
  • Several days (score 1)
  • More than half the days (score 2)
  • Nearly every day (score 3)

Add up your scores for both questions. A score of three or more suggests the presence of an anxiety disorder.

It's possible that some people who are coping with anxiety by avoiding people, places or situation might score quite low.

If this sounds like you, ask yourself: 'Do I find myself avoiding places or activities and does this cause me problems?'

What is anxiety?

We feel fear when our body responds to a frightening or threatening experience. We're simply preparing for action, either to freeze (to 'play dead'), to fight, or to run away as fast as we can. Overwhelming sudden stress, or strain endured for a long period can cause us to have this 'fear' reaction for much of the time. The body is not designed to endure such continuous stress and our fear can become very severe and long-lasting. When it does, we may develop an anxiety disorder.

Although we may realise our anxiety is excessive and inappropriate, we feel powerless to do anything about it. The systems which regulate our anxiety work automatically outside of our awareness, a little like a thermostat - we can have problems with anxiety when this 'thermostat' becomes 'stuck' at too high a setting. The good news is that modern methods can help us 'reset' this internal thermostat to a lower level, easing our tension and anxiety.

There are different types of anxiety disorder, and it's not unusual for people to be diagnosed with more than one.

Different types of anxiety disorder

  • Social Anxiety
  • Specific Phobia
  • Agoraphobia
  • Post-Traumatic Stress Disorder (PTSD)
  • Panic Disorder
  • Obsessive Compulsive Disorder (OCD)

There are a range of assessments available from this site which can help rate the severity of anxiety symptoms. For social anxiety we can use the LSAS or SPIN assessments. For PTSD symptoms we can use the Impact of Events Scale, the PDSS can help evaluate the severity of panic attacks (amongst other things) while the OCI can help rate the symptoms of obsessive-compulsive disorder.

Why we get anxious

There may be many reasons why we become anxious. There's not usually one simple cause. Many scientists argue over the most important factors leading to anxiety, however it's not necessary to know 'why' we're anxious before we begin to tackle our symptoms.

Genes - some of us seem simply to be born more anxious than others. Research suggests that a vulnerability to anxiety can be inherited from our parents.

Circumstances - sometimes it seems obvious what's making us anxious. When the problem disappears, so does the anxiety. However our world sometimes feels so dangerous (e.g. war or serious accidents) or so stressful over long periods of time (e.g. working many long hours in a stressful job) that we can 'switch on' our anxiety response. Living alone, working difficult shifts and being a single parent all make us more vulnerable to anxiety.

Drugs - recreational drugs like amphetamines, LSD or ecstasy, even the caffeine in tea or coffee can make us feel anxious.

Life experiences - traumatic experiences in the past, particularly overwhelming experiences or a lack of security when we were young, or major life-changes such as pregnancy, redundancy, divorce, job insecurity or moving house can all 'switch on' our anxiety.

What turns stress into anxiety ?

As the symptoms of anxiety can feel very frightening and strange we might think there's something seriously physically wrong, or that something awful is about to happen to us. This can make us worry more, cause more symptoms, and so a vicious circle develops. The end result can be a panic attack.

If we've felt anxious in a certain situation, we may start to predict feeling anxious again and become frightened of our symptoms themselves, especially if we think they're really serious. This in turn can cause another vicious circle and can intensify the very symptoms we fear.

Avoiding the things we're afraid of might seem sensible but it doesn't tend to help in the long run. Once a vicious circle has developed, we might use avoidance as a way of coping. It's natural to want to avoid something that feels scary, but the sorts of things we avoid aren't usually really dangerous to us.

Avoiding situations can make life very difficult. Avoiding things prevents us from overcoming our fears and learning to manage our anxiety in challenging times, which can block our recovery. We need to 'feel the fear and do it anyway!'

Anxiety affects us in four different ways

  • Anxiety affects the way we feel
  • Anxiety affects the way we think
  • Anxiety affects the way our body works
  • Anxiety affects the way we behave

Anxiety affects how we feel, it can make us ...

  • Anxious, nervous, worried, frightened
  • Feel something dreadful is about to happen
  • Tense, stressed, uptight, 'on edge', unsettled
  • Feel unreal, strange, 'woozy', detached, panicky

Anxiety affects how we think, it can make us ...

  • Worry constantly, even about 'silly things'
  • Unable to concentrate
  • Make our thoughts race and go 'round and round'
  • Unable to follow things through
  • Dwell on the worst thing that could possibly happen

Some common thoughts we might have ...

  • 'I’m losing control'
  • 'I'm going to die'
  • 'Everyone's looking at me'
  • 'I’m cracking up'
  • 'I’m going to faint'
  • 'My legs are going to collapse'
  • 'I’m going to have a heart attack'
  • 'I’m going to make a fool of myself'
  • 'I can’t cope'
  • 'I’ve got to get out of here'

When we're anxious we may get several of the following symptoms ...

  • Our heart pounds, races, skips a beat, we're aware of it 'hammering'
  • Our chest feels very tight and painful
  • We get a 'lump' in our throat or difficulty swallowing
  • We get a tingling sensation or numbness in our toes or fingers
  • Our stomach churns and we get cramps or 'butterflies' in our tummy
  • We have to go to the toilet more often
  • We feel jumpy or restless, we fidget
  • Our muscles tense up painfully
  • Our whole body aches
  • We sweat excessively
  • Our breathing becomes shallow and rapid, we gasp for air
  • We feel dizzy and light-headed

What we might do ...

  • Pace up and down
  • Start jobs and not finishing them
  • We can’t just sit and relax
  • We're 'on the go' all the time
  • We talk quickly or more than usual
  • We can become snappy and irritable
  • We may turn to drinking, smoking
  • Our appetite changes, we may feel sick
  • We may avoiding difficult situations

The Serenity Programme is especially designed to help you in each of the 'four areas' of anxiety. These areas are all interconnected, so change on one area can help bring about change in all of the others.

It's important to understand that many factors other than depression or anxiety can cause the symptoms listed above. A diagnosis can only be provided by appropriately trained health professionals. If you're concerned in any way about your symptoms, please consult with a trained professional.


  1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.
  2. U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh
  3. Office of National Statistics; Psychiatric Morbidity Among Adults Living in Private Households, 2000 (1.2Mb PDF)

Thanks for reading to the end.

Best wishes to you

Steve Cottrell

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Page last updated:  Monday, January 4, 2016