This leaflet aims to describe the features of anxiety and
panic, different options for treatment, and how one form of
treatment - Cognitive Behavioural Therapy (CBT) can be of help. It
is hoped that this leaflet will be useful for sufferers of anxiety
and possibly for friends and family who also wish to know more about
anxiety, panic attacks, and CBT.THE EXTENT
OF THE PROBLEM
Anxiety is a very common
problem in the community. About one in twenty of the population will
suffer from anxiety symptoms that are present for most of the time.
It results in considerable suffering. This is known as Generalised
Anxiety Disorder or GAD. A smaller number of people suffer from
anxiety symptoms that come in short very distressing bursts. This is
known as panic disorder.
WHAT IS ANXIETY?
What we mean by anxiety can vary a lot between
individuals but tends to be made up of features of altered thoughts,
emotions, behaviours and physical sensations. These are described
below. Each of these features can influence each other leading to a
worsening of the anxiety.
Altered Physical Sensations
Often anxious people are aware of their heart beating
harder and faster. This is known as palpitations. Sweatiness and
shaking can also occur. Sometimes people feel light-headed, dizzy
and nausea as well as a range of other symptoms.
Altered Thoughts
Very often worrying is a feature of anxiety
particularly in generalised anxiety disorder. Here people often
become concerned that the worrying will harm them. In panic attacks
people often believe that they may be at risk of fainting. Sometimes
they interpret the palpitations as evidence of heart problems and
again fret about the risk of ensuing harm or even death.
Altered Behaviours
With anxiety the person may be uneasy, jumpy and
restless. They appear to be always on the lookout for possible
danger in order to avoid such situations. In panic disorder the
panic attacks may happen at any time. In some people, however, they
happen only in certain situations such as when there are lots of
people about. In this case a panic sufferer may simply avoid those
situations and appear on the surface to have few problems in their
lives. While in a panic attack, they may lie down, sit, or quickly
remove themselves from the situation. Others use drugs or alcohol in
the hope that this will help. Unfortunately, in the longer term they
make anxiety worse.
Altered Emotions
In panic disorder the main emotion is fear. In less
severe anxiety people feel keyed up and irritable. Unfortunately, in
generalised anxiety disorder when the symptoms last for much of an
individual's day people can feel desperate. Sometimes their mood can
drop.
CAUSES
There is no one cause of anxiety disorder. In some
cases it appears to run in families. Sometimes it also starts after
a big life change such as a bereavement, childbirth, or losing a
job. A smaller number of cases are associated with physical or other
psychological illnesses. These include depression or thyroid
problems. Anxiety can also be a feature of phobias, which are fears
of different situations such as types of animals or of crowds.
Lastly, some prescribed medications can make people feel anxious as
a side effect, including some anti-depressants.
CONSEQUENCES
Sufferers begin to avoid those things or places that
they associate with their symptoms. This can get worse until it
forms a significant part of the person's life. Fear of having a
panic attack can be very disabling. Eventually it can prevent people
from going about normal work or social activities and can lead to
agoraphobia. Less commonly the distress and disablement caused by
anxiety may cause periods of depression or drug and alcohol
problems. It is therefore better to get treatment for anxiety
problems rather than letting them continue.
TREATMENT
Treatment of anxiety can be by psychological
(talking) treatments or by using prescribed medications.
Medications: In the past benzodiazepines (tranquilliser) medications
were used such as diazepam (another name for Valium). Unfortunately,
these drugs are addictive and become much less effective in the
longer term. They are used much less commonly nowadays. More
commonly anti-depressant medications are used. They have been shown
to be effective but unfortunately the anxiety often comes back when
the medication is stopped.
Psychological Treatments: Counselling and practical techniques to
teach relaxation are found to be helpful by some. Likewise,
self-help materials on tapes or in books can teach strategies to
help people feel better. The psychological approach with the most
evidence of effectiveness for anxiety disorders is Cognitive
Behavioural Therapy (CBT).
CBT is likely to include the following:
1. Teaching about the nature of anxiety, including
the physical symptoms. Any misinterpretations that such symptoms
such as palpitations are harmful or dangerous can be corrected.
2. Exploring the extreme and unhelpful thoughts that happen
particularly when the sufferer is very anxious. Learning techniques
to balance some of these biased thoughts.
3. The features of worry can be explored and techniques tried to
lessen the impact of worrying.
4. Where many situations are being avoided they will be looked at.
The therapy will attempt to reintroduce these into the life of the
sufferer. This is done gradually in small steps and only when the
client feels ready to try.
5. Sometimes the therapy may include training in relaxation
techniques to reduce the physical symptoms of anxiety.
6. Where depression has become a feature of the
person's problem this can also be treated using CBT.
Information about anxiety problems including panic is also
available from: -
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National Phobics Society
Zion Community Resource Centre
339 Stretford Road
Manchester M15 4ZY
Tel 0870 7700 456
Fax 0161 227 9862
www.phobics-society.org.uk
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