The anxiety management guide

TV medic Dr Nighat Arif offers some tips for dealing with anxiety and generalised anxiety disorder

Anxiety is how our bodies and brains respond to something we perceive as a threat. We all encounter things that make us anxious, but generalised anxiety disorder is when we frequently feel uncontrollably anxious – not about one particular event, like a job interview, but in a way that affects our daily lives.

Symptoms

• Feelings of fear, dread and uneasiness
• Trouble concentrating or making decisions
• Feeling irritable, angry, tense or restless
• Nausea and/or digestive problems
• Heart palpitations, light-headedness
• Sweating, trembling or shaking
• Trouble sleeping
• Feeling tired and ‘wound up’ frequently
• Tingling or numbness in the hands or feet

Diagnosis
It’s a good idea to write a list of your symptoms, triggers and underlying concerns before you talk to a doctor or therapist, to help them understand your particular experience. You may experience these symptoms sometimes, often or all the time. There is not always an identifiable trigger for anxiety – someone may not be able to explain what they are ‘worried about’.

There is a seven-question survey you can find online called the GAD-7, which I use in my surgery. This survey gives a good indication of how mild or severe your anxiety is and allows you to carefully consider your symptoms. There is no physical or medical test for anxiety. It exists on a spectrum so it’s not a case of you either have it or you don’t.

See a GP or self-refer to your local mental health team if your anxiety:

• Is not helped by any of the management techniques discussed below.
• Is stopping you living a life that is ‘normal’ for you, for example, going to work or to your place of study.

Treatment
The first thing to do is to try to develop your own personal coping strategies to address your anxiety and its causes – everyone’s experiences of anxiety, and therefore the best way to address it, will be different. Treatments can range from lifestyle changes to management techniques, talking therapies or medication, or could be a combination of them.

Lifestyle changes

• Limit alcohol intake. Alcohol may feel like a short-term reprieve, but it will only compound the problem in the long-term.
• Make a list of the things you find calming, such as spending time with pets, friends, family or in nature, and certain smells or places that make you feel calm, and incorporate these into your day as much as possible.
• Exercise is great for the nervous system. Find exercises that work for you.
• Look after your gut health. In particular, complex carbohydrates are linked to serotonin production which alleviates the symptoms of anxiety, while low potassium is connected to anxiety and depression.

Anxiety management techniques

• These techniques are all essentially aimed at calming your nervous system.
• Breathing techniques are central and useful for anyone in a stressful situation.
• Writing down your worries and dedicating a specific time to do this can help to contain them.
• The anxiety self-care section of the MIND website also has lots of management techniques to try.

Talking therapies

• Cognitive behavioural therapy (CBT) is often used as it takes a practical approach to managing symptoms.
• Applied therapy helps you to practise relaxing your muscles in anxious situations.

What is a panic attack?

• Unlike anxiety, which is ongoing and chronic, panic attacks are severe and intense.
• They usually last for five to twenty minutes.
• They often appear suddenly without warning.
• Physical symptoms include a racing heart and chest pain (it can feel like you are having a heart attack), shaking, stomach knots or cramps, diarrhoea, nausea and/or vomiting.
• You may feel disconnected from your body or surroundings.

What to do if you have a panic attack

• Focus on breathing slowly and deeply (a prior knowledge of breathing exercises will be useful).
• Try to stay where you are if you can.
• Focus on what’s immediately in front of you: what can you see, hear, smell and taste?
• Remind yourself that it will pass; you just need to get through the next few minutes.

See a GP or mental health professional if you are regularly experiencing panic attacks.

Taken from: The Complete Guide to Family Health by Dr Nighat Arif, published by Hamlyn.

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