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Mood and Mind

ANXIETY REPORT: Why are we all so worried?

Constantly in a panic? Chronic anxiety accounts for 30 per cent of mental health problems seen by GPs and it’s more prevalent in women than men. So why are we all so worried and how can we stop? A special Healthista report for World Mental Health Day 

You start to worry, you can’t seem to stop. At times a lump develops in your stomach that won’t go away or you feel you might be sick. Perhaps your breathing gets irregular or your sleep disjointed. You can’t relax. You’re constantly on edge. Sound familiar? What you’re experiencing is chronic anxiety and you’re far from alone.

Experts are now warning of a new age of anxiety in British women. At Anxiety UK, CEO Nicky Lidbetter – a former anxiety sufferer herself – points to a ten per cent increase in calls to the charity’s helpline and email support network, more than 60 per cent from women.   NHS figures published in 2012 by the Health and Social Care Information Centre (HSCIC) showed outpatient attendances for anxiety disorders increased roughly five fold between 2007 and 2011. Meanwhile, just under 50 million antidepressant prescriptions – commonly used to treat anxiety – are written by doctors each year.

‘In the past the source of people’s anxiety might have been a certain phobia but the rise in the last five years is mainly in women with Generalised Anxiety Disorder or GAD,’ she explains. GAD affects one in 20 adults, the majority of them women (about a third of women will experience an anxiety disorder in their lifetimes compared with about a fifth of men).

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‘Women are now worrying non-specifically about everything, constantly feeling on edge, frightened and concerned about the future. They say things like ‘I have this horrible feeling in the pit of my stomach,’ then go on to describe their worst anxious moments when the anxiety spills over into panic attacks in which they feel like they are going to be sick or suddenly need the loo. Women tend to experience anxiety as physical symptoms such as feeling sick, sweating and palpitations.’

But why are so many of us feeling anxious? ‘Often we will see a busy high-achiever managing fine, juggling all the many stresses that come with her family, social life and job suddenly develop anxiety for seemingly no reason,’ says Lidbetter. ‘But drill down into the surrounding events and there’s an external trigger, usually an event she can’t control such as a house move, job loss, bereavement, divorce or even having children.’

The busy-ness of our over-subscribed lives may also stop us from having to deal with unresolved emotional issues, says Lidbetter. ‘That anxiety is your body’s way of forcing you to look at your emotional life and the stress you’re under,’ says Lidbetter.

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Meanwhile, the flipside to a high-functioning woman’s success can be thinking patterns that make us more prone to anxiety. ‘Perfectionism and an intense fear of failure may predispose ambitious, conscientious women to anxiety,’ says psychologist Vijaya Manicavasagar, author of Overcoming Panic and Agoraphobia: Talks with Your Therapist ‘They may catastrophise situations,’ she explains. ‘Someone may think ‘I must not mess up that presentation or I will lose my job, become bankrupt and end up living in a tower block’ which turns into a vicious cycle of anxious reaction before every presentation’. Cognitive Behavioural Therapy or CBT may help because it teaches us to change the habitual thinking patterns that make us anxious. ‘Over time she can learn that messing up a presentation is only messing up a presentation which alleviates the anxiousness,’ she says.

In this post recession world, being seen as not coping can feel like failure so many of us keep schtum. ‘If you try and hide anxiety it adds another layer of stress and can make it worse,’ says Vijaya. ‘But left alone, anxiety can become agoraphobia or depression, it’s much more easily treatable in its early stages.’ This doesn’t necessarily mean therapy. ‘Reading a self-help book or learning a meditation technique such as mindfulness on-line can help. Anything that deals with the background stress in your life makes you less prone anxiety. Learning some quick fixes for when anxious feelings strike can also help,’ she explains (see box). ‘You need both short and long-term solutions.’

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What about mother’s little helper type pills such as Valium? Some 7 million prescriptions were issued for these tranquilising drugs, also called benzodiazepines in 2011 suggesting an increasing number of us are self-medicating with them to help us relax or sleep. But they’re only ever a short tem solution, says Professor David Taylor, head of pharmceutical science at King’s College London. ‘After as little as two weeks you may need bigger doses to get the same effect,’ he says. ‘If you are anxious, first you need to see your doctor who can rule out any medical conditions,’ he says. ‘He/she may refer you for an electrocardiogram or thyroid test as overactive thyroid and some heart conditions may be behind the conditions,’ he explains.

Once underlying medical conditions are ruled out antidepressants are the main medical way anxiety is treated. But Nicky Lidbetter explains they are best combined with a psychological approach such as CBT or mindfulness therapy to help drill down into the reasons for people’s anxiety. ‘Ultimately you want people to feel in control of their anxiety,’ she says. ‘If it’s so bad you can’t go to work or get out of bed then of course a course of medication will help someone get back on track. But in its early stages, we would say try and tackle it with non-drug treatments first as these are incredibly effective against anxiety’.

Desert Road Runner

For example she says, running and other aerobic exercise and cutting out refined carbohydrates and sugars and excessive caffeine can have a significant effect on anxiety. ‘The time someone should stay on medication can vary from a typical course of around six months to years. It’s important not to stop using medication once you start feeling the benefit thinking you’re cured which we find often happens, as coming off medication at the right time and in the right way is an important part of your treatment,’ says Lidbetter. ‘Likewise if running and eating well begin to work for you, keep doing them or the effect does wear off!’ she says.

7 OPTIONS TO REALLY HELP YOUR ANXIETY

1. Lengthen the breath Sit still, breathe slowly and make the out breath longer than the in breath. Panic attacks stimulate inhalations which activate the sympathetic nervous system increasing fear and panic. Lengthening the outbreath stimulates the parasympathetic nervous system, the brain’s calming centre.

2. Exercise A 2010 study in the Archives of Internal Medicine found that regular exercise reduced panic and anxiety by 30 per cent.

3. Therapy Cognitive Behavioural Therapy (CBT) is available on the NHS for panic attacks. Other therapies include Solution Focused Brief Therapy and Compassion Focused Therapy. Find a therapist at itsgoodtotalk.org.uk

4. Self-help Mindfulness Based Stress Reduction (MBSR) of Mindfulness Based Cognitive Therapy (MBCT) are eight-week courses combining meditation and group therapy to help the stress that underpins panic attacks. Talk to your GP or call the charity Mind‘s helpline 0300 123 3393 as they also run courses.

5. Herbal help The herb Rhodiola Rosea could help symptoms as it’s been shown to alleviate stress. Try Healthspan Rhodiola Rosea Stress Relief, one tablet daily £19.95 (from healthspan.co.uk).

6. Medication Drugs such as Valium, Ativan or Xanax – called benzodiazepines – knock out anxiety and relax muscles fast but they are highly addictive. Beta-blockers, antidepressants called Selective Serotonin Reuptake Inhibitors (SSRIs – Prozac is one) as well as a new drug called Lyrica may be prescribed for panic attacks. Talk to your doctor as side effects include diminished sex drive and weight gain.

7. Books on prescription New government rulings have made it possible to be prescribed approved books to help control mood issues such as your anxiety so talk to your doctor. One on the list is Overcoming Anxiety: A Self-Help Guide Using Cognitive Behavioral Techniques (Robinson £10.99) by Helen Kennerly

Anxiety UK recently launched a free app to help deal with stress and anxiety – download it here. For help call the helpline on 08444 775 774

October 10th is World Mental Health Day

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