Anxiety

Overview

Anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome. Everyone feels anxious now and then, but when the feeling is very strong, lasts a long time, or happens often, it can become a health condition called an anxiety disorder. Anxiety disorders make it hard to cope with everyday life.

Yes, anxiety is very common. It affects millions of people of all ages, and it is one of the most frequent reasons people visit a general practitioner.

Anxiety can affect anyone — children, teenagers, adults, and older people. It affects people of every gender, background, and culture. It often starts in the teens or early adulthood, but it can begin at any age.

Symptoms

Common symptoms

• Feeling restless, tense, or on edge
• Racing thoughts or constant worry
• Difficulty concentrating or blanking out
• Irritability or impatience
• Sleep problems, like trouble falling asleep or waking often
• Rapid heartbeat, sweating, or trembling
• Shortness of breath or a feeling of choking
• Dizziness or light-headedness
• Nausea, stomach pain, or digestive changes
• Muscle tension or headaches
• Feeling like something bad is about to happen

Symptoms in children

• Clinginess or fear of separating from parents
• Tummy aches, headaches, or other physical complaints
• Tantrums, crying, or withdrawal
• Avoiding school, friends, or activities they used to enjoy
• Trouble sleeping or nightmares
• Constant worry about school, family, or the future

Symptoms in older adults

• Physical symptoms like fatigue, dizziness, or pain
• Memory problems or confusion
• Sleep difficulties
• Worrying a lot about health, money, or family
• Feeling irritable or easily overwhelmed
• Less likely to report feeling anxious, but showing withdrawal or increased dependence

Causes

Main causes

• A family history of anxiety or other mental health conditions
• Stressful or traumatic life events, such as a death, illness, divorce, or job loss
• Ongoing stress, like work pressure, money problems, or relationship difficulties
• Brain chemistry — certain naturally occurring chemicals may play a role
• Personality traits — for example, being a perfectionist or very sensitive to criticism
• Other health conditions — like thyroid problems, heart disease, or chronic pain
• Certain medicines or substances, including caffeine, alcohol, or recreational drugs

Risk factors

• Having a close relative with an anxiety disorder
• Going through a difficult or abusive childhood
• Long-term physical illness or chronic pain
• Major life changes, like becoming a parent or moving to a new place
• Using caffeine, alcohol, or stimulant drugs
• Being female — anxiety is more often diagnosed in women than men

When to see a doctor

See a doctor urgently if:

• If you have thoughts of harming yourself or ending your life — call your local emergency number right away.
• If you have severe anxiety along with chest pain, fainting, or trouble breathing.
• If you feel you cannot cope or your anxiety is completely overwhelming

Book a routine appointment if:

• If anxiety is affecting your work, school, relationships, or daily activities
• If you have been feeling anxious most of the time for more than a few weeks
• If you are avoiding more and more situations because of fear
• If your sleep, appetite, or energy are disturbed
• If you have been drinking or using substances to cope with anxious feelings

Diagnosis

Your doctor or nurse will talk with you about your symptoms, how often they happen, how long they last, and how they affect your life. They may ask about your health, family, work, and personal history. There is no single test for anxiety — the diagnosis is based on the picture you describe.

Tests that may be done

• A physical examination to look for other health problems
• Blood tests to check for thyroid problems, vitamin levels, or other physical causes
• Questionnaires about your anxiety and mood
• A conversation about your sleep, lifestyle, and any medicines or substances you use

What to expect at your appointment

The appointment may take a while — it helps to bring someone you trust if you are nervous. The doctor will listen and may ask sensitive questions. They may also ask about your thoughts, feelings, and any past experiences. The goal is to understand your difficulties and work out the best next steps together.

Treatment

Anxiety is treatable. Most people benefit from talking therapies, practical self-management, and sometimes medication. The right plan depends on the type and severity of your anxiety, as well as your personal preferences. Your healthcare team will help you choose.

Self-care at home

• Practice slow breathing — breathe in for 4 seconds, hold for 4 seconds, and breathe out slowly for 6 to 8 seconds
• Try grounding exercises, like naming 5 things you can see, 4 you can hear, 3 you can touch, 2 you can smell, and 1 you can taste
• Get regular physical activity — even a short walk can help
• Cut down on caffeine, alcohol, and sugary energy drinks
• Build a regular sleep routine — try to go to bed and wake up at the same time each day
• Talk to someone you trust about how you feel
• Break big tasks into small, manageable steps
• Set aside a specific short time to worry, then try to move on

Medical treatments

Treatment may include talking therapies such as cognitive behavioural therapy (CBT), which helps you notice and change unhelpful thought patterns and behaviours. For moderate to severe anxiety, a doctor may suggest a course of talking therapy with medication. Medication is not a quick fix — it usually takes several weeks to work, and it should be reviewed regularly. A doctor or nurse will explain the options, benefits, and possible side effects, and you can decide together what is right for you.

Living with this condition

Living with anxiety can be exhausting, but you can learn to manage it. Start with a simple daily routine: regular times for meals, activity, work, and rest. Avoid taking on too much at once. Be kind to yourself — recovery takes time and there will be good and bad days.

Lifestyle tips

• Learn a few relaxation techniques and practice them when calm, so you can use them during anxious moments
• Keep a journal — write down what triggers your anxiety and what helps
• Limit how often you check the news or social media if it makes you feel worse
• Stay connected — spend time with people who make you feel safe and calm
• Consider joining a support group where you can share experiences with others
• Set small realistic goals for facing things you fear — gradually, not all at once

Diet and exercise

A balanced diet with regular meals can help keep your energy steady. Include plenty of vegetables, fruits, whole grains, and lean protein. Limit caffeine and alcohol — these can increase anxiety or make sleep worse. Exercise is one of the best ways to release tension and improve mood. Try to do something active most days, such as walking, cycling, swimming, or dancing.

Mental health and emotional wellbeing

Anxiety is a real condition and it is not your fault. It can also affect your mood, confidence, and self-esteem. You may feel frustrated, ashamed, or sad. It is common to feel depressed as well. Remember that anxiety is a health problem, and health problems deserve the same compassion as any physical illness.

Prevention

You can't always prevent anxiety, but you can reduce its impact. Learning healthy coping skills, keeping a good sleep routine, exercising regularly, and getting help early are powerful ways to reduce the chance that anxiety becomes overwhelming. If you treat anxiety early, you are less likely to develop more severe or long-term problems.

Complications

If left untreated

• Anxiety can become more severe and harder to treat over time
• It can lead to depression or worsen existing mental health conditions
• It can affect relationships, work, and social life
• It may cause you to avoid important activities or opportunities
• Chronic anxiety can contribute to physical problems, such as headaches, stomach issues, and trouble sleeping
• There is a higher risk of using alcohol, tobacco, or other substances to cope

Long-term outlook

With the right support and treatment, most people with anxiety improve significantly. Many people learn to manage their symptoms well and live full, active lives. Even severe anxiety can get better. It may take time, and treatment may need to be adjusted, but there is every reason to be hopeful.

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