How to deal with anxiety

How to deal with anxiety – This information will help you recognise the signs of anxiety, think about whether you need treatment, how to find the right psychologist and learn how to deal with anxiety.

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In our modern daily lives, anxiety is a regular fixture. The point where you should be concerned is when your anxiety becomes unmanageable which can lead to poor levels of social and occupational functioning. If you find yourself in this situation, it would be important to be able to learn how to deal with anxiety. Let’s look at the characteristics of anxiety and what anxiety looks like when the anxiety you are experiencing becomes classifiable as a medical and psychological issue.

How to deal with anxiety – Recognise the overarching characteristics of anxiety disorders

  1. Excessive nervous energy
  2. Overwhelming fear
  3. Being apprehensive of day-to-day situations
  4. Experiencing unreasonable levels of worry

There are several distinct physical symptoms involved in an anxiety disorder. Anxiety disorders often change how a person perceives and responds to the world around them (Laufer, Isreali & Paz, 2016). In comparison to mild anxiety that is experienced on a daily basis, chronic, acute or severe anxiety can be a source of discomfort and be quite disruptive to daily life. The more severe forms of anxiety will affect your social, educational and occupational function drastically (American Psychiatric Association, 2013, Lépine, 2002).

The global prevalence of anxiety disorders is 3.6% (World Health Organisation, 2017). In Australia, it stands at around 2.3 million or 14.4% of the population (Department of Health, 2007). Unfortunately, only a fraction of people can able to afford or for that matter identify that they might require treatment through utilising a trained psychologist and medical professional to help them deal with their anxiety.

How is anxiety defined?

The Diagnostic Statistical Manual describes anxiety as an emotion that invokes feelings of tensions, enabling the sequence of thoughts and cognitions that involve worry. Often immediate physical symptoms can be observable such as, increased blood pressure, heart rate and perspiration (APA, 2013).

Relaying your symptoms accurately to your psychologist is a crucial first step in learning how to deal with anxiety. The psychologist needs to determine the context or situations where you experience these symptoms and decide whether you are simply experiencing normal levels of anxiety or if it is a deep-rooted anxiety disorder that requires medication or therapy in order to effectively diagnose and treat your condition (Jongsma & Peterson, 2006).

How to deal with anxiety – Learning why you experience anxiety and when has it reached a point where it might need treatment

In most cases, the anxiety stems from a particular event, object or changing circumstances (APA, 2013). It is important to be aware that the anxiety you experience may not always require medical or psychological help. From an anthropological perspective, the anxiety that stresses you and that you experience may be an important component of daily life and your survival. It is usually triggered by a harmful or stressful situation and ensures your survival in various contexts (Steimer, 2002).

When you encounter a snake or a dangerous animal, it triggers a fight or flight of fright response in your brain and body, which alerts you to a threatening situation (Cannon, 1915). The flight or flight response may be vital to specific situations such as where you might confront a moving vehicle that is speeding towards you. The flight or flight response allows you to instinctively assess the danger. Hence, aversive situations may evoke the original flight or flight response.

This fight or flight response was developed early in the development of the human brain. For example, when an impending danger of such as a Sabretooth tiger was a real and present danger, this required your body to respond in a manner that may have involved fighting or evading the situation (Goldstein & Kopin, 2007). When your fight or flight response kicks in, so does the increased heart rate, perspiration and awareness of your immediate surroundings. This would have driven you to seek escape points or methods to defend yourself. In the modern context, facing larger animals and being threatened by your natural environment is less of concern especially in large metropolises. Modern anxiety triggers usually encompass issues evaluations of performance at work, such as a boss or teacher that might be chasing after you for an overdue report.

Being entrenched in such situations includes the release of neurotransmitters called dopamine, norepinephrine and epinephrine involved in the ‘fight or flight’ response, which allows the body to prepare for a confrontational situation or flee from safety (Gleitman, Fridlund & Reisberg, 2004). However, if this is experienced over extended periods of time, this can be detrimental to your mental and physical health. Chronic stress can also be brought on by financial difficulties, reduced health and other extended demanding situations. Therefore, understanding how to deal with anxiety through psychoeducation and therapy based on recommendations and techniques suggested by your psychologist can drastically improve the outcome of your anxiety condition.

How to deal with anxiety – Classify the anxiety disorder accurately

Caveat: It is very important to work together with a psychologist and/ or medical practitioner when reading the following information.

If it is observed that your symptoms of anxiety are disproportionate or becoming generalised to other stressors where physical and mental symptoms that continue past the duration of the original trigger, this is where the anxiety symptoms are no longer classified as just an anxiety response but now become an anxiety disorder.

The DSM-5 describes a constellation of symptoms that constitute an anxiety disorder. Primarily, these include recurring intrusive thoughts, high blood pressure, overstimulation of the parasympathetic nervous system and avoidance of situations or cues where an event has occurred (APA,2013).

After reading the information below and you start wondering, “I’ve experienced all of the above symptoms. Am I experiencing anxiety or an anxiety disorder?” and more importantly, “How do I deal with this anxiety?” It is vital to consult a professional which can include a psychologist or medical professional regarding your symptoms. It is common for individuals to experience some or many of these symptoms occasionally throughout daily life. The key distinction is that individuals with anxiety disorders and will experience the following symptoms disproportionately and disruptions to their social and occupational functioning.

We will briefly cover some of the major anxiety disorders in this article:

Separation anxiety disorder

This disorder is characterised as a disproportionate fear, anxiety or distress due to the separation from a significant person in their lives. This can include a parent, grandparent, sibling, etc. Though patterns involving worry regarding the loss, death or other horrifying event occurring to the significant figure, a refusal to leave the home, the reluctance to be away from or sleeping without the attachment figure are prevalent. Physical symptoms such as gastrointestinal problems and headaches may occur in tandem. The symptoms are present in children for 4 weeks and 6 months in adults and must not be better explained by symptoms in other mental health presentations such as ASD, Agoraphobia, GAD or illness anxiety (APA, 2013).

Selective mutism

Children experience this disorder with symptoms such as being are unable to speak within certain environments due to their increased in anxiety response. The child may, in fact, have appropriate social and communication skills around people that they know however once outside these familiar contexts, selective mutism is expressed. This condition cannot be classified by another mental health issue i.e. ASD, schizophrenia, psychosis, communication disorder or alternatively when communication difficulties with the spoken language in social contexts are present. Symptoms must be evident for a month (APA, 2013).

Phobias

Fear or anxiety relating to phobias are specific, situational, almost always immediate, intense and disproportionate. Phobias involve irrational but learned fears. This can involve the fear, anxiety and avoidance of objects or situations but unlike the other categories of anxiety disorders, they can be directly related to particular stimuli or trigger.

It’s quite common for the person experiencing the phobia to have a very deep understanding that the fear of the trigger, stressor or stimuli is irrational. The person experiencing the phobia will evoke feelings of anxiety in response to the trigger. . There is a very comprehensive list of phobias which include some of the most common including; animal e.g. fear of dogs (cynophobia), natural environments e.g. fear of water (aquaphobia); blood-injection-injury e.g. fear of blood (hemophobia), situational, e.g. the fear of flying (aviophobia or aerophobia) or others e.g. fear of vomiting (emetophobia). Symptoms cannot be better explained by panic disorder, Agoraphobia, OCD, PTSD, separation anxiety or social anxiety disorder and must be evident for six months (APA, 2013).

Social anxiety disorder

Social anxiety disorder encompasses debilitating anxiety that is felt in social situations, which can include a fear of humiliation, embarrassment or the perception of negative judgement. This disorder can involve characteristics of persistent fear, anxiety and avoidance for 6 months that is disproportionate to the actual threat of the situation. Social situations will be avoided such as interaction with others, being placed in a situation where they are perceived to be assessed and performances i.e. stage fright. It cannot be classified as such if it is due to substance usage or another medical or psychological condition (APA, 2013).

Panic disorder

Panic disorder is characterised as unexpected intense terror and apprehension that occurs rapidly and peaks briefly after. The duration is within the space of minutes. The symptoms associated include (APA, 2013):

Physical symptoms:

  • Feeling that your heart is racing/accelerating
  • The chest has a pounding sensation
  • Increased perspiration
  • Uncontrollable trembling or shaking
  • Difficulty breathing akin to feeling like you are suffocating or choking
  • Pain in the chest or gastrointestinal areas
  • Feeling faint or light-headed,
  • The onset of giddiness or dizziness
  • Unsteady gait or feeling a loss of balance
  • Hot or cold flashes
  • A feeling of numbness or tingling
  • Feeling as if you have lost touch with reality (derealization) or feeling apart or outside yourself (depersonalization)
  • Feel as if you are ‘losing your mind’
  • A key feature is a fear of death

An unintended consequence is that the person experiencing the panic attacks may make drastic adjustments to their lifestyle or develop the avoidance of certain scenarios because of the impending fear of the future attack. If this fear persists for a month and is not explainable by substance usage, physical or mental conditions after a month, then it is classified as a disorder. When it is a feature of another mental health issue, then your psychologist or medical practitioner will indicate that it is a feature alongside another mental health presentation. Unfortunately, it is not necessary for a trigger to be present and it can be quite frightening or feel like it is prolonged (APA, 2013).

Agoraphobia

The fear of open spaces. The characteristics of this condition involve (APA, 2013):

  • Fear and anxiety with respect to public transportation, open spaces, enclosed spaces, standing in lines and crowds and being alone in a public space
  • Thought processes around limited capacity to escape or obtain help result in panic symptoms
  • In elderly populations, the fear of falling, freezing up and incontinence is present
  • The agoraphobic situations evoke fear and anxiety disproportionally to the actual danger posed, which may also include persistent avoidance.
  • Symptoms are present, lasting 6 months or more.
  • Distress and impairment in social and occupational functioning is observed in the agoraphobic contexts
  • If present with a medical condition is present the agoraphobic symptoms are pronounced
  • Agoraphobia cannot be better explained by another mental health classification

Generalised anxiety disorder

This involves chronic anxiety with the symptoms of anxiety in the context of situations or life events and has to be present for a minimum of six months (APA, 2013).

The key features are:

  • Finding it difficult to control the worry and three of the following have to be present (one for children)
  • A feeling that described as being keyed up or on edge
  • Being susceptible to being tired or fatigued
  • Concentration on tasks becomes a challenge and you feel as if your mind is going blank
  • Being easily irritable
  • The experience of muscle aches and tension
  • Insomnia or finding it challenging falling or staying asleep

It is important to take note when symptoms begin to affect other areas of your life socially or occupationally. The symptoms cannot be due to drugs, alcohol or medication or an underlying medical or psychological condition. Distress and impairment in social and occupational functioning is observed.

Physical signs and symptoms may include:

  • Experiencing tension or aches in your muscles
    • Being able to observe trembling or twitchiness
    • Being persistently nervous or having the quality of being easily startled
    • Profuse sweating may be observed
    • Feeling nausea, diarrhoea or irritable bowel syndrome

Substance/ Medication-Induced Anxiety Disorder

This classification is given when symptoms of an anxiety disorder appear after intoxication, withdrawal or the administration of medication and the following criteria are met (APA, 2013):

  • the key presenting symptoms are panic attacks and anxiety
  • is known that the substance causes these symptoms during, soon after intoxication, exposure or withdrawal
  • the anxiety symptoms do not fit another mental health classification
  • the anxiety symptoms cannot be uniquely present before the consumption of the substance and/or continue to substantially persist thereafter
  • No delirium is present

Distress and impairment in social and occupational functioning are observed.

Anxiety Disorder Due to Another Medical Condition

In this anxiety disorder, panic attacks or anxiety symptoms are observed. There must be evidence that the anxiety is a result of another medical condition and not better classified as another mental disorder. No delirium must be present (APA, 2013).

Other Specified Anxiety Disorder

This occurs when anxiety symptoms representing an anxiety disorder are present, but none of the full criteria for the above classifications is met. Your psychologist or medical practitioner specifies the reason such as when the chronological progression is difficult to ascertain, restricted presentation of symptoms i.e. attacks, cultural presentations of anxiety i.e Khyâl cap, Ataque de nervios (APA, 2013).

Unspecified Anxiety Disorder

As in other specified anxiety disorders, this occurs when anxiety symptoms representing an anxiety disorder are present, but none of the full criteria is met. In this case, your psychologist or medical practitioner does not specify the reason for the diagnosis or there is inadequate information. i.e. in emergency settings (APA,2013).

How to deal with anxiety – Understanding the root causes of anxiety

Your psychologist or medical practitioner will undertake an initial assessment to determine what is causing your anxiety. This can often be quite a challenging task as the causal factors of anxiety in an individual’s life can be hard to pinpoint and in some cases evolve over time. What can occur is a significant event exacerbating the generalisation of anxiety symptoms toward other novel or unrelated situations, circumstances or objects. While that is true, the opposite has also been observed where an individual experiencing anxiety symptoms may not necessarily generalise their anxiety symptoms to other stimuli or reach the point where it develops into a full-blown anxiety disorder (APA, 2013).

In reference to the roots causes, some of the factors include (APA, 2013):

  • A trigger in one’s environment, objects, persons or situations that have been characterised in the brain as stressors
  • Persistent/consistent and unmanageable challenges in educational, occupational or social environments
  • Persistent/consistent and unmanageable family and relationship difficulties
  • The hereditary and genetic components – there is a high probability that if one has a family member has an anxiety disorder, they may experience that particular anxiety disorder themselves
  • Underlying medical condition – side effects of medications over time, the burden from experiencing a particular medical condition, stress from the post-surgery period, a period after a long hospitalisation or a medical condition that has required extended recovery.
  • Neurochemistry – when hormonal or neurochemical issues cause disruption within specific pathways in the brain
  • Drug and alcohol, or prescription use – certain compounds maybe exacerbate an underlying medical or psychological condition or illicit certain symptoms that are similar to anxiety disorders
  • Access to psychoeducation – often the lack of access to informative resources on how to deal with anxiety and the development of coping strategies may result in poorer mental health outcomes
  • Treatment accessibility – often the lack of access to mental health clinics or facilities in areas where the number of psychologists per population is lower has a significant impact on mental health outcomes for individuals dealing with anxiety

How to deal with anxiety – Therapy, medication or both?

The most effective forms of treatment to deal with your anxiety are cognitive behavioural therapy and medication (Bandelow et al., 2015).

Certain mental health conditions coexist and exacerbate anxiety disorders (APA, 2013). This can include substance dependency, depressive disorders and other mental health conditions. There are conditions that have been shown to display significant comorbidity with anxiety disorders. Often the underlying condition will affect an individual’s health outcomes hence, it is important for the psychologist or medical practitioner to recognise that the underlying condition must be treated prior to or concurrently to being referred for treatment for an anxiety disorder.

If it is observed that your anxiety is not considered a chronic, acute or severe condition, your psychologist or medical practitioner will guide you with techniques that may be useful to reduce your anxiety. Please note that these techniques may not be effective for chronic, acute or severe instances of an anxiety disorder. In cases, where chronic, acute or severe anxiety presents a combination of therapy and medication is recommended. Please check with your medical practitioner about the medications involved.

How to deal with anxiety – Recommendations and techniques from your psychologist:

Identify and reduce the amount of stress you experience

This is the first step to deal with your anxiety. In your initial assessment and subsequent sessions with your psychologist, you will work together to determine what your triggers are. This will help you map out and identify potential stressors in your life and teach you how to deal with your anxiety (Jongsma & Peterson, 2006). When you can identify your triggers and stressors this may help you reduce your anxiety symptoms. Often being able to identify demands within your daily life such as social, educational and occupational stressors, challenges in relationship with a partner, peers or family should be identified early as possible. This will allow you to take time off for yourself, apply coping strategies and better manage the stressful situations, and relationships in your life (Jongsma & Peterson, 2006).

Learning to implement calming skills and relaxation techniques will improve how you deal with anxiety

Your psychologist will be able to provide guided imagery, meditation, slow diaphragmatic breathing and muscle relaxation techniques that will address the immediate anxiety you experience in challenging situations, that can be reinforced and applied in your daily life (Jongsma & Peterson, 2006).

Being aware of your cognitive biases, fearful self-talk and replacing them with adaptive ones is the cornerstone of how to deal with anxiety

Being aware of fear and worry-based negative expectations of situations and maladaptive thought patterns is a key component of cognitive behaviour therapy. Your psychologist will help you identify these types of thoughts recurring in your mind. Often incorporating exercises to challenging those negative thoughts and replacing them with positive ones is something that you will be able to practice which in turn, helps you deal with your anxiety (Jongsma & Peterson, 2006). Over time you will be able to face your negative thoughts and fears and be able to reframe the situation or context. Being able to work through with your psychologist to imagine overcoming difficult situations or contexts is part of the therapeutic process. All these techniques are useful after identifying the root cause of your anxiety (Jongsma & Peterson, 2006). In the case of phobias, these are some of the most effective evidence-based techniques (Jongsma & Peterson, 2006).

Having a supportive network and community will help you maintain how you are coping with your anxiety

In addition to your psychologist, having a support network that can empathize with you and family members, friends and peers that support you in this process are important. Support groups are now even readily available within the community and even online (Jongsma & Peterson, 2006).

Regular exercise has shown promising results

Your psychologist may also recommend that you engage in regular physical exercise. The effects of physical exercise in terms of release endorphins and improving resilience have been documented in research (Jayakody, Gunadasa & Hosker, 2014). Over time, with regular exercise, your self-esteem, focus and concentration may improve. As a consequence, this will help you reassess your situation carefully which includes the evaluation of difficult situations or circumstances (Jongsma & Peterson, 2006).

Psychotherapy

Psychotherapy provided by your psychologist can involve a particular psychological therapy method or a combination of the other therapies, known as a multimodal approach. Cognitive behaviour therapy is the form of therapy that has shown the highest efficacy of anxiety-related disorders (Kaczkurkin & Foa, 2015).

Cognitive behavioural therapy

Your anxiety therapist may utilise cognitive behaviour therapy to treat your anxiety. Cognitive behavioural therapy will help you identify maladaptive thought patterns and faulty cognitions that allow you to identify triggers and feelings that reinforce your state of anxiousness. A good psychologist will guide you to identify and challenge distorted and maladaptive thinking patterns, cognitions and beliefs. Over time you will be able to contrast and utilize adaptive and healthy thinking patterns when faced with anxiety-provoking objects and situations (Jongsma & Peterson, 2006). An example would be identifying your ‘freezing’ behaviour in challenging situations as not that you are stuck or trapped in a situation, but that this is the coping situation you have developed.

There is also a form of cognitive behaviour therapy called graduated exposure therapy which involves exposing yourself to your fears and triggers. Graduated exposure therapy involves systematically desensitising yourself to those situations, objects and environments that evoke your anxiety thereby confronting your fears and reduce the levels of anxiety you experience. This is called graduated exposure therapy (Jongsma & Peterson, 2006).

As a quick recap of the above information on how to deal with your anxiety, remember to:

  • Identifying your triggers and stressors
  • Meditation, breathing and relaxation exercises
  • Recognising maladaptive thoughts
  • Having a support network
  • Exercise
  • Treatment

How to deal with anxiety – Start with your daily routine, how does it impact your anxiety?

It’s important to reduce factors that can impact or increase the onset of your anxiety. Please pay attention to the following points below in your daily routine in order to reduce your risk of anxiety onset. Highlight any of the following during the initial evaluation with your psychologist or medical practitioner. (Jongsma & Peterson, 2006).

  • Highlight how much coffee (caffeine) you may be consuming or for that matter any other stimulant in the content of your drinks and food items you consume.
  • Over the counter medications, alternative therapies or herbal remedies should be highlighted to your medical practitioner as these may exacerbate your symptoms
  • It’s important to identify any drug and alcohol consumption as this has a significant impact on anxiety symptoms.
  • Highlight to your anxiety therapist if you are having insomnia and beware if you are using your computer, tablets or smartphone in bed. These reduce your capacity to maintain a consistent and regular sleep pattern.

Psychologist Services at Chat Clinic

To determine the best way for you to obtain timely and effective psychological services at Chat Clinic:

  1. Call one of the numbers listed below or;
  2. Fill your details in the form below and we can schedule a callback or;
  3. Talk to us in the chatbox on the right-hand corner.

Here are some of our Psychologist profiles.

We can provide to our clients with a scope of psychological services which may be rebated by funding bodies such as Medicare Australia or fully funded by the NDIS. You also have the option of paying a full fee if you prefer to not obtain a referral.

Our services may include:

  • A referral to a psychologist registered with the Psychology Board of Australia and where required, to other healthcare professionals or practitioners within your community or by Telehealth who are skilled in helping you deal with your anxiety.
  •     A referral to anxiety psychologists of different genders.
  •    Taking a complete view of your situation and collaborating with all healthcare professionals involved in your situation if you consent for us to do so.
  •    Undertaking your personal request to work alongside family members, service providers and community support and networks.
  •    Providing psychology services outside normal working hours or after hours.
  •    Access to a friendly team of anxiety therapists with an extensive breadth of experience and skillsets.
  •    Connecting you with anxiety therapists i.e psychologists and other healthcare professionals or practitioners who speak your language of preference.

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA

Bandelow, B., Reitt, M., Röver, C., Michaelis, S., Görlich, Y., Wedekind, D. (2015). Efficacy of treatments for anxiety disorders: a meta-analysis. International Clinical Psychopharmacology. Jul 30 (4):183-92.

Cannon, W. B. (1915). Bodily changes in pain, hunger, fear, and rage. New York: Appleton-Century-Crofts.

Department of Health. (2009). Prevalence of mental health disorders in the Australian population.

Gleitman, H., Fridlund, A.J., & Reisberg, D. (2004). Psychology (6th ed.). W. W. Norton & Company. ISBN 978-0-393-97767-7.

Goldstein, D., & Kopin, I. (2007). Evolution of concepts of stress. Stress (Amsterdam, Netherlands). 10. 109-20. 10.1080/10253890701288935.

Jayakody, K., Gunadasa S. & Hosker, C. (2014) Exercise for anxiety disorders: systematic review, British Journal of Sports Medicine; 48:187-196.

Jongsma, A. E & Peterson, L.M. (2006). The Complete Adult Psychotherapy Treatment Planner. 4th ed., John Wiley & Sons

Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioural therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337–346.

Laufer, O., Isreali, D. & Paz, R. (2016). Behavioural and Neural Mechanisms of Overgeneralization in Anxiety. Current Biology

Lépine, J.P. (2002). The epidemiology of anxiety disorders: prevalence and societal costs. Journal of Clinical Psychiatry. 2002;63 Suppl 14:4-8.

Steimer, T. (2002). The biology of fear- and anxiety-related behaviours. Dialogues in clinical neuroscience, 4(3), 231–249.

World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: Licence: CC BY-NC-SA 3.0 IGO