If you are suffering from anxiety, you will probably feel apprehensive and tense and be unable to concentrate, think clearly, or sleep well. You may have a sense of foreboding for no obvious reason or have repetitive worrying thoughts. Some people also have physical symptoms such as headaches, excessive sweating, chest pains, palpitations, abdominal cramps, and a general feeling of tiredness. Anxiety is a natural reaction to stress, and it is normal to feel anxious if, for example, you are worried about money or family matters or if you have exams coming up. Such anxiety may help you to deal with stressful events and can help to improve your performance in certain situations. However, anxiety is not normal if it comes on without an apparent cause or if it is so severe that you can no longer cope with everyday life.
Possible cause If you have become addicted to any of these substances, trying to give them up may lead to feelings of anxiety developing. Consult your doctor.
Action Your doctor will give you advice on the best way to deal with your addiction and will monitor your progress. Some people may benefit from psychological therapies or from contacting a self-help organization. Such organizations should be able to put you in touch with people who can help, including others going through the same process.
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Possible cause Many recreational drugs can cause psychological disturbances, both during use and after withdrawal.
Action If you still take recreational drugs, it is important that you stop now. If you have trouble stopping, consult your doctor, who may be able to help or may put you in contact with a counsellor or a self-help organization. Such organizations should be able to put you in touch with people who can help, including others going through the same process.
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Possible cause Stress as a result of this event is probably the reason for your feelings of anxiety (seeRecognizing stress).
Action Try to keep stress to a minimum, and discuss any problems with close family or friends. To help you relax, devote some time each day to leisure activities that you enjoy. Regular exercise may help, as may relaxation exercises. Consult your doctor if you feel that these measures are not working or if your anxiety seems to be becoming worse.
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Possible cause Hyperthyroidism (overactive thyroid gland) is a possibility. Without medical testing, anxiety caused by hyperthyroidism can be difficult to distinguish from anxiety due to other causes. Consult your doctor.
Action Your doctor will take a blood sample to measure your levels of thyroid hormones. If the diagnosis is confirmed, you will probably be treated with thyroid drugs or radioactive iodine, which are usually rapidly effective. In some cases, surgery to remove part of the thyroid gland may be needed.
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Possible causes Anxiety about sex is common, particularly during early adult life. A specific difficulty affecting you or your partner, such as premature ejaculation or a fear of pregnancy or contracting a sexually transmitted disease, can be a source of anxiety. Worries about sexual orientation may also cause anxiety. In later life, anxiety may be related to decreasing sexual activity or worries about attractiveness (seeSex in later life).
Action If you have a regular partner, you should discuss your feelings with him or her. Talking about sex openly (seeCommunicating your sexual needs) is often the best way to deal with anxiety. If you are unable to communicate satisfactorily or if you do not have a regular partner with whom you can talk, consult your doctor. He or she may be able to advise you or may suggest that you receive counselling (seeSex counselling).
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Possible cause In some situations, a degree of anxiety is natural, and the problem usually improves with experience. If your anxiety is so severe that you avoid certain types of social interaction, consult your doctor.
Action Your doctor may be able to teach you coping strategies for dealing with social situations, or he or she may refer you to a counsellor for help. If your anxiety is severe, drug treatment with beta blockers or some types of antidepressant may be helpful.
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Possible causes Your anxiety may be caused by a phobia, which is an irrational fear of a specific object or situation - for example, you may be afraid of spiders. Otherwise, you may have obsessive-compulsive disorder, in which you feel an irresistible need to behave in a certain fashion, even though you may know that it is not necessary - for example, you may feel the need to repeatedly wash your hands and become excessively anxious if you are unable to do so. Consult your doctor.
Action Your doctor will ask you about your feelings. He or she may advise psychological therapies or drug treatment for your anxiety. Most people can learn to manage their fears and anxiety so that they do not affect their lives on a day-to day basis.
19See your doctor within 24 hours
Possible cause You may be having panic attacks, in which feelings of intense anxiety are coupled with alarming physical symptoms. Panic attacks are unpredictable and usually have no obvious cause.
Action It is important to see your doctor as soon as possible so that he or she can confirm the diagnosis and rule out a physical cause for your symptoms. If you are having panic attacks, you will need treatment with psychological therapies. Follow self-help measures for coping with panic attacks.
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Consult your doctor if you are unable to find a cause for your anxiety from this chart and/or unexplained anxiety persists for more than a few days.
Recognizing stress
Stress is a normal part of life for many people and has a beneficial effect under certain circumstances, readying the body for action. The normal stress response causes the release of epinephrine (adrenaline), which increases heart rate and maximizes blood flow to the muscles in preparation for action. These responses are beneficial if stress is released. However, prolonged or excessive stress can result in a range of symptoms, including chest pain, stomach upsets, headaches, tiredness, insomnia, and anxiety. Having a series of infections, such as colds, or getting recurrent mouth ulcers is often a sign of stress as stress tends to depress the immune system. Stress can also result in flare-ups of existing disorders such as eczema. In the long term, stress may seriously damage health; it can, for example, contribute to high blood pressure, which increases the risk of heart attack. It is therefore important that you learn to recognize signs of stress and take action to deal with it.
Self-Help Coping with a panic attack
Rebreathing from a bag Hold a paper bag tightly over the mouth, and breathe in and out slowly.
Rapid breathing during a panic attack reduces carbon dioxide levels in the blood and may lead to frightening physical symptoms, such as palpitations and muscle spasms. You can control the symptoms by breathing into and out of a paper bag. When you do this, you rebreathe carbon dioxide, restoring your blood levels. Place the bag over your mouth, and breathe in and out 10 times. Then, remove the bag and breathe normally for 15 seconds. Repeat this process until your breathing rate is back to normal.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
