Don’t panic!

Anxiety disorders affect approximately 10% of people in the UK. David Baldwin, Professor of Psychiatry at Southampton University, tells TLLhow to spot and treat the symptoms.

Anxiety is the feeling of fear we get when faced with threatening or difficult situations. Anxiety is normal and can help us avoid danger. It makes us more alert and gives us the energy to deal with problems. But if the anxiety is too strong or is there all the time, it can cause problems.

Is anxiety different from depression?

Anxiety and depression have quite different symptoms; if you’re depressed you’ll suffer from low mood, reduced energy and lose interest in things, but if you’re anxious you’re agitated, have increased energy and can maintain interests.

People with depression are self-critical and regret past behaviour, but anxious people worry about the future. Yet anxiety may stop you doing things, leaving you feeling isolated and depressed. Anxiety becomes a problem if it’s interfering with your daily life.

Panic attacks

A panic attack is a sudden surge of intense anxiety that can come from nowhere. Whilst feeling panic and anxiety is normal in stressful or dangerous situations, panic attack sufferers can have these feelings at any time, for no apparent reason.

Symptoms peak within 10 minutes and usually subside after half an hour. They are not dangerous but can feel very frightening.

How common are panic attacks?

One in 10 people will have a panic attack during their lifetime, one in 20 will have recurrent attacks and one in 50 will suffer from panic disorder (regular, unexpected panic attacks). Symptoms usually begin before the age of 20.

Physical symptoms

Symptoms, experienced by the body producing the ‘fight or flight’ hormone adrenaline, include:

• Heart palpitations
• Shaking
• Sweating
• Breathlessness
• Rapid breathing
• Tingling in the fingers and around the mouth
• Dry mouth.

Is it a heart attack?

About a quarter of people who go to an emergency department with chest pain, thinking it’s a heart attack, are actually having a panic attack. Symptoms are easily distinguishable; heart attacks are characterised by crushing central chest pain – usually on the left and also in the arm – but in a panic attack there is no pain. Heart attack symptoms will worsen, but a panic attack will usually subside after 30 minutes.

Psychological symptoms

People experiencing a panic attack will feel intensely worried, agitated and fearful, often feeling like they are going to die or frightened they’re ‘going crazy’ or losing control.

What causes anxiety and panic attacks?

No one knows for sure; there are certain triggers, including:

• Your genes– some inherit a tendency to worry
• Stressful events– divorce, money worries, bereavement or exams are obvious (usually short-term) anxiety triggers. Other traumatic events such as car crashes, assaults and fires can cause anxiety and nervousness for months or years (post-traumatic stress disorder)
• Drugs– caffeine highs, and illegal highs from amphetamines, LSD or ecstasy, can make you anxious.

Treatments

If you’ve only ever had one panic attack, your doctor is unlikely to prescribe treatment, as 50% of patients never experience another, but recurrent problems may need drugs, psychological therapy or both.

Psychological therapies

• Cognitive behavioural therapy (CBT)– focuses on current, rather than past problems and can alleviate feelings of anxiety and panic to help change how you think and act
• Exposure therapy– if panic attacks/anxiety are triggered by a specific fear, such as enclosed spaces, CBT techniques can help expose yourself to your particular trigger for a short period.

Drugs

• Anti-depressants– selective Serotonin Reuptake Inhibitors are frequently prescribed for people with anxiety who suffer from panic attacks. Treatment is effective in around 65% of patients, even though you may not be depressed
• Beta blockers– these can be prescribed in low doses to control shaking, etc.

A combination of psychological therapies and anti-depressants can work in 85% of patients.

Self-help

• Talk your fears through– tell someone you trust
• Join a support group– Anxiety UK runs a helpline (08444 775 774) and online support.

For more information on anxiety, visit www.axappphealthcare.co.uk