Anxiety is something just about everyone experiences to some extent. It’s how you feel when you’re worried about something, or if you feel uneasy or fearful. It’s also perfectly natural to feel anxious about some things in life – taking exams, for instance, doing your driving test, going for a job interview or speaking/performing in public.
However, it’s not normal to feel anxious most or all of the time. According to the Mental Health Foundation, more than eight million people in the UK experience anxiety, with women in England almost twice as likely to be diagnosed with anxiety disorders as men (i). The problem with always feeling anxious is it can affect your day-to-day life, and can make you feel depressed and unable to concentrate, feel self-confident or get a good night’s sleep.
Fight or flight
From an evolutionary point of view, anxiety is related to something called the fight or flight response. This is a natural reaction we experience when we feel under threat that, many years ago, helped us to survive. When faced with a life-threatening situation, our ancestors’ bodies released stress hormones including adrenalin and cortisol. This release of hormones helped them to feel more alert and react faster to threats, making their hearts beat faster so they could better face the danger or run away from it. In other words, the fight or flight response was actually useful.
The problem, however, is that while few of us these days face the same level of life-threatening situations our ancestors experienced, we still have the same biological reaction when we feel afraid or anxious.
What causes anxiety?
If you have feelings of anxiety most or all of the time, and feel anxious about lots of different things rather than one thing in particular, you may have a condition called generalised anxiety disorder (GAD). There may be several reasons why you feel persistently anxious. For instance, some researchers believe it has something to do with an imbalance of serotonin and noradrenaline – brain chemicals that help to control your moods – or that some areas of the brain linked with emotions and behaviour become overactive.
You may also have long-term anxiety if one of your parents also suffered with anxiety issues (according to the NHS, people with a close relative with GAD are five times more likely to develop the condition (ii)). Things that happen to you may increase your risk of developing anxiety too, such as having stressful or traumatic experiences, having a medical condition that causes chronic pain or having a history of drug or alcohol abuse. Your age can have something to do with it too, with GAD more common in adults aged between 35 and 59 (ii).
How to tell if you have anxiety
Anxiety causes physical sensations such as shakiness, dizziness, feeling breathless or breathing too quickly, sweating, rapid heart rate, churning stomach, tense muscles, dry mouth and an inability to concentrate. It can make you feel nervous, stressed and panicky, as if you’re constantly on edge.
But how can you tell if you’re experiencing anxiety more often than is considered normal or natural? Think about how often you experience the following:
You worry all the time that something bad will happen
You always fear the worst will happen
You feel as if everything’s going too fast or too slow
You get obsessed with negative experiences, churning them over in your mind
You’re constantly on the lookout for things that could go wrong
You find it impossible to relax most of the time
You get flustered easily and snap at people
You suspect everyone is looking at you and knows you’re anxious
If more than one or two of the above apply to you on a regular basis, you may be experiencing long-term anxiety. This is often seen as a mental health issue, but it can cause physical symptoms too, including depression, problems sleeping, a change in your sex drive and problems with your immune system, making you more likely to be affected by a range of illnesses. Tiredness and fatigue can also be a side-effect of anxiety, but there are measures you can take to prevent them.
Long-term anxiety may also make you more likely to turn to crutches such as smoking, drinking or using drugs to help you cope with your feelings. All of these things may make it more difficult for you to keep your job, maintain relationships and have much enjoyment in your life.
If you have been diagnosed with generalised anxiety disorder (GAD), there are a few treatments your GP may offer you, including talking treatments, medicines and self-help courses. Depending on how severe your symptoms are, the first step is usually to suggest working through a self-help course in a book or on a computer. You can do this on your own and at your own pace. If you want to see the kind of resources that are often recommended, there are books, CDs and DVDs you can buy from No Panic, a charity set up to help people with anxiety disorders.
Your GP may also prescribe exercise as a way of treating a mental health problem such as anxiety, which means you may be enrolled on an exercise programme at your local gym or with a qualified trainer.
Usually, if you have tried self-help measures and haven’t had much success, your GP may recommend a talking therapy such as CBT, where you may be referred for regular CBT sessions with a trained therapist. These weekly sessions will aim to help you change the way you see your worries and anxieties, and may last for three or four months. Some people with GAD are advised to try applied relaxation, which involves learning how to relax your muscles in situations when you tend to feel anxious. Again, sessions are usually weekly and last for three to four months.
According to the NHS you don’t need a referral from your GP for therapies such as CBT and applied relaxation (though your GP can refer you if you prefer). You can refer yourself directly to a psychological therapies service – to find one in your area, visit the NHS website.
Usually, medication is only used if self-help and talking therapies haven’t helped. The main medicines your GP may prescribe include types of antidepressants called selective serotonin reuptake inhibitors (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SNRIs). Both are designed to boost the levels of brain chemicals that help to regulate your mood and behaviour. However, if you decide to take them you should be aware of the possible side effects they can cause, including nausea, dizziness and insomnia. Other medications used for GAD include an anticonvulsant drug that’s also used to treat epilepsy and strong sedatives – though the latter are only suitable for use in the short term because they can be addictive if used for more than four weeks (iii).
Ways to reduce anxiety
Thankfully there are several things you can do to help yourself manage the symptoms of anxiety, whether you experience it frequently or just every now and then:
Eat as healthily as possible
Sticking to a healthy diet with at least five portions of fruit and vegetables each day can help support your general health. Some foods may also be worth avoiding, as they may increase feelings of anxiety. These include sugar – which, after creating an initial ‘high’ by boosting your blood sugar levels can dip too low, making you feel irritable and shaky. Too much caffeine can also increase your anxiety levels (iv), so try to choose caffeine-free or decaffeinated drinks instead of having too much tea or coffee.
Cut down on stimulants
As well as reducing the amount of caffeine in your diet, it’s also a good idea to give up if you’re a smoker and to cut back on your alcohol intake if you drink more than the recommended amount (the government suggests no more than 14 units of alcohol a week for both men and women – find out more about alcohol units by visiting the Drinkaware website).
Exercise can help to boost your brain’s production of ‘feel-good’ chemicals, which can improve your mood and general wellbeing as well as reduce stress and tension. Aim to do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking, cycling, swimming, dancing, jogging and sports like tennis and football. Most people find five 30-minute sessions of exercise a week is the best way to break up the 150 minutes, though you could break it up into more, smaller sessions if it suits your lifestyle.
Talk it through
It may not be easy to talk about your feelings if you’re experiencing anxiety, but opening up to someone you trust – such as a friend, relative or co-worker – can help you cope with your problems. If you prefer to talk to someone you don’t know, you can chat online, by phone or by text to a trained volunteer at Anxiety UK or join the Elefriends online community.
Learn to relax
Making time to do something that will help you unwind could reduce your anxiety levels, especially when you feel you’re too busy to take any time out. It could be something simple like having a relaxing bath or reading a good book, or you could indulge your creative side and get involved in a hobby, or just get out and visit someone who makes you feel at ease. A few minutes of deep breathing could help to make you feel better when you’re anxious: try breathing in for a count of three, holding for a count of two, breathing out for a count of three and holding again for a count of two (repeat until you feel more calm.)
Share and support
Spending time with others who are having the same feelings and experiences as yourself can help, especially if your anxiety is making you feel isolated. The mental health charity Mind offers support groups in many areas – call 0300 123 3393 to find out if there’s a group near where you live. Rethink Mental Illness also has registered support groups across England.
Natural anxiety remedies
Whether you have long-term or occasional anxiety symptoms, there is a range of natural nutritional and herbal supplements that may help, including the following:
Magnesium may be useful for general muscle health as well as muscle and nerve function, but some experts believe your levels may be depleted if you’re feeling stressed (v). If stress is keeping you from getting a good night’s sleep, there is some evidence to suggest magnesium could help (vi). One study also claims anxiety and stress symptoms may be reduced by taking a multivitamin and mineral supplement containing magnesium, calcium and zinc (vii), while a review of 18 studies concludes that magnesium may have a beneficial effect on subjective anxiety in people vulnerable to anxiety (viii). .
This herb, rhodiola has been used traditionally throughout Europe and is a popular remedy for stress. One study claims a rhodiola supplement performed significantly better than a placebo (dummy pill) in reducing anxiety and stress and boosting overall mood after just 14 days (ix). It may also be useful for anxiety by improving mental alertness, especially if you’ve been having problems sleeping (x).
There is some evidence that taking this herbal remedy may help to keep you calm whenever you face stressful situations (xi), though valerian is more than often recommended for sleep problems, with studies suggesting it could help you fall asleep faster as well as tackling insomnia (xii). The US-based National Institutes of Health also states that valerian has sedative properties (xiii).
This amino acid is often used as a natural remedy for depression and low mood, with studies suggesting it may be as effective as antidepressants (xiv). It may also help if you’re finding it difficult to sleep properly (xv). 5-HTP has been studied to find out if it could help people with anxiety disorders, with the results suggesting it may well be effective (though not as effective as an antidepressant called clomipramine) (xvi).
St John’s Wort
This traditional herbal remedy may also help if your anxiety is causing mild to moderate depression, as there’s evidence it could be as effective as conventional antidepressants (xvii). However, this remedy may interact with some other medicines, so consult your GP before taking it if you’re on any kind of medication.
Tea made from the herb lemon balm is often used to help aid relaxation. A couple of small-scale studies have also found it may help to reduce anxiety levels (xviii), and there’s evidence that combining lemon balm with valerian could help if your anxiety is contributing to increased stress levels (xix). Adding lemon balm extract to food has also been found to improve mood (xx).
Some of the B vitamins are needed for healthy nerve function, while vitamin B6 is needed for the body’s production of neurotransmitters. These brain chemicals include serotonin and norpepinephrine, both of which are needed to regulate mood (an imbalance of serotonin is thought to play a part in the cause of anxiety). One study suggests people with lower blood levels of vitamin B12 may be more likely to experience depression or anxiety (xxi), while another has found those who eat foods high in B vitamins have better anxiety and stress scores than those who don’t (xxii).
Siberian ginseng (Elutherococcus senticosus) is described as an adaptogen – a substance that helps the body adapt to different kinds of stress. It may help to manage the effects of the ‘fight or flight’ response linked to anxiety because it may help to support the adrenal glands (the adrenals produce cortisol, the stress hormone). It may also be useful as general support for the immune system. One study – which examines the effect ginseng may have on stress-related diseases, suggests it provides a potential way of adapting to the stress of everyday life (xxiii).
It may be a good idea to take fish oil supplements if you have anxiety symptoms, especially if you don’t eat oily fish very often. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – the omega-3 fatty acids found in fish oil – are widely believed to support brain health, with a review of 19 clinical trials suggesting omega-3 fatty acids may have a positive effect on anxiety (xxiv). There’s also evidence to suggest fish oil supplements may help to relieve short-term anxiety, such as when taking exams (xxv).
If you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish.
A vitamin-like substance (also sometimes called a pseudovitamin) found in many natural sources, myo-inositol – often called simply inositol – is a carbohydrate with a molecular structure similar to that of glucose. It’s found in high concentrations in the brain and is often used to relieve the symptoms of anxiety. In fact there is evidence to suggest myo-inositol works similarly for anxiety and low mood medications, as it increases the function of a receptor in the brain called GABA-A and enhances the sensitivity of serotonin receptors (xxvi). A review of double-blind, randomised, placebo-controlled trials has also found that inositol may be beneficial for people with depression, particularly women who are experiencing premenstrual dysphoric disorder (PMDD) (xxvii).
If you experience anxiety, whether occasionally or more frequently, it can have a significant impact on your quality of life. However these simple steps may be helpful. To find out more information on a range of other health conditions, visit our dedicated health library.
Available online: https://www.nhs.uk/conditions/generalised-anxiety-disorder
Available online: https://www.nhs.uk/conditions/generalised-anxiety-disorder/treatment
Available online: https://www.nhs.uk/conditions/generalised-anxiety-disorder/self-help/
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.