Overview
Anxiety disorders are characterised by persistent, excessive worry or fear that is disproportionate to the actual situation and interferes with everyday life. They are the most common group of mental health conditions. Anxiety is different from normal stress in that it does not go away once the threat has passed.
How common is it?
About 1 in 4 people will experience an anxiety disorder at some point. Generalised anxiety disorder (GAD) affects around 1 in 20 adults in the UK at any one time.
Causes and risk factors
Anxiety results from a combination of brain chemistry, genetics, life experiences, and personality. The brain's threat detection system becomes overactive, generating fear responses even when there is no real danger.
Common risk factors
- Family history of anxiety or other mental health conditions
- Childhood trauma or adverse experiences
- Prolonged stress at work or home
- Chronic physical illness
- Substance use including caffeine, alcohol, and cannabis
- Personality traits such as perfectionism or low self-esteem
Symptoms
- Persistent worry that is hard to control
- Feeling restless, wound up, or on edge
- Irritability
- Muscle tension
- Difficulty concentrating
- Sleep problems: difficulty falling or staying asleep
- Physical symptoms including rapid heartbeat, sweating, or stomach upsets
When to see a doctor
See a doctor if anxiety is affecting your ability to work, socialise, or care for yourself, or if you are using alcohol or other substances to cope. Seek urgent help if you have thoughts of harming yourself.
Diagnosis
Doctors assess symptoms using standardised questionnaires (such as GAD-7) and clinical interview. Physical causes such as thyroid overactivity are ruled out with blood tests.
Treatments
Cognitive behavioural therapy (CBT)
The most evidence-based psychological treatment. CBT challenges unhelpful thought patterns and teaches gradual exposure to feared situations to break the anxiety cycle.
Selective serotonin reuptake inhibitors (SSRIs)
First-line medications for anxiety disorders. They adjust brain chemistry and reduce the intensity of anxiety over weeks. Usually taken long-term.
Mindfulness-based therapy
Teaches skills to observe anxious thoughts without reacting to them, reducing their power over behaviour and mood.
Self-care and lifestyle
- Limit caffeine and alcohol, both of which amplify anxiety symptoms
- Establish a regular sleep routine, as poor sleep worsens anxiety significantly
- Regular aerobic exercise (30 minutes most days) reduces baseline anxiety
- Practice slow diaphragmatic breathing during moments of acute worry
Prevention
Early psychological support after trauma or significant loss can prevent anxiety disorders developing. Building stress management skills before they are needed is more effective than treating established anxiety.