How to manage anxiety and fear

This content mentions anxiety and panic attacks, which some people may find triggering.

Anxiety is a word we use for fears about the threat of something going wrong in the future, rather than right now.

Anxiety can last for a short time and then pass when whatever was causing you worry is over, but it can also last much longer and disrupt your life. Ongoing anxiety can affect your ability to eat, sleep, or concentrate. It can prevent you from enjoying life, travelling, or even leaving the house to go to work or school.

When anxiety holds you back from doing the things you want or need to do, it can also affect your health. Some people become overwhelmed by fear and want to avoid situations that might make them frightened or anxious. It can be hard to break this cycle, but there are lots of ways to do it. You can learn to feel less fearful and to cope with anxiety so that it doesn’t stop you from living.

What makes you afraid?

Lots of things make us feel afraid.

Being afraid of some things – like fires – can keep you safe. What you’re afraid of and how you act when you’re afraid of something can be different for every person. Knowing what makes you afraid and why can be the first step to overcoming anxiety.

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What makes you anxious?

Because anxiety is a type of fear, the things we’ve described about fear above are also true for anxiety.

The word ‘anxiety’ tends to be used to describe worry, or when fear persists over time, often without any one cause. Anxiety is when fear is about something in the future or something that might happen, rather than what is happening right now.

Anxiety is a word often used by health professionals when they’re describing persistent fear. The ways that you feel when you’re frightened and anxious are very similar, as the basic emotion is the same.

What does fear and anxiety feel like?

When you feel frightened or seriously anxious, your mind and body work very quickly.

These are some of the things that might happen:

1. Your heart beats very fast – maybe it feels irregular
2. You breathe very fast
3. Your muscles feel weak
4. You sweat a lot
5. Your stomach churns or your bowels feel loose
6. You find it hard to concentrate on anything else
7. You feel dizzy
8. You feel frozen to the spot
9. You can’t eat
10. You have hot and cold sweats
11. You get a dry mouth
12. You get very tense muscles

These things occur because your body, sensing fear, is preparing you for an emergency. It makes your blood flow to the muscles, increases blood sugar, and gives you the mental ability to focus on the thing that your body perceives as a threat.

With anxiety, in the longer term, you may have some of the above symptoms as well as a more nagging sense of fear. You may get irritable, have trouble sleeping, develop headaches, or have trouble getting on with work and planning for the future; you might have problems having sex, and might lose self-confidence.

Why do I feel like this when I’m not in any real danger?

Early humans needed the fast, powerful responses that fear causes, as they were often in situations of physical danger. However, we no longer face the same threats in modern-day living.

Despite this, our minds and bodies still work in the same way as our early ancestors, and we have the same reactions to our modern worries about paying the bills, work, and social situations. But we can’t run away from or physically attack these problems!

The physical feelings of fear can be scary in themselves – especially if you are experiencing them and you don’t know why, or if they seem out of proportion to the situation. Instead of alerting you to a danger and preparing you to respond to it, your fear or anxiety can kick in for any perceived threat, which could be imaginary or minor. This can cause you more problems than whatever triggered the reaction in the first place.

Why won’t my fear go away and leave me feeling normal again?

Fear may be a one-off feeling when you are faced with something unfamiliar. But it can also be an everyday, long-lasting problem – even if you can’t put your finger on why.

Some people feel a constant sense of anxiety all the time, without any particular trigger. There are plenty of triggers for fear in everyday life, and you can’t always work out exactly why you are frightened or how likely you are to be harmed. Even if you can know how out of proportion a fear is, the emotional part of your brain keeps sending danger signals to your body. Sometimes you need mental and physical ways of tackling fear and anxiety.

What is a panic attack?

A panic attack is when you feel overwhelmed by the physical and mental feelings of fear – the signs are listed under ‘What do fear and anxiety feel like?’.

People who have panic attacks say that they find it hard to breathe, and they may worry that they’re having a heart attack or are going to lose control of their body.

If you are experiencing symptoms like these, you should speak to a healthcare professional urgently to ensure there are no other underlying causes.

What is a phobia?

A phobia is an extreme fear of a particular animal, thing, place, or situation.

People with phobias have an overwhelming need to avoid any contact with the specific cause of the anxiety or fear. The thought of coming into contact with the cause of the phobia makes you anxious or panicky.

How do I know if I need help?

Fear and anxiety is something that we will all experience now and then. It is only when it is severe and long-lasting that it can become a mental health problem.

If you feel anxious all the time for several weeks, if it feels like your fears or phobias are taking over your life, or if you’re experiencing panic attacks, it’s a good idea to ask your doctor for help. Alternatively, try one of the websites or numbers listed at the bottom of this page.

How can I help myself?

Face your fear if you can

If you always avoid situations that scare you, it might stop you from doing things you want or need to do, making you miss out on life. This means you won’t be able to test whether the situation is as bad as you expect, so you also miss the chance to work out how to manage your fears and reduce your anxiety. Anxiety problems tend to increase if you get into this pattern.

Exposing yourself to your fears can be an effective way of overcoming this anxiety. You can try setting yourself small, achievable goals for facing your fears.

Know yourself

Try to learn more about your fear or anxiety. Keep an anxiety diary to note down how you’re feeling, what causes you to feel anxious, and what happens. When you understand how anxiety affects you, you’ll be better able to manage the feelings.

You could carry with you a list of things that help at times when you are likely to become frightened or anxious. This can be an effective way of addressing the underlying beliefs that are behind your anxiety.

Talk to a trusted friend or family member

It’s very common to feel silly or even ashamed of fears and anxieties. This can lead us to hide what’s going on from those we are close to. But there’s no need for us to feel this way and you don’t have to overcome your anxieties alone! If you have a friend or family member you feel confident will respond in a supportive way, it can often feel better to open up about what’s going on. The act of talking about something can help reduce your anxiety levels and encourage you to get more support if needed.

Exercise

Try to increase the amount of physical activity you do. Exercise requires some concentration, and this can take your mind off your fear and anxiety. Remember, activity doesn’t have to be vigorous; gentle stretches, seated exercises, or walking are all good for you.

Relax

Learning relaxation techniques can help you with the mental and physical feelings of fear. It can help just to drop your shoulders and breathe deeply. Or imagine yourself in a relaxing place.

You could also try complementary therapies or exercise such as massage, t’ai chi, yoga, mindfulness techniques, or meditation.

4-7-8 breathing technique

Close your mouth and quietly breath in through your nose, counting to four in your head. Hold your breath and count to seven. Breathe out through your mouth, making a whoosh sound while counting to eight. Repeat three more times for a total of four breath cycles.

Healthy eating

Eat lots of fruit and vegetables and try to avoid eating too much sugar as resulting dips in your blood sugar can give you anxious feelings. Try to avoid drinking too much tea and coffee, as caffeine can also increase anxiety levels.

Avoid alcohol, or drink in moderation

It’s very common for people to drink when they feel nervous. Some people call alcohol ‘Dutch courage’, but it’s not good for you and the after-effects of alcohol can make you feel even more afraid or anxious.

Faith/spirituality

If you are religious or spiritual, this can give you a way of feeling connected to something bigger than yourself. Faith can provide a way of coping with everyday stress, and attending places of worship and other faith groups can connect you with a valuable support network.

How can I get help?

Talking therapies

Talking therapies, like counselling or Cognitive Behavioural Therapy (CBT), are very effective for people with anxiety problems. This includes Computerised Cognitive Behavioural Therapy (CCBT), which takes you through a series of self-help exercises on screen. Contact your GP to find out more.

• In England, you can also refer yourself to NHS Talking Therapies.
• In Scotland, you can access the Living Life service.
• In Wales, you can access Silver Cloud.
• In Northern Ireland, see what is available in your Trust area.

Medication

Drug treatments are used to provide short-term help, rather than looking at the root of the anxiety problems. Drugs may be most useful when they are combined with other treatments or support.

Support groups

You can learn a lot about managing anxiety from asking other people who have experienced it. Local support groups or self-help groups bring together people with similar experiences so that they can hear each other’s stories, share tips, and encourage each other to try out new ways to manage feelings of anxiety. Your doctor, library, or local Citizens Advice bureau will have details of support groups near you.

Support and information

• Every Mind Matters
  You can access information and advice on the Every Mind Matters website.
• Anxiety UK
  Anxiety UK provides confidential help and support. Contact their helpline on 03444 775 774, text support on 07537 416 905 (Open Monday to Friday 9:30am to 5:30pm), or go to their website at www.anxietyuk.org.uk.
• Samaritans
  Samaritans provide emotional support, 24 hours a day. Visit their website, email [email protected] or telephone 116 123
• The British Association of Counselling and Psychotherapy
  Website: www.bacp.org.uk. Email: [email protected] . Telephone: 01455 883300
• Council for Psychotherapy
  Website: www.psychotherapy.org.uk. Email: [email protected] . Telephone: 020 7014 9955
• NHS 111
  NHS 111 provides information 24 hours a day. Telephone: 111

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