What is anxiety?

Anxiety is the feeling of fear that we get when faced with threatening or difficult situations. It is a normal response when faced with danger as it makes us more alert and gives us energy to deal with problems. But if the anxiety is too strong or is there all the time, then it can be a real problem. Anxiety disorders affect about 1 in 10 people.

What is panic?

Panic is a sudden surge of intense anxiety that can come out of nowhere.

What is a phobia?

A phobia is a fear of a situation, or object. Whilst they are not dangerous, some people find troublesome. and the fear can interfere with their life.

What causes anxiety, panic and phobias?

  • Genes: Some of us seem to be born more anxious than others. This tendency might be inherited through our genes. 
  • Life experience: Bad experiences in the past, big changes in life in the present - pregnancy, changing job, becoming unemployed or moving house.
  • Drugs: Caffeine in coffee can make you feel anxious. Street drugs like amphetamines, LSD or ecstasy can all make you anxious.
  • Circumstances: Sometimes it is obvious what is making you anxious. When the problem disappears, so does the anxiety. However, some things are so threatening - like car crashes, train crashes or fires - that the anxiety can go on long after the event. You can feel nervous and anxious for months or years after the event, even if you were physically unharmed. This is called post-traumatic stress disorder.

What does it feel like to have anxiety, panic or a phobia?

Anxiety

  • Your Mind:
    • Worrying all the time
    • Tired
    • Being irritable
    • Sleeping badly
    • Struggling to concentrate.
  • Your Body:
    • Racing heartbeat
    • Sweating
    • Muscle tension and pains
    • Shaking
    • Heavy breathing
    • Dizziness
    • Faintness
    • Indigestion and diarrhoea.

Panic

Panic is a sudden, overwhelming sense of fear and a feeling that you are losing control. You breathe quickly, feel your heart racing, sweat, and may feel that you are going to die. You may try to escape from the situation as quickly as you can.

Phobia

When certain situations frighten you, you can get strong feelings of anxiety and this is a phobia. So if you have a phobia of dogs, you feel anxious when there are dogs around, but feel OK at other times. You may tend to avoid the situations that make you anxious, which can make the phobia worse as time goes on. Your life can become dominated by your fear and the precautions you take to avoid such situations. You will usually realise that there is no real danger and may even feel silly about your phobia, but you can't control it.

... and you may also feel depressed

Anxiety and panic can often lead to depression, when you feel down, lose your appetite and see the future as bleak and hopeless.

What help is available?

  • Psychotherapy

There is a more intensive talking treatment which can help you to understand and control your anxiety. The treatment can take place in groups or individually. Most groups are based on cognitive behavioural therapy and Mindfulness techniques.

  • Medication

Tranquillizers: These include the benzodiazepines, like diazepam and most sleeping tablets. They are very effective, but can be addictive, even after just a couple of weeks. Ideally, they should not be taken for longer than 2 weeks.

Antidepressants: They usually take two to four weeks to make a difference. They can cause nausea, drowsiness, dizziness, dry mouth and constipation.

Beta blockers: can be used in low doses to control the physical shaking of anxiety.

How to help yourself

There are ways you can learn to relax. You may be taught this by a professional, in a self-help group or using books, CDs and DVDs (see our main leaflet). Regular practice will help you to relax more easily and more quickly.

Self-help groups. Talking to people with similar problems can be good because they understand what you are going through and you can share ways to cope. 

How other people can help you

Talking it through. It can help to talk to family or friends about your feelings of anxiety or phobia, even if it is difficult. Ask a friend or relative whom you trust and you respect, and who is a good listener. They have had the same problem, or know someone else who has.

For more in-depth information see our main leaflet: Anxiety, panic and phobias

This leaflet reflects the most up-to-date evidence at the time of writing.

Produced by the RCPsych Public Education Editorial Board.

Series Editor: Dr Philip Timms

Reviewed by Dr Sophie Swinhoe

© February 2014. Due for review: February 2016. Royal College of Psychiatrists.