Anxiety, panic and phobias

Anxiety is a feeling we all get in a situation that is threatening or difficult. The anxiety stops when you get used to the situation, when the situation changes, or if you just leave.

But if you feel anxious all the time, or for no obvious reason, it can make life difficult.

This information deals with three particular kinds of anxiety:

  • general anxiety disorder
  • panic attacks
  • phobias

What is anxiety?

Anxiety feels like fear. When it’s there a lot of the time, caused by a problem in our life that can’t be solved, like money difficulties, we call it worry.

If it is a sudden reaction to a threat, like looking over a cliff or being confronted by an angry dog, we call it fear.

Although worry, fear and anxiety are unpleasant, they can all be helpful:

  • psychologically – they keep us alert and give us the ‘get up and go’ to deal with problems;
  • physically – they make our body ready for action – to run away from danger or to attack it – the ‘fight or flight’ response.

These feelings become a problem when they are too strong or when they carry on even when we don’t need them anymore. They can make you uncomfortable, stop you from doing the things you want to – and can generally make life difficult.

Isn’t anxiety just ‘stress’?

In English, ‘stress’ can mean two different things:

the things that make us anxious – “my work is stressful” our anxious reaction to them – “I feel really stressed out”.

This can make things confusing, so we don’t use this term much in this leaflet.

Isn’t anxiety/stress bad for you?

Some anxiety is good for you. It keeps you alert and can help you to perform well. But only some.

If it gets too intense, or goes on for too long, it can make you feel bad and interfere with your life. It can make you depressed and damage your physical health.

What does anxiety feel like?

In the mind

  • Feeling worried all the time
  • Feeling tired
  • Unable to concentrate
  • Feeling irritable
  • Sleeping badly
  • Feeling depressed

In the body

  • Fast or irregular heartbeats (palpitations)
  • Sweating
  • Face goes pale
  • Dry mouth
  • Muscle tension and pains
  • Trembling
  • Numbness or tingling in fingers, toes or lips
  • Breathing fast
  • Dizziness
  • Faintness
  • Indigestion
  • Passing water frequently
  • Nausea, stomach cramps
  • Diarrhoea

It’s easy to worry that these feelings are the signs of a serious physical illness – and this can make the symptoms even worse.

When anxiety and panic go on for a while, it’s easy to start to feel depressed

  • you start to feel down, lose your appetite and see the future as bleak and hopeless.

Anxiety seems to take three main forms, but they overlap and most people will probably experience more than one type.

Generalised anxiety disorder (GAD)

You have the symptoms of anxiety most of the time.

Panic attacks

You get unpredictable, sudden and intense attacks of anxiety – often in a situation that is likely to make you anxious. The feelings come on suddenly and reach a peak in 10 minutes or less. You may also feel:

  • that you are going to die
  • frightened or ‘going crazy’ or losing control
  • short of breath and that you are choking.

About a quarter of people who go to an emergency department with chest pain thinking that they may be having a heart attack are actually having a panic attack.

Although the symptoms are much the same as those for GAD, they are much more powerful and only last a short time.


You feel really frightened of something that is not actually dangerous and which most people do not find troublesome.

The nearer you get to the thing that makes you anxious, the more anxious you get … and so you tend to avoid it. Away from it you feel fine.

Common phobias include:

  • agoraphobia – a fear of going where there are other people – which can stop you from leaving the house;
  • social phobias – a fear of being with other people – which can make it hard to talk to other people.

Are these problems common?

About one in every ten people will have troublesome anxiety or phobias at some point in their lives. However, most people with these problems never ask for treatment.

How can I get help for anxiety?

Anxiety is very common and many of us overcome it or cope with it without professional help.

However, if it is severe or goes on for a long time, anxiety can affect your physical and stop you doing the things you want to do.

The good news is that there are ways to help yourself.

Helping yourself

Talk about it. This can help when the anxiety comes from recent knocks, like a partner leaving, a child becoming ill or losing a job. Who should you talk to? Try a friend or relative who you trust and respect, and who is a good listener. They may have had the same problem themselves, or know someone else who has.

Self-help groups. These are a good way of getting in touch with people who have similar problems. They can understand what you are going through. As well as having the chance to talk, you may be able to find out how other people have coped. Some of these groups are specifically about anxieties and phobias. Others may be for people who have been through similar experiences – women’s groups, bereaved parents’ groups, survivors of abuse.

Learning to relax. It sounds too obvious – surely everyone can relax? But if your anxiety just won’t go away, it can be really helpful to learn some special ways of relaxing, to be a bit more in control of your anxiety and tension. You can learn these through groups, with professionals, but there are several books and self-help materials you can use to teach yourself. It’s a good idea to practice relaxation regularly, not just at times of crisis.

Using a self-help book. This works well for many people. Most of the books use the principles of Cognitive Behavioural Therapy (CBT) – see below.

Family and friends

Someone with troublesome anxiety or may not talk about their feelings, even with family or close friends.

Even so, it is usually obvious that things are not right. The sufferer will tend to look pale and tense, and may easily be startled by normal sounds such as a door-bell ringing or a car’s horn.

They may be irritable and this can cause arguments with those around them, especially if they don’t understand why the person feels that they cannot do certain things.

Although friends and family can understand the distress of an anxious person, they can find them difficult to live with, especially if the fear seems unreasonable.

Other types of help

If you have an anxiety problem which just won’t go away, you may not ask for help because you worry that people might think that you are “mad”. They won’t. It’s a common problem and it’s much better to get help rather than suffer in silence.

Cognitive Behavioural Therapy (CBT)

This is a talking treatment which can help you to understand how some of your ‘habits of thinking’ can make anxiety worse – or even cause it – and come to terms with reasons for your anxieties that you may not have recognised yourself. The treatment can take place in groups or individually, and is usually weekly for several weeks or months.