Anxiety

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Anxiety is a feeling of unease, worry or fear which, when persistent and impacting on daily life may be a sign of an anxiety disorder. Generalised Anxiety Disorder, which is one common type of anxiety disorder, is estimated to impact 5.9% of adults in England1.

Symptoms

Symptoms of anxiety include changes in thoughts and behaviour such as2:

  • Restlessnes
  • A feeling of dread
  • A feeling of being “on-edge”
  • Difficulty concentrating
  • Difficulty sleeping
  • Irritability

It can also involve physical feelings such as dizziness, nausea, heart palpitations (a noticeably strong, fast heartbeat), sweating, shortness of breath, headache, or dry mouth.

Occasionally feeling anxious, particularly about events or situations that are challenging or threatening, is a normal and extremely common response. However, if feelings of anxiety regularly cause significant distress or they start to impact on your ability to carry out your daily life, for example withdrawing or avoiding contact with friends and family, feeling unable to go to work, or avoiding places and situations then it may be a sign of an anxiety disorder2.

Types of Anxiety Disorder

There are different types of anxiety disorder, each of which will have slightly different symptoms and treatment. Some examples of anxiety disorders include2-5:

  • Generalised Anxiety Disorder
  • Panic Disorder (regular sudden attacks of panic or fear)
  • Post-traumatic stress disorder (PTSD)
  • Social Anxiety Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Specific Phobias (overwhelming and incapacitating fear of a specific object, place, situation or feeling)

Causes

There are many different factors that may contribute to the development of mental health problems like anxiety disorders. These factors include biological factors (for example genetics6, experience of chronic physical illness or injury7 and psychological or social factors (experiences of trauma or adversity in childhood8, struggles with income or poverty1, employment status1, family and personal relationships, and living or work environment1.

Getting Support

There are a range of approaches for treatment and management of anxiety disorders, and the most appropriate method will vary depending on the type and severity of anxiety disorder, and personal circumstances.

Some common approaches to managing and treating anxiety disorders include:

Psychological Therapies:

This can involve working through thoughts, feelings and behaviours with a clinical psychologist or other mental health professional in regular sessions over a set period of time.

Cognitive Behavioural Therapy (CBT) which helps to teach strategies for recognising and overcoming distressing or anxious thoughts, is one of the most common therapies for treatment and management of anxiety disorders2,3,5.

Self-Help and Self-Management:

This involves specially-designed resources (like information sheets, workbooks, exercises, or online programmes and courses) to support people to manage their feelings of anxiety in their own time.

Some of these approaches may involve the support of a therapist or other mental health professional, and some may be entirely self-led2-5.

Group Support:

Group sessions with other individuals experiencing similar problems where people can work through ways of managing anxiety. Some groups may involve the support of a therapist or other mental health professional2.

Medication:

Your GP or other healthcare provider can discuss different medication options to manage both the physical and psychological symptoms of anxiety. There is a range of medication that can be used to manage anxiety and it is important to discuss with your GP which one would be most appropriate for your circumstances2.

For more information about medication for anxiety disorders, visit the NHS Choices website.

Other Approaches

There may be other treatments or approaches available that are not outlined here. If you are considering support for anxiety disorders, we recommend getting in touch with your GP or primary care provider to discuss which approach may be best for you.

LAXATIVE ABUSE

Laxative Abuse

Laxatives are available in several forms, functioning in a manner depending on the needs of each user. For example, bulk-forming laxatives work like fiber, and increase “the bulk of the stool.” Osmotic laxatives increase water that go out of the bowels to soften the stool; stimulant laxatives increase the speed of movement in the bowels. Some of these are available in powder form and can be mixed into liquids.

Lastly, stool softeners reduce the texture of stools by decreasing the surface tension. Some forms of laxatives can take a day or 2 to work; therefore, if someone is seeking instant relief, they may have to try another form, or some may double their dosage. Though laxative abuse is relatively small in past years, it can become a problem, with short and long-term side effects.

Laxative Side Effects

Despite its intended use, people have used laxatives to achieve their ideal body weight. Since laxatives encourage regular bowel movements, they can decrease bloating and assist in weight loss. Side effects are mild, but uncomfortable, including:

  • Flatulence
  • Bloating
  • Dehydration
  • Feeling sick
  • Dark urine

Taking laxatives according to the recommended doses is usually harmless. However, when taken over time, laxatives have potential for abuse as well as harmful side effects.

Laxative Myths

Laxative abuse occurs when someone wants to use laxatives to lose weight. Studies revealed laxatives do not assist in weight loss. Laxatives do help with shedding water weight, hence their popularity in weight detox regimens.

No studies have confirmed the connection between laxative use and weight loss. However, other studies confirm weight loss that does occur is temporary. Water weight, or bloating differs from losing fat in the body. Because of how laxatives work by “keeping water in the gut around the stool,” the loss of water weight causes a temporary reduction of the appearance of belly fat or bloating.

A study noted “56.3% of people with eating disorders used laxatives.”

Laxative Abuse And Eating Disorders

Laxative misuse is often associated with people who suffer from the eating disorders anorexia nervosa or bulimia nervosa. Additionally, it is most commonly associated with teenagers and some obese populations. Sadly, statistics concerning laxative use were revealing of the myths surrounding their use.

A study noted “56.3% of people with eating disorders used laxatives.” Additionally, “71.6% of people suffering with purging anorexia abused laxatives.” Furthermore, these findings reveal laxative use is not just for vanity, but can be addictive to support feelings of shame, depression, body dysmorphia, the need to fix in, or anxiety.

These statistics noted women between 14 to 19 endured eating disorders. Often times, there is a connection between traumas like Post-Traumatic Stress Disorder and eating disorders like bulimia; hence the laxative dependence. While the laxative itself may not be as addictive as other substances, the desire to feel empty via abusing a chemical can be a motivating factor.

Effects of Laxative Abuse

When someone uses laxatives on a continued basis, he or she reduces vital minerals in the body like magnesium, sodium, potassium, and phosphates, which allow muscles to work correctly. As a result, our most important organs may not function in the best form for our bodies. Long-term laxative use can wreak havoc on the bowels, the digestion, and cause dehydration.

Since laxative use is intended to reduce bloating and lose weight, many of the effects of laxative abuse will be physical, although they will vary. Some of the signs of laxative abuse include but are not limited to:

  • Vomiting
  • Blurred vision
  • Fainting
  • Dehydration
  • Skin rashes
  • Depression
  • Gas
  • Bloating
  • Heart attack
  • Muscle spasms
  • Urinary Tract Infections (UTI)
  • Diarrhea
  • Intestinal paralysis
  • Increased risk of colon cancer

Not only do these symptoms cause physical injury and physical dysfunction, the added pressure to be thin, and concerned family members can complicate matters even more. Lastly, if someone is not feeling physically well, he or she won’t be their healthiest self, and may withdraw from feelings of depression. Once depression occurs, he or she may self-medicate in unhealthy ways.

Long-Term Effects of Laxative Abuse

In addition to health problems, depression, a lack of self-confidence and digestion problems, there are more long-term health risks associated with laxative abuse. Many of these are irreversible and severely damaging. Some of these include:

  • Kidney failure
  • Gastrointestinal damage
  • Liver damage
  • Bowel nerve damage

Bowel nerve damage can cause the intestinal tract to function poorly, hence someone continually using laxatives to assist in bowel movements.

Get Help Today

Stopping a laxative use disorder can be difficult to do at home or alone. If you are struggling to stop abusing laxatives, and have experienced a traumatic experience, you may need a hands-on approach to treatment. Contact a treatment provider and discover how having support and one-on-one counseling can target deep-seated trauma. Lastly, nutritional plans are available to help restore a healthy weight for patients. Don’t delay; you owe it to yourself to find the best treatment available.

Book Review: What Happened to Make You Anxious? — Mental Health @ Home

What Happened to Make You Anxious? by Jaime Castillo aims to help readers uncover and process the unresolved past little-t traumas that are fuelling their anxiety. It incorporates concepts from several therapeutic approaches, including internal family systems therapy (IFS) and the adaptive information processing model, which is the theoretical basis for eye movement desensitization and […]

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The Anxious Perfectionist by Clarissa W. Ong and Michael P. Twohig uses an acceptance and commitment therapy (ACT) approach to help readers who struggle with perfectionism. I’m a big fan of ACT, and I think it makes a great approach for perfectionism. The book begins by exploring what perfectionism is, including the differences between adaptive […]

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Depression, Anxiety & Me

Around the year 2000 I started suffering Depression, Anxiety and what I remember most about it was I had no get up and go about me. (I just couldn’t be bothered). As far as the anxiety was concerned I would get up tight about things to a point where I realised I was holding my breath. ( Not a clever idea is it?)

There are two things that stick in my mind even all these years later about my depression and anxiety,

Around this time our daughter was 8/9yrs old and we decided to hire a static caravan in Northumberland here in the UK along with my parents. As my wife wasn’t sure of the way there my father said he knew how to get where we were going.

It was on the road home an anxiety issue arose because despite being told to follow my father, my wife overtook my father and I and up ahead their was a fork in the road. She should have taken the fork to the right when she took the fork to left. This meant my father and I waiting at that junction anxiously till they reappeared.

Having Depression and anxiety quite often meant I couldn’t go further than my front door. I am a uniformed Salvationist of the Salvation Army and I can even remember every Sunday for weeks on end putting my uniform on (except jacket) until it came time to go and I would come to put jacket on and I couldn’t. Nerves and anxiety got the better of me and I used to ask my wife to call the Church to say I wouldn’t be there.

The main factor that played a part in my recovery was every week my father came to see me and we didn’t just talk about my depression we had general conversations as well. I also used to get regular visits from my then pastor who used to suffer from Clinical Depression, again the discussion I had with him again were general.

There’s a saying on one of the UK’s tv channel’s says “It’s good to talk”.

What Causes Anxiety

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Anxiety may be caused by a mental condition, a physical condition, the effects of drugs, or a combination of these. The doctor’s initial task is to see if your anxiety is a symptom of another medical condition.

Common causes of anxiety include these mental conditions:

These common external factors can cause anxiety:

  • Stress at work
  • Stress from school
  • Stress in a personal relationship such as marriage
  • Financial stress
  • Stress from global occurrences or political issues
  • Stress from unpredictable or uncertain world events, like a pandemic”
  • Stress from an emotional trauma such as the death of a loved one
  • Stress from a serious medical illness
  • Side effect of medication
  • Use of an illicit drug, such as cocaine
  • Symptom of a medical illness (such as heart attackheat strokehypoglycemia)
  • Lack of oxygen in circumstances as diverse as high altitude sickness, emphysema, or pulmonary embolism (a blood clot in the vessels of the lung)

The doctor has the often-difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain — a sign of heart disease — 43% were found to have a panic disorder, not a heart-related condition.

Anxiety and panic attacks

Explains anxiety and panic attacks, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

What are anxiety disorders?

Anxiety can be experienced in lots of different ways. If your experiences meet certain criteria your doctor might diagnose you with a specific anxiety disorder.

Some commonly diagnosed anxiety disorders are:

  • Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
  • Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia. See our page on types of phobia for more information.
  • Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks. See our page on panic attacks for more information.
  • Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders). See our pages on phobias for more information.
  • Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced at the time of the traumatic events. See our pages on PTSD and complex PTSD for more information.
  • Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges. See our pages on OCD for more information.
  • Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD. You can find out more about health anxiety on the Anxiety UK website.
  • Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance. See our pages on BDD for more information.
  • Perinatal anxiety or perinatal OCD – some people develop anxiety problems during pregnancy or in the first year after giving birth. See our pages on perinatal anxiety and perinatal OCD for more information.

You might not have, or want, a diagnosis of a particular anxiety disorder – but it might still be useful to learn more about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.

Anxiety and other mental health problems

It’s very common to experience anxiety alongside other mental health problems, such as depression or suicidal feelings. If you have symptoms of both anxiety and depression but don’t fit one more clearly than the other, you might be given a diagnosis of ‘mixed anxiety and depressive disorder’.


Living with GAD & panic attacks after losing my Dad

“I really believe that talking is one of the best therapies you can have.”Read Zoe’s story

How to manage stress

Explains what stress is, what might cause it and how it can affect you. Includes information about ways you can help yourself and how to get support.

What is stress?

We all know what it’s like to feel stressed, but it’s not easy to pin down exactly what stress means. When we say things like “this is stressful” or “I’m stressed”, we might be talking about:

  • Situations or events that put pressure on us – for example, times where we have lots to do and think about, or don’t have much control over what happens.
  • Our reaction to being placed under pressure – the feelings we get when we have demands placed on us that we find difficult to cope with.

“It’s overwhelming. Sometimes you can’t see beyond the thick fog of stress.”

There’s no medical definition of stress, and health care professionals often disagree over whether stress is the cause of problems or the result of them. This can make it difficult for you to work out what causes your feelings of stress, or how to deal with them. But whatever your personal definition of stress is, it’s likely that you can learn to manage your stress better by:

  • managing external pressures, so stressful situations don’t seem to happen to you quite so often
  • developing your emotional resilience, so you’re better at coping with tough situations when they do happen and don’t feel quite so stressed

Is stress a mental health problem?

Being under pressure is a normal part of life. It can help you take action, feel more energised and get results. But if you often become overwhelmed by stress, these feelings could start to be a problem for you.

Stress isn’t a psychiatric diagnosis, but it’s closely linked to your mental health in two important ways:

  • Stress can cause mental health problems, and make existing problems worse. For example, if you often struggle to manage feelings of stress, you might develop a mental health problem like anxiety or depression.
  • Mental health problems can cause stress. You might find coping with the day-to-day symptoms of your mental health problem, as well as potentially needing to manage medication, heath care appointments or treatments, can become extra sources of stress.

This can start to feel like a vicious circle, and it might be hard to see where stress ends and your mental health problem begins.

“[When I’m stressed] I feel like I’m on the verge of a breakdown.”

Why does stress affect me physically?

You might find that your first clues about being stressed are physical signs, such as tiredness, headaches or an upset stomach.

There could be many reasons for this, as when we feel stressed we often find it hard to sleep or eat well, and poor diet and lack of sleep can both affect our physical health. This in turn can make us feel more stressed emotionally.

Also, when we feel anxious, our bodies release hormones called cortisol and adrenaline. (This is the body’s automatic way of preparing to respond to a threat, sometimes called the ‘fight, flight or freeze’ response). If you’re often stressed then you’re probably producing high levels of these hormones, which can make you feel physically unwell and could affect your health in the longer term.

Borderline Personality Disorder

Alicia’s story: how I reframed my perspective after my mental health diagnosis

Having a diagnosis of a mental health condition doesn’t determine the rest of your life.

Feeling hopeless

After a desperate plea to the doctor late last year, I was referred to a consultant psychiatrist and received a formal diagnosis. Sitting on the edge of my chair in the clinical assessment room, I told her how anxiety was plaguing nearly every moment of my day and how I felt too low to function most of the time. How I felt like I was dragging my body and mind around all day, doing everything I had to do, but feeling no connection or emotion to it. How I felt angry, hopeless, self-destructive and even suicidal. Things had gotten really bad this time and I had no idea how I would get out of it.

The consultant looked concerned. She stopped me and said, ‘We need to rule something out,’ then handed me a list of questions and a pen.

The diagnosis 

Less than an hour later, I found myself leaving the hospital grounds in a state of shock. The consultant seemed to think I had something called Borderline Personality Disorder (BPD), also sometimes called Emotionally Unstable Disorder. I had vaguely heard of it before. Crazy, out of control, mentally unwell, unstable, dangerous… were all the stigmatising words that raced through my mind, negative connotations I felt deeply afraid of.

Shock and fear

Up until now, I thought I’d been struggling with anxiety and depression, so it came as a shock to be given a new diagnosis I’d never even considered before. I was still in a state of disbelief when I returned home to my partner and broke the news. He didn’t want to believe it either.

What sort of person had I become? Was I way more messed up than I thought I was? How could I have not been diagnosed with this before now? Was this something I could recover from or was my life, as I knew it, over? These were more of the stigmatising thoughts that initially came to mind.

I felt confused, angry, close to tears, anxious, frightened and ashamed, all at once.

But I also felt something else pawing for my attention.

A gentle relief 

Finally, my struggles had been identified. Validated. Heard. Understood. Yes, I’d been given a label, and maybe that comes with both pros and cons but, truthfully, I took great comfort in knowing that other people felt this way. I have an amazing partner, the most brilliant best friend and a wonderful support network, but I often struggle to articulate how I am feeling to them. It often leaves me feeling like nobody really understands me, and never will.

The consultant had a thorough understanding of my inner world, and made sense of the whys and the how’s of what had happened to me, what was happening to me right now, and how the right treatment could, over time, help me to manage and overcome my difficulties. I felt relieved that a fulfilling and meaningful life still seemed possible, with the right professional help and support.

A ray of hope

I’d had several different types of talking therapy including counselling, CBT and long-term psychodynamic therapy. Some of these had been helpful but I still felt something was missing. I’d been in and out of the NHS system for over three years. I’d tried meditation, medication, exercise, putting my career on hold, online courses and countless self-help strategies. I had begun to give up hope of ever feeling normal again.

Although hard to digest for the first few weeks, the diagnosis gave me hope that one day things would get better. My huge highs and lows started to make sense, as did my interpersonal difficulties, self-sabotaging anxiety and highly critical inner voice tearing me down daily. The diagnosis seemed to fit. The funny thing is, I sometimes felt deep down that there was something more serious and complex happening inside of me all along.

Knowledge is power

After the diagnosis, I began searching for as much information as I could about BPD from reliable sources on the internet and soon discovered that, like any mental health condition, I was on a spectrum in terms of my symptoms and behaviours. I found out that there were many types of personality disorders and how these were split into a number of overlapping categories. I discovered the term Quiet BPD. There was a whole wealth of new information to absorb and, although scary to read at times, it felt good to feel a little back in control of my life.

I read about the different types of specialised therapy options for people with BPD, studying in-depth scholarly articles on the evidence and effectiveness of each approach. I also researched the recovery and remission rates, which helped set my own expectations of what was actually achievable and realistic.

It doesn’t need to define me

Overwhelmed by a constant whirlwind of negativity, I was completely out of touch with who I was and what I was actually like before things got so bad. I had been trying so hard to get rid of how I felt and desperately hold onto any good feelings. Feeling better had become a full-time job, and it was exhausting.

I often felt so anxious, low or self-destructive that it was easy to lose touch with the other parts of myself that make me, me. The parts of me that make me a loving partner, a loyal friend and a thoughtful daughter. The parts of me that love to meet new people, have fun, write, go to live gigs, be creative and help others. The part of me that is a little ditsy, making my partner and friends laugh (they actually write lists of hilarious things I come up with). Although I still have a way to go, slowly but surely, those parts of me are returning. All it took was to realise they were still there all along and make small positive actions to reconnect with myself.

Being given a diagnosis can help you, not hold you back. Accept it as yours, don’t let it define you and always remember it is only one part of you.