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.

Disability discrimination

What is a disability?

You have to show that your mental health problem is a disability to get the protection of the Equality Act.

‘Disability’ has a special legal meaning under the Equality Act, which is broader than the usual way you might understand the word. Even if you don’t think you have a disability, the Equality Act may protect you from discrimination if your mental health problem fits its definition of disability.

The Equality Act says you have a disability if you have a physical or mental impairment that has a substantial, adverse, and long-term effect on your ability to carry out normal day-to-day activities.

The focus is on the effect of your mental health problem, rather than the diagnosis. So you need to show that your mental health problem:

  • has more than a small effect on your everyday life
  • makes things more difficult for you, and
  • has lasted at least 12 months, is likely to last 12 months, or (if your mental health problem has improved) that it is likely to recur.

Examples of ‘substantial adverse effect’

Simon has obsessive-compulsive disorder (OCD). He has to check and recheck whether lights are switched off and doors are locked. This can make him late for work or other appointments. His obsessive thoughts often distract him from activities that he is doing and disrupt his daily routines. His mental health problem therefore has a substantial adverse effect on the way he does things.

Examples of ‘long term’

  • Jenny has had depression for 10 months and the doctor says it will be likely to last at least another 4 to 5 months.
  • Selina has bipolar affective disorder. She had her first and second episode in January 2013, then a third episode in January 2014. Even though there was a gap between her second and third episode, her mental health problem is considered to have continued over the whole period (in this case, a period of 13 months).

What if I’m getting medication or treatment for my mental health problem?

If you are getting some treatment or taking medication for your condition, you ignore the effect of your treatment when deciding whether your condition is having a substantial, adverse effect on your daily activities. This means the law is looking at how your condition affects you without your treatment or medication.

Example

Mohammed has long-term anxiety and is being treated by counselling. Anxiety would normally make him find simple tasks difficult. Because he has counselling, he is able to get up and go to work.

The Equality Act says you have to ignore his treatment in deciding whether his mental health problem has a substantial adverse effect on his day-to-day activities and so he has a disability.

What if I had a disability in the past?

You are still protected from discrimination if you had a disability in the past. That means that if your past mental health problem had a substantial, long-term and adverse effect, you will get the protection of the Equality Act.

Examples

Four years ago, Mary had depression that lasted 2 years and had a substantial effect on her ability to carry out normal day-to-day activities. She has not experienced depression since then.

If Mary is treated worse by her employer because of her past mental health problem, she will be protected by the Equality Act.

Checklist: Is my mental health problem a disability?

You can ask yourself these questions:

  1. Do I have a mental or physical health impairment?
  2. Is it long-term (meaning lasting more than 12 months or likely to do so)?
  3. Does it have a more than minor adverse effect on my day-to-day living, if I discount my treatment or medication?

If you answered “yes” to all three questions, then your mental health problem could get the protection of the Equality Act.

If you want to get the protection of the Equality Act, you may find it helpful to get some evidence from your GP, or another medical professional. You can ask them to write a letter saying whether they think you have a disability under the Equality Act. It would be particularly useful if they can give their opinion on the answer to each of these three questions.

Example

Esra doesn’t consider herself disabled because she doesn’t receive disability benefits and she is physically healthy.

Esra has been living with an anxiety disorder for the past 3 years. Because of this, it takes her a longer time to do things like get up in the morning, dress herself for the day and do the shopping. She takes medication to control the symptoms.

Esra would be protected by the Equality Act because she has:

  • a mental impairment – an anxiety disorder
  • it is long term – she has had it for the past 3 years
  • it has a substantial effect on her daily life – her mental health has a major effect on her daily life when you ignore the effect of her medication  
  • it has an adverse effect – her mental health problem makes things more difficult for her.

What are the different types of discrimination?

The Equality Act only protects people who have a disability against these types of discrimination:

It is possible that you have experienced discrimination in more than one way.

Direct discrimination

Direct discrimination is when you are treated worse than someone else because you have a disability. You have to show that there is a link between your disability and the way you have been treated, which can be difficult. However, you don’t always have to provide an example of a particular non-disabled person who was treated better than you if it is clear from all the circumstances that your disability was the reason why you were treated as you were.

Discrimination by association: you may be treated worse because of your connection or association with another person with a disability, even if you don’t have a disability yourself.

Discrimination by perception: you can also be treated worse because a person or organisation believes you do have a disability when you don’t.

Examples of direct discrimination

  • Jon is not offered a promotion because he has depression. But his colleague Harry, who does not have depression, is offered a promotion – even though he has less experience and fewer qualifications.
  • Carrie is interviewed for a job. She has better qualifications and more experience than all the other candidates, and performs the best at the interview. One of the interviewers knows of Carrie’s diagnosis of bipolar disorder. Carrie is not offered the job, but neither are any of the other candidates. Carrie hasn’t clearly been treated worse than any of the other candidates, but she has been treated worse than a non-disabled person would have been treated in the same situation.
  • Jenny is not offered an apprenticeship after she tells the training provider that she has caring responsibilities for her partner, who has a mental health problem. This is an example of discrimination by association.
  • A bank incorrectly assumed that David had a long-term mental health problem. They refused him a loan for this reason, even though he has no mental health problem. This is an example of discrimination by perception.

Discrimination arising from disability

This is where you are treated badly not because of your disability but because of something that happens because of your disability.

Unlike direct discrimination, there is no need for you to compare yourself with anyone else. You just have to show that you were treated badly, and this treatment was linked to your disability.

You don’t need to show that the person who treated you badly was aware that the behaviour was due to your disability, but they do need to be aware that you have a disability.

Examples of discrimination arising from disability

  • Peter experiences psychosis and hears voices, which he manages by talking to them. Staff in a shop ask Peter to leave when he is talking to his voices. Peter has been treated unfavourably because of behaviour related to his disability.
  • Jan is given a disciplinary warning from her employer for taking sickness-related absences because of her bipolar disorder. Her employer’s decision to treat this as a disciplinary matter may be discrimination arising from Jan’s disability.

Situations when unfavourable treatment might not be discrimination

There are some situations in which it might be lawful for a person or organisation to treat you unfavourably. These are if they can show that:

there were valid intentions behind their action (such as ensuring the health and safety of others, or keeping up staff attendance so that their business can run properly), and that it was an appropriate action to take in the circumstance (legally this is called a ‘justification‘), or
they did not know you had a disability (and could not reasonably have known).

For example, in Jan’s situation above, her employer might argue that the reason why they disciplined her was because they need to keep up staff attendance – therefore their action was justified. Jan might accept that her employer’s intentions were valid, but argue that the action they took was much too harsh and not appropriate in the circumstance – therefore their action was not justified.

Whoever is deciding whether or not unfavourable treatment is justified needs to balance the needs of both sides carefully, which can be very complicated.

Indirect discrimination

Indirect discrimination is where:

  • a person or organisation has practices or arrangements that seem to treat everyone in an equal, non-discriminatory way, but
  • these practices or arrangements put you and others with your disability at a disadvantage compared with those who do not have your disability.

Examples of indirect discrimination

  • An advice centre will only provide advice to people who visit their centre and will not offer advice by phone or email. This practice puts people with mental health problems like agoraphobia at a disadvantage because they can’t leave their homes to travel to the centre.
  • An employer only offers promotions to people who have a driving licence and are able to drive even though this is not a key requirement of the job. This will discriminate against people with mental health problems that prevent them from holding a driving licence.

For indirect discrimination, it doesn’t matter whether the person or organisation knew about your disability. This means they have to plan in advance and think about how their policies and practices may affect people with mental health problems.

But it is not indirect discrimination if the person or organisation can show these practices and arrangements were justified.

Harassment

Harassment is behaviour from others that you don’t want, that:

  • violates your dignity or creates an environment that is intimidating, degrading, offensive or humiliating, and
  • relates to a disability. It does not have to relate to a disability that you have.

Examples of harassment

  • Mary has an eating disorder. Mary’s manager knows she has an eating disorder and she makes offensive remarks in the open plan office about people with anorexia.
  • Steve has schizoaffective disorder. He is on a day out from inpatient treatment in a psychiatric hospital and is eating with fellow patients at a local café. A member of staff who knows he is a psychiatric patient uses silent gestures and mime to make fun of him. Steve is very upset.

Victimisation

Victimisation is when an employer or organisation puts you at a disadvantage just because:

  • you have made allegation about discrimination, or
  • you have supported someone who has made an allegation of discrimination

Examples of victimisation

  • Jibin’s colleague has bipolar disorder. Jibin supports her colleague to complain to their employer about disability discrimination. After this, Jibin’s manager refuses her promotion on the basis that her loyalty to the company is in question.
  • Deb has an anxiety disorder. She complains to her local supermarket that she genuinely believes that she has been discriminated against by an assistant who made remarks about her condition in front of customers. After this, the manager says she should shop elsewhere.

Making reasonable adjustments

The Equality Act says that employers and service providers should think about making reasonable adjustments (in other words, changes), if you are at a substantial disadvantage compared to other people who do not have a mental health problem.

Reasonable adjustments include:

  • making changes to the way things are organised or done
  • making changes to the built environment, or physical features around you (for example physical features of a building that put a disabled person at substantial disadvantage)
  • providing aids and services for you to overcome the substantial disadvantage.

You cannot be asked to pay for the cost of reasonable adjustments. If a person or organisation does not make reasonable adjustments when it would have been reasonable to do, this will be unlawful discrimination.

To find out more, see our pages on asking for reasonable adjustments from:

Examples of reasonable adjustments

  • Sylvie is working in an office and has depression. She is taking part in a supported employment scheme from the workplace mental health support scheme. Her employer lets her make private phone calls to her support worker in the working day as a reasonable adjustment.
  • Tomasz has a range of problems with anxiety, and he gets particularly anxious travelling on crowded public transport. He speaks to his manager about his mental health problem and explains that he is finding it hard to get to work in the morning travelling during the rush hour. Tomasz’s manager agrees to adjust his working hours so that he comes into work before the morning rush hour and leaves before the evening rush hour. His employer would not have to make adjustments if they did not know about Tomasz’s condition, or how it was affecting his working life.

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

O.C.D Mental Obsessive Disorder — Kindness – Wisdom💥

Intrusive thoughts or obsessions as psychologists call them affecting everyone. But some people can’t get rid of them as easily as the rest of us. Obsessive Compulsive Disorder (OCD) is a mental anxiety disorder which produces repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; […]

O.C.D Mental Obsessive Disorder — Kindness – Wisdom💥

Essential Tremor

Essential Tremor

Essential Tremor is considered one of the most common neurological movement disorders and is estimated to be eight to 10 times more prevalent than Parkinson’s disease.  People exhibit a rhythmic trembling of the hands, head, legs, trunk and/or voice.  It can afflict persons of any age, gender and race and in the vast majority of all cases it is inherited.  While more commonly noticed in older individuals, essential tremor can begin as early as birth.

Symptoms of tremor

Essential tremor is considered the most common neurologic movement disorder, and is 8–10 times more prevalent than Parkinson’s disease.

Essential tremor is a chronic condition characterised by involuntary, rhythmic tremor of a body part, most typically the hands and arms. 

Essential tremor is considered a slow progressive disorder and, in some people, may eventually involve the head, voice, tongue (with associated dysarthria), legs, and trunk.

However, in many people, the disorder may be relatively non-progressive. The tremor may be mild throughout life.

Identifying tremor

Tremor may be most visible when people maintain a fixed position. In some patients, the tremor may worsen upon performance tasks. People most often describe this feeling as a general “shakiness” or a vibrating sensation in the body. 

Hand tremor may cause difficulties with writing, drinking fluids from a glass or cup, eating, sewing, applying makeup, shaving, or dressing. 

In individuals with essential tremor, the next most frequently affected area of the body is the head, followed by the voice, tongue, legs, or trunk. These tremors may occur in isolation or along with tremor of the hands or arms. People find that tremors usually disappear during sleep.

Psychological and social effects of essential tremor

The psychosocial effects of essential tremor may be embarrassing and debilitating. Essential tremor may eventually affect the patient’s ability to perform certain work-related tasks; interfere with activities of daily living; or lead to withdrawal from social activities and interactions due to embarrassment. For some people with essential tremor, other symptoms may also be present such as unsteady, uncoordinated walking.

Diagnosing tremor

To be diagnosed with tremor it is best to see a doctor, who understands tremor, or a neurologist.

There are a number of ways in which tremor can be diagnosed:

  1. The diagnosis will typically begin with the person’s medical history being taken.
  2. The doctor will be looking not only for offending drugs (drugs prescribed for other medical conditions which can cause tremor as a side effect).
  3. The doctor will also ask about the family history.
  4. While the diagnosis of essential tremor remains a visual one, Brain scans Magnetic Resonance Imaging (MRI) and Computerised Tomography (CT) may be helpful in eliminating any other conditions which also produce tremor as a symptom.
  5. Blood samples may also be taken to rule out thyroid or copper metabolism problems.
  6. DATScan a diagnostic test can distinguish between essential tremor and tremors of Parkinson’s disease.

Downloadable information

Essential Tremor Information Leaflet

Coping with Disability

Probably everyone reading this will have or know someone with a disabilty of some kind. The list of disabilities is endless.

I myself was born with slight Cerebral Palsy which later in life contributed to me developing Epilepsy. Although my seizures are controlled by medication I sltill suffer the odd Focal or Partial seizure (though i haven’t had any for weeks).

My Cerebral Palsy is giving me more cause for concern at the moment as I keep loosing my balance.

Fortunately because of my positive mind I think I try not to let my disabilities get me down .

For more information check the link below

How to Emotionally Cope With Having Disabilities: 14 Steps (wikihow.com)