Understanding the origins, treatments and management of anxiety

We’ve all experienced some anxiety at some point in our lives.

Whether that be pre-meeting nerves before giving a presentation or the mild panic that comes with thinking you’ve lost your phone for a moment. While this is very common and healthy behaviour to have, there are forms of anxiety that can ruin people’s lives.

What is anxiety?

Anxiety is one of the most common mental health disorders in the UK. Along with depression, it affects almost 7% in the country with women disproportionately affected. The Office for National Statistics (ONS) saw rates of anxiety shoot up during the coronavirus pandemic as people began to feel unsafe and isolated.

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Anxiety is characterised by a feeling of fear and worry. Severe anxiety can be life-limiting and prevent people from doing certain activities that many of us take for granted. There are many types of anxiety, from generalised anxiety disorder to phobias. Not everyone can pinpoint a time when they began to feel anxious, for many it is a state of which it is all they’ve ever known. To truly understand why we have such varying degrees of anxiety as a species, we need to understand what it is and what contributes to feelings of unease.

The origin of anxiety

It’s thought that some of us are more anxious than others because of what we’ve inherited from our ancestors. If they didn’t have the fear to run away from a predator, we wouldn’t be here today. So why are some of us more anxious than others?

Well that stems partly from our genetics but also from how we were raised. There is evidence to suggest that children whose mothers experienced elevated levels of stress during pregnancy are more likely to have children with emotional and disruptive behaviours1. Ultimately, the main cause of anxiety comes from the environment we live in. Animal models have shown that stressful experiences impact future developmental outcomes by dysregulating the major stress response system3. Repeated stressful life experiences also contribute to the likelihood of a person developing anxiety disorders.

Many studies support the idea that both genetic and environmental factors have an impact on how we manage stress. Individuals who experience anxiety tend to display anxious behaviours throughout their lives2.

Two brains

To understand why we do what we do, it’s important to separate our mind into the rational and the emotional brain. The rational brain thinks and plans ahead. It makes decisions based on evidence and rarely steers away from fact. The emotional brain, however, is designed to respond and act to emotional stimuli. Ever been told to go with your gut feeling? That’s the emotional brain at work, leading your decisions with feeling.

Having emotions we can express often separate us from the rest of the animal kingdom. As we grow, our early emotional experiences shape how we handle certain situations today. In those with anxiety, the rational struggles to manage the emotional. This is why someone may have a terrifying fear of clowns which might seem irrational to anyone else.

Treatment

Anxiety can be treated in a number of ways from talking therapies to medication. Beta blockers such as Propranolol and selective serotonin reuptake inhibitors (SSRIs) such as sertraline may be prescribed to help manage the physical effects of anxiety.

Beta blockers work by slowing down the heart rate and blocking the release of adrenaline. This can be helpful in situations where immediate relief is needed, particularly in the event of a panic attack or situation that may trigger one. SSRIs work by increasing the hormone serotonin that regulates mood and anxiety. Medication can provide comfort for many but healthcare professionals encourage the use of self-help and talking therapies which can be instrumental in treating anxiety in the long-term.

Talking therapies

Trained therapists can help people with anxiety to talk through their worries and help map out ways to approach and manage them. There are a myriad of techniques to help change the way of thinking and understand the reasoning behind anxieties. Upon dissecting the issues, it can be helpful to understand where anxious thoughts come from and why they can be so debilitating. One method is keeping a diary of worries that you can later look on and dissect.

Often, we are so preoccupied in the moment with panic that we struggle to rationalise the worry. On writing it down, which can be a relief in itself, it gives more time to look at the problem later on and enable the rational brain to process and possibly solve the worry in question.

Talking therapies can be incredibly helpful in helping people to develop techniques that help them manage their anxiety themselves. Anyone can make a start today and there’s a wide range of self-help resources on our website to help with overcome anxiety.

Activities

Anxiety can be alleviated with a balance of treatment and healthy daily habits. Aside from medication, meditation and yoga have been instrumental in helping many sufferers manage their stress and anxiety. Studies have shown that these activities provide an effective alternative to using drugs and improve general wellbeing. Exercise boosts the production of serotonin and ultimately improves mood which makes it no surprise that yoga has some positive impact on the management of good mental health.

You might be forgiven for thinking that mental health disorders are more prevalent in today’s society than they were 50 years ago, but truthfully it's important to remember that we are probably only just comfortable talking about it.

For years, any sort of mental health problem was widely regarded as a taboo subject and therefore possibly ignored or dismissed. In 1895, Sigmund Freud coined the term ‘anxious expectation’ to define what anxiety could be. He described it as “a woman will think of influenza pneumonia every time her husband coughs when he has a cold, and, in her mind's eye, will see his funeral go past.” Anxiety has been, for the most part, a misunderstood illness. It is only now, as we become more aware of the condition, that we see how important it is to open up a discussion and share our experiences in order to treat them better.

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References

1) Rice F, Harold GT, Boivin J, van den Bree M, Hay DF, Thapar A. The links between prenatal stress and offspring development and psychopathology: disentangling environmental and inherited influences. Psychol Med. 2010;40:335–45.

2. 2)  Gross, C. & Hen, R. The developmental origins of anxiety. Nat. Rev. Neurosci. 5, 545–552 (2004).

3. 3)  Schiele, M. A., and Domschke, K. (2017). Epigenetics at the crossroads between genes, environment and resilience in anxiety disorders. Genes Brain Behav. doi: 10.1111/gbb.12423.

4. 4)  Saeed SA, Antonacci DJ, Bloch RM. Exercise, yoga, and meditation for depressive and anxiety disorders. Am Fam Physician. 2010;81(8):981–986.

5. 5)  Crocq MA. The history of generalized anxiety disorder as a diagnostic category. Dialogues Clin Neurosci. 2017;19(2):107–116. doi: 10.31887/DCNS.2017.19.2/macrocq.