Dual Diagnosis: Anxiety
DUAL DIAGNOSIS RECOVERY FOR ALL
What is anxiety and causes it?
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
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)
- Face goes pale
- Dry mouth
- Muscle tension and pains
- Numbness or tingling in fingers, toes or lips
- Breathing fast
- Passing water frequently
- Nausea, stomach cramps
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.
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.
What causes these kinds of anxiety?
Some of us seem to be born a bit anxious – research suggests that it can be inherited through our genes. However, even if you aren’t naturally anxious, you can become anxious if you are under enough pressure.
A psychological explanation suggests that, for some people, it is because they start to believe that the physical symptoms of mild anxiety are symptoms of serious physical disease. This makes them worry more, so the symptoms get worse, so they worry more … and so on.
Sometimes it is obvious what is causing anxiety. When the problem disappears, so does the anxiety.
However, there are some circumstances that are so upsetting and threatening that the anxiety they cause can go on long after the event. These are often life-threatening situations like car crashes, train crashes or fires.
If this happens to you, you can feel nervous for months or years after the event, even if you weren’t physically harmed.
It can also happen:
- if you have been neglected or abused in childhood;
- if you have been abused, persistently mistreated or tortured as an adult.
This is part of post-traumatic stress disorder.
Street drugs like amphetamines, LSD or Ecstasy don’t help. Even the caffeine in coffee can be enough to make some of us feel uncomfortably anxious!
Mental health problems
Many mental health problems can make you anxious. About half the people with depression get panic attacks at some point.
Some physical problems, like thyroid disease, can make you feel anxious.
Some or all the above …
On the other hand, it may not be clear at all why you feel anxious. It’s a mixture of your personality, the things that have happened to you, or big changes in your life.
Generalised Anxiety Disorder:
How to cope with anxiety:
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