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The Student
Guide to
Understanding
Anxiety
An Anxiety UK
self help guide
Contents
Introduction ................................................... 3
About Anxiety UK ......................................... 4
What is Anxiety? ............................................ 5
Symptoms of Anxiety ................................... 10
What causes Anxiety?................................... 19
Common Anxiety Conditions ....................... 24
Treatment of Anxiety ................................... 38
Getting help and Support ............................ 53
Top Tips for Students with Anxiety .............. 56
Student Experiences .................................... 59
Resources and References ............................ 62
Useful Contacts ........................................... 63
The aim of this guide is to provide support and general
information only. The material contained therein is not intended
to be used for the diagnosis or treatment of a condition, nor
should it replace the advice of your GP or any other healthcare
professional.
If you think you may be experiencing or have experienced an
anxiety related condition you should consult your GP or relevant
healthcare professional.
2
Introduction
Moving into higher education can be very exciting!
You are potentially leaving home and gaining a lot
more freedom. You’ll be entering a new world where
you’ll have the opportunity to make new friends, try
new things, join amazing societies and develop a
sense of independence.
At the same time, all of these changes can be fairly
daunting. It’s completely normal to have some
apprehension about these sudden changes which are
happening in your life. It’s completely reasonable
also to experience some anxiety in response to these
changes.
Anxiety is a completely natural emotion. However,
when anxiety starts to impact on your day-to-day life,
it can become debilitating and difficult to manage.
This guide has been developed to help support you
through the first few months at university or college
and to help you manage any feelings of
apprehension and anxiety that you might be having.
The guide will also help you to recognise symptoms
of anxiety and enable you to identify when anxiety
might be beginning to impact negatively on your
ability to function on a day to day basis.
Inside this guide, you will also find a section that
gives helpful tips on how to manage anxiety in the
short and long term along with details on further
support services available.
Anxiety UK is here for you every step of the way
to support you through this exciting transition.
3
About Anxiety UK
What is Anxiety?
Anxiety UK is a national registered charity (number
1113403, company number 5551121) formed in 1970
by Katharine Fisher, who had personal experience of
agoraphobia for those affected by anxiety disorders.
Today we are still a user-led organisation, run by and
for those with personal experience of anxiety
disorders, supported by a high-profile clinical
advisory panel.
Anxiety can be thought of as an emotion like anger
and sadness. Anxiety (sometimes referred to as
stress, nerves or fear), plays an important role in the
normal functioning of the body; without it we would
not be able to function. Indeed anxiety can be a
helpful emotion as it can prepare us for future events
as well as improving our performance. It is great to
have a little anxiety when entering a new situation
such as starting university or college as it can push
you to work harder and provide you with the kick
start that you might need.
Anxiety UK works to relieve and support those living
with anxiety and related conditions such as
depression by providing information, support and
understanding via an extensive range of support
services, including 1:1 therapy. We work regularly
with other organisations and healthcare professionals
to improve services for those living with anxiety and
campaign to raise awareness of anxiety and related
conditions with an aim of making things better.
We can provide support and help if you’ve been
diagnosed with, or suspect you may have anxiety or
an anxiety related condition. For example, we can
help you deal with specific phobias such as fear of
spiders, blushing, vomiting, being alone, public
speaking, heights – in fact, any fear or anxiety related
condition that’s stopped you from getting on with
your life.
However, when anxiety becomes so severe, intense,
disproportionate or overwhelming that it starts to
restrict daily routine and life as a whole, it is then
anything but helpful and can be disabling and life
changing. When this point is reached, those affected
can be said to be living with an ‘anxiety disorder or
anxiety related condition’ of which there are many
different types including panic disorder, social
anxiety, agoraphobia, obsessive compulsive disorder
(OCD), phobias and post-traumatic stress disorder
(PTSD). We will go through some of the more well
known anxiety disorders later on in this guide, but it
is important to educate yourself about anxiety as it
can certainly help you to understand much better
what you, or a person you are supporting that is
living with anxiety, is going through.
With our help you can
start to recover your
confidence and forget
your fear.
4
5
Despite the numerous forms of anxiety, all anxiety
disorders have elements in common including
physical, psychological and behavioural responses.
Knowledge of how anxiety results in these responses
is incredibly helpful if you are affected by anxiety or
are a caregiver/supporter to someone with anxiety,
because it will help you better understand what can
sometimes seem like strange thoughts and
behaviours. It is, however, important to point out that
those with anxiety do not necessarily constantly
operate in the ways described later on in the guide,
and often there will be periods of time (usually when
the anxiety stimulus is absent) when life appears to
be ‘normal’.
For example, it is not uncommon to find that
someone who has agoraphobia is able to live their
life relatively unaffected by anxiety and free from the
symptoms of anxiety until they are required to travel
outside of their comfort zone. Similarly, those with
social anxiety may seek to avoid social contact and in
doing so will not have symptoms of anxiety until
faced with a situation that triggers anxiety.
Some people find they are more bothered by the
physical symptoms of anxiety whilst others find the
thoughts, or psychological symptoms more
problematic. Others find that the avoidance
behaviours they undertake in response to anxiety can
lead to problems longer term and prolong the
lifespan of the disorder.
6
Embarking on a Higher Education course may bring
to light a number of situations that could induce
anxiety, such as:
•
•
•
•
•
•
•
•
•
•
leaving home and feeling homesick
moving to a new area
the requirement to give presentations,
or to perform in social situations
coping with work and exams
dealing with relationships or the lack of
relationships
sexuality issues
impending exams
apprehension about entering new situations
having to deal with people in authority
worrying about whether you have chosen
the right course
•
panic about facing exams or making a
presentation
•
•
feeling that you don’t fit in
fear of failure.
7
Hey Monster
by illustrator Spencer Salberg
Many living with anxiety often explain it to others like being
‘followed by a monster’. It can certainly seem that way, and
this monster can be especially hard to shake off; seemingly
always being there in the background. The comic illustrations
below show how 'the anxiety monster' can take hold:
8
creator of the anxiety
More from Spencer Salberg, the
er.tumblr.com
comic can be found at heymonst
1
9
What are the
symptoms of Anxiety?
are in any situation which causes them anxiety, their
sympathetic system starts to dominate, and the fight,
flight or freeze reaction begins (also known as the
adrenaline cascade).
Anxiety is characterised by a sense of fear or dread,
which can be overwhelming. Although the exact
experience of each person’s anxiety will be unique to
them, most people experience some common
physical, psychological and behavioural symptoms.
The below shows a diagram to illustrate what
happens once the sympathetic system is switched on:
The hormone adrenaline is released into the
bloodstream.
Physical aspects of anxiety
When faced with an anxiety-provoking situation, an
automatic chain of events begins, known as the
‘Fight or Flight’ response. More recently this has
been updated to include the ‘freeze’ response as
sometimes people find themselves unable to move
from the spot when faced with an anxiety stimulus.
The ‘fight, flight or freeze’ response happens
without thinking because it is triggered by the part
of the nervous system whose job it is to control
automatic functions (e.g. breathing, heartbeat etc.).
This part of the nervous system is called the
autonomic system, and has two components; the
parasympathetic and sympathetic systems. These
systems work opposite to each other, and generally
only one can dominate at a time (for example, when
threatened – say by suddenly noticing a speeding car
when crossing the road – there is an automatic
increase in sympathetic arousal; for example, blood is
shunted away from the abdominal organs and moved
into the major skeletal muscles, the heart rate is
increased whilst parasympathetic processes such as
digestion reduce or stop altogether). When people
10
The pulse rises as the heart beats faster in order to
pump blood quickly around the body to supply the
muscles with energy, ‘to enable them to respond to
the perceived threat’.
Blood is diverted away from areas of the body
such as the stomach to where it is needed e.g. the
arms and legs, where there are muscles. The
diverting of blood away from the stomach explains
the ‘butterflies’ in the stomach feeling that many
people with anxiety experience.
The blood now pumps faster and breathing rate
increases to match the body’s need for oxygen. This
causes a rise in blood pressure. The breathing rate
increase can make us feel dizzy and light headed.
The blood pumping faster also leads to a rise in
temperature. Your body reacts by trying to
cool you down – this is why you perspire.
11
This system is designed to serve us when we are in
real danger. However, problems arise when this
system is turned on when it’s not really needed i.e.
panicking in a non life-threatening situation which
happens quite frequently in those living with anxiety
and anxiety related conditions. It can often feel very
frightening to experience such a raft of very real
physical symptoms particularly when there is no
obvious trigger or reason for the onset of anxiety.
Jenny, a member of Anxiety UK tells her story:
“
I did not realise that I had social phobia until about 2
or 3 years ago. I had joined Anxiety UK and sent off
for some of the factsheets, including the one on social
phobia. In a way, reading the information was a
huge relief as it described perfectly how I had felt
since my early teens.
”
The physical symptoms of anxiety are not imagined;
they are real and are caused by the adrenaline
release and include:
Increased heart rate
Increased muscle tension
Feeling of having “jelly legs”
Tingling in the hands and feet
Hyperventilation (over breathing)
Dizziness
Difficulty in breathing
Wanting to use the toilet more often
Feeling sick
Feeling as if there is a tight band
across the chest area
Tension headaches
Hot flushes
Increased perspiration
Dry mouth
Shaking
Choking sensations
Palpitations
Please note: the above list is not exhaustive.
12
13
Natalia tells of her experience of emetophobia
(fear of being sick):
“
I don’t know why I ended up with this problem. I
can only assume that somewhere in my mind I had
this belief that being sick was very socially
unacceptable, and certainly not something a young
woman should do in public. All I know is that the
fear of getting out of control to the point where I
might be sick, eventually led me to become a recluse
and to stop socialising, travelling and eventually I
had to give up college.
”
Of course there are other physical symptoms that
bother people such as profuse sweating, shaking,
blushing etc. and we have found that these
symptoms in particular seem to cause distress to
people with social anxiety, a condition where people
worry that their anxiety is noticeable to others.
ms
In most cases the physical sympto
iety.
anx
by
described above are caused
se living
tho
t
However, we strongly advise tha
ensure that
with anxiety consult their GP to
dition
there is no underlying medical con
se of
cau
the
(such as thyroid disorders) for
any symptoms experienced.
14
Psychological symptoms:
The term ‘psychological symptom’ is used to describe the
thoughts/ altered perceptions that are experienced when a
person is feeling anxious.
Some of the most common thoughts and altered perceptions
felt by those who are anxious are;
•
•
•
Thinking that you may lose control and/ or go ‘mad’
•
Feeling that people are looking at you and observing your
anxiety, specifically if you are surrounded by new friends
and peers
•
•
Feeling as though things are speeding up / slowing down
•
Feeling like wanting to run away/escape from the situation
e.g. if you are in a packed lecture theatre
•
Feeling on edge and alert to everything around you.
Thinking that you might die
Thinking that you may have a heart attack/
be sick/ faint/ have a brain tumour
Feeling detached from your environment and the people
in it
Those affected by anxiety disorders often have a tendency to
think very negatively and have a tendency to catastrophise
(i.e. think of the worst case scenario) when they are thinking
about a particular situation. In fact, often it is the case that
some people find that the build up to an event is worse than
the event itself. This is known as ‘anticipatory anxiety’. Many
students may experience high levels of anticipatory anxiety in
the lead-up to a new term, in the lead-up to coursework
deadlines or exams or when moving into a new house with
other students that they do not know.
15
Behavioural symptoms:
Rushing out of situations when you feel anxious
These are the things that we do when we are feeling
anxious. The behaviour that we carry out is a
symptom of the anxiety and is often a response to
our thoughts, feelings and physical symptoms. The
most common behavioural symptom of an anxiety is
avoidance. Although avoiding an anxiety-provoking
situation can provide immediate relief from the
anxiety, this approach offers only a short term
solution. This means that whilst it may seem like the
best thing to do at the time, the anxiety often
returns the next time that you face the situation and
avoiding it will only psychologically reinforce the
message that the situation that you were in was in
fact dangerous, even though it was not. The problem
with avoidance is that you never get to find out
whether your fear about the situation and what
would happen is actually true. Anxiety acts like a
bully – if you give into it, it only gets worse. However,
as with all bullies, if you can stand up to it, you will
find it not as scary as you first thought.
Only shopping when it is quiet
Some examples of avoidance behaviours are:
Getting taxis instead of using public transport
or walking
Making excuses to avoid going out with friends
or going to university/college social events
Sitting at the end of the row in the theatre/cinema
or in the lecture theatre
Using public transport when it’s the least busy
Crossing the street to avoid people
Going out of your way to avoid a feared object
or situation
Other key behavioural symptoms of anxiety are
called ‘safety behaviours’- so called because they
make you feel safe, although they tend to feed into
the negative cycle of anxiety. These are behaviours
we exhibit when we can’t avoid the situation but are
very fearful, so we take steps to make sure things
won’t go wrong, e.g. carry medication, wear baggy
clothing (if fearful of sweating); sit at the back of the
room; avoid looking at people, etc.
se symptoms are ver y
You must remember that all the
tion that you are
common and could be an indica
if you are concerned
suffering from anxiety. However,
may not be related to
that a cer tain physical symptom
nd that you would
your anxiety, we would recomme
when you do embark
visit your GP. It is ver y important
education that you
on living in a new city for higher
ve, or soon after you
register with a GP before you arri
have moved in.
Feeling as though you can’t go out alone and
need a trusted person with you
16
17
Depression and anxiety
It is probably no surprise to learn that anyone who
has had anxiety for a period of time will tell you that
it is frustrating, demoralising, challenging and
difficult to live with. Over time, living with these
feelings will wear even the strongest person down
which in turn may lead to the onset of secondary
depression. If you notice yourself, or someone else
that you are supporting with anxiety is tearful, has
lost hope and is detached it may be that you/they
are feeling depressed and would benefit from having
treatment for this condition as well as for your/their
anxiety. Certainly our experience at Anxiety UK is
that if depression has set in then it is advisable to get
support, as addressing this is important if any
subsequent treatments for anxiety are to be
effective. Of course the ideal here is that anyone with
anxiety receives an accurate diagnosis at the point of
presenting to their GP and is immediately put on the
right treatment pathway. For some, however, the
prospect of going to the GP is too daunting or it may
be that support is sought through an organisation
such as Anxiety UK because of reluctance to have
anything detailed on medical records.
ious a lot or all
Almost one in five people feel anx
re anxious than
the time, while nearly half feel mo
2
they used to.
18
What causes anxiety?
Anxiety can be said to be caused by a number different
factors. Triggers for anxiety are often specific to each
person and what can make one person feel anxious may
have no impact on someone else. Some of the most
common factors that can lead to anxiety are the
following:
Life Strains – ‘the stresses of life’
Often people find it very hard to understand just
where their anxiety came from because there is not
always an obvious trigger. However, in our
experience, we have found that the majority of
people develop anxiety after having been under
‘stress’ for a period of time, and that there is not
necessarily a specific trigger. You may have suffered
lots of minor stresses, which in themselves seem
small. However, accumulated together they amount
to quite significant stress. Think back over the past
few years - what have you been through? You do not
even have to have experienced stressful, distinct
events to experience anxiety. It may be, for example,
that you had an unpleasant teacher for a long period
of time, and the stress and stain of this relationship
has gradually worn you down. This type of stress is
called ‘life strain’. Another example may be
struggling to manage financially whilst in
higher education or at university; it may be
the first time many students have had full
control over their personal finances, and
this in itself can be quite overwhelming.
19
Sometimes there is confusion over the source of
anxiety. For example, it is common to have flown
regularly throughout your life, with family or friends
for example, and then suddenly, out of the blue, to
experience an anxiety attack during a flight. You
could then, from this experience, develop what you
believe is a fear of flying. What is important is to
distinguish a true fear of flying from an anxiety attack
which just happened to take place whilst on a plane.
In these cases, more often than not, the person
concerned will have been considerably stressed for a
period of time. This stress unfortunately came to a
head whilst that person was flying and ‘two and two
were put together to make five’. It then becomes
very easy to associate these feelings of panic with
that specific scenario, and therefore begin to avoid
it. You can become frightened of the anxiety attacks
themselves and start to live in ‘fear of fear’.
Avoiding situations that a person is fearful of serves
in the long term to feed that fear.
Specific stressful events
If you feel you have not been particularly ‘stressed
out’ over the past year or so, it may be that anxiety
started after a specific incident, known as a ‘trigger’.
This is also a very common reason for developing
anxiety. We have found that people are more likely
to suffer anxiety disorders after experiencing any of
the following: bereavement, a break up, moving
house, surgery, illness and violence. There are other
triggers of course but these are typical and frequent
ones. If you have developed a more ‘specific’
phobia, such as claustrophobia, you may have been
20
stuck in a lift or on the underground
and it is therefore probable that this
triggered your current anxiety. Think back again to
events that have occurred over the past months now.
Have you experienced anything which caused you
considerable anguish at the time?
Having said this, some people who experienced a
particularly traumatic incident during their childhood
find that their ‘experience’ stays with them into
adulthood, although they may have consciously
forgotten it. For example, a child who was frightened
during a thunderstorm may grow into an adult with a
fear of storms. Anxiety which is caused by specific
triggers usually starts very soon after the trigger and
so is more easily traced to its source. For example, a
bad flight may lead immediately to anxiety about
further air travel, and a traumatic experience at the
dentist may lead to dental phobia.
Social conditioning
Some people appear to have ‘learnt’ their anxiety
from a family member or friend. How often do you
hear that a person who is frightened of spiders also
has a parent who was also frightened of spiders?
Sometimes when we are children we subconsciously
pick up on other people’s fears. This is because we
believe that adults know best. If you had a parent
that was frightened of spiders, as a child you would
too most likely have believed that spiders were
dangerous and something to be scared of.
21
Lifestyle issues
Other causes
Anxiety can be caused or increased by lifestyle
factors including:
It is sometimes the case that anxiety has no
discernible cause. It can be very frustrating for the
person concerned to be unable to identify a clear
trigger and to consequently have no indication as to
where the anxiety has come from.
•
Not getting enough physical exercise
as this leads to a build up of tension
in the body.
•
Caffeine and alcoholic drinks induce adrenaline
release which can lead to the development of
physical anxiety symptoms
•
•
Recreational drugs such as amphetamines, LSD
and Ecstasy, can also be a factor in intensifying
anxiety symptoms and even causing anxiety in
some cases
Being aware of how much stress you can handle is
also important; people vary in the amount of
stress they can take and by being aware of how
much you can cope with means that you won’t
take on more than you can handle.
Biochemical theory
This is based on the assumption that some people
are more genetically predisposed to anxiety than
others. Some studies have shown that anxiety
disorders are due to a chemical imbalance in the
brain, particularly involving neurotransmitters
including serotonin. A range of antidepressants and
anti anxiety drugs have been developed over the
years in response to this theory.
22
1:5 students experience
mental health difficulties
on of Students (NUS)
“Research from the National Uni
erience mental
shows that 20% of students exp
sity.3
health difficulties while at univer
92 per cent of respondents identified as having had
feeling of mental distress, which often includes feeling
down, stressed and demotivated. On average,
respondents who experience feelings of mental distress
experience them once a month or more (74 per cent), and
almost one third suffered mental distress every week.3
nd to be course work
The main causes of this were fou
ms and study were
for 65 per cent of respondents, exa
t), with almost as
a cause for over half (54 per cen
per cent).”3
many citing financial difficulty (47
23
Common Anxiety Conditions
and Personal Experiences
There are many different types of anxiety and anxiety related
conditions which can manifest themselves in a variety of
different forms.
In this section, we have listed the more common anxiety
conditions and have including accounts from Anxiety UK
members that have experience of these types of anxiety:
Agoraphobia
Agoraphobia affects between 1.5% and 3.5% of the general
population in its fully developed form; in a less severe form,
up to one in eight people experience this.4
Agoraphobia can be seen as a very complex phobia which
usually manifests itself as a collection of inter-linked phobias.
An example of this is that many agoraphobics also fear being
left alone (monophobia), dislike any situation in which they
feel trapped (exhibiting claustrophobia type tendencies) and
fear travelling away from their ‘safe’ place which is usually the
home. Some agoraphobics will find that they are able to
travel more easily if they are with a trusted friend or family
member, this can however lead to a high level of dependency
on their caregiver. The severity of agoraphobia will vary
enormously with some individuals being house, or even room
bound to those who are able to travel specific distances
within a defined boundary.
“
I have had agoraphobia and monophobia (fear of being
alone) for the past 10 years. My problems developed after
lots of little things went wrong in my life: my car was stolen,
I started suffering with agoraphobia approximately 3 and a
half years ago and had to leave college as a result. I now find
it really difficult to go out alone and will not go anywhere
outside the house unless I really have to. I recently went on
holiday for a week but had a massive panic attack on the
way back and am still recovering from it. My partner bought
me a dog to keep me company at home as I also hate being
alone in case I have a panic attack. I have however learnt to
control the attacks by occupying myself with the internet
and the dog. I have also started trying to go to the shops even though it is only going down one aisle and then coming
straight back. I’m absolutely terrified if anyone says
anything to me, but I am trying to push myself further and
further each day, and one day I know I will conquer it. I
never thought that I would go out again at one point in my
life, but I am putting this all behind me as I’m determined to
resume my studies.
Clare
”
A YouGov survey of 2,300 adults in Britain
reveals that:5
likely to feel anxious
• Younger people are much more
about personal relationships.
• The youngest people surveyed (aged 18
- 24) were
twice as likely to be anxious about being alon
e than
the oldest people (aged over 55 years).
• A third of the students in the survey said they cope by
‘hiding themselves away from the world’.
AGORAPHOBIA
affects up to 1:8
24
25
Social Anxiety
Social or public situations of any kind may induce this
anxiety condition which is often expressed as a fear
of being the centre of attention or of others noticing
their anxious behaviour. Social anxiety can also be
characterised as a ‘specific social phobia’ i.e. when
the social anxiety is present only in specific social
situations. The fear that an individual will behave in a
way that will be embarrassing or humiliating can lead
to a complete withdrawal from social contact, as well
as avoidance of specific social situations such as
eating out and going to parties. This problem can
physically manifest itself with blushing, shaking and
sweating.
“
My own social anxiety started from a very early age
(about four years old) when my mother told me I
used to hide behind the sofa when visitors came.
This phobia went on for years and it wasn’t until
recently that I recognised for myself that I had some
form of social anxiety. For a number of years I was
having panic attacks in crowded places and was
even taken to hospital sometimes. In fact I was
frightened to open the door at times at home
because I didn’t want to have to meet or talk to
anyone. I would run upstairs and let someone else in
the family answer it. I stopped going out to social
occasions in case I would have a panic attack and so
all forms of usual student social life came to an
abrupt end. I’ll keep trying to think positively and
take one day at a time as I’m determined that I will
complete my degree.
Robert
”
26
Increasingly, students are expected to stand up and
speak knowledgably about their chosen subject in
front of groups of unfamiliar people. These
assessments usually contribute to the overall grade in
the subject, in addition to providing students skills
they can use when applying for jobs in the future. It
is increasingly the case that employers expect good
presentation skills from the graduates they recruit.
Semesters are often structured now to include not
only lectures, but seminars, group projects and
presentations which can produce heightened feelings
of anxiety. Although anxiety can be a natural reaction
to stress, those who have social anxiety can find their
uncomfortable symptoms in such situations so
debilitating that it may impact on their studies.
There are options to ensure you gain the support you
need if you do experience anxiety in a specific
learning context as follows:
•
Get to know your classmates. Although this may
be a bit of a challenge when you’re in a lecture
theatre of around 200 students, what will hopefully
make you feel less anxious is knowing there are
some friendly faces out there. Most subjects at
universities will host sessions in Freshers’ Week
where you can get to know those on your course,
whether this be a 'welcome meeting' in your first
week, or a few drinks in the union. You know you’ll
all have something in common – i.e. being new to
the university or college and, of course, the
subject itself! – so immerse yourself in getting to
know your peers if you can, and then when the
time comes to give a presentation in a seminar,
27
Generalised Anxiety Disorder (GAD)
you’ll know there’ll be some friendly faces at least
rooting for you.
•
Here
to help!
•
Speak to your Head of Department, or a specific
lecturer; usually you can obtain their contact
details readily on the internet so that if you feel a
little bit awkward staying behind after a lecture to
have a chat, you’ll be able to send an email in your
own time. Explain your concern about your studies
in relation to anxiety. For example, state that when
it comes to giving presentations due to your
anxiety you find this very challenging and
therefore you would appreciate some guidance
and support from them in this aspect. Try and do
this early on so that your lecturer is aware from the
outset of the difficulties that you face in a
particular situation.
Make use of your university and college advisors
and counsellors. If your university/college has
specific services designated for supporting
students living with anxiety (often this is the
student support office), then make an
appointment. They will have seen many students
in the past who require support for their social
anxiety, so you certainly won’t be alone and they
may be able to offer you some practical advice or
further specialised support to help you through
the presentation element of your course.
Generalised Anxiety Disorder affects between 2–5% of the
population, yet accounts for as much as 30% of the mental
health problems seen by GPs.6
This is defined as an anxiety condition in which
people feel in a constant state of high anxiety. The
anxiety is not the result of any specific trigger but
those affected feel that they are on the edge all the
time for no specific reason. It is also sometimes
referred to as ‘free floating’ anxiety. GAD can often
be accompanied by depression.
“
I have always been a worrier, but it wasn’t until
recently that normal worrying turned into GAD. At
the start, I was completely uneducated on this topic
and of course it made it worse, because I couldn’t
understand why I felt like this. My symptoms
included:
• Waking up with my stomach knotting
• Inability to be at ease
• Waking up earlier and earlier each day
• Tension headaches
• Dry mouth
• Adrenaline rushes and sweating
• Loss of appetite
As I’ve managed to tackle the physical symptoms,
I’ve realised that underlying all of this is negative
thought patterns and that the key to recovery is
dealing with these thoughts – no matter how small
you think that they are.
Craig
”
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29
Post-Traumatic Stress Disorder (PTSD)
Once PTSD develops, its symptom pattern is remarkably
uniform regardless of the individuals’ previous psychological
history or cultural background. However different a person is
before developing PTSD, there is a very characteristic human
pattern of response to an extreme stressor that includes
avoidance of stimuli that remind the person of the stress or,
re experiencing the stressor in a number of ways, and
increased physiological arousal, particularly on exposure to
memory jogging triggers.
This condition can affect individuals who experience a
traumatic incident such as:
• Being physically assaulted, mugged or bullied
• Being involved in some type of disaster
• Being the victim of rape or being sexually assaulted
• Being involved in a traffic accident
“
• Being involved in a war or other violent conflict.
PTSD affects
2.6% of men and
3.3% of women.7
2.6%
3.3%
Some of the symptoms of PTSD include:
• Flashbacks- this includes images, sounds and even smells
that link to the incident. These will often just pop into a
person’s mind when they don’t want them to.
• Having upsetting nightmares.
• Avoiding certain places or things that remind the person of
what happened or getting very upset when reminded of
the event.
• Feeling stressed out and on edge and finding that things are
more likely to cause a person to feel startled than before.
• Having problems sleeping or paying attention to what is
going on.
• Having angry outbursts
• Feeling numb and not getting any enjoyment out of things
30
I was diagnosed with PTSD about 9 months ago. In a way,
the diagnosis was a huge relief as I thought I was going mad.
I was in an abusive relationship for a year, and after I left
him, my whole life fell apart. He made sure during the
relationship that he was supporting me financially,
emotionally, physically and he ended up manipulating my
closest friends who went on to believe I was making
everything up. The first few months were tough, but I was
moving on with life and managed to push what happened to
the back of my mind. But slowly, after about 6 months, I
started to get flashbacks in the middle of the day of the
physical abuse; I had horrible nightmares that I couldn’t
wake up out of and any time I even heard his name, I had a
sudden outburst of anger that I couldn’t control. Without
realising it, I found I was isolating myself, avoiding going out
in case I saw anybody I knew that knew him, and anytime I
did go out, I was constantly on edge - I almost crashed my
car because I thought I saw him. I couldn’t sleep at all, and I
couldn’t concentrate on anything as my mind kept being
jolted back to those experiences.
A lot of people associate PTSD with war veterans and don’t
necessarily associate it with situations like mine, but the
outcomes of experiencing these traumatic events can
produce very similar symptoms. I’m now just taking life one
day at a time.
Louise
”
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Panic Disorder & Panic Attacks
Obsessive Compulsive Disorder (OCD)
The most common link between most anxiety
disorders is the panic attack. However if the panic
attacks are experienced out of the blue with no
apparent trigger, this is classified as panic disorder.
This disorder can be looked at in two parts;
obsessions which are repetitive, intrusive, unwanted
thoughts experienced by the individual which often lead to
unreasonable fears, and compulsions; acts or rituals which are
carried out in response to fears generated by the obsessions.
A very common presentation of OCD is that of compulsive
hand washing in response to an irrational fear of
germs/contamination. Another common presentation of OCD
is linked to thoughts of responsibility towards other people,
which can lead to obsessional behaviours in order to avoid
the ‘bad thing’ happening. For example, a new mother may
worry about harm coming to her baby and so feels the need
to check repeatedly that they are still breathing. It is however
possible to experience obsessive thoughts only and not carry
out a compulsion. When it comes to compulsions, however
some examples are excessive cleaning, counting, checking,
measuring and repeating tasks or actions.
Those affected by panic disorder will feel fine one
minute and then may feel totally out of control the
next and in the grip of a panic attack. Panic attacks
produce physical symptoms that include a rapid
increase in heart rate and a churning sensation in the
stomach. These symptoms are unpleasant and the
accompanying psychological thoughts of terror can
make a panic attack a very scary experience. Due to
this, individuals will start to dread the next attack and
will often enter into a cycle of living ‘in fear of fear’
which is known as panic disorder.
“
I have suffered with panic attacks for over 10 years
with my first attack happening whilst sat in a
lecture theatre. The first one that I had was the
worst as I didn’t know what was happening to me.
I have learnt to keep saying to myself that I’m not
going to faint or die when I have an attack. I also
focus on something that makes me feel happy. I
have found that if you can tell someone you know
about what you are experiencing, it can really
relieve some of the pressure. I usually have an
attack when I am in a crowded area (work usually)
or when I go to bed.
Kev
”
About 1.2% of the UK population experience panic
disorders, rising to 1.7% for those experiencing it with or
8
without agoraphobia.
32
OCD affects
around 2–3% of
the population.9
Examples of obsessions are worrying excessively about
death, germs, illness –usually serious illnesses such as AIDS,
cancer etc (this can however also be classified as an illness
phobia or health anxiety), having undesirable sexual thoughts
and fearing causing harm to others.
“
I have suffered with OCD for about 9 years. I still find it very
hard to talk about. I am afraid that I will hurt people. I get all
of these thoughts and feelings and I just can’t cope with
them. I avoid people just in case I have done something to
them. I have a sister who is 9 years old and I really can’t go
near her as I’m afraid of doing something bad.
Charlotte
”
33
“
Simple or Specific Phobias
Body Dysmorphic Disorder/Dysmorphophobia (BDD)
A specific phobia can be described as an irrational
fear of a specific object or situation. Some are very
common (e.g. spiders), others less so (e.g. clowns)
but it is really about the degree to which the phobia
affects a person’s life. For example, some they may
never encounter their phobic stimulus, for others
even a picture of the feared object could cause an
extreme anxiety response. As the name implies these
phobias are about specific objects or situations.
They will be distinct in nature and therefore easily
identified. For example, a fear of spiders, a fear of
thunderstorms or a fear of heights. Any of these
phobias will lead to a state of panic if the individual
is confronted with the phobic object/situation. A
number of physical symptoms will be experienced
and can include nausea, increased heart rate and
‘jelly legs’. Due to this a person affected by a phobia
will often enter into a pattern of avoidance. This can
vary enormously in severity from someone who will
not touch a spider for example, to someone who
cannot even look at a picture of one in a magazine
and who therefore has to vet everything they come
into contact with.
This anxiety condition is sometimes referred to as ‘Imagined
Ugliness Syndrome’ as those affected will often have an
irrational preoccupation with a perceived body defect, either
present in themselves or in others; the latter being
‘dysmorphobia by proxy’. People with this anxiety problem
cannot accept that their fears of their perceived body defect
are out of proportion, and they will frequently seek drastic
measures such as plastic surgery in an attempt to rectify the
perceived problem.
“
I am fully aware that other people probably see me as a good
looking person but when I look at myself I hate the way that
my skin looks and I don’t want to go out. I remember not
really wanting to go into college looking the way that I did
and feeling so down. I was not aware that there was a name
for what I was going through but looking back I was
constantly in the bathroom scrutinising my face which
wasn’t normal.
Matt
”
I am terrified of wasps. People say rational things like
‘stand still and it won’t sting you’ which probably
sounds like sensible advice until you understand that
rationalising an irrational fear simply doesn’t work. It
is the equivalent of me saying ‘stay still’ whilst
coming under siege by a wild bear or tiger. I once ran
across the road to escape the stripy little flies of evil
and then realised that I had left my three year old
son on the other side.
Jacqui
”
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35
Emetophobia
Claustrophobia
(fear of confined spaces/being trapped)
This is often known as vomit phobia and refers to
either a fear of vomiting/being sick or a fear of
seeing others being sick. Those affected by
emetophobia will often:
This involves a fear of being in a confined space and is
fuelled by the perceived ‘lack of an escape route’. Those
affected by this anxiety condition may have panic attacks
when faced with these situations. It is also the case that those
affected by panic attacks can develop claustrophobia. This is
linked to the fear that is panic is triggered in a confined
space they may not be able to escape. Those affected by
claustrophobia will often:
• Fear being sick in public
• Avoid people who are ill with any illness that makes
them vomit or even refuse to leave their home
when there are stomach bugs going around
• Avoid eating out either in restaurants or ordering
from takeaways and college canteens
• Ensure that when they are in a confined space they have an
escape route. For example, sitting at the end of a row of
seats in a lecture theatre or cinema.
• Have a strict diet; avoiding eating any foods that
they perceive might carry a higher risk of food
poisoning
• Avoid driving on motorways and other busy roads.
• When in crowded rooms, staying near the fire exit/exit
route
• Take extreme measures to avoid becoming
pregnant due to the fear of developing morning
sickness
• Avoid travelling in an aeroplane or long distances where
confinement is likely.
• Avoid taking medications that might have nausea
listed as a side effect
• Avoid travelling particularly by air, sea or coach due
to the possibility of developing travel sickness.
“
I am 20 and I have had a fear of being sick nearly all
my life. I don’t know why I feared being sick so much
but it totally took over my life. I used to go to
extraordinary lengths to avoid anything to do with
being sick. I would wash my hands about five times
before eating. If I knew that someone was ill, I would
stay away from them for at least two weeks. There
were even also irrational things that I did such as
avoiding the number ‘6’ because it sounds like ‘sick’.
Sharon
“
Crowded places always make me feel claustrophobic. I get
very anxious and start to feel as though I can’t breathe. I
often worry that I will not be able to escape and this makes
me feel even more panicky. I have now started to avoid
situations that I know will make me feel trapped which is
having a big, negative impact on my ability
to continue my studies.
Danny
”
”
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37
Treatment of anxiety
NICE (The National Institute for Clinical Excellence)
produce guidance on evidence based treatments for
anxiety. However, as anxiety affects individuals in
many different ways, the types of treatment that
people find helpful often varies from person to
person. What may work for one may be of no use for
another. The idea of ‘one size fits all’ certainly does
not apply!
For many people affected by anxiety and related
conditions, finding the right type of treatment is a
case of giving many things a try to see what works
best. It is important to realise that talking about a
‘cure’ for anxiety is not helpful. Cure implies that the
problem is fully resolved and that it cannot happen
again. With anxiety, the reality is that it can come
and go; it can be managed but it can also reoccur
during stressful periods. However, the good news is
that anxiety and related conditions can be treated
and therefore the symptoms of anxiety can be
managed and controlled. Sometimes it can feel as
though you may be taking two steps forward when
you embark on a course of treatment and one step
back , but overall its important to recognise that you
are making progress.
Impor tantly, anxiety is a totally normal emotion – therefore
to seek to completely eradicate an emotion would be
unrealistic and unhelpful just as it would be ridiculous to
seek to never experience anger or another emotion ever
again in your life.
38
Coping with anxiety
As you will have seen from the personal experiences
detailed in this guide, whilst the principles of anxiety
are the same, people are individuals and find
different combinations of things helpful when
obtaining support for the management of their
anxiety. So now that we have looked at the three
parts of anxiety: the physical, psychological and
behavioural aspects, we shall look at methods of
coping with and controlling anxiety. There are various
ways of tackling anxiety – each being designed to
deal with one or a combination of them.
Generally, relaxation training is helpful in dealing with
the physical symptoms of anxiety. Thought-modifying
techniques, distraction and therapies that help you
look at your thoughts and ways of thinking such as
Cognitive Behavioural Therapy are useful ways of
tackling the psychological symptoms, and
behavioural therapy is useful for tackling avoidance
behaviour that you may have developed along
the way.
39
Relaxation training
Hyperventilation and Faulty Breathing
Relaxation training is a technique that aims to reduce
physical tension in the body that has built up as a
result of anxiety and involves practising specific
exercises on a regular basis. There are variations on
the theme of relaxation but most centre on each
muscle group of the body, alternating between
tensing and relaxing. When this is carried out on the
whole body, a person’s overall muscular tension will
be very much reduced. Relaxation training also helps
to lower the heart rate and blood pressure, and slow
down the rate of breathing. People also experience a
feeling of ‘mental tranquillity’.
It is important to mention breathing at this point,
because many people with anxiety tend to overbreathe, or hyperventilate. It is very likely that you
have slipped into a pattern of breathing whereby you
take your breaths from the top part of your chest,
which results in your shoulders going up and down.
To breathe properly, you should use your lower
abdomen, and your tummy should gently rise and fall
with each breath. To check that you are breathing
correctly (funny though this may sound), place your
hand on your tummy, and see if your tummy is rising
and falling. If it isn’t, it is very likely that you have
developed the anxious breathing technique, i.e.
taking lots of little, shallow breaths from your upper
torso, instead of deep, long breaths from the lower
abdomen.
Relaxation works by helping you to let go of any
anxiety that you have been holding in. Most of us
with anxiety problems try and contain the anxiety by
holding ourselves in a stiff, rigid way. We feel that if
we let go, we might just panic. Unfortunately, this
couldn’t be further from the truth. By remaining
constantly tense, we only add to the background
level of anxiety in our body and make it more likely
for a panic attack to occur.
Also, if you get yourself into a state of deep
relaxation before a situation that you feel will cause
you anxiety, it will be harder for you to get worked
up later on! The effects of deep relaxation last
several hours, sometimes days! Hypnotherapy utilises
a range of relaxation techniques and is very helpful in
bringing about a reduction in overall anxiety levels.
Anxiety UK has a range of relaxation resources
available from the Anxiety UK website:
www.anxietyuk.org.uk.
40
Normal breathing is so important in controlling
anxiety. Breathing is much more than just taking in a
gasp of air – with each breath, the proportions of
very important gases in our blood are regulated. A
change in the balance of these gases can result in
you feeling light-headed, dizzy and unreal. Many
people find that just by correcting their breathing,
their anxiety symptoms considerably reduce, so it’s
important to rectify faulty breathing at an early stage.
It is also important to point out that hyperventilation
in itself is nothing to be concerned about and will
not cause you any harm. In fact it is just like anxiety –
unpleasant, but harmless.
41
The deep breathing exercise below is something you
might wish to incorporate into your daily routine:
Deep Breathing Exercise
• Breathe in slowly throught your nose for a
count of three
• As you breathe in, ensure you are using the
abdominal muscles rather than the upper
chest/shoulder muscles, inhaling so your belly rises
• Hold for a count of three
• Breathe out through your mouth for a count of five
• As you breathe out, exhale so your belly falls
For the next exercise, you will need to set aside at
least 30 minutes each day. Make sure you are in a
quiet room, where you will not be disturbed. You
may find it helpful to read out the exercise and
record it, so that you can listen to the exercise with
your eyes closed whilst lying down. Just as with
anything new, it will take some time for you to learn
to relax, but in time, the exercises will become
second nature.
Relaxation Exercise
Please do not tense any area of the body where you
have experienced an injury nor that causes pain. If
you do experience any pain whilst doing these
exercises, please do speak to your GP.
• Concentrate on your toes. Scrunch your toes up
tightly and hold for a count of three. Relax and
uncurl your toes.
Repeat this twice.
• Concentrate on your feet. Push the soles of your
feet downwards. Feel the tension. Hold for a count
of three, and then relax.
Repeat this twice.
• Tense the muscles in your thighs and hold for a
count of three, then relax.
Repeat this twice.
• Tense the muscles in your bottom and hold for a
count of three, then relax.
Repeat this twice.
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43
• With a deep breath, hold your tummy lightly in for
a count of three. Take a big breath out and release
your tummy.
Repeat this twice.
• Lift your shoulders up to your ears and
hold for a count of three, and relax.
people to become more aware of their thoughts,
feelings, and body sensations so that instead of
being overwhelmed by them, they’re better able to
manage them. Practising mindfulness can give more
insight into emotions, boost attention and
concentration, and improve relationships.
Repeat this twice.
The next methods are designed to help you deal
with the psychological symptoms of anxiety:
• Scrunch your eyes up tightly and
hold for a count of three, and relax.
Distraction Techniques
Repeat this twice.
The aim of these techniques is to get you to think of
something else in place of your anxious thoughts.
Distraction is a very useful thing to practice in
situations where you feel confined – for example
whilst waiting in a supermarket queue, a busy lecture
theatre or whilst stuck in a traffic jam! Instead of
thinking thoughts such as, ‘I’ve got to get out of
here, I feel panicky’, look around your environment –
look at the people in the queue; notice what they are
wearing, what they are buying. You would be
surprised what you can think about when you make a
positive effort to stop thinking anxiously!
• Now, roll into a position that feels comfortable
and keep your eyes closed for five minutes.
• At the end of the exercise, gently stretch,
and get up slowly.
Whilst practising relaxation techniques you may wish
to play relaxing music – such as those which feature
the sound of the sea, dolphin sounds or rainfall.
Some people find it useful in addition to burn
essential oils such as lavender, geranium etc.
Mindfulness
Mindfulness is an integrative, mind-body based
approach that helps people to manage their
thoughts and feelings. It is becoming widely used in
a range of contexts. It is recommended by NICE as a
preventative practice for people with experience of
recurrent depression.
There are other ways of distracting yourself that you
may find helpful too. These include:
• Counting backwards from 100 in groups of 3s
• Saying the alphabet backwards
You could devise your own distraction technique if
you find these boring, or too easy!
Mindfulness exercises are ways of paying attention to
the present moment, using techniques like
meditation, breathing, and yoga. Training helps
44
45
Thought Stopping
This technique is about stopping any anxious,
unpleasant thoughts the moment it enters into your
head. It is about learning to produce an almost
automatic response to an unwanted thought.
The process is as follows:
• Shout STOP loudly to yourself as soon as an
anxious thought enters your head
• Visualise a flashing red STOP sign appearing
You then need to either distract yourself by using
one of the techniques above, or by concentrating on
something else that will full occupy you. This last
point is important because it is no good picking up
something to read but half-heartedly reading it, and
expecting this to do the job. Whatever you engage
in, be it physical or mental activity, it must interest
you to the extent that there is no room in your mind
for anxiety.
Psychological Therapies
Clinical Hypnotherapy
During our daily lives, we may not realise, but we
experience trance states quite often. The experience
of hypnosis is similar in neither being asleep nor
awake, but being in a tremendous state of relaxation;
an altered state of consciousness.
Hypnosis is a natural, effective way of making contact
with your unconscious – the source of many of our
problems and a huge area of untapped potential
strength and knowledge. The unconscious mind is
the part of us that doesn’t sleep, therefore, because
our unconscious mind is always ‘on duty’, nobody
can be hypnotised against their will or ‘duped’ to do
something they do not agree with. During hypnosis
you can reject or accept suggestions, even in a deep
state of relaxation.
Hypnotherapy utilises hypnosis for the treatment and
relief of a variety of somatic and psychological
symptoms. It also produces a deeply relaxed state
more easily and quickly than many other forms of
treatment. When carried out by a professionally
trained and skilled hypnotherapist, the benefits can
be long lasting and often permanent and is
completely natural and safe, with no harmful side
effects.
The number of sessions required for a course of
hypnotherapy varies, and the exact amount of
therapy required will be agreed upon between the
client and therapist depending on the client’s
condition. However hypnotherapy is aimed at
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47
producing results in a relatively short period of time
and solutions can be reached within 4-6 sessions.
Anxiety UK has an extensive clinical hypnotherapy
service which offers members the opportunity to see
a practitioner of clinical hypnotherapy through the
Anxiety UK Approved Therapist Scheme, available
throughout the UK.
Cognitive behavioural therapy
Cognitive Behavioural Therapy (CBT) is an approach
used to help people experiencing a wide range of
mental health difficulties. The basis of CBT is that
what people think affects how they feel emotionally
and also alters what they do. CBT has been found to
be extremely useful and effective in the treatment of
a range of anxiety disorders.
CBT combines two very effective kinds of
psychotherapy – Cognitive therapy and Behavioural
therapy. Behavioural therapy helps weaken the
connections between troublesome situations and
habitual reactions to them. It also teaches how to
calm the mind and body; aiding clearer thinking and
better decision making. Cognitive therapy teaches
how certain thinking patterns influence behaviour.
When combined into CBT, behavioural therapy and
cognitive therapy represents a powerful tool for
reducing anxiety and getting more satisfaction out of
life.
48
The number of CBT sessions needed varies and will
be agreed on by a therapist and their client, and will
mainly depend on the severity of the client’s
problems. Typically, a therapist will see clients once a
week for one hour, usually for 6-8 sessions, although
if a person’s anxiety is severe or longstanding they
could need more sessions. After treatment
completion, therapists and clients usually agree to a
number of follow-up sessions to maintain the
progress achieved. Anxiety UK has a team of
experienced Cognitive Behavioural Therapists who
can provide support on a face-to-face basis, over the
phone or via the Anxiety UK Approved Therapist
Scheme.
Counselling
Counselling is a form of therapy in which clients have
the opportunity to explore their anxiety and
problems that might be causing this in a safe,
understanding environment. The key process in this
specific therapy is facilitation of the experience of
the client becoming a more autonomous,
spontaneous and confident person. Any changes
which occur during therapy are brought about by the
client. Anxiety UK has a team of counsellors that
provide therapy across the country on a 1:1 basis,
either in a face-to-face capacity, over the phone or
via the Anxiety UK Approved Therapist Scheme.
49
What else can help?
Diet
Try to eat a sensible, balanced diet. This is important
because fluctuating blood sugar levels which can
result from snacking, and not eating nutritional meals,
can produce the same symptoms as anxiety.
It is advisable to cut down on instant sugar
fixes, and switch to eating foods that will give
you a more sustained release of sugar. Certain
carbohydrate foods (complex carbohydrates) are
very good at this – brown bread, brown rice,
cereals, pasta etc.
Eliminate caffeine from your diet. Caffeine increases
anxiety symptoms, particularly palpitations and
feeling jittery and shaky. Caffeine whilst being present
in coffee is also found in tea, chocolate, and cola
based drinks.
Cut down on your alcohol intake. This may be
challenging as a student because of the prevailing
‘drinking culture’ at university and colleges but many
people find that the day after they have had a drink
they do feel much more anxious, and this is not
related it seems to any hangover that they may
also have. Excess alcohol can make you more
prone to the effects of stress.
Physical exercise
There is no getting away from the fact that physical
exercise as well as being great at keeping us healthy,
also keeps us mentally well. In fact there has been a
wealth of studies which have found that regular
exercise is one of the most effective ways to raise
self-esteem. The reason for this is thought to be due
to exercise causing release of the body’s natural
endorphins. Exercise will help to lower your stress
level, and therefore help to control anxiety. This
doesn't mean you have to spend hours at a gym;
instead you could opt to join a yoga class, or go for a
gentle swim or a walk.
Self help groups
Many students find it helpful to share what they are
experiencing with others who have been similarly
affected. It can often be very therapeutic to realise
that there are others experiencing similar forms of
anxiety. Self help groups are one way of accessing this
form of support. They offer a way of sharing and
gathering information on coping strategies. Anxiety
UK maintains a comprehensive list of self help groups
in operation throughout the UK.
Cut down on smoking, or stop completely. Nicotine
and other chemicals found in cigarettes actually
increase symptoms of anxiety by increasing the heart
rate and blood pressure.
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51
Medication
It may be that you have tried everything mentioned
so far, and your anxiety levels are still sky high. If this
is the case, you may need to go and see your GP
and enquire about psychiatric medication.
Unfortunately most people do not find a medication
that they are best suited to straight away, and end
up having to try a few drugs first. This is quite
frustrating naturally, but do remember if you find one
drug doesn’t work for you, don’t discount trying
others.
It is very important that you have a full conversation
with your GP or pharmacist about the pros and cons
of taking medication and how they are going to help
you access psychological therapy to deal with the
problems that are making you anxious.
Getting help & support
with anxiety at university/college
When it comes to going to university/college, help
and support is available; you just need to know
where to look.
In a study conducted by the Equality Challenge Unit
201510, surveying a wide range of universities over
the UK, many students stated that they benefited
greatly from reaching out and talking to fellow
students whilst experiencing mental health
difficulties, including anxiety at university.
However, before coming to university, most
students are unaware of the support offered
at their chosen place of study.
• Before applying, just 28% of respondents who had
experienced mental health difficulties before they
decided to apply to university were aware of the
support and adjustments that universities provided
that may be beneficial to them.
Anxiety UK has a psychiatric pharmacy helpline
available which enables members to speak to a
qualified psychiatric pharmacist who can give advice
and information on all aspects of medication.
52
• Around three-fifths of the general population
experience anxiety on a daily basis, yet, rather
worryingly, only 7% admit they would see their GP
over feelings of anxiety.11
53
The main reasons that people cited as to why
they did not reach out for help included:12
• believing they would not receive any support
or adjustments
• fear that they would receive unfair treatment
However, in reality, the students who were reaching
out and accessing support through their universities
did, in the majority, have a positive or very positive
response.
• Around 78% of student respondents who received
support or adjustments said that it had a positive
or very positive effect on their studies and other
experiences at university
Positive effects of receiving individual support and
adjustments mentioned by respondents included:
• giving staff and students a feeling of
empowerment
• allowing students to demonstrate their ability to
meet course requirements
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Ultimately, most universities provide a wide range of
adjustments and support for those experiencing
mental health difficulties including anxiety.
The following examples of support or adjustments
were mentioned by respondents to the survey:13
• Study support for students, for example peerassisted learning schemes, individual learning plans,
mental health support
• Being given access to dedicated support workers
and mentors
• Being provided with specific equipment, for
example dictaphones or audio recorders to record
lectures, laptops, speech recognition software,
desktop lightbox
• Adjustments being made to course assessments,
for example alternative assessment types,
alternative exam arrangements, and extensions
and adjustments to deadlines
• Being provided with individual therapeutic
support, for example mindfulness training,
counselling sessions, resilience training and
Cognitive Behaviour Therapy (CBT).
55
Anxiety UK’s top tips
for students living with anxiety
1
3
Research GP practices that are located nearby to
your campus/halls and register online before you
move. Having that GP support in place from day one
will mean you have one less thing to worry about.
4
2
Disclosure: UCAS advises14, “If you have a disability,
mental health condition or learning difficulty, it’s a
good idea to contact course providers to discuss
what you might need as early as possible – even
before submitting your application.”
The University Mental Health Advisers Network, says,
“Early disclosure can ensure the impact on your
studies is considered.” This can include access to
counsellors and mental health and financial advisors.
It also means that you can ask for your needs to be
taken into account when it comes to housing
allocation. If you have an eating disorder, and have a
preference towards either catered or self-catered
halls of residence, it’s worth raising this as soon as
possible. Though disclosure of mental health
difficulties can be daunting, it’s also beneficial:
78% of students who sought support15 from their
university say doing so had a positive effect on their
studies.
56
Get in touch with the Head of your Department
before you start your course. There should be a
Welfare Tutor in your department who can point you
in the right direction for support if you have an
anxiety condition.
Have a plan. Create a plan of what you will do if
you’re affected by anxiety at university or college.
This could start with self help; the things that you
can do to make yourself feel better, such as going
for a run. Then include support services, whether
these are provided by the university/college, or in
the local community.
This could include arranging daily or weekly calls
with family and friends, putting in place specific
support, or even creating a positive vision board in
your room to encourage you when you’re feeling
low. Having a plan can be reassuring in itself as it
offers you a means to take control. If you’re the
parent or friend of a prospective student with mental
health needs, try creating an action plan with them.
5
At times, universities can make special
adjustments for those experiencing mental health
issues including anxiety and can put support in
place for you throughout your studies. Talk with
the Head of your Department to discussion options
that are available by way of special adjustments.
57
6
Many Student Unions have Welfare Officers who
are employed to look after the welfare of
students, including providing support for student
mental wellbeing.
Familiarise yourself with these people and get in
contact before leaving home. A lot of universities will
have different names for their services but if you
search under ‘welfare’ you can usually locate the
support that is available quite quickly.
7
8
58
Join a gym or sports society. It is well publicised
that engaging in physical activity can be beneficial
for those people affected by anxiety.
Become a member of Anxiety UK and join our
community of like-minded people.
In doing so, you will be able to tap into a wide range
of support services specifically aimed at students.
Student Experiences
of student life and anxiety
“
I just finished my second year and was diagnosed with GAD
last November. The diagnosis was very hard to come to
terms with, especially because I was diagnosed with
depression at the same time. The depression took over my
life which made my anxiety symptoms much worse. A
combination of medication, counselling and making changes
was the only way I was able to continue the year at
university. Staff at the university were really understanding
and helpful which made me less stressed about my
situation.
“
Make sure you get all the help you need from the relevant
people at the university. There should be a welfare tutor in
your department who will be able to point you in the right
direction for those who can make sure you have all the
support mechanisms in place. The earlier that you let your
department know, the better the help will be.
“
Anxiety has meant that everything that students have to
cope with ordinarily seemed impossible for me to deal with.
Either because I was worried about failing, getting it wrong
or just because a busy life left me completely flustered, not
knowing where to start.
“
Give uni lecturers and health advisors as muc
h information
as possible. Everyone at uni who I contacte
d was so
supportive.
”
”
”
”
59
“
“
“
“
Be kind to yourself; talk where you can and remember there's
always more empathy in the room than you thought.
If your anxiety condition is diagnosed make sure it's logged
on the system ASAP just in case you need an extension on
coursework or extra time in exams.
”
Knowing that you may be eligible for DSA - Disabled
Students Allowance/other forms of assistance- is something
that not many students with anxiety may know about.
I think it's really important that more students are aware
they can apply and may be entitled to free equipment and
software to aid their studies.
“
”
“
”
Talk to someone. Once I'd been diagnosed the staff at uni
I spoke to were very supportive and helpful. They're there
for you.
I was diagnosed with GAD in my second year
and found
that adapting to uni was difficult at first,
but once you
realise that help is available - like the univ
ersity
‘Advice and Counselling services’, it becomes
a lot easier.
“
“
60
”
One thing that helped me was getting a job at the Student
Union bar. It took me a while to settle in and become
comfortable with my surroundings, but now I think it’s the
best decision I’ve made at university. The more you work
with people, the closer you become - and abracadabra - you
have a ready made group of friends. It also forced me to go
into university on a regular basis and had a knock on effect
by increasing my attendance at lectures. Working boosts
your confidence, and lines your pockets; which will make you
happier.
”
Allow yourself to be anxious; remember it's only an emotion.
”
As someone who once had severe social anxi
ety - give
living in halls a go. You may surprise your
self.
”
Another thing I would strongly suggest is living in halls of
residence. Although the halls were pretty dire, one of the girls
that I lived with (who I probably wouldn’t have bumped into
otherwise), has become one of my really good friends, and
through her I met more people, and so on. You might be stuck
with people you don’t get on with, but it’s a lesson in
patience, tolerance and generally being a grown up.
”
“
“
Making the most of the free support your university offers,
can be invaluable!
“
We were all starting a new segment in our lives, and we
didn't know each other, so it was a given that we all had to
go through the process of getting to know each other. It was
easy to do because most people kept their doors open for
others to walk-in and hang out.
“
“
The best way to meet people is at clubs and
through
participating in recreational activities. At
least you know
you will be hanging out with people with
similar interests.
”
It'll be difficult at first but as you join societies and mix with
your course mates you'll find like-minded people and the
'uni experience' will begin. You're not just restricted to
socialising with your flatmates but being in halls makes you
much more accessible for house parties etc...
”
”
” ”
”
Self-care is so so so important; schedule time for chilling out
and/or hobbies and stick to it like self-care is your job.
61
And finally...
Useful Contacts
It’s important to remember that you should never feel
ashamed or embarrassed to reach out for support if you have
anxiety or an anxiety condition.
1 in 4 people experience mental health issues at any one
time; just take a look around your lecture theatre and count
how many of your classmates may too be in need of support.
Help is available at college and university, so access it.
Good luck.
Student Minds
www.studentminds.org.uk
info@studentminds.org.uk
01865 264 168
1:4
people experience
mental health issues
References
1 Spencer Salberg, http://heymonster.tumblr.com/post/19350033745/a-comic-about-anxiety
2 YouGov survey April 2014
https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/olf77euh8m/YouGov-SurveyMental-Health-Foundation-Anxiety-140410.pdf
3 NUS Mental Distress Survey 2013
http://www.nus.org.uk/Global/Campaigns/20130517%20Mental%20Distress%20Survey%20%20Overvie
w.pdf
4 Mental Health Foundation ‘Living with Anxiety’ report 2014, http://www.mentalhealth.org.uk/helpinformation/mental-health-statistics/anxiety-statistics/
5 YouGov survey April 2014
https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/olf77euh8m/YouGov-SurveyMental-Health-Foundation-Anxiety-140410.pdf
6 Mental Health Foundation ‘Living with Anxiety’ report 2014, http://www.mentalhealth.org.uk/helpinformation/mental-health-statistics/anxiety-statistics/
7, 8 and 9 as above
10 ©Equality Challenge Unit 2015; http://www.ecu.ac.uk/publications/understanding-adjustmentsmental-health/
11 AXA PPP Healthcare; 12.05.2014 “Anxiety Levels on the Rise across Britain”
https://www.axappphealthcare.co.uk/Health-worries/Stress/news/anxiety-levels-on-the-rise-acrossbritain/
12 ©Equality Challenge Unit 2015; ‘Understanding Adjustments: supporting staff and students who are
experiencing mental health difficulties’ http://www.ecu.ac.uk/wpcontent/uploads/2015/02/ECU_Understanding-adjustments.pdf p.5
13 ©Equality Challenge Unit 2015; As above p.14
14 https://www.ucas.com/ucas/undergraduate/getting-started/individual-needs
15 Equality Challenge Unit Feb 13th 2015: “Mental health in HE: staff and students not accessing
support”
62
Nightline Association
http://nightline.ac.uk
The University Mental
Health Advisers Network
(UMHAN)
http://www.umhan.com
01865 264 170
National Institute for
Health & Clinical
Excellence (NICE)
www.nice.org.uk
nice@nice.org.uk
0300 323 0140
British Association for
Behavioural and Cognitive
Psychotherapies
www.babcp.com
0161 705 4304
British Association for
Counselling and
Psychotherapy
www.bacp.co.uk
bacp@bacp.co.uk
Tel: 01455 883 300
Complementary and
Natural Healthcare Council
www.cnhc.org.uk
info@cnhc.org.uk
02076 531 971
These links are provided for your information and reference only. The
websites operate independently of Anxiety UK, who cannot be held
responsible for their contents.
63
If you or someone else needs help and support with any
anxiety condition, Anxiety UK provides a range of services.
For further information contact Anxiety UK on
08444 775 774 or visit www.anxietyuk.org.uk
If you would like to receive support for your anxiety,
Anxiety UK provides a range of services to members,
including access to reduced cost therapy, the chance
to get support from other sufferers and the
opportunity to campaign on behalf of anxiety
sufferers.
To become a member, ring our helpline on 08444
775 774 or visit www.anxietyuk.org.uk
Anxiety UK
Zion Community Resources Centre,
339 Stretford Road, Hulme,
Manchester M15 4ZY
Tel: 08444 775 774
Website: www.anxietyuk.org.uk
Email: info@anxietyuk.org.uk
Established 1970
Registered charity no: 1113403
© Anxiety UK