Understanding
Anxietyismorethanjustfeeling
stressedorworried.Anxious
feelingsareanormalreactionto
asituationwhereapersonfeels
underpressure–forexample,
meetingworkdeadlines,sitting
examsorspeakinginfrontof
agroupofpeople.However,
forsomepeopletheseanxious
feelingshappenfornoapparent
reasonorcontinueafterthe
stressfuleventhaspassed.
Forapersonexperiencing
anxiety,anxiousfeelingscannot
bebroughtundercontroleasily.
Anxietycanbeaseriouscondition
thatmakesithardforaperson
tocopewithdailylife.
Anxietyisthemostcommonmental
healthconditioninAustralia.On
average,oneinfourpeople–onein
threewomenandoneinfvemen–
willexperienceanxietyatsomestage
intheirlife.Ina12-monthperiod,over
twomillionAustraliansexperience
anxiety.1Anxietyiscommon,butthe
soonerpeoplewithanxietygethelp,
themorelikelytheyaretorecover.
Howdoyouknowif
someonehasanxiety?
Thesymptomsofanxietycanoften
developgraduallyovertime.Giventhat
weallexperiencesomeanxiety,itcan
sometimesbehardtoknowhowmuch
istoomuch.Tobediagnosedwithan
anxietydisorder,theanxietymusthave
adisablingimpactontheperson’slife.
www.beyondblue.org.au
230330_0613_BL0384.indd 1
anxiety
Therearemanytypesofanxiety.
Whilethesymptomsforeachtype
aredifferent,somegeneralsignsand
symptomsinclude:
− changeinlivingarrangements
• feelingveryworriedoranxious
mostofthetime
− experiencingamajoremotional
shockfollowingastressfulor
traumaticevent
• fndingitdiffculttocalmdown
• feelingoverwhelmedorfrightened
bysuddenfeelingsofintensepanic/
anxiety
• experiencingrecurringthoughts
thatcauseanxiety,butmayseem
sillytoothers
• avoidingsituationsorthingswhich
causeanxiety(e.g.socialeventsor
crowdedplaces)
− pregnancyandgivingbirth
− familyandrelationshipproblems
− experiencingverbal,sexual,
physicaloremotionalabuse
ortrauma
− deathorlossofalovedone.
• Physicalhealthproblems:
Continuingphysicalillnesscan
alsotriggeranxietyorcomplicate
thetreatmentoftheanxietyorthe
physicalillnessitself.Common
conditionsthatcandothisinclude:
• experiencingongoingdiffculties
(e.g.nightmares/fashbacks)aftera
traumaticevent.
− hormonalproblems
(e.g.overactivethyroid)
Whatcausesanxiety?
− asthma
It’softenacombinationof
factorsthatcanleadtoaperson
developinganxiety.
• Familyhistoryofmental
healthproblems:Peoplewho
experienceanxietyoftenhavea
historyofmentalhealthproblems
intheirfamily.However,this
doesn’tmeanthatapersonwill
automaticallydevelopanxietyifa
parentorcloserelativehashad
amentalhealthcondition.
• Stressfullifeevents:Stressful
eventscanalsotrigger
symptomsofanxiety.Common
triggersinclude:
1300224636
− diabetes
− heartdisease.
Ifthereisconcernaboutanyof
theseconditions,askadoctorfor
medicalteststoruleoutamedical
causeforthefeelingsofanxiety.
• Substanceuse:Heavyorlong-term
useofsubstancessuchasalcohol,
cannabis,amphetaminesor
sedatives(suchasbenzodiazepines)
canactuallycausepeopleto
developanxiety,particularlyas
theeffectsofthesubstancewear
off.Peoplewithanxietymayfnd
themselvesusingmoreofthe
substancetocopewithwithdrawalrelatedanxiety,whichcanleadto
themfeelingworse.
− jobstressorchangingjobs
1
13/06/13 3:30 PM
• Personalityfactors:Some
researchsuggeststhatpeoplewith
certainpersonalitytraitsaremore
likelytohaveanxiety.Forexample,
childrenwhoareperfectionists,
easilyfustered,lackself-esteem
orwanttocontroleverything,
sometimesdevelopanxietyduring
childhoodorasadults.
Generalisedanxietydisorder
(GAD)
Apersonfeelsanxiousonmostdays,
worryingaboutlotsofdifferentthings,
overaperiodofsixmonthsormore.
Forsixmonthsormore,onmoredays
thannot,haveyou:
• feltveryworried
• foundithardtostopworrying
• foundthatyouranxietymadeit
diffculttocarryouteveryday
activities(e.g.work,study,seeing
friendsandfamily)?
Ifyouanswered‘yes’toallofthese
questionshaveyoualsoexperienced
threeormoreofthefollowing:
• feltrestlessoronedge
• felttiredeasily
• haddiffcultyconcentrating
• feltirritable
• hadmusclepain(e.g.sorejaw
orback)
Typesofanxiety,theirsigns
andsymptoms
Therearemanytypesofanxiety,with
arangeofsignsandsymptoms.It’s
importanttonotethatthefollowing
areonlyguidestorecognising
differenttypesofanxiety.Theywillnot
provideadiagnosis–forthatyouneed
toseeahealthprofessional.
Socialphobia
Apersonwithsocialphobiahas
anintensefearofcriticism,being
embarrassedorhumiliated,evenjust
ineverydaysituations,forexample,
publicspeaking,eatinginpublic,being
assertiveatworkormakingsmall
talk.Haveyou:
• feltfearofoneormoresocialor
performancesituationswhereyou
maybecriticised
• thesituationisavoidedorendured
withanxietyanddistress
• theanxietyinterfereswithnormal
routine,workinglife,social
functioning,oryouaredistressed
abouttheproblem
• thefearisidentifed
asunreasonable?
Formoreinformationsee
beyondblue’s‘Socialphobia’fact
sheetatwww.beyondblue.org.au
• hadtroublesleeping(e.g.diffculty
fallingorstayingasleepor
restlesssleep)?
Formoreinformationsee
beyondblue’s‘Generalised
anxietydisorder’factsheetat
www.beyondblue.org.au
Specifcphobias
Apersonfeelsveryfearfulabouta
particularobjectorsituationandmay
gotogreatlengthstoavoidtheobject
orsituation,forexample,havingan
injectionortravellingonaplane.
Therearemanydifferenttypesof
phobias.Haveyou:
• feltverynervouswhenfacedwitha
specifcobjectorsituatione.g.:
− fyingonanaeroplane
− goingnearananimal
− receivinganinjection
• avoidedasituationthatmight
causeyoutofacethespecifc
phobiae.g.:
− neededtochangeworkpatterns
− notgettinghealthcheck-ups
• foundithardtogoaboutdailylife
(e.g.working,studyingorseeing
friendsandfamily)becauseyouare
tryingtoavoidsuchsituations?
Formoreinformationsee
beyondblue’s ‘Specifcphobias’fact
sheetatwww.beyondblue.org.au
Obsessivecompulsivedisorder
(OCD)
Apersonhasongoingunwanted/
intrusivethoughtsandfearsthat
causeanxiety.Althoughtheperson
mayacknowledgethesethoughtsas
silly,thepersonoftenfndshimor
herselftryingtorelievetheiranxiety
bycarryingoutcertainbehaviours
orrituals.Forexample,afearof
germsandcontaminationcanlead
toconstantwashingofhandsand
clothes.Haveyou:
• hadrepetitivethoughtsor
concernsthatarenotaboutreal
lifeproblems(e.g.thoughtsthat
youorpeopleclosetoyouwillbe
harmed)
• performedthesameactivity
repeatedlyandinaveryordered,
preciseandsimilarwayeach
timee.g.:
− constantlywashinghands
orclothes,showeringor
brushingteeth
− constantlycleaning,tidyingor
rearranginginaparticularway
thingsathome,atworkorin
thecar
− constantlycheckingthatdoors
andwindowsarelockedand/or
appliancesareturnedoff
• feltrelievedintheshorttermby
doingthesethings,butsoonfeltthe
needtorepeatthem
• recognisedthatthesefeelings,
thoughtsandbehaviourpatterns
areunreasonable
• foundthatthesethoughtsor
behaviourpatternstakeup
morethanonehouradayand/or
interferedwithyournormalroutine
(e.g.working,studyingorseeing
friendsandfamily)?
Formoreinformationsee
beyondblue’s‘Obsessive
compulsivedisorder’factsheetat
www.beyondblue.org.au
Post-traumaticstressdisorder
(PTSD)
Thiscanhappenafteraperson
experiencesatraumaticevent
2
230330_0613_BL0384.indd 2
13/06/13 3:31 PM
(e.g.war,assault,accident,disaster).
Symptomscanincludediffculty
relaxing,upsettingdreamsor
fashbacksoftheevent,and
avoidanceofanythingrelatedto
theevent.PTSDisdiagnosedwhen
apersonhassymptomsforat
leastamonth.Haveyou:
• experiencedorseensomething
thatinvolveddeath,injury,torture
orabuseandfeltveryfrightened
orhelpless
• hadupsettingmemoriesordreams
oftheeventforatleastonemonth
• foundithardtogoaboutdailylife
(e.g.diffcultyworking,studying
orgettingalongwithfamilyand
friends)?
Ifyouanswered‘yes’toallofthese
questionshaveyoualsoexperienced
atleastthreeofthefollowing:
• avoidedactivitiesthatarea
reminderoftheevent
• hadtroublerememberingpartsof
theevent
• feltlessinterestedindoingthings
youusedtoenjoy
• hadtroublefeelingintensely
positiveemotions(e.g.loveor
excitement)
• thoughtlessaboutthefuture(e.g.
aboutcareerorfamilygoals)?
andhaveyouexperiencedatleasttwo
ofthefollowing:
• haddiffcultysleeping(e.g.hadbad
dreamsorfoundithardtofallor
stayasleep)
• becomeangryorirritatedeasily
• hadtroubleconcentrating
• feltonguard
• beeneasilystartled?
Formoreinformationsee
beyondblue’s‘Post-traumatic
stressdisorder’factsheetat
www.beyondblue.org.au
• shaky
Treatmentsforanxiety
• increasedheartrate
Therearemanyhealthprofessionals
andservicesavailabletohelpwith
information,treatmentandsupport,
andtherearemanythingsthat
peoplewithanxietycandotohelp
themselves.Effectivetreatmenthelps
peoplewithanxietytolearnhowto
controlthecondition–soitdoesn’t
controlthem.
• shortofbreath
• choked
• nauseousorpaininthestomach
• dizzy,lightheadedorfaint
• numbortingly
• derealisation(feelingsofunreality)
ordepersonalisation(feeling
detachedfromyourselforyour
surroundings)
• hotorcoldfushes
• scaredofgoingcrazy
• scaredofdying?
Ifyouanswered‘yes’toallofthese
questions,haveyoualso:
• feltscared,foronemonthor
more,ofexperiencingthese
feelingsagain?
Formoreinformationsee
beyondblue’s ‘Panicdisorder’fact
sheetatwww.beyondblue.org.au
Panicdisorder
Apersonhaspanicattacks,which
areintense,overwhelmingand
oftenuncontrollablefeelingsof
anxietycombinedwitharangeof
physicalsymptoms.
Withina10minuteperiodhaveyoufelt
fourormoreofthefollowing:
Itisimportanttonotethatmany
peoplewithanxietyexperience
symptomsofmorethanonetypeof
anxietydisorder. It’salsoimportant
tonotethattheseareonlyguides
torecognisingdifferenttypesof
anxiety.Theywillnotprovidea
diagnosis–forthatyouneedtosee
ahealthprofessional.
Thetypeoftreatmentwilldepend
ontheanxietybeingexperienced.
Mildsymptomsmayberelievedwith
lifestylechanges(suchasregular
physicalexercise)andself-help
(e.g.onlinee-therapies).Where
symptomsofanxietyaremoderateto
severe,psychologicaland/ormedical
treatmentsarelikelytoberequired.
Psychologicaltreatments
Psychologicaltreatmentmaynot
onlyhelpapersontorecover,butcan
alsohelptopreventarecurrenceof
anxiety.Ithasbeenfoundtobethe
mosteffectivewayoftreatinganxiety.
Thereareseveraldifferenttypesof
psychologicaltreatments,including
cognitivebehaviourtherapy(CBT).
Psychologicaltherapiescanbe
undertakenwithaprofessional,
andincreasingly,viastructured
sessionsdeliveredviatheinternet
(withorwithoutsupportfrom
aprofessional).
• sweaty
3
230330_0613_BL0384.indd 3
13/06/13 3:31 PM
Cognitivebehaviourtherapy(CBT)
CBTisastructuredpsychological
treatment,whichrecognisesthata
person’swayofthinking(cognition)
andacting(behaviour)affectsthe
waytheyfeel.InCBT,aperson
workswithaprofessionaltolookat
thepatternsofthinkingandacting
thatareeitherpredisposingthem
toanxiety,orkeepingthemfrom
improvingoncetheybecomeanxious.
Oncethesepatternsarerecognised,
thepersoncanconsciouslyand
deliberatelymakechangestoreplace
thesepatternswithnewonesthat
reduceanxietyandenhancetheir
copingskills.
Forexample,thinkingthatfocuseson
catastrophising(thinkingtheworst,
believingsomethingisfarworsethan
itactuallyis,anticipatingthingswill
gowrong)isoftenlinkedwithanxiety.
InCBT,thepersonworkstochange
thesepatternstouseawayofthinking
thatismorerealisticandfocusedon
problem-solving.Anxietyisalsooften
heightenedwhenapersonactively
avoidsthethingsofwhichhe/sheis
afraid.Learninghowtofaceupto
situationsthatareanxiety-inducing
isalsooftenhelpful.
Medicaltreatments
Researchshowsthatpsychological
treatmentsarethemosteffectivein
helpingpeoplewithanxiety.However,
ifsymptomsaresevere,some
medicaltreatmentsmaybehelpful.
manufacturersofantidepressantsdo
notrecommendantidepressantusein
youngpeopleundertheageof18.
Thedecisiontostarttaking
antidepressantmedicationshould
bemadeinconsultationwitha
doctoraftercarefulassessmentand
consideration.Stoppingmedication
shouldonlybedonegradually,on
adoctor’srecommendationand
undersupervision.
Benzodiazepines
Unlikeantidepressants,
benzodiazepines(sometimescalled
sedatives)aredesignedtobeused
onlyforashorttime(twoorthree
weeks)orifusedintermittentlyas
partofabroadtreatmentplan–not
asthefrstoronlytreatment.They
canhelppeoplecopewithanxiety
byreducingtension,withoutmaking
peopledrowsy.
Benzodiazepinesarenot
recommendedforlong-termuse
astheycanbeaddictive.Ifaperson
hasbecomedependent,withdrawal
symptomsmaybequitesevere.
Acommonwithdrawalsymptomis
highanxiety,whichparadoxically
canworsentheproblemandmake
itdiffculttoassesswhethercurrent
anxietyisrelatedtotheanxiety
disorderoraresultoflong-term
useofthebenzodiazepines.
Howtohelpyourselfifyou
haveanxiety
• Postponemajorlifechanges
Makingmajorchangesinyourlife
canbestressfulatanytime.If
you’refeelingstressedoranxious,
it’sprobablyagoodideatotryto
avoidmovinghouseorchanging
jobs.Leavethemtoatimewhen
you’refeelingbetter.
• Resolvepersonalconficts
astheyarise
Ongoingstressinpersonal
relationshipscancontributeto
anxiety.Learnhowtoletpeople
knowaboutyourfeelingssothat
youcanresolvepersonalconficts
astheycomeup.Talkingtoa
counsellororpsychologistcan
helpyoufndwaystoaddress
yourproblems.
• Takepartinenjoyableactivities
andlearntorelax
Todothis,youneedtoallocatetime
todothethingsyouenjoy,suchas
exercising,meditating,reading,
gardeningorlisteningtomusic.
beyondblue’swebsitealsohas
informationaboutreducingstress,
includingaguidedprogressive
musclerelaxationexercise.
• Maintainahealthylifestyle
Eatinghealthily,exercising
regularlyandgettingenoughsleep
canhelpapersontomanagethe
symptomsofanxiety.
Antidepressantmedication
Sometypesofantidepressant
medicationcanhelppeopleto
manageanxiety.Thisisusually
becauseanxietyanddepression
frequentlyoccurtogether,andsome
typesofanxietyarelonglastingand
antidepressantmedicationsare
consideredbettertouseoverlonger
periodsoftimethanbenzodiazepines
(seeright).
Researchindicatesthatwhenpeople
haveanxiety,therearespecifc
changesthatoccurinthebrain’s
chemicals–serotonin,noradrenaline
anddopamine.Antidepressant
medicationisdesignedtocorrectthe
imbalanceofchemicalmessages
betweennervecells(neurones)in
thebrain.
TheTherapeuticGoods
Administration(Australia’sregulatory
agencyformedicaldrugs)and
4
230330_0613_BL0384.indd 4
13/06/13 3:32 PM
• checkforanyphysicalhealth
problemormedicationthatmaybe
contributingtotheanxiety
• discussavailabletreatments
• workwiththepersontodrawupa
MentalHealthTreatmentPlansohe
orshecangetaMedicarerebatefor
psychologicaltreatment
• providebriefcounsellingor,in
somecases,talkingtherapy
• prescribemedication
• referapersontoamentalhealth
specialistsuchasapsychologistor
psychiatrist.
• E
xerciseregularly
Physicalexercisesuchaswalking,
swimming,dancing,playinggolfor
goingtothegymcanhelprelieve
thetensioninyourmuscles,relax
yourmindanddistractyoufrom
negativethoughtsandworries.Try
todosomephysicalexerciseevery
day,evenifit’sjustgoingfora
walk.Keepitsimpleandenjoyable.
knowthatyou’retheretolisten
withoutbeingjudgmental.
• Encouragethepersontoseek
help.Assistthepersontofnd
outaboutavailableservicesand
offertoaccompanythepersonto
appointments.
• Acknowledgethatthepersonhas
adisorderandisnotjustbeing
diffcult;theanxietyisaveryreal
anddistressingexperience.
• Reducealcoholandotherdrugs
Theycancauselong-term
• Encouragethepersontotrytoget
problemsandmakeitmuchharder
enoughsleep,exercise,eatwelland
torecover.It’salsoagoodidea
useself-helpstrategies.
toavoidstimulants,inparticular
• Workwiththepersontoreexcessiveamountsofcaffeine,
establishadailyroutinethat
sugarandanykindofamphetamine
includesenjoyableand/orrelaxing
(speed,ecstasy,ice),asthesecan
activities.
worsensymptomsofanxiety.
• Invitethepersonoutandkeepin
• Seeyourdoctorormental
touch.Alsoencouragefriendsand
healthprofessionalforregular
familymemberstodothesame,
check-ups
butdon’tpressurethepersonto
Forsomepeople,itcantake
participate.
awhilebeforetheyfeelwell
again.It’simportanttostickwith
treatmentplansandcheckinwith
treatinghealthpractitionersona
regularbasis.
Formoretipsandinformationsee
the‘Recoveryandstayingwell’
sectionofthebeyondbluewebsiteat
www.beyondblue.org.au
Howtohelpsomeone
withanxiety
Familymembersandfriendscanplay
animportantroleinhelpingpeople
recoverfromanxiety.
• Letthepersonknowifyou’ve
noticedachangeintheirbehaviour.
• Spendtimetalkingaboutthe
person’sexperiencesandletthem
• Encouragethepersontoface
theirfearswithsupportfromtheir
doctor/psychologist.
• Acknowledgeanygainstheperson
makes,nomatterhowsmall.
Formoreinformationsee
beyondblue’sfreebooklet‘Aguide
forcarers’,availablefrom
www.beyondblue.org.auorby
calling1300224636.
Wheretogethelp
AGeneralPractitioner(GP)isagood
personwithwhomtodiscussyour
concernsinthefrstinstance. Agood
GPcan:
• makeadiagnosis
Itisrecommendedthatpeopleconsult
theirregularGPoranotherGPinthe
sameclinic,asmedicalinformationis
sharedwithinapractice.
Psychologistsarehealth
professionalswhoprovide
psychologicaltherapies(talking
therapies)suchascognitivebehaviour
therapy(CBT)andinterpersonal
therapy(IPT).Clinicalpsychologists
specialiseintheassessment,
diagnosisandtreatmentofmental
healthproblems.Psychologistsand
clinicalpsychologistsarenotdoctors
andcannotprescribemedication
inAustralia.
Psychiatristsaredoctorswho
haveundergonefurthertrainingto
specialiseinmentalhealth.They
canmakemedicalandpsychiatric
assessments,conductmedical
tests,providetherapyandprescribe
medication.Psychiatristsoftenuse
psychologicaltreatmentssuchas
cognitivebehaviourtherapy(CBT),
interpersonaltherapy(IPT)and/or
medication.Iftheanxietyissevere
andhospitaladmissionisrequired,a
psychiatristwillbeinchargeofthe
person’streatment.
Mentalhealthnursesarespecially
trainedtocareforpeoplewith
mentalhealthconditions.They
workwithpsychiatristsandGeneral
Practitionerstoreviewaperson’s
mentalhealth,monitormedication
andprovideinformationaboutmental
healthconditionsandtreatment.
Somehavetraininginpsychological
therapies.Ifyouwouldlikeareferral
toamentalhealthnursewhoworksin
ageneralpractice,askyourGP.
Socialworkersinmentalhealthare
speciallytrainedtoworkwithpeople
whoareexperiencingdiffculties
inlife.Socialworkerscansupport
5
230330_0613_BL0384.indd 5
13/06/13 3:30 PM
peoplewithanxietybyhelpingthem
fndwaystomanagemoreeffectively
someofthesituationsthattrigger
thesedisorderssuchasfamily
issues,fnancialproblems,work
stressandlivingarrangements.
Mentalhealthsocialworkerscan
alsoprovidefocusedpsychological
self-helpstrategies.
Occupationaltherapistsinmental
healthhelppeoplewhohave
diffcultiesfunctioningbecauseofa
mentalhealthconditiontoparticipate
innormal,everydayactivities.Mental
healthoccupationaltherapistscan
alsoprovidefocusedpsychological
self-helpstrategies.
AboriginalandTorresStraitIslander
mentalhealthworkersarehealth
workerswhounderstandthemental
healthissuesofIndigenouspeopleand
whatisneededtoprovideculturallysafeandaccessibleservices.Some
workersmayhaveundertakentraining
inmentalhealthandpsychological
therapies.Supportprovidedby
AboriginalandTorresStraitIslander
mentalhealthworkersmight
include,butnotbelimitedto,case
management,screening,assessment,
referrals,transporttoandattendance
atspecialistappointments,education,
improvingaccesstomainstream
services,advocacy,counselling,
supportforfamilyandacute
distressresponse.
Post-traumatic
stressdisorder
(PTSD)factsheet
Obsessive
compulsive
disorder(OCD)
factsheet
Generalised
anxietydisorder
(GAD)factsheet
Specifcphobias
factsheet
Panicdisorder
factsheet
Socialphobia
factsheet
1. AustralianBureauofStatistics.(2008).National Survey of Mental Health and Wellbeing:
Summary of Results,2007(4326.0).Canberra:AustralianBureauofStatistics.
Thecostofgettingtreatmentfroma
healthprofessionalvaries.However,
inthesamewaythatpeoplecanget
aMedicarerebatewhentheyseea
doctor,theycanalsogetpartorallof
theconsultationfeesubsidisedwhen
theyseeamentalhealthprofessional
fortreatmentofanxietyordepression.
Seebeyondblue’s‘Gettinghelp–
Howmuchdoesitcost?’factsheet
atwww.beyondblue.org.au
ForalistofGeneralPractitioners,
clinicalpsychologists,psychologists,
mentalhealthnurses,social
workersandoccupational
therapistswithexpertiseintreating
mentalhealthproblems,visit
www.beyondblue.org.auorcall
thebeyondbluesupportserviceon
1300224636.
Where to fnd more information
beyondblue
www.beyondblue.org.au
Learnmoreaboutdepressionandanxiety,ortalkitthroughwithour
supportservice.
1300 22 4636
Email or chat to us online at www.beyondblue.org.au/getsupport
Lifeline
www.lifeline.org.au
13 11 14
Accesstocrisissupport,suicidepreventionandmentalhealth
supportservices.
mindhealthconnect
www.mindhealthconnect.org.au
Accesstotrusted,relevantmentalhealthcareservices,onlineprograms
andresources.
facebook.com/beyondblue
www.beyondblue.org.au
230330_0613_BL0384.indd 6
1300224636
twitter.com/beyondblue
©BeyondBlueLtd. BL/0384 6/13
13/06/13 3:30 PM