Understanding and Managing Anxiety

Learning to manage anxiety
Image © Shutterstock/ Tero Vesalainen

The symptoms of anxiety can interfere with work, school and relationships, but research and medical backed steps can help us to understand and manage anxiety, writes Aleney de Winter

I’ve suffered from anxiety in some shape or other since I was five years old. Back then it was post-traumatic stress disorder following a near death experience and months in and out of emergency wards and surgery. My frequent stays (once on a gurney in the hallway of an overcrowded and understaffed emergency ward), meant I saw dead people. Literally.

There was no paediatric emergency ward back then and through flimsy cubicle curtains that were never quite completely shut, I had a surreal front row seat as accident victims were rushed in by paramedics and medical staff hurried to emergency situations. I heard the beeps and buzzes of equipment and the shattered cries of families who had lost a loved one. And, as I was being prepped for emergency surgery, I also heard the terrifying conversations my parents were having with the doctors about how precarious my own situation was. Of course, I was somewhat sedated through most of this, so can only assume the doctors and nurses didn’t know that their terrified five-year old patient was still mentally alert enough to be seeing and hearing what was happening.  

I was one of the lucky ones though and, thanks to the genius of my surgeon and an extended stay in the children’s ward, eventually made it home. My hospital bestie, a little girl a few years older than me, did not. The result was a child so anxious I was a card-carrying insomniac by the age of six. My mother was ill-equipped to deal with the post-trauma panic attacks and nightmares that followed. Whenever I voiced my anxiety, she would tell me I was being silly and to snap out of it. I’m sure she thought it would help. It didn’t. Instead, it helped bolster a social anxiety disorder … because if my own mother thought I was an idiot, what on earth must everyone else be thinking? 

Almost five decades on, I still suffer from a mild generalised anxiety disorder and need to actively work at controlling the social anxiety that many people simply put down to me being aloof. But what may look like detachment is just me being quietly terrified of speaking due to a not-all-that subconscious fear of being admonished. However, through working hard, researching and studying, and learning to love and accept myself, I am living a happy life. Because even as a five-year-old child, I understood that when you’re given a second chance, you don’t waste it.  

While I am generally able to defeat my own anxiety pretty quickly, I’m now experiencing it from a different side as several close friends and an even closer family member struggle through the extreme overwhelm and social isolation of post-traumatic stress disorder. Having done the existential homework on anxiety, and learning from my mother’s misguided efforts, I have infinite patience and support for them. And it turns out that, according to my friends at least, I might be even better at managing other people’s anxiety than I am my own. So here I’m sharing the – research-based and medical backed – steps I’ve used to understand and manage anxiety. 

Understanding what anxiety is…

Anxiety is an often misunderstood but normal and healthy response to stressful situations and experiences. It is a feeling of unbridled fear or apprehension which can trigger the adrenal glands to release the hormone cortisol, which in turn produces a perfectly choreographed series of physiological changes from heightened levels of breathing and an increased heart rate to tensed muscles and sweating.  

This “fight-or-flight” response is nature’s built-in alarm system enabling us to react quickly to life-threatening situations. But while it may have been helpful for our cave dwelling ancestors, a build-up of modern world stressors like traffic jams and work pressure can result in our body reacting as if everything is an existential threat. It might feel momentarily unpleasant, but these feelings should pass with the stressful situation.  

When they don’t, or when a person regularly feels disproportionate levels of anxiety, or they cause you to stop doing things you enjoy, it may indicate an underlying anxiety disorder that needs to be addressed. 

What are the most common types of anxiety disorders?

According to Beyond Blue, anxiety is the most common mental health condition in Australia and disproportionately effects women, with one-in-three Australian women experiencing anxiety at some stage of their lives, compared to one-in-five men.  

Anxiety can manifest in both mental and physical symptoms leading to an avoidance of work, school and social situations that could trigger symptoms.  But it is important to understand that anxiety is a key part of several different disorders. Some of the most common anxiety disorders are; 

Generalised Anxiety Disorder (GAD): An anxiety disorder characterised by unrealistic and exaggerated worry, restlessness, and tension with little reason. 

Panic disorder: Recurring, intense, and overwhelming panic attacks that result in feelings of anxiety and physical symptoms such as shortness of breath, chest pain and dizziness.  

Social Anxiety Disorder: An overwhelming feeling of self-consciousness, or excessive worry of being judged or ridiculed in everyday social situations. 

Post-Traumatic Stress Disorder (PTSD):  Ongoing and excessive anxiety, difficulty relaxing, upsetting dreams or flashbacks following a traumatic event. 

Obsessive Compulsive Disorder (OCD): A fear about a particular object or situation and the person may go to great lengths to avoid it, for example, having an injection or travelling on a plane.  

Separation anxiety disorder: This one isn’t just reserved for young kids and can manifest as a fear of being away from home or loved ones. 

Specific phobias: Irrational and ongoing excessive fear of a specific object, place or situation, or activity. Examples of more common phobias include aerophobia (fear of flying), trypanophobia (fear of needles) or acrophobia (fear of heights).

What should you do if you’re suffering from anxiety?

If you’re suffering from ongoing anxiety or think you might have an anxiety disorder, talk to a professional straight away. Explain to friends and family that you are feeling overwhelmed and DO NOT be afraid to ask for help.  

Visit your GP as soon as possible, as they will provide valuable information, treatment, and support for anxiety as well as referrals to specialists who can provide the right treatment for your needs. They can also assist with self-care strategies to help you manage or reduce anxiety.  

While different people respond to different treatments, most anxiety-related conditions do respond well to treatment. But left unchecked, anxiety can lead to serious long term mental and physical health problems including depression, cognitive issues, insomnia, chronic pain, social isolation, and a weakened immune system.  

Managing anxiety

So, what can you do to minimise the impact when anxiety does strike? Here are my 12 natural coping strategies… 

Accept it – Acknowledge your feelings and accept them as valid but avoid labelling yourself as it only perpetuates the idea in your own mind.  

Be kind to yourself – Remember that anxiety isn’t YOU; it is something you experience. Kindness begins with self care. Research has demonstrated that high levels of negative self-talk are associated with anxiety. By withholding self-judgement, you take away some of its power. 

Breathe through it – Shallow breathing can contribute to anxiety. Studies indicate the 4-7-8 breathing technique can be effective in reducing anxiety. The 4-7-8 breathing technique involves breathing in deeply through the nose for 4 seconds, holding the breath for a further 7 seconds, then exhaling slowly through your mouth for 8 seconds. 

Talk it out – Speaking to a trusted friend or confidant about how you are feeling can help diffuse the intensity of your anxiety. 

Laugh it off – Phone a funny friend or watch a funny TV Show. Laughter has great short-term effects in soothing tension and lightening the mental load. In the longer term, laughter can have significant health benefits.  

Practise mindfulness – When we are anxious, we can become trapped in false narratives and thinking. Keep your mind focused on the present as anxiety can lead to catastrophising a future that hasn’t happened. 

Learn to relax – Learning relaxation techniques such as yoga and meditation can improve symptoms of generalised anxiety disorder and increase feelings of wellbeing and internal peace. 

Walk it off – Regular exercise can help maintain your health and clear the mind. Research even suggests that physical activity can protect against the emergence of anxiety

Limit alcohol – While it may initially make those suffering social anxiety feel more relaxed and at ease, alcohol alters serotonin levels and can impair neurotransmitters in the brain, exacerbating existing anxiety disorders and leading to new symptoms. Reliance on alcohol to relax can also lead to more serious alcohol addiction. 

Cancel caffeine – Caffeine stimulates your “fight or flight” response and the jittery effects of coffee on the body can aggravate existing anxiety and trigger panic attacks.  

Eat well – It’s important to eat  healthy, well-balanced meals regularly, as this can help maintain steady blood sugar and energy, and improve moods. 

Switch off social media  Avoid exposure to social media as it can have a negative impact – research has demonstrated a connection  between social media use and depression, anxiety, loneliness and insecurity.

Disclaimer: This article provides general information only, and does not constitute mental health or medical advice. If you have concerns regarding your mental health, seek appropriate medical care or contact Lifeline on 131 114.