Anxiety and Panic Attacks

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What is anxiety?

Anxiety is a normal human emotion. It can be described as a feeling of unease, such as fear or worry. Anxiety becomes a problem when you misinterpret and/or catastrophise these feelings so your thoughts become unhelpful.

Most people feel anxious or scared sometimes. However, if these thoughts are affecting your life, then you could be experiencing an ‘anxiety disorder’.

What causes anxiety?

Anxious feelings are caused by an automatic response our bodies make to an event which is perceived as stressful or frightening. This response evolved millions of years ago. It was designed to help us respond to sudden dangers or threats. It helped keep early humans alive when they met with physical dangers which were often life-threatening, such as facing a wild animal. This response is called ‘fight or flight’. It causes a physical reaction in our bodies (see ‘fight or flight’ description below).

This automatic response is still triggered in the present day. Although the stressful situations we experience in today’s world are very different to the life-threatening ones experienced by our ancestors, they still result in exactly the same response within our bodies. So, whatever situation we perceive as stressful or scary will trigger this automatic response. It is something that happens to our bodies whenever our brain becomes aware of a possible danger. We have no control over it.

When is anxiety a mental health problem?

As a result, everyone can feel anxious from time to time. A little bit of anxiety can be helpful as it makes you more alert and can improve your concentration/performance. However, at times in our life, we may experience periods of increased or prolonged anxiety. This may be because of things that are happening in our lives or due to particular stressful thoughts or feelings. For example, you may feel constantly anxious if you are worried about what people think of you or when comparing yourself to others.

Feelings of anxiety usually pass after the stressful situation has come to an end. However, if those feelings continue and our worries become overwhelming or harder to control, then they may affect our lives in a negative way. For example, anxiety can affect your behaviour. You may hide away from others or avoid certain places. It can make you feel unable to cope with a certain situation.

Anxiety feels different for everyone. It can last for a long time or it might come and go. It is helpful to try and understand what is causing your feelings of anxiety, why your body is responding in a certain way and how you can manage your anxiety. See our resources and courses below for more information and advice. If you need further help managing your anxiety there is help available.

What is the Fight or Flight (escape) Response?

The fight or flight response triggers your brain to release hormones (cortisol and adrenaline) which was originally designed to help prepare your body to run away or fight when it sensed danger. This response still happens today when we sense a perceived danger or a stressful situation. This happens even if you are not using your body to fight or flight. It can trigger the following immediate physical symptoms:

• Our breathing gets faster and heavier, so we can take in extra oxygen for us to run. This can result in feeling sick, dizzy, sweaty or short of breath.
• Our muscles tense to get ready to run which can leave your legs feeling shaky.
• Blood is diverted from our digestive system, to create more energy for running which can result in a feeling ‘butterflies’ in the stomach and our mouths to go dry.
• Our heart beats stronger and faster, and sometimes irregular, to send blood to the leg muscles.

It is important to remember that these feelings are normal and an automatic physical response. These feelings will gradually face when the stressful situation passes and your body returns to a normal state. However, when we experience these feelings and we aren’t using up this ‘energy’ it can feel scary and unpleasant.

However, when feelings of anxiety continue for a length of time this can result in other signs and symptoms which you might want to seek help for. Some people can experience these symptoms so strongly that they might think they are dying; this could be what is called a ‘Panic Attack’.

Other signs and symptoms of anxiety/panic

• Feeling tired, on edge, restless or irritable
• Difficulty concentrating or making decisions
• Not knowing what is the ‘right thing to do’
• Sleep problems
• Headaches and stomach aches
• Trying to avoid situations or put off doing things you are worried about
• Avoiding, hiding away or withdrawing from friends and family, or from our regular tasks (like work or hobbies)
• Feeling the need to repeatedly check things or seek assurance from others
• Over generalised thinking – thinking that something that has happened in one situation will happen in another
• Experiencing a low mood if you have struggled with anxiety for a long time – see our low mood page for more information.

Self-help advice to manage anxiety

Sometimes we just don’t know what is that is making us feel anxious. Some of the strategies that we use to help manage our anxiety (such as avoiding certain situations or places) may keep us in the cycle of anxiety. We hope you find the advice below useful in helping you identify and manage those feelings:

• Try to identify how you are feeling and what thoughts you are having in that moment. This can help you understand and better manage it. Sometimes it is useful keeping a diary to identify what thoughts you are having in times of heightened anxiety, as well as what behaviours you ‘do’ when feeling anxious. For example, not going out with family/friends or cancelling plans. This is sometimes known as ‘safety behaviours’.
• Try a free online course such as the ACTivate Your Life and Silvercloud (see list of courses below) which you can do your own at home, to help you understand anxiety and how you can manage it. We also have links to free courses specifically for anxious children, teens and their parents.
• Try and shift the focus of how you are feeling in that moment – try breathing exercises or practice mindfulness. See our courses below and information on mindfulness. Mindfulness can help us notice how our minds tend to focus on worries, which make it worse. Learning to recognise and shift that negative focus can help us feel calmer.
• It can be helpful to change your focus and get involved in activities going on in your local area. This may help you challenge the way you are thinking and feeling.  Find out what’s going on in your area by visiting our in your area page.
• You don’t need to experience anxiety on your own. Talk to someone you trust or see our ‘helplines & services’ section below. And if you or someone you know need urgent help – go to our urgent help page immediately.

If you need further help managing anxiety

If the information, advice, resources and courses on this page have not been helpful and/or you think you need more help, there are many free support services available.

If you are worried about your general mental health, contact NHS Mental Health 111 Option 2. This service is available 24 hours a day, 7 days a week and is free to call from a mobile (even when the caller has no credit left) or from a landline. The service will provide immediate support over the phone to help cope with how you are feeling, and if needed, a referral to mental health services will be arranged.

If you live in the Aneurin Bevan University Health Board (ABUHB) area, and are aged over 18, you can contact your GP surgery to make an appointment with a Psychological Health Practitioner (PHP) or a GP. PHPs are NHS mental health practitioners, that are available at most GP surgeries in ABUHB area, who provide a free service for people experiencing mild to moderate mental health problems. Appointments can be either face to face, or over the phone.

If you are under 18 or worried about someone aged under 18 and need advice/self-referral to local mental health and wellbeing services in the Aneurin Bevan University Health Board area, contact SPACE-Wellbeing.

Or alternatively contact another approved helpline or service. Some services are available 24 hours a day, 365 days a year.

If you are an unpaid carer for someone experiencing anxiety, visit our Unpaid Carers page for more information and advice.