Overview of anxiety
<p>Anxiety is a normal response to stress or danger, but anxiety disorders involve persistent, excessive, and irrational worry and fear about everyday situations. These disorders can interfere with daily functioning and can be debilitating. There are several different types of anxiety disorders, including generalised anxiety disorder, panic disorder, phobias, social anxiety disorder, and separation anxiety disorder.</p><p>Symptoms of anxiety disorders may include racing thoughts, difficulty concentrating, restlessness, irritability, muscle tension, and sleep disturbance. Anxiety disorders are often treated with a combination of therapy and medication, and can be effectively managed with proper treatment.</p>
What is anxiety?
<p>The DSM-5-TR defines anxiety as "excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)."</p><p>Anxiety is characterised by feelings of worry, nervousness, or fear that can be mild or severe and that can interfere with a person's ability to function normally. It may also manifest as physical symptoms such as a racing heart, difficulty breathing, or sweating. Anxiety can be a normal and healthy reaction to stress, but when it becomes excessive or persistent, it may be a sign of an anxiety disorder.</p><p>There are several different types of anxiety disorders recognised in the DSM-5-TR, including generalised anxiety disorder, social anxiety disorder, specific phobias, panic disorder, and agoraphobia. Each of these disorders has specific diagnostic criteria that must be met in order for a diagnosis to be made.</p>
What are the symptoms of anxiety?
It is important to remember that everyone experiences anxiety differently and the symptoms may present themselves in a variety of ways. If someone is experiencing symptoms of anxiety, it is important to speak to a mental health professional for an accurate diagnosis and appropriate treatment.
Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder. Anxiety disorders form a category of mental illnesses and the symptoms can vary depending on the specific type of anxiety disorder.
Common physical symptoms of anxiety include: 
Muscle tension or shakiness; rapid heartbeat or palpitations; shortness of breath or feeling smothered; dry mouth; sweating or chills; nausea or upset stomach; dizziness or light-headedness; fatigue; insomnia or trouble falling asleep; headaches.
Emotional symptoms can include:
A sense of impending danger, panic, or doom; irritability; restlessness; feelings of being on edge; fear; worry.
Behavioural symptoms can include:
Avoidance of things that trigger anxiety; substance abuse; difficulty concentrating; irritability or anger outbursts; changes in eating habits; changes in sleeping habits; social withdrawal.
Cognitive symptoms can include:
Negative self-talk or negative thoughts about the future; racing thoughts; difficulty making decisions; impairment in concentration and memory; intrusive thoughts or images.
How to diagnose anxiety
<p>A variety of clinical assessments can be used to help diagnose and treat anxiety. Some commonly used clinical assessments for anxiety may include:</p>
It's important to note that psychologists may use a combination of different assessments to accurately diagnose and treat anxiety, and the specific assessments used may depend on the individual's specific needs and concerns.
Common treatment approaches for anxiety
<p>Several different treatment approaches are commonly used to help individuals manage anxiety disorders. These approaches may include:</p>
It's important to note that different treatment approaches may be more or less effective for different individuals, and a combination of treatments may be necessary to effectively manage anxiety. It's important to work with a mental health professional to determine the best course of treatment.
Best practice treatment guides for anxiety
<p>Here are some peak body clinical practice guidelines for the management of anxiety:</p><ul><li>The Royal Australian and New Zealand College of Psychiatrists (RANZCP) – <a target='_blank' href='https://www.ranzcp.org/files/resources/college_statements/clinician/cpg/anxiety-cpg.aspx'>Anxiety Clinical Practice Guidelines</a></li><li>National Library of Medicine (National Centre for Biotechnology Information) – <a target='_blank' href='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310105/'>Clinical Practice Guidelines for the Management of Generalised Anxiety Disorder (GAD) and Panic Disorder (PD)</a></li><li>American Psychiatric Association (APA) – <a target='_blank' href='https://www.psychiatry.org/psychiatrists/practice/clinical-practice-guidelines'>Clinical Practice Guidelines</a></li><li>American Psychiatric Association (APA) – <a target='_blank' href='https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf'>Treatment of Patients with Panic Disorder</a></li></ul>
Common comorbidities with anxiety
<p>Anxiety disorders are frequently comorbid with other mental health disorders, such as:</p><ul><li>Depression</li><li>Substance abuse</li><li>Eating disorders</li></ul><p>Anxiety disorders can also be comorbid with physical health conditions, such as heart disease, asthma, and chronic pain.</p><p>Clinicians should consider comorbidities when treating anxiety because the presence of other health conditions can complicate treatment. For example, if a person with an anxiety disorder is also struggling with depression, the clinician may need to address both conditions in treatment. Similarly, if a person with anxiety is also dealing with chronic pain, the clinician may need to consider how the pain is impacting the person's anxiety and vice versa.</p>
MHA courses on anxiety
<ul><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/anxiety-symptoms-causes-and-treatment'>Anxiety: Symptoms, Causes, and Treatment</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/diagnosing-anxiety-disorders'>Diagnosing Anxiety Disorders</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/using-cbt-with-generalised-anxiety-disorder'>Using CBT with Generalised Anxiety Disorder</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/using-cbt-with-panic-disorder'>Using CBT with Panic Disorder</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/using-cbt-with-social-anxiety-disorder'>Using CBT with Social Anxiety Disorder</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/mens-anxiety-why-it-matters-and-what-is-needed-to-limit-its-risk-for-male-suicide'>Men’s Anxiety, Why It Matters, and What is Needed to Limit its Risk for Male Suicide</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/how-are-we-going-in-treating-anxious-youth-status-of-the-field-and-current-directions'>How Are We Going in Treating Anxious Youth? Status of the Field and Current Directions</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-link-between-anxiety-and-alcohol-use-implications-for-treatment-and-early-intervention'>The Link Between Anxiety and Alcohol Use: Implications for Treatment and Early Intervention</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-psychopharmacology-of-anxiety'>The Psychopharmacology of Anxiety</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/anxiety-and-how-it-affects-our-behaviours-and-mental-health'>Anxiety and How It Affects Our Behaviours and Mental Health</a></li></ul>
CBT treatment resources for anxiety
<p>For additional information on other approaches to treat anxiety disorders and available digital tools (including screening and assessment tools) for clinicians and clients, refer to these websites:</p><ul><li>Black Dog Institute – <a target='_blank' href='https://www.blackdoginstitute.org.au/resources-support/anxiety/treatment/'>Anxiety Treatment</a></li><li>Better Health Victoria – <a target='_blank' href='https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/anxiety-treatment-options'>Managing and Treating Anxiety</a></li><li>Centre for Clinical Interventions (Government of WA) – <a target='_blank' href='https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety'>Anxiety Self-Help Resources</a></li><li>Anxiety Treatment Australia – <a target='_blank' href='https://www.anxietyaustralia.com.au/resources/'>Resources</a></li><li>Anxiety Treatment Resources – <a target='_blank' href='https://www.anxietytreatmentresources.com/resources/'>Resources</a></li><li>Anxiety & Depression Association of America (ADAA) – <a target='_blank' href='https://adaa.org/find-help/treatment-help/self-screening'>Self-Screening Tools</a></li><li>Psychology Foundation of Australia – <a target='_blank' href='http://www2.psy.unsw.edu.au/groups/dass/'>Depression Anxiety Stress Scales (DASS)</a></li><li>The Recovery Village – <a target='_blank' href='https://www.therecoveryvillage.com/mental-health/anxiety/anxiety-screening-tools/'>Screening for Anxiety Disorders</a></li></ul>
It's important to note that these are just a few examples of the types of activities that clients may undertake during sessions on CBT for anxiety. The specific activities and techniques used will depend on the needs and goals of the individual client.
During CBT sessions, clinicians may facilitate clients through numerous activities to assist with anxiety. Some common CBT-based activities include:
Identifying negative thought patterns:
Clients may work with their therapist to identify negative thought patterns, such as catastrophizing or all-or-nothing thinking, and learn to challenge and replace these thoughts with more realistic and helpful ones.
Gradually exposing oneself to feared situations:
Clients may be asked to gradually expose themselves to situations that they fear or avoid, with the goal of learning to cope with their anxiety in these situations.
Relaxation techniques:
Clients may be taught relaxation techniques, such as deep breathing, progressive muscle relaxation, or meditation, to help manage anxiety.
Problem-solving skills:
Clients may work on developing problem-solving skills to help them better manage and cope with stress and anxiety.
Modifying behaviour:
Clients may be asked to modify their behaviour, such as avoiding avoidance or procrastination, to help reduce anxiety.
Frequently asked questions about anxiety
How can I assess the severity of a client's anxiety?
<p>Several tools and scales can be used to assess the severity of a client's anxiety. Some commonly used measures include the Beck Anxiety Inventory (BAI), the Hamilton Anxiety Rating Scale (HARS), and the Clinical Global Impression Scale (CGI). These measures can help clinicians understand the severity of a client's anxiety and track progress over time.</p>
What are the most effective treatment approaches for anxiety?
<p>The most effective treatment approaches for anxiety may vary depending on the specific type and severity of anxiety, as well as the individual needs and preferences of the client. Cognitive-behavioural therapy (CBT) is a widely-used and evidence-based treatment for anxiety disorders, and may be used alone or in combination with medication. Other treatments that may be effective for anxiety include exposure therapy, mindfulness-based therapies, and relaxation techniques.</p>
How can I help a client manage anxiety in daily life?
<p>Clinicians can use several strategies to help clients manage anxiety in daily life. These may include teaching relaxation techniques, such as deep breathing or progressive muscle relaxation, and encouraging the use of self-care strategies, such as regular exercise and getting enough sleep. Clients may also benefit from learning to identify and challenge negative thought patterns and developing problem-solving skills to better cope with stress and anxiety.</p>
How can I identify and address potential comorbid conditions, such as depression or substance abuse, in clients with anxiety?
<p>It's important for clinicians to assess for comorbid conditions, such as depression or substance abuse, in clients with anxiety, as these conditions may exacerbate anxiety and may need to be addressed in treatment. Clinicians can use various assessment tools, such as questionnaires and structured interviews, to identify comorbid conditions. Once comorbid conditions are identified, treatment may involve addressing the underlying issues and developing strategies to manage the conditions in addition to treating the anxiety.</p>
What are the potential side effects of anxiety medication, and how can they be managed?
<p>Several types of medication may be used to treat anxiety, including selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. Common side effects of anxiety medication may include dizziness, drowsiness, dry mouth, and gastrointestinal upset. In some cases, anxiety medication may also cause more serious side effects, such as changes in mood or behaviour. It's important for clinicians to carefully monitor clients for side effects and adjust the medication as needed to minimise them.</p>
How can I effectively incorporate relaxation techniques and self-care strategies into treatment for anxiety?
<p>Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can be helpful in managing anxiety and reducing physical and emotional tension. Self-care strategies, such as getting regular exercise, getting enough sleep, and eating a healthy diet, can also be beneficial in managing anxiety. Clinicians can work with clients to develop a self-care plan that includes relaxation techniques and other strategies tailored to the individual's needs and preferences. The therapist, together with the client, should regularly review and adjust the plan as needed to ensure that it is effective in managing anxiety.</p>
Popular books on anxiety
<ul><li><em>At Last a Life</em> (2006) by Paul David</li><li><em>Better than Perfect: 7 Strategies to Crush Your Inner Critic and Create a Life You Love</em> (2014) by Elizabeth Lombardo</li><li><em>Conquer Anxiety Workbook for Teens: Find Peace from Worry, Panic, Fear, and Phobias</em> (2019) by Tabatha Chansard</li><li><em>Dare: The New Way to End Anxiety and Stop Panic Attacks</em> (2015) by Barry McDonagh</li><li><em>Declutter Your Mind: How to Stop Worrying, Relieve Anxiety, and Eliminate Negative Thinking</em> (2016) by S.J. Scott & Barrie Davenport</li><li><em>Detox Your Thoughts: Quit Negative Self-Talk for Good and Discover the Life You've Always Wanted</em> (2020) by Andrea Bonior</li><li><em>Essential Strategies for Social Anxiety: Practical Techniques to Face Your Fears, Overcome Self-Doubt, and Thrive</em> (2020) by Alison McKleroy</li><li><em>Freedom from Health Anxiety: Understand and Overcome Obsessive Worry about Your Health or Someone Else’s and Find Peace of Mind</em> (2022) by Karen Lynn Cassiday</li><li><em>From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer Your Fears, and Put You in Control of Your Life</em> (2001) by Lucinda Bassett</li><li><em>Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness</em> (2013) by Jon Kabat-Zinn</li><li><em>Getting Over OCD: A 10-Step Workbook for Taking Back Your Life</em> (2018) by Jonathan S. Abramowitz</li><li><em>Hardcore Self Help: F**k Anxiety</em> (2015) by Robert Duff</li><li><em>Helping Your Anxious Teen: Positive Parenting Strategies to Help Your Teen Beat Anxiety, Stress, and Worry</em> (2017) by Sheila Achar Josephs</li><li><em>Mind Over Mood: Change How You Feel by Changing the Way You Think</em> (2015) by Dennis Greenberger & Christine A. Padesky</li><li><em>Mindfulness Workbook for Panic Attacks: Healing Strategies to Reduce Anxiety, Manage Panic and Live in the Moment</em> (2022) by Lauren Maher</li><li><em>My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind</em> (2015) by Scott Stossel</li><li><em>Panic Attacks Workbook: A Guided Programme for Beating the Panic Trick</em> (2021) by David Carbonell</li><li><em>Please Yourself: How to Stop People-Pleasing and Transform the Way You Live</em> (2021) by Emma Reed Turrell</li><li><em>The Anxiety and Phobia Workbook</em> (2020) by Edmund J. Bourne</li><li><em>The Anxiety and Worry Workbook: The Cognitive Behavioural Solution</em> (2023) by David A. Clark & Aaron T. Beck</li><li><em>The Anxiety Toolkit: Strategies For Managing Your Anxiety So You Can Get On With Your Life</em> (2015) by Alice Boyes</li><li><em>The Highly Sensitive Person: How to Thrive When the World Overwhelms You</em> (1997) by Elaine N. Aron</li><li><em>The Negative Thoughts Workbook: CBT Skills to Overcome the Repetitive Worry, Shame and Rumination That Drive Anxiety and Depression</em> (2020) by David A. Clark</li><li><em>The Opposite of Worry: The Playful Parenting Approach to Childhood Anxieties and Fears</em> (2013) by Lawrence J. Cohen</li><li><em>The Stress-Proof Brain: Master Your Emotional Response to Stress Using Mindfulness and Neuroplasticity</em> (2017) by Melanie Greenberg</li><li><em>The Worry Trick: How Your Brain Tricks You into Expecting the Worst and What You Can Do About it</em> (2016) by David A. Carbonell</li><li><em>Unwinding Anxiety: Train Your Brain to Heal Your Mind</em> (2021) by Judson Brewer</li><li><em>When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life</em> (2007) by David D. Burns</li></ul>
Recent research on anxiety
<ul><li>Science Daily – <a target='_blank' href='https://www.sciencedaily.com/news/mind_brain/anxiety/'>Anxiety News</a></li><li>Nature Portfolio – <a target='_blank' href='https://www.nature.com/subjects/anxiety'>Anxiety</a></li><li>National Institute of Mental Health (NIH) – <a target='_blank' href='https://www.nimh.nih.gov/news/science-news/science-news-about-anxiety-disorders'>Science News About Anxiety Disorders</a></li><li>PsyPost – <a target='_blank' href='https://www.psypost.org/exclusive/mentalhealth/anxiety-research-news'>Scientific Studies About Anxiety</a></li><li>Anxiety Centre – <a target='_blank' href='https://www.anxietycentre.com/research/'>Research Archive</a></li></ul>
References
<ul><li>American Psychiatric Association (APA). (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, D.C., U.S.A.: <em>APA</em>. ISBN 978-0-89042-576-3</li><li>Healthline. (n.d.). <em>Everything you need to know about anxiety.</em> Retrieved February 10, 2023, from <a target='_blank' href='https://www.healthline.com/health/anxiety#outlook'>https://www.healthline.com/health/anxiety#outlook</a></li><li>Mayo Clinic. (n.d.). <em>Anxiety</em>. Retrieved February 10, 2023, from <a target='_blank' href='https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961'>https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961</a></li><li>WebMD. (n.d.). <em>Anxiety Disorders</em>. Retrieved February 10, 2023, from <a target='_blank' href='https://www.webmd.com/anxiety-panic/guide/anxiety-disorders'>https://www.webmd.com/anxiety-panic/guide/anxiety-disorders</a></li><li>Healthdirect Australia. (n.d.). <em>Anxiety</em>. Healthdirect Australia. Retrieved February 10, 2023, from <a target='_blank' href='https://www.healthdirect.gov.au/anxiety'>https://www.healthdirect.gov.au/anxiety</a></li></ul>
