Portfolio of Hope

1. What is anxiety?

Anxiety, according to Mind, refers to the natural human response we experience when we are worried, tense, or afraid, particularly about things that are about to happen, or which we think could happen in the future. It can be experienced via our thoughts, feelings and physical sensations ( https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/.)

2. What is a panic attack?

Panic attacks, much like anxiety, are a natural human response which lead us to experience feelings of fear, usually as a result of us being involved in a stressful, dangerous, or, in some cases, exciting, scenario.

Although they can present themselves differently in people depending on their personal circumstances, common symptoms of panic attacks are largely physical and include a racing heart, rapid breathing, dizziness, shaking, nausea, pain in chest and abdomen, and dissociation. Coupled with the intense fear one will experience during a panic attack, they can be very frightening to go through, lasting from anywhere between 5 minutes to half an hour.

3. What are the causes of different types of anxiety?

• Social anxiety disorder, sometimes referred to as ‘social phobia’, is a type of anxiety diagnosed in people who experience extreme fear which is triggered by social situations. It can affect people in their everyday life as they may struggle to talk to other people.

Whilst we can easily highlight the triggers of social anxiety (parties, large gatherings, workplace meetings etc.), the causes are less easy to identify. However, having researched into social anxiety disorder and its origins, I can report that potential causes of SAD can be divided into three categories: inherited traits, brain structure, and environment.

The first category, inherited traits, points to the ideology that social anxiety is a result of nature as opposed to nurture (i.e., it does not develop later in life, people are just ‘born with it.’) The argument here however, is that this does not answer the question; is anxiety inherited or is it in fact learned behaviour?

Similarly to the belief that social anxiety is due to inherited factors meaning ‘it has been there all along’, there is also a belief that it has always been there, inside our brains since the day we were born.

The final category, and the one I personally believe to have the most credibility, is the belief that social anxiety is brought on due to environmental factors (nurture not nature.) This points to things such as childhood experiences as the cause of anxiety.

• Health anxiety, a type of OCD, refers to the obsessions and compulsions one experiences surrounding their health. People suffering with this condition are likely to find themselves fearful of catching an illness or contracting an injury. This may prevent them from carrying out activities they would have previously enjoyed, out of a fear that ‘today will be the day when my health suffers.’

The exact cause of health anxiety is unknown, however research suggests that, much like any mental illness, there is no ‘one size fits all’ approach that can be applied here, instead, it is important to recognise that there are multiple different causes that can be relevant for different people. One example of such a cause is genetic deposition, which presents the argument that anxiety is something which is inherited, much like our eye colour and our hair colour is. Our environment, according to this viewpoint, has no influence over our relationship with anxiety. Other causes however include the recent illness, injury, or death of a loved one, past experience of physical health problems, as well as having a generally anxious temperament.

• General anxiety disorder, aka GAD, is the most common type of anxiety, causing those who suffer with it to worry about not just one area of their life, but every area. It can therefore very much be described as all-consuming, leaving you with no mental energy or headspace to think rationally. The result? Often deterioration and the worsening of symptoms. But what are the causes of such an illness?

The main causes of general anxiety disorder include personality, genetics, and experiences. Notice a theme going on here? All anxiety disorders, regardless of their exact ‘type’, are caused by the same three things, as I have just outlined.

I can personally notice how one’s personality can influence their likelihood of developing anxiety, as I can self-confess that I am a ‘perfectionist.’ I want everything I do to be completed to the absolute best standard, and I cannot rest until that is done. As such, I frequently find myself getting anxious over everyday tasks that I really shouldn’t be getting anxious about, such as cooking tea or writing a blog post- things that I used to enjoy, and should still enjoy, but things that have been shadowed by the anxious voice in my head telling me that nothing I do will ever be ‘good enough.

4. Has there ever been a situation where you have experienced anxiety?

I sometimes struggle with anxiety when I am meeting people, especially if they are people whom I have not met before. I find myself worrying for days before the event, going over and over things in my head, obsessing over whether I will ‘say the right thing’ or ‘come across well.’ One example I can remember vividly is a job interview. Rather than being able to get the most out of the interview by meeting new people and asking questions, instead the symptoms of my anxiety seemed to make me incapable of holding a conversation, let alone answering interview questions.

I left the interview feeling incredibly deflated. I can remember getting home and looking at myself in the mirror, questioning why I was like this. ‘Why did I, out of everyone, have to be subjected to such a demoralising mental illness?’ Of course, the question was never, and can never, be answered. Despite this, I do not allow my anxiety to ‘win.’ Now when I can feel myself becoming increasingly anxious, rather than judging myself harshly for it and tearing myself down, causing me to feel even more anxious and depressed, instead I give myself time- time to ‘destress’ and calm down until I’m in a place that feels more like reality and less like a nightmare. The anxiety still affects me, but I have learnt to manage it better. Now if I have an interview and I feel anxious, I will not leave the room feeling worthless, I will be patient as I learn to love myself, or for now at least, like myself.

5. How does anxiety affect everyone?

Whilst incredibly difficult for the sufferer of anxiety, anxiety can also affect the individuals’ friends and family.

If in a relationship, for example, one partner has social anxiety and subsequently avoids going out to social events, this might prevent the other partner from going to social events. This could put immense strain on relationships, potentially causing break ups. It could also affect the mental health of the partner who does not have anxiety, since they may begin to experience feelings of isolation if they too avoid social situations in order to stay at home with their partner. It can also affect relationships in other ways. If the person experiencing anxiety is prone to cancelling plans last minute, they may be perceived as not being committed to the friendship/relationship, which can, again, cause strain and potentially lead to arguments. Therefore, anxiety is certainly not an illness that only affects those with the diagnosis, it is an illness which effects whole families, friendship groups, and partnerships.

6. What is the cycle of negative thinking?

When someone is feeling stressed and/or anxious, they enter a process of negative thinking, whereby negative thoughts involuntarily and perhaps subconsciously go round and round in their head, becoming increasingly destructive as they do so. They become ingrained in their mind. As such, they are made to feel distressed which can sometimes lead to one becoming clinically depressed.

To provide some insight into negative thinking ‘in practice’, I will use the example of having the self-defeating belief that your worth is defined by your achievements and only your achievements. When faced with a challenging obstacle, such as a difficult period at work, negative thinking heightens your self-defeating belief and you become trapped in the cycle, triggering anxiety, and causing you to negatively label yourself as a ‘failure.’

Although the feelings can differ in everyone, people who have had experience with negative thinking and have become caught up in the cycle as I have described, often report having a heightened sense of low self-esteem, another incredibly self-defeating thought.

Unfortunately, as is always the case when one becomes trapped in a cycle, it is difficult to ‘get out of’, and therefore the negative thinking is not easily overcome.

7. How can an individual’s personality and outlook on life determine their anxiety levels?

Anxiety can be influenced by one’s personality, with people who might be described as ‘optimists’ who ‘always look on the bright side of life’ less likely to develop anxiety, and people considered to be ‘pessimists’, people who ‘always think the worst’, having a far greater chance of developing the mental illness.

Whilst this is not always the case, personality is recognised as a significant cause of anxiety, with certain personality types being more dispositioned to suffering from mental illness than others.  

Someone with a negative outlook on life is likely to be always worrying, perhaps unnecessarily, which of course will heighten their risk of becoming anxious. In contrast, people who possess a positive outlook on life are more likely to ‘take things for what they are’ and refrain from overanalysing and worrying about everything. By focusing on the good, optimists naturally spend less time dwelling on the bad.

8. What are three examples of self-help for anxiety?

Although when you are in the depths of your anxiety, your symptoms playing havoc both on your mental and physical health, self-care is probably the last thing you feel like doing, it is so important to actively practice it, especially if you suffer from anxiety.

One example of self-help is rest. It sounds simple, but it can be surprisingly difficult, especially if you are of the personality type that places productivity very high up on their list of priorities. Resting can be perceived by some as a lazy thing to do, but the reality is, without rest you will experience heightened feelings of anxiety, because you are not giving your body what it needs to function at its best. You should therefore always aim to get an adequate amount of sleep each night (7-9 hours.) This will give you the energy to cope with your difficult feelings and emotions, rather than letting them overwhelm you which will only serve to increase your anxiety.

Another example of self-help is maintaining a good, healthy, and varied diet. Whilst there are many things which I can tell you that you should be doing regarding your diet to practice self-help (eating your 5 a day, limiting your intake of fat and sugars etc.), there are also many things you should avoid doing. These things include consuming caffeine, nicotine, drugs, and alcohol. Whether they are legal or not, all the substances I have just listed can become very addictive. The danger with turning to substances when trying to reduce feelings of anxiety is that it can become a compulsion- something you feel like you must do in order to stop anxiety taking a hold of you. This can very quickly escalate into substance misuse, which will not only result in your anxiety worsening in the long-term, but it will also increase your risk of developing further mental health problems, and potentially physical health problems too. You should seek your energy from real, nutritious food, not substances that could potentially harm your body (and your mind.)

A final example of self-help is to keep a diary. You should aim to record a little bit of information each time you feel yourself getting anxious, so that you have something to look back on, somewhere for you to document your journey through and, one day, hopefully out of, anxiety. Key things to record in a diary include what you were doing immediately before the anxiety surfaced, how the anxiety presented itself (symptoms), how long the symptoms lasted, and how you managed to calm yourself down. By doing this, you should, over time, be able to notice any patterns that arise in terms of triggers and early warning signs that suggest an anxiety attack is imminent. You should also be able to identify what works for you regarding distraction techniques to get you through the anxiety. This will equip you with greater knowledge for the future.

9. What are three activities which may help an individual manage anxiety?

One activity that may help individuals to manage and relieve symptoms of anxiety is exercise. The recommended amount of exercise we should all be aiming to complete is at least 30 minutes of moderate activity per day. This does not mean you have to go for a 30-minute run 7 days a week though, for there are so many ways you can exercise. Whether you choose to go out for a walk-in nature, go for a swim, or take part in a tennis match, you are sure to return home feeling less stressed and anxious, and more empowered and happier. Why? Because when we partake in exercise, endorphins are released which encourages your brain to release serotonin- the ‘feel good’ hormone.

Another activity to reduce feelings of anxiety is based around mindfulness. Mindfulness is when you focus on the present moment, while calmly acknowledging and accepting your thoughts and feelings. A way to be mindful is via meditation. By relaxing into meditation, perhaps followed by some yoga, you will be able to tune in to both your mind and your body. The result? Reduced anxiety, increased feelings of contentment, and a sense of being ‘at peace’ within.

A final activity that can reduce anxiety is reading. Reading, particularly fiction, allows you to escape reality for a while, experiencing a whole new world where you become so engrossed in the characters lives that your own life becomes temporarily forgotten about. By not thinking and worrying about the things going on in your life, you are given a break from your head, and subsequently, a break from your anxiety. It is not all down to the mental changes that make reading great for managing anxiety though, for reading is also known to physically change your body too. Some physical changes associated with the simple act of reading include the lowering of your heart rate and relaxation of your muscles. Reading and its combination of mental and physical benefits therefore ultimately results in a reduction of stress and anxiety.

10. What are two examples of treatment available to individuals experiencing anxiety problems?

One example of anxiety treatment available for people struggling with their mental health, of which anxiety is included, is cognitive behavioural therapy (CBT.) CBT is the most widely used therapy for the treatment of anxiety in the community, helping to relieve people from anxiety by breaking negative cycles, including the cycle of negative thinking. In CBT, you are encouraged to identify your negative thoughts, challenge them, and reframe them in a more positive way. This helps to reduce feelings of anxiety, making you realise how irrational your thoughts can be.

Another example of treatment available for people struggling with anxiety is ‘solution focused hypnotherapy’, which consists of a combination of psychotherapy and hypnotherapy. The objective of this alternative therapy is for us to enter a ‘trance’ state, in which our conscious mind and subconscious mind can be balanced, resulting in us being more open and receptive to the concepts proposed in therapy. The overall aim of hypnotherapy is for clients to come away from it better equipped with the knowledge and tools needed to turn their thinking ‘on its head’ and transform their whole outlook on life into a much more positive one.