Anxiety, phobias and panic attacks: are your fears holding you back? 

Anxiety exists more than we realise: one in four people will experience an anxiety disorder at some point during their lives.

We all experience fear and anxiety at times, as these are normal emotions that help us to deal with danger. But it’s when these feelings become excessive, irrational, ongoing, distressing or interfere with daily life that they become a problem.

Are certain people more vulnerable to anxiety? 

A variety of things can make you more at risk of developing an anxiety disorder. These include:

• High stress levels
• Being physically tired or run-down
• Certain personality traits
• Experiencing lots of change
• Physical or emotional trauma
• Family history

People who experience anxiety are also at an increased risk of developing depression.

Types of anxiety

There are many different types of anxiety disorders and sufferers often have symptoms of more than one type. “Some people think that their high anxiety is normal and that it’s just their personality,” says Jean Hailes psychologist Gillian Needleman. “Unfortunately this often means they don’t seek professional help where a lot could be done to ease their symptoms.”

Generalised anxiety disorder (GAD) 

GAD involves excessive, irrational and persistent anxiety or worry over common issues (e.g. family, work, finances and illness). This worry is generally out of proportion to the circumstances causing it. GAD usually affects the person on a day-to-day basis, and can hamper their ability to do even the most basic everyday activities.

Signs and symptoms of GAD may include:

• Excessive worry that is difficult to control
• Irritability
• Fatigue
• Restlessness
• Difficulty concentrating
• Muscle tension
• Difficulty sleeping or unsatisfying sleep

Panic disorder

Panic disorder is when a person experiences frequent, unexpected panic attacks and where there is persistent concern about having more.

Panic attacks occur when the body’s normal anxiety response to feared situations is not working
properly. Symptoms of a panic attack may include:

• An increased heart rate
• Rapid breathing
• Tightness in the chest
• Sudden intense feeling of terror
• Feeling like you are going to lose control or some imminent catastrophe is about to happen

Panic attacks may also be a symptom of another anxiety disorder; for example people who experience panic attacks when confronted by a specific situation may be suffering from a phobia.

Phobias

When specific fears become excessive or interfere with daily life it is called a phobia. People who suffer from phobias either avoid the feared situation, or show obvious signs of distress at having to confront it.

Phobias can range from more common fears of things such as spiders, aeroplanes or going to the dentist, to more debilitating fears such as social phobia. Social phobia is a fear of being embarrassed or judged negatively in social situations. People with social phobia may fear activities where attention could be drawn to them, such as speaking in public, meeting new people, or being watched whilst doing something. Phobias are usually treated with professional help and through controlled, gradual exposure to the feared situation.

Post-traumatic stress disorder (PTSD)

PTSD can occur following a traumatic event wherein the person reacts with intense fear, horror or helplessness to an event or events where there was actual, or threat of, death, or a fear of injury. Common traumas which can lead to PTSD include car accidents, natural disasters, instances of violence, assault or abuse, or being diagnosed with a life-threatening illness. “Feelings of anger, grief and shock are normal after these events,” says Gillian. “However people with PTSD experience symptoms that are more severe and prolonged.”

Symptoms of PTSD may include:

• Nightmares, flashbacks or constant distressing thoughts relating to the trauma
• Avoidance of anything that triggers memories of the event
• Increased anxiety, irritability or anger
• Feeling emotionally withdrawn, sad or detached
• Difficulty concentrating and loss of interest in activities previously enjoyed 

Obsessive compulsive disorder (OCD)

OCD occurs when a person experiences thoughts or obsessions that frequently enter and cloud their mind, despite their best efforts not to think about them. These people often feel compelled to act in a certain way to ease the anxiety caused by these thoughts, for example cleaning something over and over again or needing to do the same task a number of times before they can move on. Whilst acting out these compulsions may temporarily relieve the anxiety of the sufferer, people with OCD often become quite distressed by the way they behave, and in the long-term, their anxiety levels usually increase.

When to seek help

If fear and anxiety is interfering with your ability to function in day-to-day life then it is time to do something about it. “Don’t self-diagnose,” says Gillian. “Your first point of call is to speak to your doctor, who can help you to clarify what is going on. They will then likely refer you on to a psychologist or mental health professional for further diagnosis, assessment and treatment”. Medicare rebates are now available for up to 12 counselling sessions with a psychologist under the Mental Health Care Plan.

The most important thing to remember is that avoidance will only make anxiety worse – even though it may be difficult and frightening, it is best to face your anxieties, seek support for the symptoms and distress you are feeling, and develop better strategies for coping.

Treating anxiety

For anxiety, medications similar to those used in depression may be recommended as a shortterm solution. However studies have shown that psychological therapies are much more effective in the long-term management and treatment of anxiety. Cognitive behaviour therapy is one example of a therapy recommended for treating anxiety.

What is cognitive behavior therapy (CBT)?

CBT is a technique that aims to help you understand, manage and change the thoughts and behaviours that are contributing to your condition. In a basic sense, CBT helps you to change negative thoughts into more useful ones, alongside giving you coping strategies to better manage your anxiety. For example, instead of putting yourself down and feeling you can’t do things, you might try thinking instead: “I don’t need to be perfect and it’s okay to make mistakes.” 

Tips to help manage anxiety

Whilst it is important to seek advice from a health professional, there is also a lot you can do yourself that will help manage your anxiety.

Challenge the way you think

Try to think about the way your thoughts progress. If you catch yourself thinking negatively or irrationally, try to challenge these thoughts.

“Keeping a thoughts diary can help you to identify negative or distorted thinking” says Gillian. “With
time and practice you can work to replace these thoughts with more positive, supportive statements,
and begin to turn your thinking around.”

Relax

Relaxation is an important part of reducing anxiety. When anxious, our body and mind becomes tense. Releasing physical and mental tension can lower your anxiety levels and help to calm you. Controlled breathing and progressive muscle relaxation are good techniques that a psychologist can teach you; however there are other relaxation methods you can try yourself, such as:

• Deep, slow breathing: in through your nose and out through your mouth
• Doing activities such as yoga, Tai Chi or meditation
• Listening to relaxing music
• Having a massage or a relaxing bath
• Taking time out to do something just for you

Maintain a healthy lifestyle

Maintaining a healthy lifestyle can be helpful in managing symptoms of anxiety. Some tips to improve your health and wellbeing include:

• Reduce your consumption of alcohol, caffeine and other stimulants, as these can cause further
  agitation, reduce sleep quality and may interfere with any medications prescribed.
• Eat a healthy diet including fresh fruit and vegetables, wholegrain foods and plenty of calcium.
• Aim for 30 minutes of moderate intensity physical activity, most days of the week.

Do your research

In order to overcome your anxiety it is important that you understand the condition itself. Educating
yourself as to why you are acting the way you are can help you to overcome it. Seek information
from reputable sources (a list of useful websites is included at the end of this article).

Seek support 

Getting support is a big step towards taking control of your anxiety. Look for support from someone you feel comfortable with, such as a:

• Psychologist
• Health professional or counsellor
• Friend or family member
• Support group

For those experiencing social phobia, finding online support groups may be less daunting.

You do not have to face your anxiety alone. With help, you can work to overcome your anxiety.

Further resources

Beyondblue
www.beyondblue.org.au  

Australian Psychological Society
www.psychology.org.au  

Clinical Research Unit for Anxiety and Depression
www.crufad.com  

Anxiety Disorders Association of Victoria
www.adavic.org.au  

© 2008 The Jean Hailes Foundation for Women's Health

Apart from fair dealing for the purposes of private study, research, criticism or review, as permitted under copyright legislation, no part may be reproduced or reused for any commercial purposes. 

Content Updated November 25, 2008