Anxiety and depression manifest themselves in different ways. Below we explain more about them and support techniques we have found useful. We will continue to add to this along our journey. Please note that if you are experiencing feelings that are affecting your daily life then please see your GP in the first instance.
We will also be writing blogs on how we define anxiety, panic disorder and depression and how we describe it in our own individual ways.
What is anxiety?
Everyone gets anxious and experiences anxiety. It's a feeling of worry, fear and uneasiness. It can be a normal experience in certain situations such as sitting a test, moving house or going for a job interview. It's helpful in situations too as it makes you more aware such as crossing the road. Anxiety becomes a problem when it becomes so severe that it stops you from doing things you need to do. There may be no clear reason for it, or when it lasts for a long time.
What can be associated with anxiety?
Phobias are an extreme or irrational fear of an object, place, situation, feeling or animal
Generalised Anxiety Disorder (GAD) – a long-term condition that causes excessive anxiety and worry relating to a variety of situations
Post-Traumatic Stress Disorder (PTSD) – a condition with psychological and physical symptoms caused by distressing or frightening events, anxiety can be a symptom on PTSD.
Why am I feeling anxious?
It may be something that runs in the family, there may be things happening in your life contributing to it such as money worries, relationships, your job, your health and more. You may not be sleeping properly, eating well or something as simple as not drinking enough water. Stress can build up and this will lead to anxiety. Anxiety can also be a symptom of another condition, such as panic disorder (when you have panic attacks) or post-traumatic stress disorder (PTSD), which is caused by frightening or distressing events, something discussed more below.
What symptoms might I experience?
- Psychological symptoms: restlessness, a sense of dread, difficulty concentrating, feeling as if you are on edge, being irritable
- Physical symptoms: tiredness, dizziness, heartbeat quickens or becomes stronger or irregular, muscle tension, shaking or trembling, dry mouth, sweating excessively, shortness of breath, aching stomach, feeling nauseous, headaches, pins and needles in fingers, toes or elsewhere, insomnia or difficulty with sleep
- Please note you may experience one, a few or more of these and they might not come all at the same time
What is a panic attack?
Panic attacks are a sudden feeling of overwhelming anxiety that is at times disabling. Sometimes it can happen for no reason. At times, it might feel like you are having a heart attack or you are going to die. It may last between 5 and 20 minutes and may repeat itself. We won't lie, a panic attack is one of the most frightening things you will go through, but you won't die from it.
What symptoms might I experience?
Irregular heartbeat, or it may quicken and race, sweating, trembling or shaking, hyperventilation or shortness of breath, a choking sensation, nausea, dizziness, tingling fingers or pins and needles, ringing in your ears, joints stiffening or you feel rooted to the spot, a feeling that you want to run from where you are or get out of a place you are in rapidly.
Why does this happen?
The physical symptoms of a panic attack are caused by your body going into "fight or flight" mode. This is a is a physiological reaction that happens in response to a perceived harmful event, attack, or threat to survival. It basically goes back to when we were cave people and helped us survive. It still is vital for us in situations, it just isn't great when you get it all the time. You can also get them in the night, one offs or recurring (panic disorder as described below).
As your body tries to take in more oxygen, your breathing quickens. Your body also releases hormones, such as adrenaline, causing your heart to beat faster and your muscles to tense up.
PLEASE NOTE: if the following occurs then please seek medical advice.
- Your panic attack continues after doing 20 minutes of slow breathing.
- You still feel unwell after your breathing returns to normal.
- You still have a rapid or irregular heartbeat or chest pains after your panic attack.
A lot of people ask this, but there isn't one definitive answer. It may have felt like it happened out of the blue, seemingly unconnected to anything that was going on at the time, but there is always a logical, underlying reason. Panic attacks are related to what has been happening to you and indeed happening in your life. They are related to your reactions to these events, an accumulation of various stresses has caused you to develop a range of symptoms that you may not have even really noticed but which have set you up to develop panic attacks.
The symptoms have reached a level where you can't fail to notice them anymore and one (or more) of them in particular has caused a trigger and this has caused you to finally react to these symptoms. The way you have reacted to these triggers has escalated the symptoms into a panic attack.
It might be that going through panic attacks is not your only problem. Panic attacks are common among people who suffer from anxiety, depression, phobias or sleep problems. Those who overuse substances such as alcohol or drugs are also more prone to the attacks. It can be sometimes difficult to determine the exact reason behind what is happening to us. Once we are in a cycle, sometimes it's difficult to come out of it.
What is panic disorder?
Panic disorder is where you have recurring and regular panic attacks, often for no apparent reason. Everyone experiences feelings of anxiety and panic at certain times during their lifetime, it's a natural response to stressful or dangerous situations. For someone, however, panic disorder causes feelings of anxiety, stress and panic to occur regularly and at any time. It can cause you to avoid situations, seeing friends and family and can even lead to agoraphobia.
What causes panic disorder?
The exact cause of panic disorder isn't fully understood which is applicable to many mental health conditions.
Listed below are a couple of reasons that it can be caused:
Trauma - events such as deaths, abuse, bullying and more can sometimes trigger feelings of panic and anxiety, these might be obvious reasons, but sometimes triggers can happen years later.
Genetics - having a close family member with panic disorder is thought to increase a person's risk of developing it. However, the exact nature of the risk is not understood.
Neurotransmitters - these are chemicals that occur naturally in the brain. It's thought that an imbalance of these chemicals may increase your risk of developing conditions such as panic disorder.
Some experts believe that panic disorder is linked to an increased sensitivity to carbon dioxide. Breathing in air with high carbon dioxide levels can bring on panic attacks, and breathing techniques can help to relieve or stop panic attacks which we explore more below in the 'Helpful techniques' section.
What is depression?
Depression is more than simply feeling unhappy or fed up for a day or so or a short amount of time. Most people go through periods of feeling down or upset, but when you're depressed you feel persistently sad for weeks or months, rather than just a short time. It can also be intermittent and at times unexpected.
Some people think depression is trivial and not a genuine health condition. This is completely wrong – it is a real illness with real symptoms. It isn't a sign of weakness or something you can "snap out of" by "pulling yourself together".
What symptoms and feelings can you get?
Depression affects people in different ways and can cause a wide variety of symptoms. You can have feeling of unhappiness and hopelessness that last for long periods. You lose interest in doing things you previously enjoyed and don't feel any desire to do them. You can feel tearful and useless and at times you don't want to leave your house, your room or even your bed and again, this can last for long periods. You can develop insomnia or just general bad sleeping patterns, you can have no appetite or sex drive, and various aches and pains.
Depression and anxiety can also come hand in hand.
The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in mood, while severe depression can make you feel suicidal, that life is no longer worth living. If you don't feel you can keep yourself safe right now, seek immediate help.
- go to any hospital A&E department (sometimes known as the emergency department)
- call 999 and ask for an ambulance if you can't get to A&E
- ask someone else to contact 999 for you or take you to A&E immediately
If you need some support right now, but don't want to go to A&E, here are some other options for you to try:
- contact the Samaritans on freephone 116 123, they're open 24 hours and are there to listen
- contact your GP for an emergency appointment or the out of hours team
- call NHS 111 (England) or NHS Direct 0845 46 47 (Wales)
- contact your local crisis team
- click the yellow 'I need urgent help' button at the top of this screen for more options
- see our page on helping yourself cope right now, and on crisis services.
It's important to seek help from your GP if you think you may be depressed. Many people can wait a long time before getting to seeking help for depression, but it's best to seek help as soon as possible. Please don't be embarrassed or scared to do so. You are worth someone else's time and you are worth helping.
What causes depression?
Sometimes there's a trigger for depression. Life-changing events, such as a death, loneliness, losing your job, having a baby or illness can bring depression on. People with a family history of depression are more likely to experience it themselves, but you can also become depressed for no obvious reason.
Depression is common, it affects about one in 10 people at some point during their life.
Breathing is one of the most important and helpful techniques you will have in order to help you control anxiety and panic. In situations when your breath begins to quicken, it's important to slow down your breathing. If you take in too much oxygen in your chest then you will start to hyperventilate and this can be one of the worst aspects of a panic attack.
It's important to slow down, focus your attention on your breath and breathe in (through your nose) pushing your tummy out so you are taking oxygen in through your diaphragm. When you breath out try to do so through your nose or pursed lips so you are controlling the air coming out whilst bringing your tummy back in again. It is also better to breathe out for longer so you are getting rid of excess oxygen.
We have created a diagram below, use the dots as a counter and follow this until you feel more relaxed. Try to relax your muscles at the same time so that you are relieving the tension in your body.
Distraction is a good way to keep your mind of panic attacks and anxiety. You have to be careful that it is used appropriately though. To cope with these challenging emotions, many panic sufferers turn to maladaptive behaviours. For example, to try and deal with these emotions, one may avoid certain situations or possibly try to mask these emotions through the use of alcohol or other means. The problem is that maladaptive ways of coping only temporarily make the emotions go away, increase anxiety, and can have long-term negative effects.
A simple activity that you can engage in will redirect your mind off your current emotions and help in turn regulate the physical symptoms your body is experiencing. Once your attention is shifted elsewhere, the other emotions will dissipate.
We have created another moving image below that may help. This is the "54321 Technique", taking these 5 steps might not be overnight magic but can significantly help reduce symptoms of anxiety, trauma triggers, and other unwanted emotions or thoughts. At the same time it is important to regulate your breathing, you can do the following: Breathe in for 5 seconds, hold the breath for 5 seconds, and breathe out for 5 seconds. Repeat until you find yourself feeling calmer and more relaxed.
What to do when in panic?
STAND YOUR GROUND - You don’t need to leave the room, go to the bathroom or call for help. You can cope by yourself, you are strong and brave and nothing bad is going to happen.
SLOW DOWN YOUR BREATHING - Take slow, regular breaths. Breathe in and out through your nose or in through your nose and out through your mouth whilst pursing your lips.
RELAX - Drop your shoulders and try not to tense up, also you can use a strategy that can help you to ease tension in your muscles called progressive muscle relaxation. It involves tensing specific muscles in your body for about 5 seconds and then relaxing them. Muscle relaxation can help you to lower the overall tension in your body which often makes your panic worse.
SAY TO YOURSELF (INTERNALLY OR OUT LOUD) - “Panic attacks are not dangerous. I know what to do to cope and I know it will not last forever”.
STOP AND LOOK AT YOUR THOUGHTS - Learn how to notice and challenge your unhelpful thoughts. Come up with more balanced, realistic thoughts.
FOCUS ON SOMETHING OR SOMEONE ELSE - Bring your attention to what is going around you. What and who can you see? What can you smell? What can you hear? What are others doing? Take 5 minutes to notice things around you. Use our moving image above to help!
Adopting some healthy lifestyle techniques are one of the most important things when coping with anxiety and panic. Please note the following that we have experienced and what we recommend:
- Dehydration - this can lead to feeling extremely ill, you will feel tired and your thoughts will start to become negative. It is really important to keep hydrated. The Eatwell Guide says we should drink six to eight glasses of fluid a day. It will help with a balanced diet and will even keep you energetic and positive.
- Sleep - it is important to get ample sleep, exhaustion and tiredness can contribute to anxiety as it reduces stress coping ability. Anxiety can also lead to a lack of sleep so it is vital that you have a "wind down" period before bed. This means not partaking in activities that stimulate the brain too much just before you go to sleep such as computer games, using your phone including checking work emails etc., having caffeine or alcohol, eating anything too sugary, smoking, high impact exercise, being too hot, going to bed on an argument (this can play on your mind too much).
- Things that you should try and do before bed are: reading a book, breathing exercises, meditate, mindfulness (we will go into this further later), having a bath, power down devices, listen to a podcast.
- Caffeine - this is a stimulant and that can be bad news for someone with anxiety. Caffeine's jittery effects on your body can be similar to those of a frightening event or like the symptoms of anxiety, consuming too much coffee, tea or energy drinks may leave you feeling nervous, it can also affect your sleep. If you consume a lot of caffeine then don't stop it immediately all together as this can be just as bad for your anxiety. Naturally, start to limit it by reducing a small part over time and replace with things like water, natural juices, herbal teas or even decaffeinated drinks.
- Eating - don't skip meals and try not to eat too many processed food or sugary or salty foods. By skipping meals you can lower your energy which will in turn make you feel nervous, shaky and bring on feelings of anxiety. Ideally eat balanced healthy meals, but don't deny yourself what you like as sometimes we need a treat every now and then.
- Alcohol - although this may temporarily relieve the feelings of anxiety and at time make you feel almost invincible, it is a quick fix and the after effects can be even more harmful. It is unrealistic to think that everyone will cut out alcohol as a lot find it is part of a sociable experience, but don't fall into the trap of using alcohol to enable you to do things. It can lead onto dependency and if this is a position you are in then please contact your GP in the first instance or you can find a list of support organisations via Drinkaware. The other side of using alcohol is that it changes levels of serotonin ("the happy hormone") and other neurotransmitters in the brain, which can worsen anxiety.
- Exercise - this is one of the best things you can do when you have anxiety. By experiencing varying levels in your heart rate, you become used to it fluctuating meaning you don't become as anxious or scared of it getting faster and developing into a panic attack. It also boosts endorphins and makes you feel great. It gets rid of nervous energy and enables you to relax more overall when you have down time.
- Mindfulness - Technology, busy lifestyle and more can stop us truly noticing what is happening in the world around us. You lose touch with the way your body is feeling and live too much 'in your head', you get caught up in thoughts and stop truly noticing how those thoughts are impacting emotions and behaviours. Mindfulness is living in the present, it is reconnecting with your body and the sensations you experience and feel. Touch, smell, sight, taste and sound are all part of this, something as simple as studying the pen you are writing with, being in the shower and just thinking about how your hair feels when you wash it or how the water feels on your skin is incredibly calming and brings you into the moment. It makes you forget about the thoughts that are trying to take over and combined with breathing exercises it can make a huge impact on feelings of anxiety and depression. You can practice mindfulness via apps, we recommend: Mindfulness Daily or Headspace, also there is a free course via bemindful.co.uk
- Talking and socialising - having tangible relationships and people to talk to is an important thing when it comes to life. We know it can be hard to do so sometimes if you feel shy or a burden, but if that is the case there are many different organisations and people that can help, including us. It is important for you to talk about your worries and your mental health issues and concerns. It can help offload your burdens, it can make you feel more grounded and also it boosts happiness by having those relationships. You can find lots of help in our Useful Links, but we also encourage you to Contact Us.
Please note that we will be continually adding to this page.