Why we are becoming worried sick

Are you stalked by irrational fears? You're not alone. Clinical anxiety is four times more common than depression – and it's on the rise. What's causing the panic? Celia Dodd investigates

Anxiety was never a problem for me until about six years ago, when I realised my worrying was getting out of hand. Most people can dismiss random thoughts about crashing the car or their children having accidents, but I couldn't. Instead they spiralled off into ever-more catastrophic "what ifs?" and triggered an overwhelmingly physical panic – my heart would lurch and I couldn't sit still.

So if I heard an ambulance screaming, I'd think one of my children might be in it, picture a range of nasty head injuries and an anxious wait in A&E. I had panic attacks when I was driving that made me feel I was losing control of the car. Or if my teenage sons were late home, I'd automatically fear the worst.

Then one morning, when I got up at 5am to catch a train, I collapsed. There was no obvious trigger, but my GP diagnosed a panic attack, and because I didn't want medication, referred me for counselling on the NHS. That helped a bit, but a year later I went back to the GP because my anxiety levels still didn't feel normal.

I was referred for cognitive behavioural therapy at the local NHS community mental health resource centre. There a trainee therapist diagnosed generalised anxiety disorder plus, halfway through therapy, post traumatic stress disorder, dating from a time many years ago when my boyfriend and I were mugged at knifepoint.

I'm not alone. Last week saw the launch of a report from the Mental Health Foundation (MHF) about anxiety, "In The Face Of Fear", which found that levels of anxiety in Britain have risen by 12 per cent since the early Nineties. It is estimated that four million people suffer from clinical anxiety, four times the number with depression. Anxiety often goes hand-in-hand with depression and other mental health problems, and according to figures from the Office of National Statistics, seven million people suffer anxiety overall. One in three will suffer panic attacks, which are often the precursor to more entrenched anxiety disorders, at some stage in their lives. Yet less than a quarter of anxiety sufferers receive any treatment, while less than five per cent receive psychological therapy.

So why are we getting more anxious? Nicky Lidbetter of the charity Anxiety UK reports a marked increase in calls since the start of the economic crisis. And the MHF report points to a "culture of fear"inflamed by the focus, by press and politicians, on terrorism, knife crime, MRSA and bird flu, and points out that the economic crisis does not only cause anxiety, but is also driven by it.

I'd always assumed that anxiety was a symptom of depression, but I didn't feel depressed at all. In fact they are quite distinct disorders, though they may occur together. The fact that there's a whole range of anxiety disorders, from agoraphobia to panic disorder and OCD, adds to the confusion.

According to Lidbetter, misdiagnosis is common, with many anxiety sufferers being prescribed anti-depressants, which can prove counter-productive. "Anxiety disorders are the poor relation of depression, and their severity is often underestimated," she says. "I think the general perception is that depression is more severe and perhaps more worthy of attention."

This may be because anxiety is largely hidden. Sufferers are often dismissed as the "worried well" because many carry on working and coping with everyday life, often self-medicating with alcohol or drugs.

Of course, non-worriers can't understand why anxiety is such a big deal. I've often struggled to explain to baffled friends how something that gives them no grief can make me feel so bad. Consultant psychiatrist Cosmo Hallstrom explains: "Anxiety can be a devastating condition. I've seen people whose lives have been crippled by it – they are housebound, they can't work, they underperform. It's one reason why people take to drink. But at the other end of the spectrum it may be a variant of normal. One of the problems is at which point we consider it crosses the boundary."

The context of general unease that most of us now inhabit can get to the most laid-back person: finances and jobs are less secure, we have high levels of debt, we measure our lives against those of celebrities, and we've got too much time to ponder how unfulfilled we feel.

"The commonsense assumption is that we're afraid of things that are dangerous," says Phillip Hodson of the British Association for Counselling and Psychotherapy. In fact, once there's a clear objective threat, anxiety is not so necessary because people have more sense of control. War tends to reduce anxiety, and suicide rates go down. The anxiety levels we've got now are because we haven't evolved to deal with the complex modern world. We're conditioned to expect we can have anything we want if we are successful, that we can do more than we can, that we don't need much sleep."

Graham Davey, professor of psychology at Sussex University, says: "These days news is often displayed in ways which are emotive and fearful when there's really no underlying threat, so it becomes very easy for people to exaggerate their fears. The problem is that while it's very easy to make someone anxious it's almost impossible to stop them being anxious by saying it's not a threat any more. Because people naturally adopt a 'better safe than sorry' attitude, and to stop feeling anxious they want objective evidence – usually from their own experience."

The "better safe than sorry" approach certainly rings bells with me. I reckon a root cause of my anxiety is the modern notion that we can do away with risk by anticipating every imaginable danger. I fell into a habit of expecting the worst when my children were young and more calamity-prone than most. It was a short step to believing I could prevent illness and accidents by anticipating every possible disaster: checking that switches were off, fires out, medicines out of reach and driving as little as possible. I didn't realise that my behaviour was creating more anxiety, not less.

Of course, some individuals are particularly prone to anxiety, thanks to genes or upbringing. High achievers, perfectionists and people-pleasers are also susceptible. But often it's a combination of vulnerability and bad luck that can affect anyone, according to Professor Paul Salkovskis, the psychologist who transformed lives on Channel 4's programme, House of Obsessive Compulsives.

Salkovskis, who is also clinical director of the Centre for Anxiety Disorders and Trauma, run by the Institute of Psychiatry, believes passionately that cognitive behavioural therapy is what many anxiety sufferers need, because unlike other therapies, its effectiveness has been carefully evaluated.

His view is endorsed by the Government, which is now at least some way towards achieving its election manifesto pledge of 10,000 new CBT therapists to be employed by the NHS to deal with mild to moderate mental ill-health.

Professor Salkovskis explains: "CBT is a type of applied common sense which works on a shared understanding between patient and therapist. It all boils down to the rather glib phrase we use to people who are anxious: 'Pull yourself together'. That's exactly what sufferers need, but they don't know how. We have evidence that CBT helps. We seek to have very brief treatments and to avoid the big pitfall of traditional psychotherapies, which is dependency."

CBT appeals because it's evidence-based, offers a quick, cheap fix (12 sessions average), and is dead practical – no self-indulgent Freudian delving into your childhood. But not everyone is so convinced. Nicky Lidbetter says, "CBT is a good therapy and it certainly works for some people. But it doesn't suit everybody. We must take a much more holistic approach and have a variety of other treatments on offer. Sometimes simple changes to lifestyle can really help."

I'm probably one of the people whom CBT doesn't suit that well. My therapist was a trainee, which bothered me a bit, and meant each session had to be taped for her supervisor. But I would have had to wait longer for a qualified therapist and I was grateful for any help.

The therapist focussed largely on the present, used diagrams to illustrate points and asked me to rate my beliefs on a scale of one to 100: it felt almost businesslike. I often got irritated by the style of questioning, which was intended to challenge my negative thoughts: I knew the "right" answer I was supposed to give, but it just didn't feel right to me.

For homework, I wrote lists of realistic alternatives to catastrophes I habitually imagined – that my son was lying in a pool of blood if he didn't answer his mobile, for example. Turning to these alternatives in a crisis proved a helpful tactic. But despite the therapist's best efforts, CBT did nothing to help my panic attacks while driving.

Five years on, the symptoms of anxiety have largely gone. Looking back, I can see that CBT helped more than I thought at the time, by setting in motion less negative ways of thinking. But other things have helped, too, such as halving my daily tea intake (which, to be fair, was the therapist's suggestion), keeping an eye on my blood sugar levels and having regular yoga sessions.

It could be, as some academics think, that seeing myself as an "anxiety sufferer" was unhelpful. Professor Graham Davey cites past studies that suggest that around 50 per cent of people who suffer bouts of anxiety can come out of it within two years without any structured form of treatment. He adds, "There is a tendency for people to go to the GP, quite rightly. But if the GP offers medication people then feel they have a disease or a medical problem, which can help it become entrenched. We mustn't medicalise anxiety." In that context, my therapist's parting shot – "What's so terrible about feeling bad?" – makes a lot more sense.

High anxiety: Do you have a problem?

* Are you haunted by totally unrealistic fears? That an armed burglar will break in while you're in the house on your own, for example, or you'll fall in front of a train, or you'll do something to hurt somebody? Everyone has random intrusive thoughts like these, but if you can't get them out of your head they can become a problem.



* Do you overestimate the chances of bad things happening and try to anticipate every possible risk?



* Do you often feel anxious for no particular reason you can identify?



* It's normal to worry about real problems, such as financial difficulties, a lump in your breast, a mistake at work. But does your anxiety continue after the initial cause has been resolved?



* Do you avoid situations or activities that have made you anxious in the past?



* If you're preparing for a job interview or a work presentation, do you go over every possible negative outcome?



* Do you hate feeling anxious? Some lucky people love risk and find the sensation almost exhilarating. But for others anxiety is so physically distressing that it interferes with daily life because they go out of their way to avoid it.



* Have you felt nervous or on edge most days over the past six months?



* Do you have problems falling asleep?



* Do you drink to escape anxiety?



* Are you a perfectionist with high standards who likes to be in control? If so, you're more likely to be affected.



www.anxietyuk.org.uk

PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Arts and Entertainment
Architect Frank Gehry is regarded by many as the most important architect of the modern era
arts + entsGehry has declared that 98 per cent of modern architecture is "s**t"
Sport
Luis Suarez and Lionel Messi during Barcelona training in August
footballPete Jenson co-ghost wrote Suarez’s autobiography and reveals how desperate he's been to return
Money
Welcome to tinsel town: retailers such as Selfridges will be Santa's little helpers this Christmas, working hard to persuade shoppers to stock up on gifts
news
Arts and Entertainment
Soul singer Sam Smith cleared up at the Mobo awards this week
newsSam Smith’s Mobo triumph is just the latest example of a trend
News
Laurence Easeman and Russell Brand
people
Sport
Fans of Dulwich Hamlet FC at their ground Champion Hill
footballFans are rejecting the £2,000 season tickets, officious stewarding, and airline-stadium sponsorship
News
Shami Chakrabarti
people
Arts and Entertainment
Benedict Cumberbatch has refused to deny his involvement in the upcoming new Star Wars film
filmBenedict Cumberbatch reignites Star Wars 7 rumours
Sport
football
News
news
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Maths Teacher

    £110 - £200 per day: Randstad Education Leeds: Secondary Maths Teacher for spe...

    Business Analyst - Surrey - Permanent - Up to £50k DOE

    £40000 - £50000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

    ***ASP.NET Developer - Cheshire - £35k - Permanent***

    £30000 - £35000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

    ***Solutions Architect*** - Brighton - £40k - Permanent

    £35000 - £40000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

    Day In a Page

    Wilko Johnson, now the bad news: musician splits with manager after police investigate assault claims

    Wilko Johnson, now the bad news

    Former Dr Feelgood splits with manager after police investigate assault claims
    Mark Udall: The Democrat Senator with a fight on his hands ahead of the US midterm elections

    Mark Udall: The Democrat Senator with a fight on his hands

    The Senator for Colorado is for gay rights, for abortion rights – and in the Republicans’ sights as they threaten to take control of the Senate next month
    New discoveries show more contact between far-flung prehistoric humans than had been thought

    New discoveries show more contact between far-flung prehistoric humans than had been thought

    Evidence found of contact between Easter Islanders and South America
    Cerys Matthews reveals how her uncle taped 150 interviews for a biography of Dylan Thomas

    Cerys Matthews on Dylan Thomas

    The singer reveals how her uncle taped 150 interviews for a biography of the famous Welsh poet
    DIY is not fun and we've finally realised this as a nation

    Homebase closures: 'DIY is not fun'

    Homebase has announced the closure of one in four of its stores. Nick Harding, who never did know his awl from his elbow, is glad to see the back of DIY
    The Battle of the Five Armies: Air New Zealand releases new Hobbit-inspired in-flight video

    Air New Zealand's wizard in-flight video

    The airline has released a new Hobbit-inspired clip dubbed "The most epic safety video ever made"
    Pumpkin spice is the flavour of the month - but can you stomach the sweetness?

    Pumpkin spice is the flavour of the month

    The combination of cinnamon, clove, nutmeg (and no actual pumpkin), now flavours everything from lattes to cream cheese in the US
    11 best sonic skincare brushes

    11 best sonic skincare brushes

    Forget the flannel - take skincare to the next level by using your favourite cleanser with a sonic facial brush
    Paul Scholes column: I'm not worried about Manchester United's defence - Chelsea test can be the making of Phil Jones and Marcos Rojo

    Paul Scholes column

    I'm not worried about Manchester United's defence - Chelsea test can be the making of Jones and Rojo
    Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

    Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

    While other sports are stalked by corruption, we are an easy target for the critics
    Jamie Roberts exclusive interview: 'I'm a man of my word – I'll stay in Paris'

    Jamie Roberts: 'I'm a man of my word – I'll stay in Paris'

    Wales centre says he’s not coming home but is looking to establish himself at Racing Métro
    How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?

    A crime that reveals London's dark heart

    How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?
    Meet 'Porridge' and 'Vampire': Chinese state TV is offering advice for citizens picking a Western moniker

    Lost in translation: Western monikers

    Chinese state TV is offering advice for citizens picking a Western moniker. Simon Usborne, who met a 'Porridge' and a 'Vampire' while in China, can see the problem
    Handy hacks that make life easier: New book reveals how to rid your inbox of spam, protect your passwords and amplify your iPhone

    Handy hacks that make life easier

    New book reveals how to rid your email inbox of spam, protect your passwords and amplify your iPhone with a loo-roll
    KidZania lets children try their hands at being a firefighter, doctor or factory worker for the day

    KidZania: It's a small world

    The new 'educational entertainment experience' in London's Shepherd's Bush will allow children to try out the jobs that are usually undertaken by adults, including firefighter, doctor or factory worker