Anxiety is a normal reaction that happens to everyone at times of danger or in worrying situations. Most people will feel anxious before an interview, going into hospital or starting a new job. In these cases sleep, appetite and ability to concentrate can be affected. Anxiety can have physical symptoms: nervousness, trembling, muscular tensions, sweating, light-headedness, a feeling like the heart is beating faster or harder, dizziness, or the feeling you need to use the toilet. If everything goes well, the anxiety usually goes away but sometimes it can persist for longer. Anxiety can also be the result of experiencing stress over a long period of time. Some signs may indicate that anxiety or stress has become a problem, including if symptoms have become unpleasant and severe, you are very worried about something but there doesn’t seem to be a reason for it, or when it is affecting your day to day life and interfering with what you want to do. When anxiety becomes a disorder, symptoms are experienced in a number of ways. Generalised anxiety disorder (GAD) can be likened to chronic worry much of the time in the absence of stressors.  As well as aforementioned symptoms, anxiety is “free floating”, i.e. it is not triggered by particular circumstances or situations, and nervousness is persistent, sometimes associated with fearing imminent illness or accident (in self or close others). In panic disorder, patients experience recurrent attacks of severe anxiety (panic), or are continuously preoccupied that they will suffer another attack. Panic attacks occur in other metal disorders. Patients can often remember exactly where they were when they suffered their first attack many years later. They are of sudden onset, peaking after a few minutes and resolving after approximately 15-20mins. These are not restricted to any particular situation and can therefore be unpredictable. Social phobia, or social anxiety disorder, is best likened to extreme and chronic shyness. The type of social situations in which the symptoms occur can range from specific and defined scenarios (such as public speaking) to more general social encounters. There are numerous other specific phobias where sufferers may go to great lengths to avoid such situations. One of the more common ones is agoraphobia, which involves fear of leaving home, riding on public transport, entering shops or crowded public places. Other examples include irrational fears about animals, heights, darkness, flying, certain foods, using toilets in public places, dentistry, blood or injury or vomiting. Phobias can coexist with panic disorder, generalised anxiety or depressive disorders.

Obsessive compulsive disorder (OCD) is characterized by obsessional thoughts and/ or compulsive acts. These thoughts present as ideas, images, or impulses that enter the mind and are almost invariably distressing. Sufferers often try, unsuccessfully, to resist them. They are recognized as own thoughts, even though they are involuntary and unpleasant.  Typical themes may involve worries about health, germs and contamination, having done (or being likely to do) something dangerous, sexual thoughts or images experienced as unpleasant, or feeling that things are “not right” or of being unsafe. Compulsive acts or rituals are repeated behaviours that the sufferer feels they must carry out to prevent the feared event occurring. They are neither enjoyable nor useful tasks, and may include excessive cleaning, washing, checking, repetitive acts or mental behaviours (e.g. counting or saying prayers). It is important to evaluate the type of anxiety disorder, as they have their own specific medical and psychological treatments.