Anxiety

What is Anxiety?

When a person is faced with danger or a threatening situation, the body's natural response is to prepare him or her to either fight or run away. The central nervous system is stimulated and a range of responses occur including increased heart rate, raised blood pressure, rapid breathing, tremor, and tightness in the stomach. The person is often afraid and highly alert to danger.  As the threat passes, the body rapidly returns to normal functioning. However, when a person experiences an anxiety disorder he or she is often in a state of prolonged and uncontrollable physical and emotional arousal and can experience severe distress. The fear or anxiety is often triggered by places or events that others would find non-threatening or benign, but can also occur without an obvious trigger.  An anxiety disorder can negatively impact on the whole of a person's life.

Types of anxiety disorder

There are many different types of anxiety disorder. These include:

• Specific phobias - fear of places, situations, animals etc, such as bugs, heights, blood, flying
• Panic disorder - sudden attacks of fear or anxiety in situations that pose little or no danger
• Social phobia - fear of social attention due to dread of negative evaluation from others
• Obsessive-compulsive disorder - intrusive and distressing thoughts, images or impulses (obsessions) accompanied by often disabling repetitive behaviours (compulsions) used to control obsessions and reduce anxiety
• Post-traumatic stress disorder - recurrent images and emotional distress following a significant trauma
• Generalised anxiety disorder - excessive worry and anxiety that's out of proportion to the trigger
• Test anxiety - see below for details

What is test anxiety?

Most students feel nervous before taking a test or an exam, and a certain amount of stress often helps to motivate people to study and otherwise prepare. Test anxiety, on the other hand, can cause some students so much distress that their academic performance is seriously affected.

Test anxiety can affect students in the physical, emotional, and thinking (cognitive) domains.  Students often experience rapid heartbeat, sweatiness, shakiness, knots in the stomach or nausea, dry moth, and tightness in the chest. Students may experience uncomfortable emotions such as worry, fear or even panic. Some students burst into tears or ‘break down' before or during an exam. Students can also experience distracting thoughts, rapid thinking, poor concentration, and difficulty recalling well-known information. Other students simply ‘go completely blank' during the exam. Students with test anxiety often lack confidence in their ability to perform well, even if they have passed exams before.

Some strategies that assist students to manage test anxiety include:

• Preparing well for the exam, including avoiding procrastination and the need to cram. Most universities offer advice to students on effective study techniques, so check with your university's resource centre or Student Counselling Service for materials.
• Using relaxation techniques, including breathing relaxation, during the exam if anxiety symptoms emerge.
• Recognising and challenging negative thinking or excessive worry about the exam and the student's potential performance.
• Using effective problem-solving strategies.
• Setting and working towards achievable study goals.

Assess your level of distress by doing our online self assessment.  For tips about how to manage your distress, view our topic page on Depression and Anxiety self-help material.

What helps with anxiety?

Treatments are directed towards the type of anxiety disorder experienced.

Psychological therapy: If a person has a specific phobia (e.g. spiders, flying, public speaking), cognitive behavioural therapy (CBT), which also incorporates gradual exposure to the feared object or situation, is very effective. CBT is also very effective for generalised anxiety and panic disorders.

Relaxation training: Evidence suggests that correctly practiced relaxation techniques are effective in reducing symptoms of panic disorder, test anxiety, and generalised anxiety. Breathing relaxation exercises are particularly important for managing anxiety as breathing too quickly or ‘hyperventilating' is not only a consequence of anxiety but can trigger symptoms.

Exercise: Regular exercise can aid in the prevention of anxiety, as well as helping to reduce symptoms of mild to moderate anxiety.

Bibliotherapy: Detailed, step-by-step computer programs, self-help books, and videos can be helpful to people who want to self-manage specific phobias and generalised anxiety. As in depression, self-help strategies for anxiety tend to me more effective when even a small amount of professional guidance is received.

Medication: Medications that treat depression (antidepressants) are sometimes also prescribed for anxiety disorders, while medications such as benzodiazepines can be prescribed for a short time only due to the risk of developing dependence.

Consult a health professional to determine the best treatment for you.

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