How therapy helps with anxiety

Anxiety is the most common mental health condition – not just in the United Kingdom but across the planet. The World Health Organisation reports around 4% of the global population has been diagnosed with an anxiety-related disorder; and, given only one in four people with anxiety ever seek help, the true scale of this mental health problem will almost certainly be higher than this estimate.

In the UK, 30% of adults struggle with anxiety to such an extent that it interferes with their daily lives and undermines their ability to cope. Women are twice more likely than men to experience anxiety; however, research suggests both genders are now significantly more susceptible to anxiety than they were a decade ago, indicating the existence of trends in society that have made everyone more vulnerable than before. As such, the need for effective therapeutic care to alleviate the suffering caused by anxiety has seldom been greater.

What is Anxiety?

Anxiety is a universal emotion characterised by unpleasant feelings of fear, nervousness, and worry, usually in the face of uncertainty and potential threats. Anxiety is a natural emotion and therefore all of us will experience anxiety from time to time. It is important to make a distinction between normal levels of anxiety and symptoms that might indicate the presence of an underlying disorder. This is because anxiety is just our body’s natural response to stress, especially when this concerns a worrisome or threatening scenario.

Although anxiety is triggered by a worrisome thought (e.g. losing one’s job), the emotion sets-off a chain reaction that affects every single organ system in the body. This biological process primes the body for action, known as the ‘fight or flight’, is the body’s natural reaction to stressful or harmful situations. As such, anxiety is a product of our evolutionary development, which for countless millennia has kept us safe from harm and helped us defend ourselves against predators. In the modern age, however, anxiety is needed less often for physical threats and more for situations that require us to be mentally alert, such as preparing for a public speaking event or dealing with uncertainties in work.

Most of the anxiety people experience on a day-to-day basis usually does not cause significant harm to the individual, as it is proportionate to the situation passes naturally with time. However, anxiety can develop into a full-blown mental health disorder in a minority of people, especially if the anxious situations are repetitious, unpredictable or severe. This is what is clinically defined as ‘anxiety disorder’, which entails an intense and excessive fear/worry about something, usually felt over an extended period of time (i.e. at least 2 months).

This type of anxiety impairs a person’s ability to function on a daily basis or to effectively carry out their responsibilities. Symptoms commonly include very strong, mixed emotions (e.g. restlessness, nervousness or feeling constantly on edge), cognitive symptoms (e.g. distractable, poor focus, thoughts of impending danger), physical symptoms (e.g. trembling, sweating, heart palpitations), and behavioural symptoms (avoidance, poor sleep and hygiene, isolation).

There are different types of anxiety disorders that involve the above symptoms but vary due to the source of distress. For example, generalised anxiety disorder is the most common anxiety-related diagnosis, characterised by nonspecific worrying about a variety of things. Contrarily, social anxiety and phobias are disorders that have a very specific object of distress, which are, respectively, exposure to social gatherings (especially where strangers are present) and proximity to a feared object or situation (e.g. spiders, closed/crowded spaces, heights, etc.).

Post-traumatic stress disorder is another anxiety-related disorder, which is caused by experiencing adversity (e.g. being abused, witnessing something extreme, having a near-death experience, etc.) that leaves a person extremely on-edge about suffering a similar fate in future, resulting in avoidant behaviours and alterations in mood. Obsessive-compulsive disorder, body dysmorphia, and health anxiety are less common anxiety-related disorders, although they each have a considerable impact on a person’s mental health and quality of life.

What Causes Anxiety?

Anxiety is not caused by just one factor, but is the result of a complex mixture of biological, psychological, and social factors. Regarding the biological, genetics do play a role in contributing to a person’s resilience/vulnerability to anxiety, but there is still considerable debate among experts as to what extent. Certain brain regions are associated with anxiety, such as the amygdala and the hippocampus, which informs how people instinctively respond to threats.

Overactivation in these regions often correlates with anxiety disorder, which overpowers other regions responsible for emotional regulation and abstract thought (i.e. the prefrontal cortex). Neuroscience studies have demonstrated that some people show more activation in these regions than others, but whether this is caused by nature or nurture remains widely disputed. Biological processes such as physical illness, menstrual problems, and neurodegenerative disorder also significantly raises anxiety levels among at-risk groups (e.g. the disabled, females, the elderly, etc.).

In the psychological regards, people who suffer from poor self-esteem and confidence are more likely to suffer with an anxiety disorder than on average. As such people often have core beliefs around their inability to manage difficult situations, which causes nervousness and self-doubt. Depression is also highly ‘comorbid’ (i.e. occurs simultaneously) with anxiety, mainly due to negative thinking influencing people’s visualisations of the future. Suffering trauma (e.g. abuse) is another significant cause of anxiety. Those affected are constantly worried about being traumatised again (i.e. clinically understood as “hyperarousal”).

People with neurodiverse conditions (e.g. ADHD, ADD, ASD, etc.) are also especially vulnerable to anxiety, with around 50% of affected adults also having an anxiety disorder. Socially, people who have been chronically exposed to poverty, racism, sexism, homophobia, and other forms of discrimination are at heighten risk of developing anxiety disorder. Such experiences considerably contribute to stress and insecurity that affects both mental and physical health.

Related article: How to manage anxiety

How Does Therapy Help with Anxiety?

Those that seek professional help for anxiety will either receive psychological therapy, medication, or both treatments. This typically comes after a consultation with their GP or mental health professional. Although all mainstream psychotherapies demonstrate effectiveness in treating anxiety, UK guidance generally recommends Cognitive Behavioural Therapy (CBT) for the treatment of anxiety disorder.

The primary reason for this isbecause it has the largest evidence-base in this field of research. CBT targets the specific core beliefs (e.g. “I will always be bad at managing conflict”) that trigger anxious reactions, as well as help clients reframe their core beliefs to ones that promote healthier, self-advancing behaviours in real life. Research suggests that around 50% of people who receive CBT report significant reduction in anxious symptoms.

Short-term, solution focussed brief therapy also has a strong evidence-base in alleviating anxiety. This approach is brief (approximately 6-10 sessions) and usually implemented with mild-to-moderate cases of anxiety. It gives people a safe space to talk through their anxious thoughts and behaviours to formulate appropriate, realistic, and time-specific solutions. Whilst not addressing the root cause of anxiety, this approach often gives people the tools to manage their anxiety, as well as achieve specific goals.

Evidence suggests that medication such as anti-depressants and anxiolytics are either equal to or slightly superior to the effectiveness of psychotherapy. That said, however, the moderate risks of adverse side- and withdrawal-effects mean that medication is usually a second option to CBT and other talk therapies. Medication is also proscribed to compliment these psychotherapies. Medication also alleviates the symptoms of anxiety disorder, rather than addressing its root psychological causes (i.e. CBT).

How to Independently Manage Anxiety?

For more mild-to-moderate anxiety, grounding techniques can be used to bring people back into the present moment and regulate their physiological functioning.

Box-breathing is a technique that has been empirically shown to help people deal with anxious symptoms in-the-moment. This technique has three parts and is used when a person is feeling overwhelmed with anxiety:

1. Inhaling through the nose for 4 seconds
2. Holding your breath for 2 seconds.
3. Exhaling through your mouth for 5 seconds.

This technique is used to primarily slow a person’s heart rate by ensuring they are exhaling longer than they inhale, which puts the body – and then the mind – into a state of rest rather than panic.

Implementing healthy self-care routines around sleep, nutrition, exercise, social connections, and spending time outdoors is a particulraly effective method of promoting resilience to anxiety, as well as lowering baseline stress levels. To achieve lasting results, these self-care routines must be practised consistently over time, which requires discipline and commitment, especially during tough periods when motivation is low.

How an Employee Assistance Programme can help with anxiety

Anxiety can be caused by a variety of things. For example, work can be a source of anxiety, especially if you feel unsupported, or have a particularly busy period that’s hard to keep on top of. It can also come about in our personal lives, which can affect other areas such as work, relationships and the like. If you’ve been suffering with anxiety, whether at work or in your personal life, our EAP can help when you when you need it the most.

At HA | Wisdom Wellbeing, we offer a 24/7, 365-day confidential support line, where you can receive support for anxiety-related issues and any further mental health support you may need.

Conclusion

Anxiety is something we all experience from time to time, but in a minority of people it can develop into an enduring mental health problem that can seriously undermine a person’s quality of life. For these people, talking therapies such as CBT and solutions-focussed therapy enable people to overcome, or manage, anxiety to ensure excessive worrying does not continue to dominate their everyday life.

If you need support with issues related to anxiety and want to explore your therapeutic options, please reach out to a counsellor at HA | Wisdom Wellbeing via live chat, online video, or the helpline, who will provide expert, instantaneous advice, guidance and signposting, 24/7, 365-days a year.