Anxiety: signs, causes and how to cope (an Irish guide)

Your chest tightens on the M50 on the way to work. Your mind races at 3am about something you said in a meeting. You tell everyone you're grand, but inside you're braced for the worst. Anxiety is very human, and it can look very different from one person to the next. This guide covers the signs, the usual triggers and practical ways to cope.

What is anxiety?

Anxiety is how your body and mind respond to a threat, or to something your brain sees as a threat. Your body releases stress hormones that get you ready for fight or flight: your heart beats faster, your breathing quickens and your muscles tense. That system was very useful for escaping physical danger. These days, though, it's just as likely to be set off by an email, a meeting or a bill.

Anxiety isn't a problem in itself. A bit of it helps you study for an exam or prepare for an interview. It becomes a difficulty when it's out of proportion to the situation, goes on for a long time, or starts to shape how you organise your life.

Signs of anxiety in your body and mind

Anxiety shows up in the body as well as the mind, and sometimes the physical signs are what people notice first. Common signs include:

• Body: racing heart, shortness of breath, tension in the shoulders or neck, headaches, an upset stomach, sweating, shaking and tiredness.
• Mind: constant worry, trouble concentrating, a feeling that something bad is about to happen, thoughts that jump straight to the worst outcome.
• Behaviour: avoiding places or people, putting things off, looking for reassurance again and again, or over-checking.
• Sleep: trouble dropping off, waking often, or waking early with your mind already racing.

Some physical signs can look like other health problems. If you have new or strong symptoms, or you're not sure, it's sensible to see your GP and get checked.

Take Aoife, an illustrative example: a nurse in Cork whose shifts change every week. She notices her worry spikes on Sunday evenings before a run of nights. Writing down the specific worries, doing a short breathing exercise before bed and keeping a regular walk along the Lee on her days off doesn't make the anxiety disappear, but it gives her back a sense of control.

If anxiety sometimes hits as a sudden, intense wave, read our guide to panic attacks.

What keeps anxiety going?

There's rarely a single cause. It's usually a mix: long-term stress at work or at home, big life changes, money worries, poor sleep, illness, or a difficult experience in the past. Some people are naturally more prone to anxiety, and caffeine and alcohol can make it worse.

The thing that most keeps anxiety alive, though, is avoidance. When you avoid something that makes you anxious, you feel instant relief. Your brain learns from that relief that the thing really was dangerous, so next time the anxiety is stronger. Over time, life can get smaller.

A useful question to ask yourself is: "What am I avoiding because of anxiety?" The answer is often the best place to start.

Eight ways to cope with anxiety

1. Slow your breathing. Breathe in through your nose for four seconds and out through your mouth for six. Keep it up for a few minutes. Long out-breaths tell your body you're safe.
2. Name the feeling. Say to yourself: "This is anxiety. It's uncomfortable, but it isn't dangerous." That puts a little distance between you and the emotion.
3. Write it down. Put each worry on paper with one small step beside it. Thoughts are easier to handle once they're out of your head.
4. Face things gradually. Instead of avoiding something completely, do a smaller version of it. If you can't stay for the whole event, stay for half an hour.
5. Move your body. A brisk walk, a swim or a cycle burns off the energy anxiety creates, and regular activity lifts your mood.
6. Cut back on caffeine and alcohol. Coffee, energy drinks and alcohol can make anxiety symptoms worse, especially in the evening.
7. Use your senses. Try 5-4-3-2-1: five things you can see, four you can feel, three you can hear, two you can smell and one you can taste.
8. Talk to someone. When you say a worry out loud to someone you trust, it's often smaller than you expected.

When to look for help

Everyone feels anxious now and then. It's worth looking for support, though, if:

• you've been anxious most days for several weeks;
• it's affecting your sleep, work, studies or relationships;
• you're avoiding more and more things;
• you feel low or hopeless, or you're relying on alcohol to calm down.

Your GP is the best first step. They can talk through your options and refer you to HSE mental health services, including counselling and talking therapies such as CBT (cognitive behavioural therapy), which has good evidence for anxiety. The HSE YourMentalHealth Information Line (freephone 1800 111 888) can tell you what's available near you. Chatting with Psychologist AI can help you get your thoughts in order in the meantime, but it isn't a substitute for professional care.

Frequently asked questions

Read more

Wellbeing

Winter blues in Ireland: coping with dark evenings, rain and low mood

Stress

Leaving Cert stress: how to cope with exam pressure (for students and parents)

Wellbeing

How to get mental health support in Ireland: GP, HSE services and where to start