It is likely that most people may experience feelings of anxiety at some points in their life, for example, when sitting exams or attending job interviews. Feeling anxious during times like these is not uncommon. However, some people find it hard to control their worries and experience anxiety on a daily basis.
This fact sheet provides information about anxiety and where you can find support.
What is anxiety?
Anxiety is a feeling of unease, worry or fear, usually focused on the future and what may happen. Feelings of anxiety exist on a spectrum ranging from mild to severe, and symptoms can be both physical and psychological.
Our bodies have evolved a complex response to danger, often called the “fight or flight” or “fight flight or freeze” response. When our bodies respond in this way, our hearts beat faster and we may feel very alert. This is in order to help us to respond to a physical threat or danger. Once the danger has passed, we usually go back to a relaxed state. This is very effective if we need to jump out of the way of a car or run away from a predator. It is not a useful response if we have received a worrying email from our boss! Anxiety can become a problem if we are unable to switch off and move into a relaxed state, or if these feelings are very strong or distressing. It can also sometimes impact one’s ability to participate fully in life, as some people may start to avoid certain situations in order to avoid triggering anxiety.
Psychological symptoms of anxiety can include:
- feeling nervous regularly over an extended period
- difficulties in falling asleep
- bad dreams when asleep
- disturbed sleep, for example, waking up worrying
- feeling tense and uptight
- feelings of extreme frustration
- a sense of dread
- feeling tearful
- wanting to escape.
Physical symptoms can include:
- trembling or shaking
- a pounding heartbeat or palpitations (an irregular heartbeat)
- churning stomach
- feeling sick
- chest pains
- loss of appetite.
Why do people become anxious?
There is often not just one reason for anxiety, but there can be multiple factors involved. Some of these can include: personality, difficult life experiences, and physical health. Anxiety conditions may develop when one or more stressful events occur in a person’s life. Common triggers include:-
- workplace stress
- pregnancy and giving birth
- family and/or relationship problems
- major emotional shock following a traumatic event
- verbal, sexual, physical or emotional abuse
- drugs and medication.
Some health conditions can also contribute to feelings of anxiety. These can be chronic and ongoing health concerns, acute and life threating health conditions, or even allergies and intolerances. Some medications can also contribute to feelings of anxiety.
If anxiety is affecting a person’s daily life or causing distress there are multiple sources of help. One place to start could be talking to your GP. Your GP will try to understand your situation and circumstances in order to ensure that the correct help is offered. There are also many places you can find to access counselling help – through your GP (you can even self-refer for counselling through some GP practices), you could check out the British Association for Counselling and Psychotherapy (BACP) to find a qualified counsellor, or turn to us at Pharmacist Support for access to counselling support through our counselling partnership. You could also get help by looking at the Anxiety UK or Mind websites.
Anxiety in pharmacy
Anxiety is the body’s natural response to real or perceived danger. When kept in check, anxiety can be very useful, for example, anxiety concerning inaccurately dispensing a prescription may result in a pharmacist double-checking his or her work, or might lead to the setting up of a safeguarding system to help prevent dispensing errors. The natural response of anxiety becomes a disorder when it is excessive and difficult to control, and causes significant distress and impairment.
At Pharmacist Support we are contacted by pharmacists whose anxiety has led them to re-check their work to the extent that prescriptions are not leaving the dispensary in a timely manner.
Pharmacies should have standard operating procedures (SOPs) in place for checking prescriptions to try to ensure that the chances of errors are minimised. Pharmacists who want to create additional SOPs could seek help from:
- an organisation such as the NPA or Numark if their employer is a member
- the RPS’ guidance for members
- courses offered by the CPPE.
Most trainees have a good experience but we are contacted by some trainees reporting anxiety and work-related stress. Pharmacist Support can help in a number of ways, including arranging to speak to a Listening Friend, arranging for counselling support through our counselling partnership, or referring to a specialist employment adviser if needed.
The pre-registration year is the culmination of many years of study and it is important that trainees try to make the most of their training and get as much information and support as possible throughout their training year.
Trainees can contact Pharmacist Support by telephone on 0808 168 2233, or email email@example.com
Moving away from home to study is for many the beginning of a whole new stage in life. It may mean taking on new responsibilities that were previously held by parents and/or older siblings. For many students, starting university can be a stressful experience. Research commissioned by UniHealth, the UK’s first health and wellbeing messaging platform for university students, revealed that 82% of all respondents suffer from stress and anxiety and 45% have experienced depression. Only 25% of students said they would seek help with this, the other three quarters quoted reasons such as being too embarrassed, thinking it was a waste of time or not knowing where to find help. A third of students said that they would prefer to receive support via private messages on social media.
Students who are struggling to find their feet at university might find the Unihealth messaging service helpful. This programme takes students through their first year, from preparation in August to exams in May. For further information, see the Unihealth website.
Most universities also offer support through a university Counselling Service. Students can receive counselling support through this service, or through their GP.
Self-help to ease anxiety
People who are struggling with anxiety will find that there are many steps that they can take for themselves to help ease the symptoms of anxiety. According to the NHS, GPs sometimes recommend trying self-help treatments before trying counselling or medication.
Self-help treatments include:-
- reading about anxiety
- trying an on-line course
- using a self-help programme available through an app
- taking regular exercise
- learning to relax
- avoiding caffeine
- avoiding smoking, drinking and drugs
- talking to somebody.
Reading about anxiety
People may find that reading about their health condition can help them to understand and manage their condition better. Reading Well is a reading scheme delivered by the Reading Agency in partnership with the Society of Chief Librarians. The aim of the scheme is to enable people to have access to a range of books covering common mental health conditions. The books on the Reading Well list have all been endorsed by health experts and are available to lend in all English libraries. To view the selected titles for anxiety, visit the Reading Well website.
Try an on-line course
Online courses aim to help people to understand the nature of their problems and to find new ways of dealing with them. This is aligned with the NICE recommendations for people with common problems to begin their pathway to help with psychoeducation. Psychoeducation is an evidence-based therapeutic intervention that provides information and support to better understand and cope with a problem or illness. These types of online courses explore useful tools and techniques for managing problems and build up coping skills for better emotional well-being. You can find out via this link if there are any online courses offered in your area: Self-help therapies – NHS (www.nhs.uk) Here at Pharmacist Support we also offer a self-learning module for students that can help with anxiety: https://wellbeinghub.pharmacistsupport.org/anxiety-and-stress-management-for-students/
Download an app
Some people may prefer the convenience of an app. There are numerous apps providing many types of help. Whilst we cannot recommend individual apps, here are a few suggestions from the NHS website to get you started. Alternatively, you can check out our app page.
You can also find a list of anxiety apps recommended by the NHS by following this link: Showing results for: “anxiety” – NHS (www.nhs.uk)
There are many benefits to an active lifestyle. Of course it will help improve your fitness, but being regularly physically active can make a huge difference to your happiness and wellbeing. It may also help you feel better about your appearance, boost your confidence and improve your self-esteem, energy and sleep, as well as reduce your risk of stress and depression.
Exercise can help manage physical and mental stress. Exercise also releases endorphins, which create feelings of happiness and euphoria. Studies have shown that exercise can even alleviate symptoms among people with clinical depression and those who suffer from anxiety. For this reason, doctors recommend that people suffering from depression or anxiety (or those who are just feeling blue) pencil in gym or exercise time.
If the thought of visiting a gym is off-putting, try alternatives such as walking, swimming or running. Our exercise fact sheet has plenty of options for you to consider.
If joining a group makes you feel anxious, how about taking a dog for walk? There is no need to be a dog owner, anybody can join a group such as BorrowMyDoggy. People can enjoy a long walk with a non-judgemental, appreciative companion. For further information, see the BorrowMyDoggy website.
For further guidance on why borrowing a dog can be better than owing one, see the Dog Advisor website.
People who suffer from anxiety find it very difficult to relax. There are techniques that can be learned that will aid relaxation. Practising mindfulness is a good starting point in helping people to relax.
According to the NHS, studies have found that mindfulness programmes, where participants are taught mindfulness practices across a series of weeks, can bring about reductions in stress and improvements in mood. In short, everybody can benefit physically, emotionally and mentally from learning mindfulness techniques. It can contribute to greater peace of mind, better sleep and more productivity at work as well as to feeling happier or to having better relationships with others.
The Free Mindfulness Project website has a large range of guided meditation exercises that are free to download. These range from 3 to 35 minutes in length, and most people, no matter how busy, could find time to fit some of these exercises into their day. For further information, see The Free Mindfulness Project website.
For more information on Mindfulness, see our Mindfulness fact sheet.
Avoiding stimulants and other substances
Using substances as a means to cope with anxiety can impact one’s ability to control anxiety naturally. When this occurs people lose their ability to cope with anxiety without the aid of substances such as drugs and alcohol.
It is work noting that stimulants come not only in the form of illegal drugs such as cocaine, they can also be a common part of our everyday diets.
One of the most common stimulants is caffeine. Although caffeine can help with feelings of alertness and sharpness, it can also affect sleep and can increase feelings of anxiety. It is also worth noting that the half life of caffeine is 4-6 hours, so being aware of when you drink your last cup of tea or coffee can be helpful. Whilst most people are aware that caffeine is often found in coffee it can also be found in a range of other products, including:-
- energy drinks
- some fizzy soft drinks.
NHS Choices’ recommended limit for caffeine is 400 mg per day for adults. They advise pregnant women to stick to 200 mg (approximately two mugs of coffee) per day. For further details on the amount of caffeine found in certain foods and drinks, see the NHS Choices website.
People may wish to consider how much caffeine they consume and cut back on certain items. Reducing overall intake can be an important step in decreasing symptoms of anxiety.
People who consume a lot of caffeine may experience withdrawal symptoms when they first cut back on their intake.
For further advice on having a balanced diet, see our Healthy eating fact sheet.
Someone may smoke as a means to reduce anxiety. Research has shown that cigarette cravings are likely to make people feel more irritable and anxious. According to the NHS, when people stop smoking:-
- their anxiety, depression and stress levels are lower
- their quality of life and positive mood improve
- dosage levels for some medicines used to treat mental health problems can be reduced.
For more information on stopping smoking, see the NHS Choices website.
Alcohol in small doses is considered to be a stimulant, although heavy consumption is considered to be a depressant. Having a few drinks may help someone to relax and feel more socially confident. However, people who use alcohol to mask anxiety problems will ultimately become more reliant on it in order to relax.
According to Drink Aware, alcohol can make an anxious person feel worse and drinking alcohol can actually contribute to feelings of anxiety. For further information on alcohol and anxiety, see the Drink Aware website.
People who are concerned that they are drinking too much can find further information, including an online alcohol test and tips for cutting down, at the Don’t Bottle it Up website.
People who are concerned about an addiction to alcohol can find further information on our Help with Alcoholism fact sheet. People can also call our Addiction Support Line on 0808 168 5132.
Drugs come in a variety of categories. Mind lists them as follows:-
- legal drugs- such as caffeine, nicotine and alcohol
- illegal drugs – this means it is illegal to have them or supply them to other people. Most street drugs are illegal
- controlled drugs – these are drugs used in medicine, such as benzodiazepines. It is legal to take controlled drugs if a doctor has given you a prescription for them but is it illegal to have them if not.
People who have severe anxiety may be prescribed a benzodiazepine tranquilliser. Doctors will usually only prescribe them at a low dose for a short period, to help people through a crisis period, as they can cause unpleasant side effects and become addictive. The NHS recommends that people who have been taking benzodiazepines regularly for more than 4-6 weeks should talk to their doctor before stopping.
According to Mind, taking drugs can lead to long term metal health problems such as anxiety, depression or shizophrenia. For further information about how drugs can affect mental health, see the Mind website.
People who are concerned about an addiction to drugs can find further information on our Help with Drug Abuse fact sheet. People can also call our Addiction Support Line on 0808 168 5132.
Anxiety is a condition that can close you off to others. Talking to people really can help. Often people are concerned about discussing their worries with family and friends. For some people, it can be much easier to speak to somebody anonymously about issues such as anxiety. Here are some suggestions for organisations that offer a listening ear.
Listening Friends at Pharmacist Support
Our Listening Friends are pharmacists who volunteer to offer a listening ear to pharmacists, trainees, and students who are experiencing difficulty relating to the workplace or their studies. This service provides callers with the opportunity to talk anonymously and in confidence to a pharmacist about any stresses they are facing in their work or studies.
For further information, see the Pharmacist Support website, or call us on 0808 168 5133.
Anxiety UK is a national charity offering support to those affected by anxiety disorders. Call their helpline on 03444 775 774, or contact them via live chat. For further information, see the Anxiety UK website.
Mind provide advice and support to anybody who is living with a mental health condition. The services it offers include talking therapies and peer support. Call their helpline on 0300 123 3393, or contact them via live chat. For further information, see the Mind website.
No Panic is a charity which helps people who suffer from panic attacks and other anxiety related disorders. The services they offer include advice and support including help for people coming off tranquillisers, step-by-step written recovery programmes and self-help cognitive behaviour therapy. For further information, call their helpline on 0844 967 4848 or see the No Panic website.
The term ‘talking therapy’ covers all the psychological therapies that involve a person talking to a counsellor or therapist about their problems. According to the NHS, for some problems and conditions, one type of talking therapy may be better than another. Equally, different talking therapies also suit different people. Here are Pharmacist Support we are able to support pharmacists, trainees, and students with six sessions of funded counselling. For further information about how to access counselling through us, you can follow the link here.
For further information on talking therapy, see the NHS Choices website.
Other useful fact sheets
Healthy eating: How to eat healthily fact sheet
Mindfulness: Information about mindfulness fact sheet
Sleep: Advice on sleep fact sheet
Stress: Help with stress fact sheet
Wellbeing: How to bring wellbeing into your life fact sheet
Wellbeing: Further reading list fact sheet
This fact sheet was last reviewed on 23 July 2021.