Four questions on anxiety answered

Every year, World Mental Health Day gives an opportunity to talk about mental health.

The importance of talking is something Joshua Fletcher, also known as Anxiety Josh, knows well. He is a psychotherapist and author who specialises in working with anxiety.

"I’ve been diagnosed with anxiety in the past," Josh told BBC Bitesize. "So I know what intense fear, panic attacks and chronic worry are like. That said, I’m doing well now. I dedicate my working life to help others overcome anxiety, or at least manage it."

We've asked Josh to answer questions about feeling under stress. He said: "If these resonate with you, rest assured that I am asked these a lot. You’re not weird or different, and anxiety is very common."

Why do I sometimes feel anxious?

Always remember that anxiety is the mind and body’s response to an actual or perceived threat.

An actual threat might look like someone being aggressive, a speeding car, or a pride of lions chasing you because it’s time for dinner. But most anxiety occurs when the brain gets confused and becomes anxious just in case of a threat. It begins to perceive threat when there might not be any.

Perceived threat could be the threat of failure, not meeting expectations or being judged. Usually, this type of anxiety is triggered by stress.

What helps is to understand that we have something in our brain called the amygdala, which is the conductor of the threat response. The amygdala hasn’t evolved since the time of our ancestors and doesn’t understand the complexities of modern life. When that part of our brain decides that you might be under threat, it releases cortisol and adrenaline. Once these two stress hormones are released into the blood stream, we have no control over them.

Step back, look at anxiety and label it.

“I’m anxious, so I’m probably going to feel uncomfortable for the next ten minutes. I’m just going to leave it alone, so my mind and body can process and let it pass.”

Why do some people seem to deal with high pressure situations better than me?

Everyone’s life is different. Some people have more stressful home lives or experiences, which contribute to how they handle stressful situations.

Genetics also plays a part. If our parents or previous generations have experienced anxiety or depression, then we are often more susceptible ourselves.

You might believe that other people are “dealing better than you”, but you never know what’s going on in their lives or inside their head. All you see is external behaviour.

Your inner critic will suggest that other people are dealing with situations better, but they might not be.

I find it hard to express my feelings. What can I do if I bottle them up?

Make sure you talk to someone who makes you feel safe and you can trust. This could be a friend, counsellor, teacher or a family member who is non-judgemental.

Counselling is something I will always advocate. I personally loved it, and it really helped me.

Anyone who is bottling up feelings of pressure, just let it out.

It’s a bit like shaking a fizzy drink bottle - when you finally take the lid off, it all spills out at once. Now this is fine, but it also relieves the pressure if you just open the bottle a little at a time. That’s what talking to someone does.

Will I always feel anxious or is it something I can grow out of?

Everyone feels anxious - even the bravest and calmest people you know. It’s a healthy, natural response.

When anxiety becomes disordered or excessive, it can be worked on. You won’t always have to live with it.

Anxiety means you care. Anxiety can be performance enhancing and, when manageable, has been shown to improve both psychological and physical performance in athletes, or those studying for exams.

So, I would encourage you to reframe anxiety in a healthier way.

Will you always feel excessively anxious? No, you won’t.

Remember, anxiety and panic attacks can’t hurt you. You can tolerate them, and they ease the better we get at practising with anxiety. It’s also very important to take a preventative approach to anxiety. Look out for stress, take time out for yourself and respect your own personal boundaries.

If you need support

You should always tell someone about the things you’re worried about. You can tell a friend, parent, guardian, teacher, or another trusted adult. If you're struggling with your mental health, going to your GP can be a good place to start to find help. Your GP can let you know what support is available to you, suggest different types of treatment and offer regular check-ups to see how you’re doing.

If you’re in need of in-the-moment support you can contact Childline, where you can speak to a counsellor. Their lines are open 24 hours a day, 7 days a week.

There are more links to helpful organisations on BBC Action Line.

This article was published in October 2022