Anxiety

Should I read this page, or get help now?

If worry, fear or panic is affecting your sleep, work or relationships, use this page to see what the NHS offers and what not to do. Skip it and get urgent help if you cannot keep yourself safe: call 999, contact NHS 111, call Samaritans on 116 123, or text SHOUT on 85258. This page cannot diagnose you.

This guide is for adults in the UK who want a clear next step. It is not a substitute for emergency care, and it is not a children’s mental health pathway. If you are under 18, a parent, GP, school nurse or NHS children and young people’s service is the right starting point.

Do not use this page to decide that chest pain, collapse or sudden severe breathlessness is “only anxiety”. The first time those symptoms happen, they need urgent medical assessment.

What does anxiety feel like in everyday life?

Anxiety is unease, worry or fear. It can show up in your thoughts, your body and what you do. You might feel tense, restless or unable to switch off, notice a racing heart or churning stomach, and start avoiding things that used to feel manageable. Everyone’s mix of symptoms is different.

The NHS groups symptoms in three ways, which is a useful way to describe them to a GP or therapist:

• Physical — a faster or more noticeable heartbeat, feeling light-headed, headaches, chest discomfort, sweating, shaking, breathlessness, indigestion, stomach cramps, constipation or diarrhoea, loss of appetite, or feeling hot.
• Mental — feeling tense or nervous, being unable to relax, worrying about the past or future, tearfulness, poor sleep, difficulty concentrating, fear that the worst will happen, intrusive memories, or obsessive thoughts.
• Behaviour — struggling to enjoy time off, finding self-care hard, avoiding places or situations, pulling back from relationships, or checking things repeatedly.

None of these on their own proves you have an anxiety disorder. They do tell you that your alarm system is working overtime, and that support is worth seeking if life is getting smaller.

When does ordinary worry become an anxiety problem?

Some anxiety is useful. It becomes a problem when it is frequent, hard to control, or starts to run your day. If worry is stopping you sleeping, working, seeing people or trying new things, treat it as something to address rather than a personality trait you must live with.

A one-off burst of nerves before an exam, interview or medical result is normal. So is a period of stress after a bereavement, money shock, illness or a big life change such as a house move, a baby or a new job. The NHS lists work pressure, family strain, money worries, health problems and difficult past experiences among common drivers.

It is more likely to need treatment when:

• the feeling does not settle once the trigger has passed
• you worry about lots of different things, not one clear problem
• you have started organising your life around avoiding fear
• self-help is not enough

For generalised anxiety disorder (GAD), the NHS says a GP may diagnose it if typical symptoms are present, you often worry about a wide range of things, daily life is affected, the feelings are hard to control, and you have felt anxious a lot of the time for at least 6 months. You do not need to wait 6 months to ask for help.

What types of anxiety does the NHS talk about?

The NHS does not treat “anxiety” as one single diagnosis. Different patterns point to different conditions, and it is common to have more than one at the same time. Naming the pattern helps you get the right therapy, but you do not need the perfect label before you refer yourself for support.

If you are not sure which row fits, that is normal. Describe what happens, how long it lasts, and what you have stopped doing. A clinician can sort the label.

What can I try myself, and what should I avoid?

Start with small, repeatable habits rather than a total life overhaul. Regular activity, regular meals, better sleep, slower breathing and talking to someone you trust all help. Do not use alcohol, cigarettes, gambling or drugs to take the edge off, and do not cut caffeine only to replace it with energy drinks.

The NHS “do” list is practical: talk about how you feel; try walking, running, swimming or yoga; eat regular meals; use calming breathing; and try free mental wellbeing audio guides. Every Mind Matters also has self-help CBT techniques for worry.

Just as important is what not to do:

• Do not try to fix everything at once. Set targets small enough to finish.
• Do not pour all your energy into things you cannot change. Put time into what helps you feel safer and more able.
• Do not avoid every situation that makes you anxious. Short-term relief teaches the brain that the situation was dangerous. The NHS suggests slowly building up time in worrying situations.
• Do not tell yourself you are the only person who feels this way.
• Do not rely on coffee, tea, cola or energy drinks if you already feel wired. The NHS GAD page notes that caffeine can disrupt sleep and make anxiety harder to control.

Breathing exercises help many people during a spike of fear. A slow breath out is often more useful than gulping air in. If you feel faint, sit or lie down rather than locking your knees.

How do I get NHS help for anxiety?

If you are 18 or over in England, you can usually refer yourself to NHS Talking Therapies without seeing a GP. See a GP as well if you want a physical check, are unsure what is going on, or might need medicine. Under 18s should not use the adult self-referral route as their main path.

Search for NHS Talking Therapies, or ask a GP to refer you. You will normally be offered an assessment, then a matched treatment such as guided self-help, a group, online CBT or one-to-one CBT. In Scotland, Wales and Northern Ireland, talking therapies are usually reached through a GP or local mental health service and are still free at the point of use.

See a GP if:

• you are struggling to cope with anxiety, fear or panic
• things you are trying yourself are not helping
• you would rather get a GP referral than self-refer
• you are pregnant, or you have given birth in the last 12 months — your midwife, GP or health visitor can also help you get support

A questionnaire such as the GAD-7 can help you describe symptoms. It is not a diagnosis. If your score is high, or life is already affected, seek help rather than waiting for a “bad enough” number.

Will I be offered talking therapy or medicine?

For most people, talking therapy comes first. NICE recommends cognitive behavioural therapy for many anxiety problems. A GP may also discuss an SSRI antidepressant, usually alongside therapy, if symptoms are more severe or therapy alone is not enough. There is no single “best tablet”, and mood stabilisers are not standard anxiety treatment.

NICE guidance on GAD and panic in adults supports a stepped approach: information and active monitoring, then low-intensity psychological help, then more intensive CBT or applied relaxation, then medicine if needed. Benzodiazepines are not a long-term treatment for GAD.

If medicine is suggested:

• it will be a clinical decision, not something to start from a website
• SSRIs such as sertraline are commonly used because they treat anxiety as well as depression
• beta-blockers are sometimes used short-term for physical symptoms such as shaking or a pounding heart, not as a cure for the worry itself
• you should not stop a prescribed medicine suddenly without advice, because some cause withdrawal effects

If anxiety is severe, a GP may refer you to a community mental health team. That is a step up, not a last resort, and it does not mean you have “failed” therapy.

Can anxiety cause physical symptoms that feel like a heart problem?

Yes. Adrenaline and cortisol can cause a racing heart, chest discomfort, breathlessness, dizziness and sweating, which is why panic can feel like a medical emergency. Treat a first episode of severe chest pain, collapse, or breathlessness you have never had before as urgent. Once a clinician has assessed you, recognised panic can be managed with slower breathing and therapy.

A panic attack, in NHS terms, is sudden intense anxiety and fear, often with a racing heartbeat, feeling faint, feeling that you are losing control, sweating or shaking, shortness of breath, tingling in the fingers or lips, and nausea. The NHS says an attack usually lasts 5 to 20 minutes. It is frightening and should not harm you, but that reassurance only applies after serious causes have been considered when symptoms are new.

If you already have a panic pattern and this attack feels different — for example pain on exertion, a very sudden headache, weakness on one side, or breathlessness that does not ease — call 999.

How can I support someone who is anxious?

Listen without rushing to fix it, and help them take one practical step such as a GP appointment or an NHS Talking Therapies referral. Do not surprise them into a feared situation. If they talk about not wanting to be alive, treat it as a crisis: 999, NHS 111, Samaritans on 116 123, or SHOUT on 85258.

Useful support looks like:

• asking what helps in the moment, rather than saying “calm down”
• offering to sit with them while they fill in a self-referral form
• keeping plans small and reliable
• looking after your own sleep and support, especially if you live together

Mind has guidance for friends, family and carers. You are not expected to be their therapist.

Some people find apps and online tools helpful alongside NHS care. brightloaf is a UK mental health app focused on practical support for anxiety, with check-ins, short educational tools, and access to counselling sessions.

This article touches on mental health. If you are struggling, support is available and you do not have to face it alone.