Medically reviewed by: Hussain Abdeh MPharm: 2211840
Updated on: 17/05/2021
What is situational anxiety?
Situational anxiety causes a feeling of fear or uneasiness in certain situations that can range from mild to extremely strong. While everybody worries about different things in life, such as sitting an exam or having a medical test, when those worries begin to affect your ability to live a normal life, it could indicate that you are suffering from situational anxiety, and treatment may be recommended.
The specific situation that triggers situational anxiety could be an everyday occurrence, such as walking through a crowded street or getting onto a packed bus; or it could be a major life change that triggers it, for example moving house or getting married. Change can be challenging, so while having some concerns may be a normal reaction, anxiety causes these concerns to seem far worse than they really are.
Fortunately, there are various ways of treating this type of anxiety and becoming more informed about it is the first step towards dealing with it, so you can live a less stressful life.
In this article, we will explain the symptoms of situational anxiety, the causes of the problem and what you can do to ease it.
What are the symptoms?
The symptoms of situational anxiety are similar to those of other anxiety disorders, but they may be triggered by specific events or situations. The symptoms can also vary widely from person to person and depend on the severity of the anxiety attack.
The kind of symptoms you experience can include but aren't limited to:
- Feeling nervous and/or tense
- Tiredness and exhaustion, often combined with difficulties in falling asleep
- Experiencing chest pains
- Feeling irritable
- Breathing rapidly
- Inability to carry on with the task at hand
While situational anxiety is not recognised as a stand-alone illness like a generalised anxiety disorder (GAD), it has certain features that GAD does not. The biggest difference is that this kind of anxiety is not constant but is triggered by specific situations. Often, trigger situations such as standing in a busy lift or walking through a crowd, cannot simply be avoided every time and we will encounter them at different points during our lives, which is why treatment is still important.
What causes anxiety?
There are many factors that can cause anxiety, which include:
- Alcohol and drug abuse: These substances can increase anxiety, and the withdrawal symptoms experienced when you stop taking such substances can make you feel even worse.
- Even nicotine and caffeine can trigger anxiety, along with some psychiatric medications.
- Traumatic childhood experiences, such as bullying, being excluded or abuse, can trigger anxiety and other mental disorders which continue into adulthood.
- Additional mental health conditions like depression are often accompanied by anxiety.
- Experiencing grief or excessive pain or stress can cause anxiety.
- Genes: Evidence suggests that you are more likely to experience situational anxiety if one or more of your family members do as well.
In many ways, the sensation of panic that occurs with situational anxiety is a result of our natural instincts, linked to the 'fight or flight' response we have ingrained to help us get out of dangerous or threatening situations. Medically, this is known as an 'acute stress response'.
In the past, these symptoms would have been useful in getting us out of danger, for example by helping us get away from a predator. The raised heart rate you feel when anxious would have moved more oxygen around the body, helping you to move quicker and for longer, while sweating would have cooled your body down.
The release of adrenaline temporarily increases our strength and stamina while sharpening our senses, aiding in a getaway. However, when this kind of reaction is triggered by modern day, non-threatening situations, it becomes situational anxiety.
Does situational anxiety go away?
Situational anxiety can be combatted in various ways, from special breathing techniques to getting a friend to be with you during a situation that causes you to feel anxious. However, if the anxiety is getting too much and is keeping you from living a normal life, it's best not to simply wait and hope that it goes away. Instead, you should seek out a specific treatment for such a disorder.
How to deal with situational anxiety
If your situational anxiety is changing the way you live and limiting what you can do, or if it is affecting your work life or relationships with others, you should talk to your doctor about the different options out there to help you manage and treat it. Most doctors will usually refer you to a specialist to undergo CBT (cognitive behavioural therapy) before prescribing any medication; although in the UK, Propranolol is widely prescribed for situational anxiety as a first line treatment.
Making an appointment to see a doctor may also trigger your anxiety. This type of anxiety is referred to as White Coat Syndrome. However, it is very important that you speak to a doctor in order to receive the support you need. Remember, your doctor is sympathetic and is there to help you. It might help to bring a friend or family member with you for moral support. There are a variety of ways to treat and manage situational anxiety, which include:
Avoiding situations that trigger anxiety
This can be a short-term help while you figure out ways to combat the anxiety itself, though understandably this is not always possible.
Cognitive behavioural therapy (CBT)
Cognitive Behavioural Therapy helps you to understand your unhelpful thought processes and work towards changing them. A therapist will work with you to get rid of the fears you feel about specific situations, so in future you will not have to avoid them in case they trigger anxiety. Other forms of therapy may also be helpful.
Attending a support group
Here, you can meet other people with the same or similar condition and work through these issues as a group while being guided by a mental health professional. This kind of group setting shows you that you're not alone with your condition and you will be able to learn tips and strategies from others to help you cope with situational anxiety.
Applied relaxation and mindfulness
There are a number of techniques which can help you fight negative ideas and thought patterns. Additionally, they can teach you how to relax your muscles and your mind. You may even be able to condition yourself to relax or calm down on command by using certain words, somewhat like training a muscle.
There are a variety of medicines available, most commonly beta blockers, to help with anxiety. You should always follow your doctor's instructions and advice when taking them. If you feel one type of medication isn't working well for you, your doctor may recommend taking a different one. It is important to remember that it can take several weeks for medication to take effect, so for the first few weeks you may feel worse as your body adjusts to the medication. Ask your doctor before altering your treatment.
Although beta blockers such as propranolol are widely prescribed to treat anxiety, a study conducted in 2016 into the efficacy of propranolol for the treatment of anxiety, found no evidence to support the use of Propranolol in the treatment of any anxiety disorders. Nonetheless, propranolol is widely prescribed to treat Anxiety.
Treatment for situational anxiety
If you have other conditions as well as situational anxiety, such as alcohol addiction or depression, you will likely be asked to try a psychological treatment like CBT before being prescribed medication. These are available on the NHS, and you can self-refer or ask your GP to make a referral for you.
Some medications are designed to be used on a short-term basis, or at certain times, while others may be prescribed for longer periods. Depending on your symptoms, you may be prescribed different medications for physical and psychological ones.