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 and carry out the actions you wish to, 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 type of action, such as walking through a crowded street or getting onto a packed out 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, with anxiety the response you feel is out of proportion to the actual threat and can make normal living difficult.
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.
What are the symptoms?
The symptoms of situation anxiety are similar to that of other anxiety disorders, but may be triggered by specific events or situations. The symptoms can also vary widely from person to person, and depend on the seriousness of the anxiety attack. The kind of symptoms you experience can include but aren't limited to:
- Feeling nervous and/or tense
- Nausea, even vomiting
- Tiredness and exhaustion, often combined with difficulties in falling asleep
- Dizziness and or/confusion
- 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 as, for example, generalised anxiety disorder (GAD) is, it has certain features that GAD does not; the most pertinent of such features is that this kind of anxiety is not felt throughout life but instead brought on by specific situations. Many times those 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 bring on anxiety, which include:
- Alcohol and drug abuse: These substances can increase anxiety, and 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, and being excluded or abused, can trigger anxiety and other mental disorders which continue into adulthood.
- Additional mental health conditions: for example, depression is 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've 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 us move quicker and for longer, while sweating would have cooled us 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, and it is a hindrance to living a healthy life, rather than a help.
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 an anxiety-producing situation. 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, and to instead seek out a specific treatment for such a disorder.
How to deal with situational Anxiety
If your situational anxiety is affecting your ability to live a normal life, and you find yourself changing how you live and limiting what you can do, or 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 a doctor’s appointment may also trigger your anxiety although this type of anxiety is referred to as White Coat Syndrome, however it is very important that you try to do so in order to receive the support you need. Remember, your doctor is sympathetic and is there to help you, and will have come across similar issues like this many times in the past. It might help to bring a friend or family member with you for moral support. There is a variety of ways to treat and manage situational anxiety, which include:
Avoiding the kind of situations that trigger anxiety: This can be a short term help while you figure out the ways to combat the anxiety itself, though understandably this is not always possible.
Cognitive behavioural therapy (CBT): This kind of 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 won't 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 them 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'll 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, and learn how to relax your muscles and your mind. You may even be able to condition yourself to relax or calm down on command, using certain words, somewhat like training a muscle.
Medication: There are a number of different kinds of medication available, most commonly beta blockers to help with anxiety, and 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's important to remember that it can take several weeks to take effect, and so for the first few weeks, you may feel worse as your body adjusts to the medication and you should ask your doctor before altering your treatment.
Using CBD for anxiety can also be a treatment method for individuals suffering from anxiety. Although CBD is not medically proven to treat anxiety, it has been widely spoken about throughout many anxiety forums and a number of specialists have now adopted CBD as a first line treatment for anxiety.
Situational anxiety medication and treatment
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 such as CBT before being given 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.
Before starting any course of medication, your GP should go over your options and take you through the different kinds available, the length of treatment you can expect, and the possible side effects and interactions they may have with other medications.
Once you've started medication, you should have regular doctors' appointments to check your progress and make any alterations to your treatment that would benefit you. You can expect to see the doctor every 2 to 4 weeks for the first three months of treatment, and then every three months after.
Propranolol for Anxiety
One of the most common medications for treating situational anxiety is a type of beta-blocker called Propranolol. It is designed to be taken as needed, usually around one hour before you enter a situation which is likely to trigger anxiety for you. Beta-blockers work by slowing down your heartbeat and reducing the force with which it beats, which slows the onset of panic symptoms and makes you feel more relaxed. This medication is also used to treat high blood pressure and angina. As this medication could be dangerous for someone who already has low blood pressure, it is not a suitable treatment for everyone and your doctor will check for any conditions you may have which could prevent you taking it.
If the side effects of the medication you are taking bother you, it's important to go back and speak to your doctor about them, as there may be a better alternative treatments for you.