For as long as she can remember, Amy Shortt’s life has been overshadowed by her anxieties.
These aren’t the little fears or niggles that bother us all from time to time; Amy lives with an almost permanent sense of dread that something awful is going to happen.
‘It hangs over me all the time,’ she says. ‘I worry about going out, what will happen as I drive to work and about what I’ve done during the day. While I try to laugh with work colleagues, inside I’m in pieces worrying about what might happen next.’
At times her fear is so intense that she feels dizzy and her palms become sweaty. Every few weeks or so she also suffers from panic attacks, when her heart starts to race and she fights for breath.
‘It can happen anywhere,’ she says. ‘The first time I was with Mum watching TV when I was suddenly overcome by this overwhelming sense of dread. I felt as if I was going to die.’
Amy – a funny, intelligent 29-year-old who is a support worker for young people – felt too ashamed to ask for help and for years has hidden the condition from all but her close family and boyfriend. ‘Even some of my best friends don’t know,’ she says.
‘Before I could say any more, she got up, shone a light in my ear and told me: “You’ve got a virus.” She told me to rest, and to come back if I didn’t feel any better.
‘I was stunned. All I could manage to say was: “I don’t think it is that.” I left feeling even more anxious than when I went in.’
Amy moved to another GP, but it was months before she could face going to see them. When she finally did, the GP diagnosed anxiety disorder and started the process of trying to find the right treatment for her.
As countless people like Amy have found, getting a diagnosis can be difficult. Indeed, such is the concern about this that last month the National Institute for Health and Care Excellence (NICE) issued new standards to improve on the ‘poor’ recognition of anxiety disorders.
And even when sufferers are diagnosed, often they don’t get the right treatment.
Anxiety – the medical term is generalised anxiety disorder – means someone feels unusually and inappropriately anxious on a virtually daily basis. It is a common problem, with 5 per cent of the UK population – some three million people – affected, according to the mental health charity MIND.
David Clark, a professor of clinical psychology at Oxford University, explains: ‘Anxiety is a natural response. If you see a lion, your body will respond. Your heart rate will increase, for example, in preparation to run.
‘For people with anxiety, the response is real but there is nothing real to trigger it. It ruins lives. People feel unable to go out and live life, even enjoy their children, because of their anxiety.’
The causes are unknown.
‘Research has shown that it is not based on a major chemical imbalance – it is just that there is a difference in the way these people think,’ says Professor Clark.
Those with generalised anxiety tend to have one or more types of anxiety. These include social anxiety disorder, about mixing with people; post-traumatic stress syndrome, which starts after a traumatic event such as an accident; obsessive compulsive disorder, feeling overwhelmed by obsessive thoughts or compulsive behaviour; and panic disorder, characterised by sudden attacks of panic when you think you’re severely ill or going to die.
‘One-third of people will have the odd panic attack because of, for example, too much caffeine,’ says Professor Clark.
Caffeine and other foods, or stress, can affect the nervous system, causing palpitations that trigger a panic attack.
Around 6 per cent of the population go on to have repeated panic attacks. This seems to hinge on if they think the worst about their first attack.
Living with any anxiety disorder can also have ramifications for your general health. Beth Murphy, head of information at MIND, explains: ‘If you feel anxious all the time, this can lead to conditions such as irritable bowel syndrome and headaches. It can also interfere with sleep.’
Some people become so anxious they end up in hospital. Last year, 8,720 were treated in hospital for anxiety – the majority of them women over 60. ‘Women in this age group can feel squeezed: they have a lot to deal with, caring for elderly parents and children, and it can take its toll,’ says Beth Murphy.
‘For someone to be admitted to hospital with anxiety, it needs to be quite serious. They will be feeling suicidal, or so anxious that they just can’t function.
‘The statistics are alarming and suggest a failure in the services available to people suffering with anxiety.’
Diagnosis is clearly an issue. ‘Some GPs are really good at picking it up, but we do hear from people who wait a long time for a diagnosis,’ she adds.
‘This can be because they’re worried about talking about mental health, so focus on physical symptoms, such as a racing heart. This might lead a GP to check for heart problems, rather than talking about the wider issues.
‘It’s unfortunate, though, as it can take a lot of courage for these people to ask for help.’
Even with the correct diagnosis, sufferers are often offered drugs rather than psychological intervention, such as cognitive behavioural therapy (CBT) – a form of talking therapy that aims to change how people view certain situations. This has been found to be more effective than medication.
Professor Clark says: ‘If you look at social anxiety, for example, 80 per cent recover with therapy (normally ten to 20 sessions), whereas medication helps only 40-50 per cent of people and the recurrence rate is higher.’ Medication also carries the risk of side-effects. Amy tried it, with disastrous results.
‘My GP said she could sign me off work, put me on medication, or get me counselling. I feared time off work would make me worse, and I wanted a quick fix, so I agreed to try medication.’
Amy was prescribed the antidepressant citalopram.
‘It made me feel zombie-like,’ she says. ‘I couldn’t concentrate at work, and felt really highly strung. I had to come off it.’
She was then prescribed sertraline, which is used for panic disorder or social anxiety, but this hasn’t helped either.
When Amy feels strong enough, she hopes to try CBT – but she may face a delay getting it. One in ten people waits more than a year to get access to talking therapy, says Beth Murphy.
Therapy did help 20-year-old Molly Woodham, who has suffered anxiety since she was 14, though the effects have not, in her case, been long-lasting.
She suffers so badly that she’s too afraid to leave the house she shares with her boyfriend in Stowmarket, Suffolk.
‘I look out of the window on a sunny day and I long to go out – but my anxiety about what might happen overrides that.
‘It’s as if you’re in a battle with your own mind. It’s not a mild feeling that something bad will happen, it’s a terrifying fear.’
Her first attack was on a bus with her mother and sister. ‘Out of the blue I had a panic attack. My heart was racing, I had sweaty palms and felt as if I couldn’t breathe.
‘I ran down to the driver and asked him to stop – I felt if I didn’t have more air, I would die.’
Her GP diagnosed anxiety and handed Molly and her mother a leaflet about the condition.
‘And that was that,’ says Molly. ‘I felt as if I was doomed.’
She gave up her dreams of going to university to become a teacher as she had to leave school. ‘I would be in class and my heart would start racing.’
She’s since had four courses of CBT which initially left her feeling ‘incredible’ – so much so that after one she managed to get a job and met her boyfriend.
But over the past six months the effects have worn off.
Like Molly, Amy fears she will never be free of her anxieties. ‘I just want some peace,’ she says.
This article first appeared on ‘Daily Mail’ on 3 March 2014.