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Dr Cindy Nour

Dr Cindy Nour

Clinical psychologist
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Dealing with anxiety

Experts — Posted 07/10/14

Everyone feels worried and stressed sometimes. But if you feel like your thoughts are ‘snowballing’ and difficult to stop, and your worries are interfering with your day to day life, you might be experiencing anxiety.

Anxiety can be an uncomfortable, distressing and exhausting experience. You might feel like your worries are uncontrollable, and getting in the way of doing the things you would like to do. You might feel restless or on edge, have trouble concentrating, or find it difficult to sleep. You might feel a tightness in your chest, your heart racing, or you might even have panic attacks.

If you are experiencing anxiety, you’re not alone. Anxiety is the most common mental health condition in Australia, affecting 1 in 4 people. It’s a disorder that can sometimes persist for a long time, but through strategies like cognitive behavioural therapy it can be effectively treated and managed

What is anxiety?

Sydney-based clinical psychologist Dr Cindy Nour describes the characteristics of anxiety as falling into three categories:

• Cognitive. “These are the thinking styles that people tend towards when they are anxious,” she explains. “A typical error people make when they’re anxious is that they appraise a situation as a threat. Then they make interpretations about it being catastrophic, and they overestimate the probability of something terrible happening. For example, if your train is late, that could then translate into something like: ‘I’m going to miss that important meeting, my boss will think I’m not motivated, I’ll be less likely to get a pay rise, how am I going to afford my upcoming wedding?’”

• Behavioural. “People tend to avoid things when they’re anxious, and that can create more problems than actually facing up to the situation or the event. For example, you might avoid the dentist or getting a pap smear,” Dr Nour says.

• Physical. Then there are the physical symptoms – heart palpitations, tightness in the chest, increased breathing, hot and cold flushes. “Often these can be quite debilitating, because they also lead to avoidance. These can also culminate in a panic attack – often people go to hospital because they think it’s a heart attack.”

Signs you should seek help

How do you know when anxiety is a problem? If you think you might be experiencing anxiety, it’s important to seek help by visiting your GP for a referral to a psychologist. Particularly, if avoidance is getting in the way of your daily life, that’s often a sign that you might have an anxiety disorder.

“When the avoidance gets worse and the consequences are worse than the event itself, that’s a sign that you should seek help,” Dr Nour says. “For example, if you don’t go to exams because you’re anxious, then you fall behind and fail your subject – then you re-enrol and you’re in the same situation again.”

Another key sign you should seek help is if the physical symptoms are interfering with your life, especially if you are having panic attacks.

Anxiety treatment

One of the most valuable tools for treating and managing is cognitive behavioural therapy. Often referred to as CBT, this evidence-based therapy is built on the idea that your feelings are a result of your thoughts and actions – and that by changing your thinking and behavioural patterns, you can improve the way you feel. CBT involves strategies that help you to identify the thoughts that are causing your anxiety, evaluate them and challenge them, replacing them with thoughts and actions that are more helpful.

Because anxiety is also often heightened by avoidance, learning to face up to the feared situation is also important. “The main component of CBT for anxiety is exposure. That basically means you’re facing the situation in a graded way,” Dr Nour says. “That’s really the best treatment for anxiety if it’s about a particular situation or phobia.”

If your anxiety is severe, medication is also an option. For many people, antidepressant medication can be helpful, and benzodiazepines can also provide short-term relief. Medication can be prescribed by your GP or by a psychiatrist, who will take you through the options suitable for you.

4 ways to reduce anxiety

Dr Nour suggests some other key lifestyle strategies to help you reduce and manage the symptoms of anxiety:

1. Exercise. “Exercise is underutilised and we know it’s great for anxiety and low mood,” she says. Research suggests 30 minutes of exercise each day can help lower stress, improve your mood, boost your energy and help distract you from worry and negative thoughts.

2. Get enough sleep. “We know that sleep and anxiety often go hand in hand, so if you’re sleep deprived you might be more anxious during the day, and if you’re anxious during the day you might have more trouble sleeping at night. So it’s important to get good rest – that means having good sleep hygiene, winding down before bed.”

3. Avoid coffee and energy drinks. “These can exacerbate the physiological symptoms of anxiety, and also interfere with sleep.”

4. Reduce alcohol. “If you’re socially anxious and you’re drinking to try to get through the situation, you’ll often feel more anxious the following day – so it’s not really going to help.”

Resources for anxiety

For more help, Dr Nour recommends trying the following resources:

• Free modules and worksheets available online at the Centre for Clinical Intervention

Change Your Thinking by Sarah Edelman

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