What is anxiety?

Anxiety is a natural response of the body to a real or perceived threat. It involves physical, emotional, and cognitive changes that prepare the body to act.

When it functions properly, it helps us to:

• recognise risks;
• maintain attention;
• prepare responses;
• make decisions more cautiously.

However, when this response is activated excessively or for too long, it can become exhausting. The WHO describes anxiety disorders as conditions in which fear or worry are intense, excessive, difficult to control, and accompanied by physical, behavioural, and cognitive symptoms.

When does anxiety stop being “normal”?

Not all anxiety is an illness. The difference lies mainly in intensity, duration, and impact.

Anxiety deserves attention when it:

• appears frequently or without an obvious cause;
• is difficult to control;
• interferes with sleep, work, studies, or relationships;
• leads to avoidance of everyday situations;
• causes significant distress;
• persists over weeks or months.

In generalised anxiety disorder, for example, worry tends to be persistent and wide-ranging, involving several areas of daily life. In other anxiety disorders, such as panic disorder, phobias, or social anxiety, symptoms may appear in more specific situations.

Main symptoms of anxiety

Anxiety can manifest differently from person to person. Some people mainly experience physical symptoms, while others notice emotional changes, repetitive thoughts, or avoidance behaviours.

Physical symptoms

• palpitations or rapid heartbeat;
• tightness or pressure in the chest;
• shortness of breath or a feeling of suffocation;
• trembling;
• sweating;
• muscle tension;
• dizziness;
• nausea or abdominal discomfort;
• persistent tiredness;
• sleep disturbances.

Emotional and cognitive symptoms

• excessive worry;
• feeling of imminent danger;
• irritability;
• difficulty concentrating;
• repetitive thoughts;
• fear of losing control;
• difficulty making decisions.

Behavioural symptoms

• avoiding places, people, or situations;
• constant need for reassurance;
• restlessness;
• difficulty relaxing;
• social withdrawal.

Common types of anxiety disorders

Anxiety can take several clinical forms. The most common include:

Generalised anxiety disorder

Characterised by persistent and excessive worry about several areas of life, such as health, work, family, money, or daily responsibilities.

Panic disorder

Involves sudden episodes of intense fear, accompanied by marked physical symptoms such as palpitations, shortness of breath, trembling, or a feeling of faintness.

Social anxiety

Consists of an intense fear of social or performance situations, usually linked to fear of judgement, embarrassment, or rejection.

Specific phobias

These are intense and disproportionate fears of specific objects or situations, such as flying, animals, heights, or enclosed spaces.

Agoraphobia

Involves fear or avoidance of situations where the person feels it may be difficult to escape or get help, such as public transport, crowds, or open spaces.

Why does anxiety occur?

Anxiety rarely has a single cause. In most cases, it results from a combination of biological, psychological, social, and environmental factors.

Contributing factors may include:

• genetic predisposition;
• traumatic experiences or prolonged stress;
• excessive responsibilities;
• sleep deprivation;
• excessive caffeine or alcohol intake;
• certain physical illnesses;
• some medicines;
• hormonal changes;
• social isolation;
• difficult life events.

Anxiety may also occur alongside other conditions, such as depression, sleep disorders, problematic substance use, or cardiovascular disease.

Anxiety and the body: why do the symptoms feel so intense?

Many people with anxiety experience physical symptoms so intense that they worry they may have a serious illness. This happens because anxiety activates the autonomic nervous system, responsible for the “fight or flight” response.

When the body goes into alert mode:

• the heart beats faster;
• breathing becomes quicker;
• muscles become tense;
• digestion slows down;
• attention focuses on danger.

These symptoms can be frightening, but they do not necessarily mean there is a heart or respiratory disease. However, symptoms such as chest pain, intense shortness of breath, fainting, or neurological changes should always be assessed by a healthcare professional.

Treatment of anxiety

Anxiety is treatable. The approach depends on the severity of symptoms, the type of anxiety disorder, the duration of the problem, and its impact on the person’s life.

Psychological therapy

Cognitive behavioural therapy (CBT) is one of the best-supported approaches for treating anxiety disorders. It helps identify thought patterns, reduce avoidance behaviours, develop emotional regulation strategies, and gradually face feared situations.

International recommendations highlight psychological interventions, particularly those based on cognitive behavioural principles, as key treatments for anxiety disorders.

Medication

In some cases, medication may be necessary. The most commonly used medicines include antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SNRIs), which can help reduce symptoms over time.

Benzodiazepines may be used in specific short-term situations, but they should not be considered a long-term solution due to the risk of dependence, tolerance, and withdrawal symptoms.

Medication should always be guided by a doctor and should never be started, changed, or stopped without professional advice.

Everyday strategies

These measures do not replace professional support, but they may help reduce symptoms and improve well-being.

Sleep

Maintaining regular sleep schedules, avoiding screens before bedtime, and creating a calming evening routine can help reduce physical and mental activation.

Physical activity

Regular exercise helps reduce tension, improve mood, and regulate stress.

Reducing stimulants

Caffeine, energy drinks, nicotine, and alcohol can worsen anxiety symptoms in some people.

Breathing and relaxation

Techniques such as diaphragmatic breathing, progressive muscle relaxation, or mindfulness may help reduce the physical response to anxiety.

Organising the day

Breaking tasks into smaller steps, setting priorities, and taking breaks can reduce the feeling of overload.

Relationships and emotional support

Talking to trusted people can reduce isolation and help put worries into perspective.

When should you seek help?

Professional help should be sought if anxiety:

• interferes with work, studies, or relationships;
• causes frequent distress;
• leads to avoidance of important situations;
• causes repeated panic attacks;
• persistently affects sleep;
• is associated with alcohol or substance use;
• appears alongside depressive symptoms;
• includes thoughts of self-harm or suicide.

In these situations, assessment by a doctor, psychologist, or psychiatrist is essential.

How can a pharmacy help?

Pharmacies can play an important role in supporting people with anxiety, especially through:

• advice on prescribed medicines;
• clarification of side effects and interactions;
• reinforcement of treatment adherence;
• guidance on sleep, caffeine, alcohol, and supplements;
• identification of warning signs;
• referral for medical assessment when necessary.

It is important to remember that natural products or supplements may also interact with medicines. For this reason, they should be discussed with a doctor or pharmacist.

Conclusion

Anxiety is a natural response of the body, but when it becomes intense, persistent, and limiting, it should be taken seriously.

Recognising the signs, seeking help early, and adopting appropriate strategies can make a significant difference to quality of life.

Mental health is part of overall health. Taking care of anxiety is not a sign of weakness — it is a way to regain balance, autonomy, and well-being.

Sources

This article is based on recommendations and scientific evidence from international organisations such as the World Health Organization (WHO), National Institute for Health and Care Excellence (NICE), National Institute of Mental Health (NIMH), National Health Service (NHS), Mayo Clinic, and scientific literature on mental health, anxiety disorders, psychotherapy, and pharmacological treatment.