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Emotional Conditions

What is an addiction disorder?

An addiction is a condition in which those affected engage compulsively in behaviours despite the adverse consequences of continued engagement in the problem behaviours.  Addictions could be substance related or may take the form of thrill seeking behaviours such as gambling.  There is usually a temporary reward associated with most addictions, and the desire to seek this reward is what sustains the addictive behaviour.

What are the types of addiction disorders?

There are many forms of addiction.  The most common are drugs, alcohol, gambling, sex, nicotine, caffeine, food and shopping.  Addictions such as drugs, alcohol, nicotine and caffeine also cause significant medical issues in addition to the psychological and emotional consequences.

What are the symptoms of substance addiction?

Most addiction to substances begins with experimental and social use of the substance.  This usually progresses to habitual use and finally to dependence and addiction.  The core symptoms of addiction to substances include:

  • A feeling that you have to use alcohol or drugs regularly
  • Having intense urges for drugs or alcohol
  • Over time needing more drugs or alcohol to get the same effect
  • Making sure you maintain a supply of drugs or alcohol
  • Spending money on drugs and alcohol even though you cannot afford it
  • Neglecting work, family and social life because of drug or alcohol use
  • Engaging in illegal activity such as stealing or fraud to get drugs or alcohol
  • Driving under the influence of drugs and alcohol
  • Failed attempts to stop using drugs or alcohol
  • Experiencing withdrawal symptoms when you attempt to stop taking substances

What are the symptoms of gambling addiction?

Gambling addiction is a form of thrill seeking addiction with mainly psychological, emotional and financial consequences.  As a result of the problem behaviour, work, family and social difficulties could arise.  The main symptoms of gambling addiction are:

  • Spending more money and time on gambling than you can afford
  • Finding it difficult to stop or manage gambling
  • Frequent disagreements with family and friends about money and finances
  • Losing interest in other activities
  • Constantly thinking about gambling and winning
  • Gambling until you have no money left
  • Borrowing money, selling possessions and stealing to fund gambling habit
  • The need to gamble with larger amounts or spend more time on gambling activity to get the same buzz or thrill
  • Neglecting work, family and other responsibilities because of time spent gambling
  • Feeling depressed, anxious, angry and distressed due to gambling
  • Feelings of guilt and shame

What is sex addiction?

Sexual addiction is characterised by compulsive participation or engagement in sexual activity, particularly sexual intercourse despite negative consequences. Symptoms of sex addiction include:

  • Engaging frequently in more sex and with more partners than intended
  • Constant pre occupation and craving for sex
  • Unsuccessful attempts to cut down and reduce sexual activity
  • Neglecting other activities due to frequent participation in sexual activity
  • Spending excessive amounts of money to engage in sexual activity
  • Anger and feeling irritable when cravings for sex not satisfied
  • Increased need for sex in order to achieve same effect
  • Continued engagement in sexual activity despite harmful consequences

What causes addictive behaviour?

There are numerous causes for addictive behaviour.  Genetics may play a role in certain types of addictions, but this is inconclusive.  In a significant number of cases, people use addictive behaviour to cope with adverse circumstances or emotional and psychological difficulties.  Boredom and stress contributes to addictive behaviour and also helps sustain and maintain these behaviours.  A lack of vocation, family and social support increases the risk of developing an addiction and reduces the chances of overcoming the addictive behaviour.  Certain personality types are also prone to developing addictive behaviour.

Is there any treatment for addiction disorders?

Treatment for addiction will depend on the nature and severity of the addictive disorder.  If numerous attempts to stop the addictive behaviour have been unsuccessful, then residential rehabilitation can be helpful.  If stopping the addictive behaviour is associated with withdrawals symptoms, your doctor may recommend medications to help reduce these withdrawal symptoms.  There are also medications that help reduce cravings and can assist as a deterrent by causing unpleasing physical symptoms if the addictive substance is consumed.  For mild to moderate cases, psychological and behavioural approaches are effective and plays a significant role in the recovery of most addicts.

What can I do to prevent myself from developing an addiction?

There are measures that can be taken to reduce the risk of developing an addictive disorder. Your chances of developing an addiction are reduced if you have an occupation or vocation that you participate in on a regular basis. Abstaining from using drugs or alcohol will also reduce the risk of developing an addition to these substances.  An awareness that thrill seeking endeavours such as gambling and extreme adventures could lead to addictions will help maintain control.  The sooner help is sought for problem behaviours the less likely they are to progress to a full blown addiction.

What is depression?

Depression is the term used to describe a state of mind characterised by a pervasive feeling of sadness, persistent negative thoughts about one’s self, the future and life in general. As a result of the persistent nature of these negative thoughts, feelings of hopelessness, helplessness and thoughts that life is not worth living could also be a feature. 

How common is Depression?

Depression is a common condition and it is estimated that 350 million people are affected globally.  1 in 4 people will suffer from depression at some point in their lives and the condition is more common in women than it is in men.  At its worst depression can lead to suicide and the global rates of suicide are increasing significantly.

What are the symptoms of Depression?

People who are depressed feel sad all the time, experience difficulties sleeping, eating and concentrating.  They tend to lose interest in things which were enjoyable and find it difficult to derive pleasure from life.  They also harbour a sense of hopelessness and helplessness and can find it difficult to see a way out of the current situation.  If symptoms persist for a long time, then thoughts that life is not worth living could be a feature which could lead to suicidal urges and intentions.  These symptoms could be severe enough to interfere with people’s lives to the extent that they find it difficult to work, study and sustain relationships.

Signs and Symptoms of depression:

  • Feeling sad or empty for significant periods
  • Difficulties sleeping, eating and concentrating
  • Anxiety, nervousness and tension
  • Tiredness and a lack of energy
  • Feeling hopeless, helpless and lacking purpose
  • Loss on interest in previously pleasurable activities
  • Lack of motivation
  • Thoughts that life is not worth living
  • Thoughts of self-harm or suicide
  • Physical symptoms like aches, pains and cramps

What are the causes of depression?

The best way to think about the causes of depression is to break them down into biological, psychological and social causes. 

Biological causes refer to a disruption in the normal chemical functioning of the brain either due to genetics or environmental factors.  A reduction in serotonin levels could give rise to depression.  Use of drugs and other psychoactive substances like certain medications could also lead to depression

Psychological causes such as stress, relationship difficulties, low self-esteem and a persistently negative perception of self, circumstances and the future could lead to depression.

Social causes of depression include financial difficulties, work related issues, relationship breakdown and other aspects of a person’s social life that could be causing significant stress.

Can depression be treated and if so how?

Yes, depression can be treated and it is worth noting than there are different treatments based on how severe the symptoms of depression are. 

The first line treatment for mild to moderate forms of depression is psychotherapy with or without medications. 

For severe symptoms, medications such as Prozac would help reduce the symptoms associated with depression. 

If symptoms do not respond to multiple trials of different medications, your doctor may consider electroconvulsive therapy if this is deemed necessary.

The first step in the treatment of depression is to visit your doctor who will take a detailed history and perform investigations to rule out medical problems that may be causing depression.  Once this has been completed, your doctor will devise a treatment plan.

How can I prevent myself from getting depressed?

There are certain things we can all do to reduce our risk of developing depression:

  • Eating healthy and optimising our nutritional intake
  • Avoiding illegal drugs and excessive consumption of substances that act on the brain
  • Regular exercise, and drinking adequate amounts of water
  • Managing stress effectively and removing ourselves from unsustainable stressful situations
  • Participating in activities you enjoy on a regular basis
  • Engaging in activities that provide a sense of purpose, meaning and fulfilment
  • Providing and receiving love and attention

How can I help a loved one who may be depressed?

If you know someone who may be suffering from depression, encourage the person to see a doctor in order to get a diagnosis and commence treatment.

You can offer support by:

  • Providing reassurance and hope
  • Never ignore comments about suicide and ensure you report these to the therapist or doctor
  • Invite him or her out for walks, outings and other activities
  • Talk to your loved one and listen carefully

What is Anger?

Anger is an emotional state which humans experience on a regular basis.  However as with all human emotions, if this persists for a significant period of time or gets too intense on a regular basis it can affect our social, family and work life.  Extreme anger could also be part of an existing mental health difficulty such as depression, anxiety and addiction disorder.

Why do people get angry?

Different people get angry for different reasons.  Things that could provoke anger include stressful situations, a perceived or actual threat to our sense of self, ego or status, physical or verbal threats by others, discrimination, unfair treatment by others, people not abiding by social norms and values, being interrupted while pursuing goals and many other life circumstances that are perceived as unfavourable.

What determines how people react when they are angry?

Different people react in different ways.  This will depend on their background and upbringing, personality, cultural values and norms, the situation that provoked the anger, habitual substance use.  The physical response to anger involves the release of the hormone, adrenaline which gets us ready to deal with a perceived external threat.  As a result of the release of adrenaline our heart rate increases, we breathe faster, blood vessels become wider allowing for increased blood flow to our muscles and other organs and we sweat more.  This occurs to enable us deal with the threat effectively, however this heightened state of anxiety and agitation could also affect our judgement and our ability to control ourselves causing us to act impulsively.

How can anger problems affect my life?

Intense anger can occur in those who have an anger problem.  This leads to uncontrollable rage which the person later regrets.  During this fit of rage many actions may occur impulsively such as physical and verbal assault which could cause significant emotional trauma or physical injury to others.  Those who find it difficult to control their anger can also cause injury to themselves by head banging or engaging in other forms of self-harming behaviour to release their anger.  These impulsive behaviours could cause significant problems at work, home or in a social setting.  This will affect relationships with partners, children, colleagues, friends and family members.  In an attempt to deal with the aftermath of intense anger, some may use substances such as alcohol to cope which may in turn lead to addiction difficulties.


How can I prevent anger from becoming a problem?

The most effective way to prevent anger from affecting your life significantly is to accept that you have an anger problem and to seek help as soon as possible.  There are numerous anger management courses available or alternatively you could have individual therapy to deal with anger and to develop constructive anger management strategies.  Refrain from using substances such as alcohol and illicit drugs as these intensify anger and make our actions even more impulsive and uncontrollable when we are angry.  Managing stress effectively and maintaining a reasonable work-life balance are beneficial.  Eating healthy, engaging in regular exercise and doing the things you enjoy or find fulfilling should not be ignored.  Identify the triggers for your anger and practice substituting anger for more constructive coping strategies when faced with these external triggers.  Therapy has been shown to be effective in dealing with anger management difficulties.

What are the signs and symptoms of anger management problems?

You may have an anger management problem if you experience the following:

  • Physical acts of aggression such as assaulting others, punching walls, breaking things and head banging
  • Reacting aggressively to minor incidents such as verbal remarks, spilled drinks, slow moving queues
  • Finding it difficult to control your feelings of anger
  • Having persistent arguments with friends, family and colleagues and accusing them of things they have not done
  • Regretting your actions after an argument or a fit of anger
  • Those close to you avoid being around and those who have no choice but to be around are fearful and terrified of you


It is normal for us all to feel some anxiety. That’s part of the normal human experience. However, if these feelings of tension and nervousness persist to the point of interfering with your work, studies or relationships then you may be experiencing an anxiety disorder.

Anxiety disorders are the most common mental health difficulties seen by doctors and psychotherapists. It is estimated that almost 4% of the world’s population is currently suffering from an anxiety disorder.

Whether you wish to understand anxiety for yourself or to aid a friend or family member, in this article we hope to convey a full understanding of what anxiety is and help put you on the right path to discover solutions.

We will cover:

  • How to define anxiety and define anxiety disorders
  • The difference between anxiety and a panic attack, and how they are related
  • The specific disorders that are categorized as types of anxiety
  • The symptoms of anxiety and panic attacks
  • The first steps that might be recommended to those wanting to find relief from anxiety


Anxiety can be defined as a state of tension, nervousness and apprehension. It may be related to external events, or there can be no obvious cause at all. It can manifest in many forms and can affect people in different ways.

It has been pointed out (such as in this paper from Oxford University Press) that anxiety, as related to fear, may a normal evolutionary reaction that can help keep us safe.

If tension, nervousness and apprehension persist for prolonged periods, or if your feelings and responses interfere in some way with your normal life, it may be considered an “anxiety disorder”, which has more specific definitions.


Anxiety can manifest in different forms and affect people in different ways. The National Institute of Mental Health lists a number of distinct (but related) forms of anxiety disorder:

  • Generalised anxiety disorder
  • Panic disorder
  • Social anxiety disorder
  • Phobias
  • Separation Anxiety Disorder
  • Obsessive-compulsive disorder

We will go into more detail about the meanings of each, describing their particular traits and symptoms, in the next section.


Panic and anxiety are closely related. The NHS describes panic as “the most severe form of anxiety”. Not everyone who suffers from anxiety will suffer from panic or panic attacks. For those that do, it can be very distressing, with an attack developing rapidly and without warning.

If you are interested in understanding panic attacks, you may find it useful to read our blog post by Sarah Keeping, a member of the British Psychological Society.


In general, common anxiety and panic attack symptoms consist of: feeling tense; nervousness; apprehensions; and an inability to relax.

Other symptoms include:

  • Intense fear of being judged negatively by others
  • Worrying for days or weeks before a social gathering
  • Avoiding public places or places there are people
  • Difficulty in forming or sustaining relationships
  • Blushing, trembling or sweating around other people
  • Feeling nauseous or sick when others are around
  • What are the causes of anxiety disorder?

When it comes to anxiety disorders, depending on the specific anxiety disorder the symptoms can vary:


Generalised anxiety is a persistent state of tension, nervousness and an inability to relax. The main symptoms include:

  • Restlessness, feeling tense and on edge
  • Irritability and apprehension
  • Muscle tension
  • Difficulty controlling worrying thoughts
  • Problems with sleep
  • Difficulties concentrating

According to NIH (National Institute of Mental Health), you might be diagnosed with this condition if you experience such symptoms on “most days” for at least 6 months.

If you think or know you have a generalised anxiety disorder, you can discuss it with your GP or therapist. Click here to find E-Therapy practitioners who specialise in anxiety.


Panic disorder is an intense form of anxiety that regularly manifests in panic attacks. Panic attacks can occur spontaneously or as a result of external situations.

People having a panic attack experience physical symptoms like feeling breathless, racing and pounding heart, sweating, trembling, shaking and/or a choking sensation.

The symptoms of panic disorder include:

  • Intense fear to the point of feeling out of control
  • Constantly worrying when the next attack will occur
  • An intense desire to escape from situations or to seek safety
  • Fear or avoidance of places that provoke a panic attack

You may wish to read this

You can discuss your panic disorders with your GP or therapist. Click here to find E-Therapy practitioners that specialise in panic.


Social anxiety disorder is characterised by feeling unusually tense, nervous and anxious in social situations such as meeting new people or when in the presence of others who are not familiar.

Social anxiety can also occur in situations that require people to perform such as public speaking or business meetings. Those with social anxiety have an intense fear of embarrassment, humiliation, rejection and offending others.

Other symptoms include:

  • Intense fear of being judged negatively by others
  • Worrying for days or weeks before a social gathering
  • Avoiding public places or places there are people
  • Difficulty in forming or sustaining relationships
  • Blushing, trembling or sweating around other people
  • Feeling nauseous or sick when others are around
  • What are the causes of anxiety disorder?

You can discuss your panic disorders with your GP or therapist. Click here to find E-Therapy practitioners that specialise in social anxiety.


There are many causes for anxiety disorders. Anxiety disorders could occur in those with a family history of mental health difficulties. Those with a personality prone to worrying could be at risk of developing a full-blown anxiety disorder at some point in their life. Being subjected to constant stress and worry regularly could contribute to the development of anxiety disorders. The repeated use of illicit drugs and stimulants like caffeine can also increase the risk of developing anxiety. Certain medical conditions are known to be associated with the symptoms of anxiety and this should be ruled out by your doctor before proceeding with a treatment plan.


There are certain things that we can all do reduce our risk of developing an anxiety disorder:

  • Finding time to relax and meditate
  • Reduce stress levels by managing workload and breaking down tasks
  • Avoid constant and unsustainable stress-provoking environments and situations
  • Optimise nutrition by eating healthy and drinking adequate amounts of water
  • Avoid unhealthy foods and drinks
  • Minimise intake of caffeine, nicotine and energy drinks
  • Adequate sleep and exercise
  • Spending time doing the things you enjoy and keeping the right company
  • Avoid news channels


There are different treatments for anxiety disorders depending on the nature and severity of the condition.

Mild to moderate anxiety:

These symptoms respond well to psychotherapeutic and behavioural therapies and this is usually the first-line treatment.

All of these treatments can be administered by an appropriately trained therapist.

Severe forms of anxiety:
Where the above symptoms may require medication, which we talk about in more detail below.


More severe forms of anxiety may require medications such as anti-depressants or benzodiazepines.

Your doctor or therapist will perform tests and investigations to rule out a medical reason for your anxiety and will devise a treatment plan based on the nature and severity of your symptoms.

Often, the first medication a doctor will prescribe will be one that slows the reabsorption of the hormone serotonin. Serotonin helps stabilise mood. By blocking serotonin from being reabsorbed by the cell that created it, more serotonin will remain at work for longer in the brain. For this reason, these drugs are called Selective Serotonin Reuptake Inhibitors, or SSRIs.

Though often effective, if the SSRI is not having the desired effect other drugs may be prescribed by the patient’s GP.

What is an eating disorder?

Eating disorders can best be described as a psychological and emotional condition that affects the eating patterns of those affected.  The underlying thought process that has given rise to the eating disorder varies depending on the type.  An intense fear of being overweight, low-self-esteem and confidence, a fear of being judged negatively by others, a persistent, obsessional and irrational belief about one’s body shape/size and an incontrollable desire for food are some of the thought processes and belief systems that contribute to the development of eating disorders.

What are the types of eating disorders?

There are three main types of eating disorders:

  • Anorexia nervosa
  • Bulimia nervosa
  • Binge eating disorder

What is anorexia?

Anorexia is a form of eating disorder in which those affected do what they possible can to avoid putting on weight.  Even though they are underweight, they see themselves as overweight and constantly fear that they will become overweight.  As a result of these fears and beliefs they over exercise, restrict the amount of food they eat and may even use laxatives and diuretics to ensure they do not put on weight. Main symptoms are:

  • Distorted body image and a sense of self that is based significantly on body weight and shape
  • Intense fear of gaining weight
  • An obsession with being thin despite being of normal weight and size
  • Restricted eating and counting calories
  • Physical symptoms such as tiredness, infertility, heart problems, low blood pressure, constipation, anaemia and brittle bones.

What is Bulimia?

People with bulimia experience recurrent and frequent episodes of overeating which they find difficult to control.  These binge eating episodes are usually followed by behaviours such as making themselves vomit, using laxatives or diuretics, fasting and exercise in an attempt to compensate for overeating.  There is sense of guilt and shame after binge eating and unlike anorexia, those who suffer with bulimia are usually of normal weight.  People with bulimia could develop physical symptoms related to frequent vomiting and laxative/diuretic use such as acid reflux, sore throat, dehydration, electrolyte imbalances and heart problems

What is binge eating disorder?

Binge eating disorder occurs when people lose control over their eating to the point of eating excessively and frequently.  Unlike bulimia, those with binge eating disorder do not engage in behaviours that serve to keep their weight down.  As a result, they tend to be overweight and obese.

Symptoms include:

  • Eating significantly large amounts of food in a short period of time
  • Eating even when you are not hungry
  • Eating fast during binge episodes
  • Eating until uncomfortably full
  • Eating alone or in secret to avoid embarrassment
  • A feeling of shame and guilt about eating habits

What are the causes of eating disorders?

There are many causes of eating disorders.  There may be a genetic element as those with a family history of eating disorders are at an increased risk of developing the disorder.  It is usually associated with other conditions like depression, anxiety and certain personality disorders.  Certain personality types are also at an increased risk of developing the disorder and an excessive and obsessional desire from a young age to meet the ideals and demands of modern society when it comes to body image is a significant factor.

Are there any treatments available for eating disorders?

Treatment for eating disorders are aimed at addressing the underlying thoughts and beliefs that have given rise to the subsequent behaviours.  Hence, psychotherapy and behavioural modification are essential in order to relieve the symptoms.  Medications such as antidepressants, antipsychotics and mood stabilisers may be used depending on the nature and severity of the condition.  Some patients may require admission to hospital for medical care due to the effects of malnutrition and its complications.

What is Existentialism?

Existentialism is the term used to describe a philosophy that is centred on finding the meaning of life and what the ultimate objective or goal is.  Is there any meaning or purpose to living apart from the mundane and monotonous existence that is everyday life?  What happens after we die?  Is there some sort of afterlife or does our existence cease completely after death?  What is the point of anything that we do in this life if it is all going to end anyway?  These are some of the questions existentialists ask.  Essentially, we are all existentialists to varying degrees, trying to figure out the point of our lives amidst all the confusion and uncertainty that bombards us on a regular basis.

Why is this relevant?

Interestingly enough, when a majority of people are facing challenges in their lives they tend to ask questions and perceive their existence from a different perspective.  There is no doubt that we will all experience multiple challenges in life which will affect us psychologically and emotionally.  For some, overcoming these challenges provides new insights and offers an opportunity to evolve and in other cases these challenges could be the beginning of a more pervasive detrimental psychological and emotional state of mind.  A person’s philosophy and beliefs about life and existence could play a crucial role in the way challenges are perceived and dealt with.


We are all born into this world. What determines who we become?  By who I am referring to personality traits, thinking habits, belief systems, character, morals, values and our general perspective on life.  We are all significantly influenced by our environment which includes our place of birth, parents, social background, schools, friends, teachers, television and mass media, religious institutions, physical attributes, life changing circumstances beyond our control and the financial system.  This programing continues throughout our formative years to the point that we are not even aware that we are programs.  This results in us concluding that we are the program and this belief persists into our adult life.  Does a robot know it is a robot? 

The good news is that challenges and obstacles that cause us emotional and psychological conflict and distress should serve as a reminder that we are all programs and we can choose to alter that programing to a more sustainable and constructive program if our learned ways of thinking, believing and feeling are causing us difficulties in our daily lives.  The awareness of this very important fact is what determines the outcome of our lives.  How else does a boy born in a council flat in East London to a low income, uneducated, working class family and surrounded by poverty and deprivation go on to become one of the wealthiest and successful businessmen in the United Kingdom.  This is just one of very many examples.

Alter your program, change your life!

What is insomnia?

Insomnia is the term used to describe difficulty getting to sleep leading to sufferers staying awake for significant periods of the night.  Those who are able to get to sleep but find it difficult to stay asleep for long enough could also be deemed as suffering from insomnia.  Waking up very early in the morning and finding it difficult to get back to sleep is another form of insomnia referred to as early morning waking.    Those who suffer from insomnia tend to feel tired and irritable throughout the day.  This subsequently affects their work, family, relationships and social life.  Most people experience bouts of insomnia periodically, however when this persists it could have a detrimental effect on a person’s mental health.

How much sleep is required?

Sleep requirements vary depending on age, occupation and level of activity.  Six to nine hours is the recommended amount of sleep, however some people require less and others need more than this.  You are most likely getting enough sleep if you are able to get through the day without feeling too tired or falling asleep and if you are able to perform daily tasks satisfactorily.


How common is insomnia?

Insomnia is a common problem which is thought to affect around one in three people in the United Kingdom.  People can suffer from bouts of insomnia secondary to stress, emotional and psychological difficulties.  However, if this persists or is prolonged can affect a person’s quality of life significantly.

What causes Insomnia?

Insomnia can be caused by the following:

  • Can occur as part of a mental health issue such as depression, anxiety or bipolar disorder
  • Medical conditions such as heart problems, pain and breathing difficulties
  • Some prescribed medications can cause insomnia
  • Feeling stressed, overwhelmed and anxious
  • Lifestyle factors such as shift work, drinking alcohol or significant amounts of caffeinated drinks, using recreational drugs and jet lag
  • Insomnia can also be caused by a less than optimal sleeping environment such as an uncomfortable bed, noise, level of brightness, and poor temperature regulation

What can I do to help my sleeping problem?

There are practical measures that can be taken to help you get a good night’s sleep:

  • Going to bed and waking up at the same time on a daily basis
  • Relaxing before bedtime by listening to relaxing music, taking a warm bath or reading a book
  • Using thick blinds or curtains to reduce the level of brightness in the room. You can also use an eye mask if this is not too uncomfortable and use earplugs if you are overly sensitive to noise
  • Avoid caffeinated drinks, nicotine, alcohol, heavy meals and exercise prior to bedtime.
  • Avoid using phones, tablets, computers or watching television prior to going to bed
  • Avoid taking naps during the day
  • Avoid excessive consumption of alcohol and abstain from using illegal recreational drugs
  • Minimise use of caffeinated drinks such as coffee, red bull and other stimulant beverages

What is the treatment for insomnia?

The approach to eradicate the symptoms of insomnia involves identifying the root cause of the insomnia.  If a cause has been established, the most appropriate course of action is to stop the offending agent in the case of prescribed medications, caffeine, alcohol and recreational substances.

For psychological and emotional difficulties such as stress, worry and anxiety, talk therapies in the form of cognitive behavioural therapy has been shown to be effective.  If insomnia occurs as part of a diagnosed mental health condition then your doctor may prescribe antidepressants, anti-anxiety medications or mood stabilisers.  Prescription sleeping tablets may be used if all else fails and should be used as a short term measure.

What are mood swings?

Moods swings refer to rapid changes in mood and they can occur in the context of numerous conditions. This usually involves a rapid change from an elevated mood state such as happiness to one of sadness and despair.  Mood swings are a prominent feature of bipolar disorder, however in this case the extremes of mood are so severe that this can affect work, study, social and family life.  More rapid fluctuations in mood may be due to less severe forms of bipolar disorder, premenstrual symptoms in women, illicit drug use, certain personality disorders and prescribed medication.

What are the symptoms of bipolar disorder?

Bi polar disorder is characterised by mania and depression.  One manic episode is sufficient to be diagnosed with the disorder.  Those who suffer from bipolar disorder may or may not have experienced a depressive phase before.  The symptoms of both mania and depression are severe enough to interfere with daily activities such as work, relationships and family life.  There are many forms of bipolar and they are categorised based on the severity of symptoms, frequency of mood swings and the cause of the disorder.  The main symptoms include:

  • Manic symptoms manifesting as excessive happiness, lack of sleep, increased energy, racing thoughts, too many ideas in a short period of time, restlessness and making unrealistic plans
  • Depressive symptoms such as low mood for long periods, reduced appetite, lack of concentration, increased need for sleep, unprovoked crying episodes, feelings of hopelessness and helplessness and suicidal thoughts and plans.

How common are mood swings?

Mood swings can occur as part of the normal human range of emotions and can be triggered by external events or occur spontaneously.  Mood swings and bipolar disorder affect 4 percent of the global population and the incidence has been steadily increasing over the years.

What are the causes of mood swings and bipolar disorder?

Mood swings and bipolar disorder could be cause by a number of factors.  Genetics is known to play a role in the development of bipolar disorder, especially when there is a significant family history of mood disorders.  Certain personality types are also at an increased risk of mood swings and bipolar disorder.  Drugs, prescribed medication and head injury can cause a bipolar like syndrome. Severe mood swings can also be caused by certain medical conditions. Triggers such as stress, insomnia and emotional distress can lead to the condition in those who are genetically vulnerable.

What is the treatment for mood swings/ bipolar disorder?

The treatment will depend on the nature and severity of the symptoms.  Psychotherapeutic approaches are beneficial in relieving symptoms of mood swings which do meet the criteria for a manic episode and do not affect the daily functioning of the individual.  Your doctor may prescribe medications known as mood stabilisers for more severe forms.  Some patients may require hospitalisation if symptoms are severe and risk issues are present.  It is important that your doctor rules out medical causes for mood swings before devising a treatment plan

How can I reduce my risk of developing bipolar disorder?

A significant family history of mood disorders could suggest that one may be genetically vulnerable.  Stress management, adequate sleep and dealing appropriately with emotional distress can be beneficial.  Abstaining from using illicit drug substances and avoiding certain prescribed medication will help reduce the risk of developing the condition.  Generally speaking, optimal nutrition, regular exercise and meaningful relationships are beneficial.

What is Obsessive compulsive disorder?

Obsessive compulsive disorder is characterised by obsessional thoughts followed by compulsive acts which are performed to ease the anxiety and distress associated with the obsessional thoughts.  These obsessional thoughts are usually unwanted, distressing and intrusive ideas, suggestions or images.  The person experiencing these thoughts may attempt to resist them as they are usually unpleasant and anxiety provoking.  In an attempt to relieve the distress associated with these unpleasant thoughts, some may engage in compulsive behaviours such as repeated hand washing to try and reduce the distressing effect of the intrusive thought which in this case may be a fear of contamination by germs.

How common is Obsessive compulsive disorder?

It is estimated that around 800,000 people in the United Kingdom are affected by obsessive compulsive disorder.  This translates to 12 in every 1,000 people.  It affects men, women and children.  Obsessive compulsive disorder is classified as an anxiety related disorder and the underlying emotion associated with this condition as with all other anxiety disorders is fear.

What causes Obsessive compulsive disorder?

The exact cause of OCD is unknown.  It has been suggested that a chemical which is present in the brain called serotonin may be out of balance.  This theory has been validated to some extent by the response of some patient to medications that increase the levels of serotonin in the brain.   Those with an anxious personality style or people suffering from an underlying personality disorder are at an increased risk of developing OCD.  Certain medical conditions could also manifest with obsessional symptoms similar to OCD.

How is OCD treated?

The symptoms of OCD respond to psychological therapies such as CBT (Cognitive Behavioural Therapy).  This involves exposure to the triggers that bring about the intrusive thoughts, allowing the obsessional thought to occur and refraining from engaging in compulsive behaviour.  If symptoms are more severe then medications may be prescribed.  The treatment usually involves higher than usual doses of selective serotonin reuptake inhibitors also known as anti-depressants. These medications although referred to as anti-depressants are effective in treating anxiety related disorders such as OCD.

What can I do to prevent myself from developing OCD?

OCD is an anxiety related disorder and the underlying emotion that fuels the condition is fear and in some cases guilt.  It will be beneficial to seek help in the form of psychological therapies if you feel you are struggling with an anxiety like condition or obsessional thoughts which are unpleasant and distressing.  Learning to manage stress effectively, maintaining a healthy work-life balance, optimised nutrition/hydration, regular exercise and participating in enjoyable and meaningful activities are all beneficial in ensuring that life circumstances do not get the better of you.  Most anxiety disorders usually result from overwhelming life situations and persistent stress in a significant number of cases can progress to a full blown anxiety disorder.

What is specific phobia?

Specific phobia is a type of anxiety disorder that is usually triggered when a person is exposed to a specific situation or object.  This situation or object causes significant anxiety to the extent that the person must avoid or escape from the feared situation or object.  Although the fearful response is recognised as excessive and irrational by the individual, it is extremely difficult for them not to experience this fear in the presence of certain situations or objects.  Phobias usually develop after someone has suffered a traumatic event, has witnessed others suffer a traumatic event and can be learned in childhood by observing the response of role models to certain situations or objects.

What are the different types of specific phobia?

There are different types of specific phobias.  These include:

  • Animal phobias such as the fear of dogs, cats, birds and snakes. These are the most common form of specific phobias
  • Situational phobias like fear of flying, driving a car, being in an enclosed space such as an elevator, going over bridges or through tunnels
  • Natural environment phobias such as water, storms and heights
  • Blood-injection-injury phobia which involves a fear of getting injured, seeing blood, invasive medical procedures like injections or blood tests
  • Others such as fear of costumed characters, fear of falling down and fear of loud noises

What are the symptoms of specific phobia?

The symptoms of specific phobia are similar to those experienced in an anxious state; however, the anxiety symptoms experienced in a phobic situation are significantly more intense and disabling.  They include:

  • Over exaggerated and somewhat irrational fear of a specific object or situation
  • Avoidance of the specific object or situation
  • Intense physical symptoms of anxiety and panic such as pounding heart, choking sensation, breathlessness, excessive sweating, trembling and shaking, numbness and tingling, dizziness or light-headedness and feelings of impending doom.
  • Becoming anxious for long periods in anticipation of coming in contact with the feared situation or object

What is the treatment for specific phobia?

The treatment for specific phobia is usually psychological therapy to help overcome the fear associated with a particular situation or object.  This usually involves exposure to the feared situation or object in gradual steps and learning to substitute the anxiety response with being relaxed and less fearful.  With time the original learned response of fear is replaced by a more adaptive new response.  Anti-anxiety medication such as Valium or Xanax may be used to help control the symptoms of anxiety when a person has to be subjected to the phobic situation.  An example would be taking Valium before getting a flight.

What is Post traumatic stress disorder?

Post-traumatic stress disorder also known as PTSD can occur in those that have been involved in a traumatic event such as a road traffic accident, rape, victims of war/torture, assault and other types of unforeseen circumstances that involved potential loss of life or serious injury.  The symptoms of PTSD usually become apparent within four weeks of the traumatic event and can persist for a significant period of time if left untreated.  PTSD can progress to depression, anxiety and addiction disorders if sufferers do not seek help initially.

How common is Post traumatic stress disorder?

Post-traumatic stress disorder usually occurs after a life threatening event.  There have been numerous cases associated with veterans of war, victims of physical and sexual abuse, those involved in road traffic accidents, terrorist attacks, aviation incidents and maritime disasters.  The risk of developing PTSD is increased if the traumatic event is very severe, not seeking help early, having a pre-existing mental health condition and possessing anxious personality traits.


What are the symptoms of PTSD?

Most people who suffer with PTSD symptoms tend to experience nightmares, flashbacks and anxiety symptoms.  The nightmares and flashbacks are usually related to the accident or incident and anxiety manifests as avoidance of places or people that are associated with the accident, feeling of tension and nervousness for no apparent reason, hypervigilance, hyperarousal and panic attacks.  Some sufferers describe feeling emotionally numb, find it difficult to enjoy life and depression with a sense of hopelessness and helplessness.  It is quite common for those with PTSD to use substances such as alcohol to cope with their difficulties.

What are the causes of PTSD?

PTSD usually occurs in those that have been subjected to an event that is associated with potential death, death of others and destruction.  Such events include war, road traffic accidents, victims of physical and sexual violence and any event or incident that could have led to loss of life or significant injury.  PTSD can occur in anyone subjected to these events, however, the risk of developing the condition is increased in those with a pre-existing mental health condition, being subjected to severe accidents/incidents and for prolonged periods and not seeking help after a traumatic event has occurred.

What is the treatment for PTSD?

The treatment depends on the nature and severity of symptoms.  Psychotherapeutic techniques have been shown to be effective for mild to moderate post-traumatic stress disorder symptoms.  Cognitive Behavioural Therapy and EMDR are approaches which have been shown to be effective in post-traumatic stress disorder.  For more severe symptoms, anti-depressant and anti-anxiety medications are helpful in reducing the symptoms associated with PTSD.

How can I prevent myself from getting PTSD?

After a traumatic event, your risks of developing PTSD will be reduced if professional help is sought sooner rather than later.  It would be helpful to seek psychological and emotional support to process the traumatic event even if symptoms have not yet developed.  This is more relevant if the event was life threatening or/and involved the loss of life of others or was severe enough to require admission to a hospital.

What are Pregnancy related mental health issues?

Pregnancy can be a difficult and stressful experience and it is not uncommon for women to experience emotional and psychological difficulties after giving birth or during the pregnancy.  These difficulties range from mild post pregnancy blues to a more severe depression or psychotic illness.  It is crucial that cases are identified early in order to prevent worsening of symptoms which could affect not only the mother but also the children involved.

What is the risk of developing post pregnancy depression?

The risk of developing a post pregnancy mental health problem is increased in those who have an already existing mental health difficulty or in those with a family history of post pregnancy mental health problems.  Factors such as a stressful or difficult pregnancy, poor social or family support, single motherhood can increase the chances of post pregnancy mental health issues arising.  A lot of new mother’s experience post pregnancy blues which occurs shortly after giving birth and only lasts for a brief period.  However, a minority of women can experience a more prolonged depression which if left untreated could progress to a psychotic episode.

What are the symptoms of post pregnancy depression/psychosis?

Women who have recently given birth can experience a melancholic feeling, loss of motivation and difficulties enjoying life as a mother.  Sleep, appetite and concentration can also be affected.  This symptom could be accompanied by anxiety and obsessional thoughts about the new born baby.  This could be brief and transient in some cases.  Others may experience a more prolonged depression which may require treatment.  Depressed mood, hopelessness, helplessness, lack of interest in the new-born child and suicidal thoughts may occur.  A more severe psychotic illness could develop which could pose a risk to both the mother and new-born.  Thoughts of harming the new born child or other children and suicidal thoughts are red flags that medical intervention should be sought immediately.

What is the treatment for post pregnancy mental health difficulties?

The treatment varies depending on the nature and severity of the illness.  Mild post pregnancy blues and depression can be treated effectively by psychotherapeutic approaches and the appropriate social support.  This may or may not require treatment with medication.  More severe forms such as pronged depression and psychosis will require treatment with anti-depressants or antipsychotics.  Some women who pose a risk to themselves or their children may need to be admitted to hospital for treatment.

What are the causes of post pregnancy mental health difficulties?

It has been suggested that genes play a role in the development of post pregnancy depression/psychosis.  Milder forms such as the post pregnancy blues could be associated with hormonal changes, stress, lack of support and coping with the demands of being a new mother.  More severe forms could be triggered by stress and hormonal changes in those who have a genetic vulnerability.   Mothers with a mental health history or a family history of post pregnancy mental health issues are at an increased risk.  Nutritional deficiencies may play a role in the development of post pregnancy mental health difficulties.

How can I reduce my risk of developing post pregnancy mental health difficulties?

Pregnancy can be a difficult time of some mother’s and having a supportive partner and social network could assist significantly in reducing this stress.  The nutritional demands of a developing baby are significant and pregnant women must ensure they are adequately nourished during and after the pregnancy.  Adequate sleep, maintaining a healthy diet, good hydration and participation in outdoor activities could be beneficial both during and after pregnancy in order to maintain an optimum state of mind.

If you or someone you know is in crisis, click here for a list of emergency services available


If you believe you may be suffering from psychological and emotional symptoms associated with pregnancy, please click here for therapists that specialise in post pregnancy mental health issues.

What is Psychosis?

Psychosis is the term used to refer to a state of mind that is out of touch with reality.  It can range from a mild brief psychotic episode to a very severe condition that requires admission to hospital.  Delusional beliefs, hearing voices, false interpretation of events and/or the actions of others and an over inflated sense of self are some of the symptoms associated with psychosis.  Psychosis can occur in the context of a psychiatric disorder such as schizophrenia, bipolar disorder and severe depression. Psychosis can also occur as a result of certain medical conditions, illicit drug use and the use of some prescribed medications.


Is psychosis common?

Psychosis associated with a serious mental health diagnosis is not common.  However, a short brief psychosis associated with illicit drug use is a more common occurrence. This may be in the form of acute intoxication, usually referred to as a “trip” or a drug induced psychotic episode that occurs due to persistent use of drugs such as cannabis.


What are the symptoms of Psychosis?

Psychosis can manifest in various forms.  Experiencing delusional beliefs is the most common type of symptom.  Delusional beliefs are thoughts and ideas that have no basis in reality, and the experiencer is convinced of these false thoughts and ideas.  Hearing voices when there is no one around or seeing things and visions can also occur. Interpreting the actions of others and external events in a biased, egocentric way is a symptom of psychosis.


What causes psychosis?

Dopamine a chemical which is normally present in the brain, has been implicated in the development of psychosis.  When this chemical is in excess the symptoms of psychosis can occur. Psychosis that occurs as part of a serious mental health condition has been shown to be associated with genes.  This is usually evident when numerous members of the same family have a history of the condition.  However, there are environmental triggers that turn on these genes.  Environmental triggers include stress, use of drugs and alcohol, nutritional deficiencies, medical conditions.  Less severe forms of psychosis could be caused by drug use, medication use, alcoholism and nutritional deficiencies.  Degenerative brain disorders such as Alzheimer’s disease, other brain disorders and head injuries could lead to a psychosis.


What is the treatment for psychosis?

Psychosis is a serious condition and in majority of cases requires treatment with tranquilisers also known as antipsychotics. These work by reducing the levels of a chemical called dopamine in certain areas of the brain.  An excess of this chemical has been shown to cause psychosis.  In most cases the psychosis subsides, however many people may be required to take medications for a significant period of time.  In other cases, depending on the nature and severity medication may be need for a time limited period. Psychosis that occurs as part of an acute intoxication due to illicit drug use like magic mushrooms subsides over time without medical intervention.


Can I get psychosis and how do I prevent myself from becoming psychotic?

Anyone can become psychotic, irrespective of whether they have a family history or not.  However, the risk is more pronounced in those with a genetic vulnerability.  Persistent and prolonged use of drugs such as cannabis and hallucinogens could lead to a more serious psychotic disorder.  Of significant importance is nutrition.  Certain nutritional deficiencies can cause psychosis and it is worthwhile ensuring that you are consuming enough fruit and vegetables.  Managing stress effectively, adequate sleep and hydration, abstaining from illicit drug use and having a vocation are will help reduce your risk.

What is Stress?

Different people experience stress in different ways.  Generally speaking, stress is a state of heightened anxiety, tension and worry usually in the context of life circumstances. People get stressed due to work commitments and deadlines, relationship difficulties, family problems, child care, illness and financial difficulties.  Stress is a normal response to the challenges and obstacles we face in life, however, being subjected to prolonged and persistent stress is detrimental to our physical, psychological and emotional well-being. 

What can significant stress lead to?

Significant stress has been linked to physical, psychological and emotional difficulties.  Heart disease, diabetes, high blood pressure, strokes, migraines and auto immune conditions are some of the physical consequences of stress.  People who are persistently stressed have a higher risk of developing anxiety, panic attacks, depression and addiction disorders.  Stress could also lead to a relapse in those with a history of mental health difficulties.

What is the treatment for Stress?

The most effective approach is to prevent stress from becoming too overwhelming in the first instance.  If you find yourself becoming stressed, try and identify the source of your stress and either take a step back or try to address the stressful situation.  Counselling and psychotherapy can assist you in dealing with the issues in your life causing you stress.  Useful coping strategies and a more effective approach in dealing with issues can help reduce stress levels significantly.  Take regular breaks from work, spend time doing the things that give you pleasure, relaxation exercises and meditation are some useful habits.

How common is stress?

Everybody gets stressed, however some people are better at handling stressful situations than others.  It is important that stress does not progress to a more severe mental health condition such as anxiety, panic disorder and depression and as such we need to be aware and mindful of the dangers of prolonged and persistent stress levels.  Factors such as personality style, level of family and social support, supportive work environment and the ability to manage stress effectively could determine the outcome.

What can I do to prevent myself from getting overstressed?

There are useful stress management tips than can be helpful. Some of these include:

  • Adopt or maintain a healthy work-life balance
  • Adequate exercise and a healthy diet
  • Having a sense of purpose in life, engaging in endeavours that provide a sense of fulfilment and meaning
  • Set aside time for relaxation and meditation
  • Getting enough sleep and adequate hydration
  • Spending adequate time with loved ones, friends and supportive family members

What is Grief and Loss?

Grief is a response to the loss of a loved one or object.  This response could be emotional, psychological and physical and usually involves feelings of sorrow and despair.  Grief is a normal human response to the loss of someone or something to which a bond or affection was formed.  However, this can progress to a more prolonged reaction which could affect the daily functioning of those experiencing grief.

What are the stages of grief?

Those experiencing grief usually go through five stages.  These are denial, anger, bargaining, depression and acceptance.  Denial is a defence mechanism used to protect an individual from becoming too overwhelmed as a result of the loss.  As the individual slowly comes to terms with the impact of the loss, denial will gradually fade away.  Bargaining involves incessant thoughts and ideas about how the loss of a loved one could have been prevented.  Intense feelings of remorse or guilt could set in if this is not resolved appropriately.  Depression tends to set in in some after they realise the permanent nature of the loss and start to process the fact that the loved one or object is not coming back.  Anger occurs in response to feeling helpless and powerless and realising that the situation is beyond our control.  This anger may be directed towards life in general or a higher power.  With the passing of time, an individual will gradually come to terms with the situation and accept the fact that the loved one or object is not coming back.  Healing can commence after acceptance has taken place.

What factors may affect the grief and healing process?

The healing process that occurs after the loss of a loved one or object could be affected by a number of factors.  These are usually defence mechanisms employed by an individual to make the situation bearable or to distract themselves from experiencing distressing emotions.  People may distract themselves by overworking.  Those experiencing grief may use alcohol, drugs or other substances to cope and numb the emotional distress.  Compulsive behaviours such as gambling could be used as a form of distraction.  All these tend to serve as a form of avoidance and may temporarily reduce the emotional distress associated with grief, however, this is short lived and if grief is not dealt with appropriately it may escalate into a dysfunctional psychological and emotional state such as depression, anxiety and addiction disorders.

What can happen if grief is prolonged or complicated?

If grief continues for a significant period of time it can lead to a more pervasive emotional and psychological dysfunction.  Some of the complications of grief include a depressive disorder, anxiety and panic attacks, addictions, suicidal feelings, hopelessness, helplessness and an intense desire to be with the loved one.



What can I do to help resolve my grief?

Grief is a normal human emotional and psychological response to the loss of a loved one or object.  It is important that those experiencing grief progress through the stages and recognise that it is entirely appropriate to experience intense feelings of sadness, anger, despair and all the distressing emotions that accompany the grief reaction.  It is important to:

  • Allow yourself to experience the thoughts and feelings associated with grief without significant attempts to block these
  • Crying and verbal expression of feelings and thoughts associated with grief is cathartic and should not be suppressed
  • Talking to loved ones and close friends about your feelings and how the loss has affected you
  • Engaging in bereavement support groups.  Receiving support and supporting those in a similar situation will re-inforce the normality of the emotions being experienced
  • Accepting that grief has become too unbearable and distressing that professional help may be required.  Seek help sooner rather than later.

Most of us understand what anxiety is. But when the idea of “high-functioning” is introduced, there may be more room for confusion.

In this article, we hope to make the experience of high-functioning anxiety clearer for everyone. That includes sufferers of the condition as well and the friends and family of people who might be suffering in silence.


High-functioning anxiety (along with high-functioning depression) is not a distinctly recognised clinical condition. Unlike other forms of anxiety, it is not given a definition as an anxiety disorder by the National Institute of Mental Health (NIH).

Rather, it is an informal way for us to recognise the experience and patterns of a particular type of anxiety/depression patient.

Therefore, the symptoms of high-functioning anxiety are the same as those suffering from an anxiety disorder. For example, persistent feelings of worry, inability to relax, overthinking, and butterflies in the stomach. Physical manifestations might include sweaty palms or increased heart rate.

The main difference we would expect in a high-functioning is the absence of debilitating responses or excessive avoidance tendencies.

In other words, a high-functioning anxiety patient is one with typical anxiety responses, but not the anxiety behaviours that significantly impact typical day-to-day activities.

Though they may be experiencing pain internally, these patients continue to work/attend school, maintain relationships, and generally keep their life running without special assistance.


If the sufferer can still work, maintain relationships, and keep on top of day-to-day concerns, does this make high functioning anxiety and depression less of an issue than debilitating anxiety and depression (which might look more familiar to us)?

Unfortunately, it is this assumption that makes high functioning anxiety and depression a particularly tricky condition. It is more hidden, and that makes it easier to ignore. Conditions that are ignored are less likely to improve.

Sufferers might want to pretend there isn’t a problem, bottling it up and suffering in silence. Friends and family might not be able to recognise a problem, and if they do recognise it they might not understand it. This can make for an isolating experience for the sufferer. As Medical News Today notes, even “Doctors may find it challenging to diagnose an anxiety disorder in people with high functioning anxiety.”

Ultimately, those with high functioning anxiety and depression may suffer for longer and are less likely to find treatment.


Some patients have described anxiety that “pushes them forwards rather than holds them back”.

Others have emphasised the difference between what they project to the outside world and what they feel on the inside. Externally, they are organised and calm, while on the inside they are overthinking and seeking reassurance.

As you might expect from the above description, some with high-functioning anxiety have noted that others find them “hard to read”.

Jordan Raskopolous describes what living life with high-functioning anxiety was like for them in this TED talk.



Remember, anxiety is a normal emotion that the majority of people experience. Anxiety is expected and potentially beneficial in response to certain events. It is only when anxiety gets excessive, irrational, or becomes a constant drain on a person’s happiness that it needs to be addressed.

It might not be helpful to assume that because you are experiencing anxiety today it is a case of high functioning anxiety. A diagnosis of GAD (Generalized Anxiety Disorder) generally looks for anxiety that has persisted for 6 months or longer.

Most people will have experienced some form of anxiousness in a social situation at some point or another, such as going on a date or doing a presentation at work. This typically doesn’t last very long and only happens occasionally. However, there are some people who suffer with extreme anxiety in everyday social situations and this is known as social anxiety disorder. This can cause people with the disorder to struggle with everyday life leading them to feel self conscious or embarrassed that they will be scrutinised or judged by others. This fear can lead to avoidance which may disrupt their life and have a negative impact on their relationships, daily routines, work, school and other activities. That being said, effective treatment for social anxiety disorder is available. Read our guide on social anxiety, the symptoms, causes, where to get help and treatment.


Social anxiety disorder, also known as social phobia, is a type of anxiety that causes overwhelming fear of social situations. People with social anxiety may find it difficult to talk to people, meet new people or attend social events as they fear that they will be judged by others. Social anxiety disorder typically starts during the teenage years and for some people, it gets better as they get older. However, for many others, social anxiety disorder doesn’t go away on its own without treatment. It’s important that if you feel that you’re suffering from social phobia that you reach out and get help as there are several treatments available that can help.


While many of us will feel shy or worried from time to time, social anxiety disorder is much greater than this and it can be a fear that rules everyday life. Someone with social anxiety may feel an uncontrollable sense of fear before, during and after social events and it has been known to affect a person’s self confidence, relationships, work life or school life.

You may have social anxiety if you suffer from the following:

  • Worry about everyday communication, such as meeting strangers, starting conversations, speaking on the phone, working or shopping
  • Avoid or worry about social situations, such as being in a group, eating with other people and parties
  • Worry about doing something you think is embarrassing out of fear of what others will think, such as blushing, sweating or appearing incompetent
  • Find it difficult to do things when others are watching – you may feel like you’re being watched and judged all the time
  • Fear being criticised, avoid eye contact or have low self-esteem
  • Often have symptoms like feeling sick, sweating, trembling or a pounding heartbeat
  • Have panic attacks, where you have an overwhelming sense of fear and anxiety

Some people that suffer from social anxiety may also suffer from other mental health issues including depression and general anxiety disorder.


The exact cause of social phobia is unknown but like many other mental health conditions, social anxiety disorder likely occurs from a complex range of biological and environmental factors. Possible causes of social anxiety include:

  1. Inherited genetics: Anxiety disorders often run in families and it’s common that if a person suffers from an anxiety disorder then other people in their family will also suffer from the same or similar disorder. However, it isn’t entirely clear how much of this may be due to genetics and how much is due to learned behaviour.
  2. Brain structure: A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
  3. Environment: Some people may develop social anxiety after experiencing a negative or embarrassing social situation. This suggests that It’s possible that social phobia is a learned behaviour.


Social anxiety disorder can be really debilitating and can prevent the sufferer from living their life. Someone suffering from the condition may avoid certain situations that others find normal such as going to work, spending time with friends or going to school. Those suffering from social phobia may see the following impact on their life:

  • Low self-esteem
  • Negative thoughts
  • Depression
  • Sensitivity to criticism
  • Poor social skills


If you feel that you may be suffering from social anxiety disorder then it’s a good idea to see your GP. The disorder is quite common and treatments are available that can help. You may feel anxious or worried about asking for help, but a GP will be aware that many people struggle with social anxiety and will try to make you feel as comfortable as possible. They will likely ask you about your feelings, behaviours and symptoms to better understand your anxiety in social situations. If your GP thinks that you may be suffering from social anxiety then you may be referred to a mental health specialist to have a full assessment and talk about treatments. You can also refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from a GP.

Alternatively, if you have already been diagnosed with social anxiety disorder, then you may wish to seek out treatment elsewhere such as online therapy. At E-therapy, we provide effective and convenient therapy for a range of disorders including social phobia with experienced and qualified therapists. Find a therapist today.

Here’s what Sarah Keeping has to say about social anxiety disorder treatment on blog:

“The best treatment is usually Cognitive Behavioural Therapy (CBT) where a therapist can help a person find out what the negative thought patterns and behaviours are and change them. However, a combination of treatments may be more effective, including guided self-help with the use of a CBT-based workbook or online course where a therapist provides regular support; or taking antidepressant medication.

I think mental health should be a much bigger priority in education than it currently is, and this condition is one of the many reasons for why. Social anxiety often starts when a person is a teenager and so along with other mental health conditions that can begin in childhood, a wider awareness of them not only helps the person affected to understand what it is they are experiencing, but it also brings a sense of normality to mental health in general; if children learn about things at a young age, they grow up with more of an understanding to different things within society, which can help erase the stigma mental health still has within some areas.