Learning to cope with anxiety

Written by: Dr Justin Sauer
Edited by: Bronwen Griffiths

Feeling worried or anxious about something every once in a while is completely normal because anxiety is a natural reaction to something that is difficult or deemed a threat. However, when those feelings start to dominate your thought processes, affecting your daily life, we can start to talk about anxiety and panic. Dr Justin Sauer, a leading psychiatrist, explains what anxiety and panic attacks are and how these can be better dealt with.

What is anxiety and the most common symptoms?

Anxiety is an intense feeling of apprehension. Often there is fear of a real situation or sometimes a fear that something awful, but unlikely, will happen. Anxiety can take many different forms, with some people anxious only in certain situations and others persistently anxious. In many cases, anxiety will ease or pass off once the situation causing worry has changed or diminished.

Persistent or unpredictable anxiety is very unpleasant and where it starts to interfere with normal life and day-to-day activities (often manifesting as avoidance and social withdrawal) is an indication that help is needed. Anxiety can, however, improve with treatment.

What is a panic attack?

Panic attacks are unpredictable, intense and overwhelming anxiety flare-ups that are often debilitating until the person understands what is happening and can take action to manage them. Up until this point, as the anxiety manifests as physical symptoms such as chest pain, breathlessness, and shaking, there is often a fear of dying which only perpetuates the anxiety further.

Common symptoms of a panic attack are:

  • Palpitations, a pounding heart or an accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed or faint
  • Chills or heat sensations
  • Paraesthesia (numbness or tingling sensations)
  • Derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
  • Fear of losing control or "going crazy"
  • Fear of dying

How common are anxiety and panic attacks?

We all feel anxious at some time or another – it is an appropriate emotional response in stressful situations and is very common. Panic attacks are also quite common and can occur in various conditions, not just in panic disorder and will probably occur in one in three of us at some point in our lives. Panic disorder (where the main feature is panic attacks) is thought to occur in around 3 to 5 per cent of the population.

How can they affect people’s everyday lives?

Suffering from anxiety is unpleasant as it can be limiting in all domains of life, including social and work lives. Avoiding social gatherings, not being able to ask for that promotion, avoiding meetings or fearing that talk you need to give, walking rather than catching public transport; the impact of day to day activities can be enormous.

Sometimes anxiety leads to excessive use of alcohol or other recreational substances as a way of self-treating the anxiety, but unfortunately this only leads to more problems and worsening anxiety. Sometimes friendships and relationships can suffer when one person is limited in what they can comfortably do.

How can I handle a panic attack?

There are a few things you can do if you have a panic attack that might help:

  1. Tell yourself this is a panic attack and the anxiety will pass – this is really important.
  2. If you can stick it out, the anxiety will pass – and you will have learnt there was no real danger – if you flee from the situation you are increasing your chances of further anxiety attacks.
  3. Try to control your breathing – the natural response is to breathe rapidly – but slowing the breathing down helps take control of the panic.
  4. Sometimes closing your eyes will reduce overstimulation and allow you to focus on your breathing and use of reassuring self-speak that “this is just anxiety, it cannot harm me, it will pass”.


If you suffer from feelings of worry and anxiety and you are struggling to cope, make an appointment with an expert.

By Dr Justin Sauer

Dr Justin Sauer is a London based consultant psychiatrist working in private practice and the NHS. He completed his specialist training at the Maudsley Hospital where he has been since 1999.

He has held a number of senior hospital positions including clinical director and has extensive experience in treating stress-related conditions, anxiety, depression, bipolar disorder, memory disorders, mild cognitive impairment and dementia.

Dr Sauer is regularly invited to lecture and teach, has a number of peer reviewed publications and has written several books on psychiatry. Dr Sauer’s recent interests include digital health technology and preventive medicine.

Dr Sauer holds a number of private clinics across London and welcomes enquiries if you want to find out what to expect and how he can help.

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