Overwhelming levels of anxiety can interfere with your daily life.

Anxiety is a feeling of apprehension and concern towards a future-oriented event. 

While it is quite normal to experience anxiety or worry before a big presentation, a major examination or when trying something for the first time, some individuals experience it quite intensely, in a form that may be excessive, irrational and quite persistent. 

They may be overwhelmed with thoughts or worries about future danger and this distress can interfere with their daily functioning.

Woman burying her face in her hands

What is a Panic Attack?

A panic attack is characterised by an overwhelming sense of fear that strikes suddenly. It is often accompanied by a number of physiological and emotional reactions, such as:

  • Increased heart rate
  • Shortness of breath
  • Trembling or shaking
  • Sweating
  • Nausea
  • Light-headedness
  • Sense of terror
  • Fears of dying, going crazy or losing control
  • Increased heart rate
  • Shortness of breath
  • Trembling or shaking
  • Sweating
  • Nausea
  • Light-headedness
  • Sense of terror
  • Fears of dying, going crazy or losing control

Not all individuals with an anxiety disorder will experience panic attacks. Some individuals experience a single episode of panic attack without any recurrent episodes or further complications. Others may experience panic attacks as part of another anxiety disorder such as panic disorder, social anxiety disorder or agoraphobia.

Causes of Anxiety

There are many causes of anxiety and one single factor or a combination of factors can lead to this condition.

Biological causes

Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter found in the brain that is designed to slow down nerve signals. As such, it plays a part in reducing our anxiety levels. When this neurotransmitter becomes less active or fails to perform its role, it can result in overwhelming feelings of anxiety.

Furthermore, an excessive amount of certain chemicals in the body like cortisol, a stress hormone, can cause higher levels of anxiety.

Environmental factors

Various factors in the environment can cause stress and anxiety to build up. This includes major life events such as death, financial difficulties and breakups or separations. Exposure to such events at a young age can also trigger anxiety in one’s later years when similar situations arise.

Medical conditions and illnesses

Drugs (prescription or over-the-counter) can be one of the causes of anxiety. Additionally, other underlying medical issues can result in this sensation. This includes:

  • Thyroid problems
  • Heart disease
  • Tumours
  • Head trauma
  • Infectious diseases
  • Respiratory disorders

Signs and Symptoms of Anxiety Disorders

Person gripping fence tightly

Some common signs and symptoms of anxiety disorders include:

  • Excessive worry that is hard to control
  • Sleep disturbances (e.g. difficulty falling asleep, restless sleep)
  • Constantly feeling on edge
  • Shortness of breath
  • Increased heart rate
  • Nausea
  • Muscle tension
  • Change in behaviour and disruption in daily life

Anxiety Test – Generalized Anxiety Disorder 7-item (GAD-7) Scale

The GAD-7 Scale is a self-report scale for the screening and severity measuring of Generalized Anxiety Disorder (GAD).

Note:
This measure is usually completed by the individual prior to a visit with the clinician. The tool has been provided here to see if you may be someone who could benefit from the treatment and support of a mental health professional. It should not be used as a diagnosis of any sort.

Time taken to complete:
5 minutes

Download Generalized Anxiety Disorder 7-item (GAD-7) Scale:
Word (Editable Version, Self-Scoring) | PDF (Printable Version) | Excel (Editable Version, Automatic Scoring)

If you think that you could benefit from anxiety therapy, get in touch with one of our counsellors today.

Types of Anxiety Disorders

1. Panic Disorder

To be diagnosed with a panic disorder, you must have experienced at least one panic attack or recurrent episodes of panic attacks.

You may develop an intense fear and have excessive worries about having another panic attack. This can lead you to behave differently in a way that disrupts your daily life.

Example:
You may avoid places where you have had a previous panic attack or social situations in general in case you have a panic attack in front of others.

2. Social Anxiety Disorder (Social Phobia)

Social anxiety disorder is a strong and persistent fear of social and performance situations where the individual is exposed to public scrutiny. These situations may range from having a conversation with others, eating or drinking in front of others, to giving a public speech.

If you have social anxiety disorder, you may go out of your way to avoid these situations. 

Example:
You may avoid having lunch with your colleagues by disappearing during lunchtime.

3. Generalised Anxiety Disorder (GAD)

GAD is characterised by excessive free-floating anxiety about a number of different things. 

You must have experienced this pervasive, uncontrollable anxiety for a period of at least 6 months. This excessive worry is also usually accompanied by symptoms such as

  • constantly feeling on edge, 
  • being easily fatigued, 
  • irritability, 
  • muscle tension, and 
  • sleep disturbances.

4. Specific Phobias

Specific phobia is a strong and persistent fear of a specific object or situation. You are likely to experience a fear response that is similar to a panic attack when you encounter these objects or situations.

The most common phobias are a fear of:

  • Height
  • Flying
  • Animals
  • Receiving an injection
  • Seeing blood

5. Obsessive-Compulsive Disorder (OCD)

OCD is characterised by repeated thoughts and ideas that are distressing. These uncontrollable obsessions cause individuals to perform actions and behaviours repeatedly, despite knowing that they are irrational.

Example:

  • Repeated washing of hands to feel clean
  • Checking repeatedly that the door is locked before leaving the house

6. Post-Traumatic Stress Disorder (PTSD)

PTSD is often the result of extreme shock, fright or trauma. Experiences such as war, natural disasters, abuse or rape can cause this anxiety disorder.

Some signs and symptoms of PTSD include:

  • Flashbacks and/or nightmares of the traumatic event
  • Avoiding places that remind them of the traumatic event
  • Excessive vigilance
  • Outbursts of anger
  • Difficulties sleeping

Note: OCD and PTSD are no longer classified as anxiety disorders under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), though they are still commonly known to many as anxiety disorders.

When Should I Go for Anxiety Therapy

Having a lot of worries does not necessarily mean that you have an anxiety disorder. However, if you experience the following, you should consider going for counselling and psychotherapy:

  • Anxiety that interferes with or affects your daily activities and relationships with others
  • Inability to achieve important goals due to anxiety
  • Avoiding social situations like work or school
  • Extreme biological responses (e.g. inability to sleep, shortness of breath)
  • Anxiety that interferes with or affects your daily activities and relationships with others
  • Inability to achieve important goals due to anxiety
  • Avoiding social situations like work or school
  • Extreme biological responses (e.g. inability to sleep, shortness of breath)

Treatment Options for Anxiety

Counselling session with Sophia Goh

1. Anxiety Therapy

Psychotherapy is usually the most effective option for anxiety. Through the process of therapy, your counsellor will help to uncover the causes of your worries and fears and teach you new skills for relaxation, coping and problem-solving. 

These techniques are most commonly used during anxiety therapy:

Cognitive-Behavioural Therapy (CBT)
CBT helps to identify the cause of your negative thoughts and feelings and point out their respective triggers. A better understanding of these triggers allows you to change your negative thoughts and response to such situations.

• Exposure therapy
A common response to fear is avoidance. Thus, exposure therapy is designed to help you confront these fears in a safe, controlled environment and subsequently reduce your tendency to avoid such situations or objects. This technique is especially useful for specific phobias.

2. Medication

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants are commonly used for the treatment of anxiety disorders. Benzodiazepines are a class of drugs that are frequently used for the short-term management of anxiety.

While this form of treatment can be very useful in helping to relieve the symptoms of anxiety in severe cases, anxiety medications such as benzodiazepines may weaken in effect over time. As such, you may require higher dosages over time.

Our Therapists for Anxiety

Sophia Goh

M.A. in Counselling and Guidance, Singapore

Sophia Goh - principal counsellor of Sofia Wellness Clinic

Sophia works with teenagers, adults and couples to address a wide range of issues including anxiety. She believes in taking a wellness approach when it comes to mental health.

Alexandra Bohnen

M.A. in Counselling, Australia

Alexandra Bohnen - Senior counsellor of Sofia Wellness Clinic

Alexandra is a counsellor dedicated to making therapy inclusive and accessible to all. She works frequently with adults and focuses on areas such as anxiety, trauma and PTSD.

Kathleen Chong

M.A. in Counselling and Guidance, Singapore

Kathleen Chong - Counsellor of Sofia Wellness Clinic

Kathleen is an active advocate for mental health and works with adults who struggle with grief and loss, anxiety, anger and more. She strives to create a safe environment where her clients can share about their challenges freely.

Claire Leong

M.A. in Counselling, Australia

Claire Leong - counsellor of Sofia Wellness Clinic

Claire’s expertise lies in working with children, teenagers and families. With her passion for helping others overcome major challenges in life, she dedicates herself to addressing issues such as anxiety, depression and stress.

Note: You can book an appointment with any of our counsellors or fill out our New Client Information Form where we will recommend a counsellor who is most suited for your situation and concerns.

FAQs about Anxiety Counselling and Therapy

What does overwhelming levels of anxiety look like in daily life?

Overwhelming levels of fear and anxiety can manifest in various aspects of your life and can be observed through your behaviour.

For example, due to excessive fear of getting into an accident, you may refrain from driving or taking public transport. Alternatively, a mother with excessive fear that her child might get hurt may prevent the child from going out of the house.

These cases of anxiety and fear affect the daily activities and lives of those involved. In such cases, seeing a counsellor or psychotherapist may be helpful.

What happens during an anxiety counselling session?

The counselling session will begin with an understanding of the nature of your anxiety, whether it is a general sense of fear and worry, social anxiety or worries related to specific situations.

Following that, the counsellor will carry out psychoeducation about anxiety and the anxiety cycle, proposing tailored strategies or interventions designed to meet your needs. This can include:

  • Relaxation exercises such as deep breathing or muscle relaxation
  • Cognitive restructuring
  • Keeping a worry journal
  • Setting aside a time during the day as worry time
  • Systematic desensitisation (for specific phobias)

How many sessions do I need?

Depending on your goals for anxiety therapy, the number of sessions needed may vary widely. Some clients may require 1 – 2 sessions, while others may require 8 sessions or more to help them work through more complex issues.

Furthermore, some clients prefer attending regular sessions to keep their mental health and well-being in check.

What are some tips for coping with anxiety?

• Learn about anxiety and fear
Learning to recognise physiological responses that are associated with anxiety can help with managing them in the long run.

• Avoid alcohol and caffeine
Alcohol and caffeine can make the symptoms of anxiety worse. Thus, avoiding food and drinks containing these elements as well as medications or herbal remedies with stimulants may help with coping with anxiety.

• Get sufficient high-quality sleep
Sleep problems and anxiety disorders often go hand in hand. To improve the quality of your sleep, try keeping to a fixed sleeping schedule and creating a sleep ritual that helps you power down for the night.

• Engage in physical activities
Engaging in physical activities help to release brain chemicals that lower our stress levels and improve our mood. This is very beneficial in relieving the symptoms of anxiety.

Anxiety Therapy and Counselling in Singapore

Excessive levels of anxiety can be overwhelming and debilitating. If you suspect that you or your loved ones are suffering from an anxiety disorder, get in touch with us or request an appointment today.

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Written by Sophia Goh, Senior Counsellor at Sofia Wellness Clinic