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Anxiety is a normal response to danger. It is the result of something called the ‘fight or flight’ response. The ‘fight or flight’ response is a body response that prepares you to fight or to run away from danger, by getting your heart beating faster, your breathing quicker and sending more blood and oxygen to your muscles. You may notice a fast heartbeat, fast shallow breathing, as well as feeling shaky, dizzy, sweaty or sick. Anxiety can be thought of as a relationship between your perception of threat or danger and of coping. The more threatening you think a situation is and the less you feel able to cope with it, the more anxious you will feel, and the more of a fight flight response you will have.


Problematic anxiety happens when this fight-flight response is kicked off in situations that would normally be thought of as safe, like travelling, crowds and busy confined places. This may happen for example when your general levels of stress are higher than normal. The normal response to a threat is to fight or flee (run away). The difficulty with anxiety in these previously ‘safe’ situations, is that running away and then avoiding them in future, strengthens beliefs that these are ‘threatening’ situations that you can’t cope with and that should be avoided and this makes anxiety worse. It also means that you will gradually be able to do less and less.

The way to tackle this type of anxiety is to gradually expose yourself to situations that are experienced as ‘a bit threatening’, staying in the situation until your anxiety starts to come down. You might make a list of situations, starting with easier ones, and moving up to more difficult ones. Notice your anxiety before and during the situation. You could try rating it: giving it a score between 0 and 10, where 0 is not at all anxious and 10 is the most anxious you could possibly be. You should aim to expose yourself to situations which you rate at most about a 7 for anxiety. Stay in the situation until your anxiety comes down to a low level (this could take up to about an hour or an hour and a half) and then practice going into this same situation, each day, teaching your body and brain that the situation is not threatening, until the situation is easy to be in and you no longer feel very anxious. Then take the next situation on your list and do the same thing again, until you gradually get your anxiety under control and your life back on track.

If anxiety is because the situations really are more threatening, e.g. if they make voice hearing worse, you may need to build up coping first, and then start doing more things again.        

The EYE Project is a research project supported by:

Sussex Partnership NHS Foundation Trust, Swandean, Arundel Road, Worthing, West Sussex, BN13 3EP