Anxiety that’s lasted for months and gets in the way of daily life is treatable, usually with talking therapy (most often CBT), sometimes with medicine, and with self-help that has real evidence behind it: regular exercise, slow breathing, cutting back on caffeine and alcohol, and gradually facing what you’ve been avoiding. If you’re in India and need someone to talk to now, call Tele-MANAS on 14416, free and open 24 hours.
Everyone feels anxious before an exam, an interview or a hospital test. That’s normal. This article is about the other kind: worry that’s hard to switch off, shows up in your body, and doesn’t match what’s actually happening.
What anxiety feels like, in the mind and the body
The most common long-term form is generalised anxiety disorder (GAD). The NHS describes the main symptom as worry that is difficult to control and affects daily life. It’s more common in women than men.
| In your mind | In your body |
|---|---|
| Constant worry, often about many things at once | Poor sleep and tiredness |
| Feeling restless, on edge or irritable | Muscle tension, aches in the neck and shoulders |
| Trouble concentrating | Stomach upsets |
| Low mood | Noticeable or unusual heartbeats |
| Avoiding situations that trigger worry | Feeling light-headed or dizzy |
Some people also get panic attacks: a sudden rush of racing heartbeat, breathlessness, a choking feeling, chest pain, sweating, shaking and a fear of dying. The NHS says most panic attacks last between 5 and 20 minutes. They’re frightening but not life-threatening. Because the symptoms overlap with a heart attack, though, a first episode of chest pain should always be checked. Our guide on gas pain versus a heart attack explains the warning signs.
Rule out physical causes
An overactive thyroid can cause nervousness, anxiety, irritability and a fast heartbeat, and a simple blood test can check for it. See our article on overactive thyroid signs in women. Caffeine can make anxiety worse too, so tell your doctor about everything you take, including medicines, supplements and alcohol.
Self-help with real evidence behind it
Move most days
Exercise is one of the best-supported self-help steps. A 2023 overview in the British Journal of Sports Medicine pooled 97 reviews covering more than 1,000 trials and found physical activity had medium-sized benefits for anxiety, depression and distress compared with usual care. Higher-intensity activity gave bigger improvements. Brisk walking, cycling, swimming, dancing, yoga or a game of badminton all count.
Slow your breathing
When anxious, you tend to breathe fast and shallow, which feeds dizziness and a pounding heart. The NHS suggests a simple breathing exercise:
- Sit or lie comfortably and let your breath go deep into your belly.
- Breathe in gently through your nose, counting steadily from 1 to 5.
- Breathe out gently through your mouth, counting from 1 to 5 again.
- Keep going for at least 5 minutes. You may not reach 5 at first, and that’s fine.
It works best as a daily habit, not only during a crisis.
Cut back on caffeine and alcohol
The NHS advises against lots of coffee, tea, cola or energy drinks, since caffeine can disturb sleep and make anxiety harder to manage. Count every cup of strong chai and filter coffee, plus energy drinks and pre-workout powders. Our article on caffeine and mental health goes into detail. The same NHS page warns against relying on alcohol, cigarettes or drugs to calm down, as they can make mental health worse.
Use CBT-based techniques
CBT (cognitive behavioural therapy) teaches you to notice anxious thoughts, test them against the facts, and change what you do. You can start on your own:
- Write the worry down. Ask: what’s the evidence for and against it? What would I tell a friend?
- Face it in small steps. The NHS suggests slowly building up time spent in worrying situations rather than avoiding them. If crowded markets scare you, start with a quiet shop for 10 minutes.
- Use structured self-help. NICE recommends CBT-based self-help materials worked through over at least 6 weeks as a first-line option for GAD.
Protect your sleep and routine
Regular meals, a fixed wake-up time and enough sleep make worry easier to handle. If late nights have crept in, our post on the effects of sleeping late may help. Talking to a trusted friend or family member, rather than keeping it all in, also helps many people.
Treatment options when self-help isn’t enough
NICE uses a stepped approach for GAD. If education and self-help haven’t helped, the options are:
- CBT with a therapist: NICE says it usually runs to 12 to 15 weekly one-hour sessions.
- Applied relaxation: a structured method of learning to relax muscles quickly in stressful situations, over a similar number of sessions.
- Medicine: usually an SSRI, a type of antidepressant, prescribed and reviewed by a doctor.
NICE says there’s no evidence that therapy or medicine is better than the other, so the choice depends on your preference. It also advises against benzodiazepines (sleeping tablets such as alprazolam and clonazepam) for GAD except as a short-term measure during a crisis. NICE also notes that drug treatments can bring side effects and withdrawal symptoms. Don’t start or stop any of these on your own; ask your doctor.
Your family doctor can refer you to a psychiatrist or clinical psychologist, and Tele-MANAS can also link you to one.
Tele-MANAS: free help in your language
Tele-MANAS is the government’s mental health helpline. Dial 14416. According to the Press Information Bureau, it offers free 24×7 counselling in 20 Indian languages, and can connect callers to psychiatrists or psychologists when needed. You can call for yourself or for someone you’re worried about.
When to see a doctor, and when it’s a crisis
See a doctor if:
- Worry or panic has lasted several weeks and is affecting work, study, relationships or sleep
- You’re avoiding places or people because of anxiety
- You’re using alcohol, sleeping pills or other substances to cope
- You’ve tried self-help and it isn’t helping
- You’re pregnant or have recently had a baby and feel anxious much of the time
Get help immediately (call 112 or Tele-MANAS 14416) if:
- You have thoughts of harming yourself or ending your life, or someone tells you they do
- Someone is confused, can’t be woken or has taken an overdose
- Chest pain is severe, spreads to the arm or jaw, or comes with sweating and breathlessness, especially if it’s the first time. Treat it as a possible heart attack until a doctor says otherwise.
If you’re with someone in crisis, stay with them, remove anything they could use to harm themselves, and get help.
Frequently asked questions
Can anxiety go away on its own?
Short spells of worry linked to a stressful event often settle. Anxiety that has lasted months usually improves much faster with self-help, therapy or medicine than by waiting.
Are there herbal remedies for anxiety?
Some herbs are sold for anxiety, but the evidence is limited and some interact with other medicines. Exercise, breathing and CBT techniques have far better evidence. Check with your doctor or pharmacist before taking any herbal product.
Will I need to take tablets for life?
No. Many people are treated with therapy alone. If you take an SSRI, your doctor will review it and, when you’re well, plan how to reduce it slowly.
Is yoga good for anxiety?
The NHS includes yoga among activities that can reduce anxiety and stress and help sleep. It works well alongside, not instead of, treatment if your anxiety is severe.
Does anxiety get worse before periods?
For some women, yes. Our article on anxiety before periods covers why it happens and what helps.
This article is for general information and is not a substitute for advice from a doctor. If you have symptoms or a health condition, please consult a qualified healthcare professional.