The cause for the anxiety may be real or imagined. When we fear something, are frightened of something, our body changes physiologically. Substances such as adrenaline are released into the circulation and they make the pulse rate quicken, the heart pound, the blood pressure rise, the mouth dry and make our bowels feel loose. The original intention of this reaction was to enable us to survive either by fighting or running away. And the same physiological mechanisms that helped our forbears escape a sabre- toothed tiger are still activated when wee feel frightened, for example by sitting an examination, going on stage or taking part in some kind of contest. This is still a normal reaction; it is just that the circumstances have changed. In one of the more serious forms of anxiety, generalised anxiety state, the sufferer feels these symptoms of fear, all the time, usually for no particular reason at all but, sometimes, or for every reason in the World. This condition affects about one in fifty people, mostly women, but lesser, though still disabling, degrees of anxiety are very much more common. Some people have irrational fears (phobias) over all manner of things –open spaces, confined spaces, insects, anything. Thus, anxiety is felt, is a fear, is subjective. Stress, on the other hand, is external, something that comes from the outside – a broken relationship, a bad job, health concerns, a delinquent child, financial worries. Stress can, of course, produce anxiety but is also implicated in all manner of other medical conditions such as asthma and heart attack

Everybody is going to be anxious at some time. Unreasonable anxiety should be exposed, talked through; positive attitudes should be taken “ The bottle is half full, not half-empty”. Good stress, happy stress is required by everybody – change, excitement, romance, challenge. Anxiety can, in part, be countered by replacing painful stress, distress, with happy stress, eustress. Change of lifestyle, holidays, weekends away, sports, dancing, exercise, seeing friends, all enhance life quality. If the anxiety is severe and ongoing, the doctor should be consulted and various treatments may be made available such as cognitive therapy and the use of medications such as beta-blockers that will reduce the adrenaline effects felt in anxiety. It is also necessary for an expert to distinguish anxiety from depression, as the two conditions often mimic and can co-exist in the same person. Antidepressant medication can also, sometimes, be very useful in what appear to be overtly anxiety and phobic states.