Anxiety: GP reviewed information

Common triggers and contributing factors

Anxiety rarely has a single cause. GPs look at a combination of biological, psychological and situational factors.

Common contributors include:

• Ongoing stress at work or home
• Health-related worries
• Financial or relationship pressures
• Poor sleep or irregular routines
• Excessive caffeine or stimulant use
• Alcohol use
• Previous episodes of anxiety
• Personality traits such as perfectionism

How GPs assess anxiety

There is no single test for anxiety. Assessment focuses on understanding the pattern, severity and impact of symptoms.

A GP may explore:

• How long symptoms have been present
• Situations that trigger or worsen anxiety
• Impact on work, relationships and daily functioning
• Sleep quality and energy levels
• Physical symptoms that accompany anxiety
• Coping strategies and avoidance behaviours
• Alcohol, caffeine and medication use

Screening questionnaires may be used to support assessment, but diagnosis is based on clinical discussion rather than scores alone.

Common types of anxiety seen in general practice

Anxiety can present in different ways. GPs often recognise patterns of symptoms rather than focusing on labels alone. Some commonly recognised forms include:

• Generalised anxiety disorder (GAD)
  Ongoing, excessive worry about multiple areas of life, often accompanied by restlessness, muscle tension, poor sleep and difficulty concentrating.
• Panic attacks and panic disorder
  Sudden episodes of intense anxiety with physical symptoms such as palpitations, breathlessness, dizziness or chest tightness. Panic attacks can feel frightening but are not dangerous.
• Health anxiety
  Persistent worry about having or developing a serious illness, despite reassurance or normal test results.
• Social anxiety
  Anxiety related to social situations, often involving fear of judgement, embarrassment or scrutiny.
• Specific phobias
  Anxiety triggered by particular situations or objects, such as flying, heights or medical procedures.

These terms describe symptom patterns. A diagnosis is based on a full clinical assessment rather than online self-identification.

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When investigations may be considered

Investigations are not routinely required for anxiety.

They may be considered if symptoms suggest an underlying physical cause, such as:

• Persistent palpitations
• Unexplained weight loss
• Heat intolerance or tremor
• New or unusual symptoms

In these cases, blood tests such as thyroid function or general screening may be appropriate.

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Practical steps that may help manage stress

Management is tailored to the individual and often involves a combination of strategies.

Common GP-recommended approaches include:

• Education and reassurance about anxiety symptoms
• Improving sleep routine and daily structure
• Reducing caffeine and alcohol intake
• Gradual exposure to avoided situations
• Talking therapies such as CBT
• Mindfulness or relaxation techniques

Medication may be considered in some cases, particularly if symptoms are persistent or significantly impairing, but is not always required.

When to seek further medical review

You should seek review if:

• Anxiety is persistent or worsening
• Symptoms interfere with work or relationships
• You begin avoiding everyday situations
• Physical symptoms are increasing or concerning
• Anxiety is accompanied by low mood

Early review can prevent anxiety becoming more entrenched.