Anxiety disorders

Anxiety disorders are a group of mental health conditions in which excessive fear, worry or apprehension causes significant distress and interferes with daily life. Unlike ordinary anxiety, which is a normal response to stress, anxiety disorders involve a level of fear or worry that is disproportionate to the situation and persists over time. They are among the most common mental health conditions in the UK and are particularly prevalent in people who have survived a life-threatening event such as cardiac arrest.

The main anxiety disorders include generalised anxiety disorder (GAD, persistent and wide-ranging worry), panic disorder (recurrent, unexpected panic attacks), social anxiety disorder, specific phobias, and post-traumatic stress disorder (PTSD). PTSD is especially relevant for cardiac arrest survivors and their families, and arises when traumatic memories of the event cause persistent intrusive recollections, hypervigilance, avoidance behaviour and emotional numbing. Health anxiety (excessive worry about physical symptoms or illness) is also common after cardiac arrest, and can be particularly difficult to disentangle from appropriate vigilance about cardiac symptoms.

Anxiety and depression frequently coexist, each making the other harder to manage. Physical symptoms of anxiety can include a racing heart, chest tightness, breathlessness, sweating, dizziness and nausea, all of which may overlap with the physical symptoms survivors are already monitoring for cardiac reasons, creating an additional layer of distress. Referral for psychological assessment can help clarify whether physical symptoms have an emotional or cardiac cause, or both.

NICE-recommended treatments for anxiety disorders include psychological therapies, primarily cognitive behavioural therapy (CBT), and medication, most commonly selective serotonin reuptake inhibitors (SSRIs) or serotonin-noradrenaline reuptake inhibitors (SNRIs). EMDR (Eye Movement Desensitisation and Reprocessing) is the recommended treatment for PTSD. NHS Talking Therapies (formerly IAPT) provides referral routes in England. If you are experiencing anxiety after cardiac arrest, speak to your GP, who can refer you to appropriate support.