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Situational Anxiety

What is Situational Anxiety?

Situational anxiety is a type of anxiety that is experienced in response to specific, new, and/or unfamiliar situations. It is common, and can be considered to be a normal response by anyone who is in a situation that causes anxiety, such as when public speaking and presenting, during a job interview, meeting new people, and leaving home for the first time.

Situational anxiety is usually triggered by a new or challenging situations. This may be because the person cannot be entirely sure of what may happen and anticipates a negative outcome, or where the situation was previously awkward or distressing. Situational anxiety may also be more likely to occur in people who are generally anxious.

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What are the effects of Situational Anxiety?

Signs and symptoms of situational anxiety can be both emotional, including nervousness, restlessness, tension, irritability, difficulty concentrating, and physical, including sweating, shaking, rapid heart rate, rapid breathing, sleeplessness, dry mouth, and diarrhoea. They may differ among individuals and in different situations. For example, a person may be restless and have a rapid heartbeat before a job interview, or be tense and sweaty when meeting new people. It should be noted that these signs and symptoms are similar to those experienced with other anxiety types, but they occur in specific situations only.

How is Situational Anxiety diagnosed?

Situational anxiety is not a distinct mental health condition, and does not mean that a person has a specific anxiety disorder. Nevertheless, it can still impact a person’s daily life. Anyone suspecting that they may have situational anxiety should speak with their doctor, because asking for help will enable them to overcome the problem. They will be assessed to determine if the signs and symptoms are due to situational anxiety or another type of anxiety disorder, such as generalised anxiety disorder (a continuous and excessive state of anxiety), social anxiety (anxiety in both new and familiar social situations) or phobia (an intense and irrational fear of a thing or situation).

Management of Situational Anxiety

Alongside self-help strategies for coping, situational anxiety can be managed with medication and/or psychotherapy.

1. Treatment

Situational anxiety can be managed with medication when the anxiety experienced causes great distress and/or interferes with daily living. Medicines include propranolol, which is a beta blocker that can control signs and symptoms of anxiety, such as a rapid heart rate, shaking, and sweating. This medicine can be used occasionally, when the situation arises, or regularly if needed. Anti-anxiety medicines may also be prescribed, such as serotonin reuptake inhibitors (SRIs) that regulate mood, and benzodiazepines that have sedative and relaxing effects (taken once or for a short time only).

2. Therapy

Exposure therapy involves exposure to the cause of the problem, starting with exposure to a mildly problematic situation, such as thinking about the cause of the anxiety, and gradually increasing to challenging situations and facing the fear, such as being in the anxiety-causing situation. The person only attempts a more difficult task when comfortable with the easier task. In this way the person becomes used to the situation, the association with previous negative situations is reduced, and more realistic thoughts are learned.

Cognitive behavioural therapy involves ways of changing a person’s thinking and behaviour. It helps people to identify, challenge, and change the abnormal negative thoughts, emotions, and behaviours and replace them with more objective, realistic patterns of thinking, emotion, and behaviour. This may include learning that the thought is unrealistic and to become more realistic, to understand the fear, calming and relaxing techniques, to build self-esteem, and how to deal with the situation.

Relaxation techniques, including visualisation, deep breathing and muscle relaxation, can also be used when experiencing situational anxiety. Visualisation involves using the imagination to experience the desired thoughts and feelings (such as confidence and calmness) and reduce nervousness during times of increased anxiety. Deep breathing when anxious redresses the effects of rapid shallow breathing by correcting the imbalance of gases (oxygen/carbon dioxide) in the blood. Progressive muscle relaxation involves slowly tightening and relaxing the muscles starting with the forehead and moving down through the body to your feet.

3. Coping strategies

Research, preparation and rehearsal for a situation can help alleviate anxiety by minimising uncertainty, reducing stress, and promoting feelings of being in control. These may include:

  • researching the place, the event, and people attending;
  • preparing by getting clothes and bags ready, learning the route, and listing likely interview topics; and
  • rehearsing a presentation, a journey, and answers to possible questions.

Additionally, self-care with a healthy diet, regular exercise, and sufficient sleep is important to help a person keep calm and to reducing stress.

Challenging negative thoughts and behaviours with positive, more realistic ones, and thinking of previous occasions when all went well and were successful can also help in situational anxiety. It is important to keep in mind that everybody makes mistakes sometimes and people usually understand this.

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