Anxiety is a forward-looking issue. This means that we become anxious when we think about what is going to, or may happen in the future, that might be either short or longer term. Anxiety is a natural response to this anticipation, it is generally an uncomfortable feeling like fear, apprehension or nervousness.
We have all experienced anxiety at some point in our lives. When we were younger it might have been linked to school. As we get older it can often be work related, be it in anticipation of an interview, starting a job or starting a new course.
For some of us our anxiety manifests in a way that can leave us feeling uncomfortable, scared or very upset. Anxiety has the potential to become so great that it impacts your life negatively and in extreme cases can lead to an anxiety disorder.
It is estimated that, as members of the LGBTQ+ community, we are 1.5- 2.5 times more likely to experience anxiety than people who are heterosexual and cis/gender-conforming. Furthermore, it is reported that 30% – 60% of LGBTQ+ people have at some point experienced moderate to severe anxiety in their lives. This type of anxiety can negatively impact the things we enjoy in life.
In some cases, if you suffer from severe anxiety, or an anxiety disorder, the feeling of fear may be with you all the time. It is intense and sometimes debilitating, some common and potentially very disruptive disorders include: generalised anxiety, social anxiety and obsessive-compulsive disorder, or OCD.
While everyday anxieties can have the potential to become more serious, we can for the most part manage them to keep them from becoming too overwhelming. However, if anxiety does become overwhelming and we don’t acknowledge and treat it, things are likely to get worse, rather than better.
Physical and emotional impact of anxiety
While the following symptoms may be experienced on occasion, feeling this way on a regular basis or for a prolonged period is a good indication that it might be time to seek out some extra support:
The physical effects of anxiety can include:
- Dry mouth and/or difficulty swallowing
- Trouble getting to sleep
- Concentration issues
- Muscle tension, headaches, migraines
- Sweating or trembling
- A flare-up of another health problem or illness e.g. Irritable bowel syndrome, eczema, psoriasis, fibromyalgia
- Sexual problems, such as not having any sexual feelings or no interest in sex
There are several ways in which anxiety can affect your behaviour and feelings these include:
- Being easily irritated, or bad moods
- Having a strong urge to avoid situations that could trigger your anxiety
- Worry or always feeling that something bad is about to happen
- Worrying you have done something wrong or people will be angry with you
- Seeking reassurance when no real need is there for it
- Being a perfectionist
- Being pessimistic and focusing on what may go wrong in any given situation
Counselling or Psychotherapy
Talking therapies are usually suggested as a way of working with anxiety, the most important element of counselling is that you, as the client, have trust in your therapist. If there is no rapport or as Carl Rogers, one of the founding fathers of psychotherapy said, ‘psychological contact’, then the therapy is unlikely to work.
There are a range of therapeutic styles available. You may have heard of cognitive behavioural therapy (CBT), which has much evidence to show the techniques used are a great way of managing symptoms of anxiety. Acceptance and Commitment Therapy (ACT) is another style that is also very useful. However, the majority of therapeutic approaches have their own way of looking at and helping with anxiety, so it really comes down to how you prefer to work. A good therapist will be flexible in their approach to using different models of therapy. Explore the different options available to see what might be right for you.
In the UK you can refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from a GP or if you prefer, your GP can refer you. You also have the option to see a therapist privately.
In Ireland, your GP can refer you for counselling with the HSE or counselling may be offered as part of working with another agency e.g. Tusla. Alternatively, and most commonly in Ireland people will self-refer for counselling, by contacting a private therapist. Group therapy is also another excellent option. All of these methods are equally as effective working face to face as online.
Self-help or guided self-help
Increasingly there are a number of guided self-help apps available to download. A simple search will bring you some of the top rated and best reviewed apps available. In the 90’s and 2000’s there was a surge in pop psychology and self-help books and while these were and still are valuable tools, they take a‘one size fits all’ approach which does not take into consideration the individuality of each reader (that is why self-help books work for some but not others).
Development groups are another way of managing anxiety, by meeting with others and, as a group, working through strategies. These may be peer or therapist led. Other groups can include meditation, yoga, mindfulness or more general peer support groups.
Medication can be used to treat the symptoms of anxiety, if you wish to pursue the medication route you should speak to your GP. Medication can be a great tool to help with the initial management of anxiety but be aware that it manages the symptoms, not the cause. Research shows that medication, together with talking therapy or some other intervention, is more effective than medication alone, so this is something worth exploring with your doctor.
James Byrne is part of the GenderGP Network, To find out more or to book a session with him visit: https://www.gendergp.com/gendergp-network/james-byrne/
Butler RM, Horenstein A, Gitlin M, Testa RJ, Kaplan SC, Swee MB, Heimberg RG. Social anxiety among transgender and gender nonconforming individuals: The role of gender-affirming medical interventions. J Abnorm Psychol. 2019 Jan;128(1):25-31. doi: 10.1037/abn0000399. Epub 2018 Nov 29. PMID: 30489112.
Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Annual review of clinical psychology, 12, 465–487. https://doi.org/10.1146/annurev-clinpsy-021815-093153
Walter Pierre Bouman, Laurence Claes, Nicky Brewin, John R. Crawford, Nessa Millet, Fernando Fernandez-Aranda & Jon Arcelus (2017) Transgender and anxiety: A comparative study between transgender people and the general population, International Journal of Transgenderism, 18:1, 16-26, DOI: 10.1080/15532739.2016.1258352