Monday; too many emails, project deadline Friday, working late. Come home feeling tired, anxious and unsettled.

Tuesday; working late again. Tomorrow, dentist, extraction. Hate the dentist. Get home with a headache, don’t feel hungry.

Wednesday; leave work early, dentist. On way home check messages; not heard from friend in California. Get home in pain, fed up, anxious about friend.

Thursday; working late again, talk of Brexit and redundancies. Feel fed up, tired and anxious; butterflies in stomach, headache worse.

Friday; meet project deadline, not sure good enough. Get home exhausted, feelings sick, headache, still no appetite etc. Have first date with someone met online; feel very anxious, a bit lightheaded; heart is beating fast, hands sweaty; not sure about date; remember last break up.

Decide to search the Internet. Look at NHS.uk; sectionon General Anxiety Disorder.

Generalised Anxiety Disorder (GAD) is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. 

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.

The symptoms match. You are always anxious about something. What causes it?……

The exact cause of GAD isn’t fully understood, although it’s likely that a combination of several factors plays a role. Research has suggested that these may include:

• overactivity in areas of the brain involved in emotions and behaviour
• an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
• the genes you inherit from your parents – you’re estimated to be 5 times more likely to develop GAD if you have a close relative with the condition
• having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying
• having a painful long-term health condition, such as arthritis
• having a history of drug or alcohol misuse

However, many people develop GAD for no apparent reason.

You look through the list one by one.

“Maybe it’s my brain. I can’t seem to stop it. Imbalance of chemicals? How would I know? Parents were both a bit stressed and uptight at times. Nothing particularly traumatic. No health condition. No drugs. Ok I like a drink occasionally but no more than most people. What does that leave ‘no apparent reason’ and it’s long term……I’ll have to cancel I can’t go out feeling like this.”

Have another look. Are these six possibilities really the causes of anxiety? None of them are truly psychological. None of them recognise that when we think, we are doing something. None of them see anxiety as an activity with a purpose; i.e., us simply trying to anticipate how things will turn out. None of them see feelings of anxiety as an ordinary and inevitable consequence of how we are thinking. (If you doubt this universal connection tonight try imagining someone breaking into your home with a mask over their face and a large cleaver in their hand.)

How come a site like NHS.uk, which will be the first port of call for many, doesn’t mention this? How come it focuses only on how we feel when we are anxious, (i.e., what it regards as symptoms) and not on what we are doing? It is true that this myopic view is only a reflection of ideas in the wider culture, but that such a high-profile site has this bias has five profound effects.

1. It encourages us to focus on our feelings and to think of these as symptoms of a condition or illness.
2. It discourages us from asking questions about what we are thinking and how we are thinking about it.
3. As the causes are apparently either unknown or beyond our control, it increases our worries about how bad we might become or how long IT might last.
4. It increases our concern/fear that there might be something wrong with us.
5. It encourages us to feel we need help because there appears to be little we can do for ourselves.

If we see anxiety as an activity with a purpose, we can connect how we are thinking and the feelings of anxiety that arise as a result. Does NHS.uk not want you to know this? Or did they simply forget to mention it in their list of causes? If not, what was their reason? What effects does it have on individuals and on services and costs?