Dr Masrita Ishaq

15 Jul 2019

What is anxiety and when does it become an issue? by Dr Masrita Ishaq

“Anxiety and Generalised Anxiety Disorder” is the most searched phrase on Counselling Directory*, a widely used therapist search tool. But how do we know when anxiety is a normal and healthy reaction to situations or when it is a signal for something more serious looming? Many of us experience the familiar flutter of heart rate quickening, face flushing, prickly sensation at the back of the neck, and/or sudden breathlessness which may be accompanied by looking away or avoiding eye contact.

Anxiety or physiological arousal in small to moderate doses is healthy and in fact leads to higher performance. Being in a lethargic or very relaxed state certainly does not drive one’s motivation. That edginess you feel close to a deadline is conducive to your concentration level and gives you the needed boost to complete your task. This is well documented and can be illustrated with an inverted U curve with Performance on the Y axis and Anxiety/Arousal on the X axis- as anxiety increases, performance increases until it reaches a peak and any further increase in arousal is unproductive. This is also known as the Yerkes- Dokson Law.

(image from https://hbr.org/2016/04/are-you-too-stressed-to-be-productive-or-not-stressed-enough)

At the other end of the curve, strong physiological arousal becomes a hindrance and barrier. These sensations might be accompanied by worrying excessively about specific or a wide range of issues, replaying conversations in your mind, imagining worse case scenarios or feeling highly self-conscious. These thoughts might then stop you from attending events where people gather, avoiding people or certain tasks, and the thought of doing these have profound physiological impact. These sensations, thoughts and behaviours combined, affect different areas of your life such as relationships, family, work and/or friendships. The cycle becomes a vicious one that unless is broken, continues to bring distress.

Sometimes intense anxiety is brought about following a significant life event such as bereavement or loss of a family home. Other times, you have not felt “quite right” for some time and a new event such as a new job starts bringing up pangs of panic. The causes for anxiety are not always apparent to the person suffering from it and this might create a sense of being out of control.

The NICE (National Institute for Health and Care Excellence) guidelines recommends best practice in physical and mental health. Healthcare professionals consult these guidelines for recent evidence to guide their assessment, pharmacological and psychological interventions. Of relevance here is the standard for Anxiety Disorders (NICE, 2014), which you can assess if you are interested. These can provide a basis for you to understand the range of anxiety disorders. However, diagnosis should always be made by an appropriately qualified professional and your GP is your first point of contact for this to happen. The charity Anxiety UK leads on anxiety, stress and anxiety based depression. Their website contains a wealth of information about accessing help with the flexibility of face to face, online or via the phone. They also provide a text service and runs an info line for the general public.



Yerkes, R. M. & Dodson, J. D. (1908). The relationship of strength of stimulus to rapidity of habit formation. Journal of Comparative Neurology and Psychology, 18, 459–482.

NICE (2014) Anxiety Disorders. Retrieved on 10th June 2019 from https://www.nice.org.uk/guidance/qs53

*Search performed in June 2019


Dr Masrita Ishaq is a Chartered Counselling Psychologist working at The Eaves. She works with a range of issues, including anxiety with adults and young people from 11+ years old. Masrita is based in our Godalming and Guildford practices and offers weekday evening and weekend appointments. If you would like to get in touch with Masrita, please go to her profile on our page for contact details.