A GP’s Guide to Propranolol for Anxiety
By Dr Daniel Gordon • 20, Nov 2025
5 Practical Answers to the Anxiety Questions You’re Too Afraid to Ask
Anxiety is something almost everyone experiences, but very few people talk about openly. Even fewer truly understand it. In this video I talk about a simple and effective option that many people haven’t heard of and how propranolol can help with the physical symptoms of anxiety, when it works best, and what to consider before using it.
I’m Dr Daniel Gordon, a GP here in London. I have spent years treating patients through anxious patches, panic attacks and long-term anxiety disorders. And from what I see every day, there is still a great deal of confusion, shame and misunderstanding surrounding anxiety.
Many of my patients quietly ask the same questions, often with hesitation or embarrassment. These questions deserve clear, compassionate, evidence-based answers. My hope is that by the end of this article, you understand anxiety a little more clearly, and feel a little less alone in what you are going through.
Let’s begin.
1. How Do I Know If My Anxiety Is Normal or Something More Serious?
Anxiety itself is not ‘bad’ - It is a normal part of being human. It is the brain’s way of keeping us safe.
If you were walking through a field and a bull started running towards you, your brain would sound the alarm. Your heart would race, your breathing would speed up and your muscles would tense. Your body would be preparing you to act.
That same response can appear during everyday situations like a job interview or a first date. In those moments, a little anxiety can actually help us stay focused and alert.
The difficulty begins when that alarm system switches on when there is no real danger, or stays switched on even when the situation has passed.
I look for three signs that anxiety may have moved from normal to something that needs support:
Everyday situations start to feel threatening: For example, crowded places, public transport or work meetings begin to feel overwhelming, even when you know they should not.
It becomes persistent: You feel anxious most days, you find it hard to switch your thoughts off, and even small tasks start to feel mentally draining.
It interferes with your life: Anxiety starts affecting your sleep, relationships, work or your ability to look after yourself.
When these signs appear, what you are experiencing may not just be everyday stress. It is your stress response becoming overactive. And the most important thing to understand is that this is treatable. You do not have to stay stuck in that state.
2. Should I Avoid the Things That Make Me Anxious, or Will That Make Things Worse?
This is one of the most common patterns I see. Something makes you anxious, such as taking the Tube or walking into a busy event, so you avoid it. At first, this feels like the right solution. You feel relief. The anxiety settles. It seems like you have solved the problem.
The difficult part is that this short-term relief can make anxiety stronger over time.
When you avoid something that makes you anxious, your brain learns a very clear message: that situation was dangerous, and staying away kept me safe. The next time the situation appears, the anxiety is stronger. It becomes harder to face, and the fear grows.
Little by little, your world can start to shrink. You might:
stop using public transport
avoid social plans
stay home more often
feel less able to manage daily life
Without realising it, your life begins to revolve around your anxiety.
There is another approach that works in the opposite direction. It is called graded exposure, and it means facing the thing that makes you anxious in small, manageable steps. Ideally, this is done with professional support or a clear plan.
For example, if crowds make you anxious:
Step one might be walking past a busy café
Step two could be standing near a shop for a few minutes
Step three might be attending a small gathering with someone you trust
The aim is not to feel completely calm. The aim is to feel safe enough to stay in the moment. Each time you do, your brain learns a new message: discomfort does not equal danger.
Over time, the alarm response becomes quieter.
Avoidance makes anxiety grow. Gentle exposure, done with care and support, helps retrain your system and rebuild confidence.
3. How Can I Stop a Panic Attack When It Starts?
If you have ever had a panic attack, you will know how frightening it feels. Many people describe it as feeling like they are dying. Your heart races, your chest tightens, you feel dizzy or detached, and it can feel impossible to breathe properly.
The truth is this: panic attacks are incredibly uncomfortable, but they are not dangerous. They happen when your body’s stress system goes into overdrive. It is a false alarm, not a real emergency.
One of the most effective long-term treatments is Cognitive Behavioural Therapy (CBT). It helps you understand how your thoughts, emotions and behaviours interact. You learn to:
Recognise common panic thoughts, such as “I cannot breathe” or “I am about to collapse”
Replace them with calmer, more accurate responses, like “This is panic. It is temporary. I am safe”
Use body-based strategies, such as deep breathing and grounding exercises, to calm your system
These skills take time to develop, but they are incredibly effective when practised regularly.
Medication can also play an important role.
For some people, especially if panic attacks are frequent or severe, certain medications called SSRIs like citalopram or sertraline can help:
Reduce baseline anxiety
Lower the likelihood or intensity of future panic attacks
Support the work being done in therapy or daily routines
And then there are the foundations. These are the daily habits that help stabilise your nervous system.
These include:
Getting regular, good-quality sleep
Moving your body each day, even gently
Limiting caffeine, alcohol and nicotine
Allowing space for rest, quiet and recovery
There is rarely just one solution that works for everyone. Most people find that a combination of approaches is more effective. Think of it as building a personal toolbox that supports both your body and your mind.
4. Could I Have High-Functioning Anxiety, Even If I Seem to Be Coping?
This is something I see more and more in clinic. The term high-functioning anxiety has become more common, especially online, and with good reason. It describes a type of anxiety that often goes unnoticed, particularly in people who seem to have everything under control.
When we picture anxiety, we often imagine someone who looks visibly nervous, overwhelmed or withdrawn. But high-functioning anxiety can look very different.
You might:
Appear calm and capable at work, while feeling overwhelmed inside
Say yes to everything because you fear letting others down
Overthink small decisions or replay conversations in your head
Seem organised and in control, while constantly chasing perfection
Feel wired, restless or emotionally drained, even on days that go well
You are functioning, but it comes at a cost. Because you seem fine on the outside, others may not realise you are struggling. That can make it harder to speak up or ask for help.
One pattern I often see is this:
People with classic anxiety tend to avoid what makes them anxious
People with high-functioning anxiety tend to push through it
You keep going, even when you are mentally and physically exhausted. Over time, this pressure can lead to burnout.
If any of this feels familiar, you are not alone. Your experience is valid, and you do not need to wait until things fall apart before seeking support.
CBT, mindfulness, medication, setting boundaries and creating space for rest can all help you feel more grounded and more in control, without losing the parts of your life that matter most.
5. Is Anxiety All in Your Head, or Does It Affect the Body Too?
The answer is simple. Anxiety is not just in your head, and it is not just in your body either. It lives in both, because it is a biological response.
When your brain senses a threat, even if the threat is emotional or imagined, it sends signals to your body to prepare for action. This is called the stress response, and it happens automatically.
That is why anxiety can trigger strong physical symptoms, such as:
A racing or pounding heart
Tightness or discomfort in the chest
Dizziness or feeling light-headed
Tingling or numbness in the hands or feet
Nausea, stomach pain or digestive discomfort
Shaking, restlessness or muscle tension
These symptoms are very real, and they can feel frightening. Often, it is not just the anxiety that causes distress. It is the fear that something serious might be wrong with your body.
That fear then fuels more anxiety, which makes the symptoms feel even worse. You end up caught in a loop that feels impossible to break. Panic attacks are one of the most intense versions of this cycle.
Understanding this connection between your mind and your body is powerful. When you recognise that your symptoms are part of your anxiety response, you can start responding to them with calm, not panic. This change in mindset can help reduce the intensity of the cycle.
One important note:
Some physical health issues, such as thyroid disease, vitamin deficiencies or heart rhythm problems, can cause symptoms that are very similar to anxiety. If you are experiencing new, unusual or persistent symptoms, it is always important to speak to your doctor. Getting clarity can make a big difference and help you access the right support.
When to See a Doctor
People often ask me, “When is my anxiety bad enough to see a doctor?”
My answer is simple. If anxiety is making you miserable, confused, or affecting your life in any way, you are not wasting anyone’s time by booking an appointment.
Seeing your GP does not automatically mean starting therapy or medication. If your anxiety is mild, it may simply be a helpful conversation, giving you space to organise your thoughts, feel heard, and explore possible next steps together.
If the anxiety is more severe, interfering with sleep, work, relationships or day-to-day functioning, your doctor can guide you through evidence-based options. That might include psychological therapies, medication, lifestyle changes, or a combination. You do not have to go through it alone.
Quick Recap: Key Takeaways
Anxiety is a normal part of life, but if it becomes constant or overwhelming, it deserves support
Avoidance may feel helpful in the moment, but it often makes anxiety worse over time
Panic attacks feel intense but they can be managed with the right tools
High-functioning anxiety is real, even if it is hidden behind a calm exterior
Anxiety affects both your mind and your body, and understanding that link can help you break the cycle
I hope this article gave you some clarity and reassurance.
Just remember, this is not personal medical advice. Everyone’s situation is different, and the best next step is always a one-to-one conversation with a qualified professional.
If anything here resonated with you, feel free to leave a comment. Your feedback helps shape future articles and may help someone else who is quietly going through something similar.
Disclaimer
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