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How to reduce extreme anxiety


Anxiety disorders - Diagnosis and treatment

Diagnosis

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

  • Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
  • Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

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Treatment

The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.

Medications

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:

  • Certain antidepressants are also used to treat anxiety disorders.
  • An anti-anxiety medication called buspirone may be prescribed.
  • In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.

Talk with your doctor about benefits, risks and possible side effects of medications.

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Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
  • Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
  • Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
  • Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Alternative medicine

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support

To cope with an anxiety disorder, here's what you can do:

  • Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
  • Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
  • Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
  • Socialize. Don't let worries isolate you from loved ones or activities.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

Preparing for your appointment

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

What you can do

Before your appointment, make a list of:

  • Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
  • What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
  • Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
  • Any other health problems you have. Include both physical conditions and mental health issues.
  • All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
  • Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

  • What's the most likely cause of my anxiety?
  • Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
  • Do I need any tests?
  • Should I see a psychiatrist, psychologist or other mental health provider?
  • What type of therapy might help me?
  • Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
  • In addition to treatment, are there any steps I can take at home that might help?
  • Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

  • What are your symptoms, and how severe are they? How do they impact your ability to function?
  • Have you ever had a panic attack?
  • Do you avoid certain things or situations because they make you anxious?
  • Have your feelings of anxiety been occasional or continuous?
  • When did you first begin noticing your feelings of anxiety?
  • Does anything in particular seem to trigger your anxiety or make it worse?
  • What, if anything, seems to improve your feelings of anxiety?
  • What traumatic experiences have you had recently or in the past?
  • What, if any, physical or mental health conditions do you have?
  • Do you take any prescription drugs?
  • Do you regularly drink alcohol or use recreational drugs?
  • Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

By Mayo Clinic Staff

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How to Ease Your Anxiety

Everyone feels anxious from time to time. Occasional anxiety is a normal reaction to uncertainty about what’s going to happen next, whether that’s in the next few minutes, days, or months.

Mental health experts define anxiety as worry over a threat that’s still in your future. Thinking about a conversation you dread, for example, could twist your stomach into knots days before it happens. Your heart may race before an exam or presentation. You might lie awake at night worried about whether you’ll catch COVID-19 at the grocery store.

It’s also normal to want to get rid of those uncomfortable, pit-of-the-stomach feelings as quickly as possible. But that approach can make you more anxious, says David H. Rosmarin, PhD, associate professor of psychology at Harvard Medical School in Boston.

“When you worry about getting rid of your anxiety, you’re signaling your nervous system that you have even more to be anxious about. And that makes your anxiety worse,” he says.

Keep in mind that if your anxiety is long-lasting and interferes with your daily life, you could have an anxiety disorder. In that case, you may need treatment to overcome it. 

Calm Anxiety by Accepting It

It’s not what people expect to hear. But one of the most effective ways to ease occasional anxiety is to accept it, says Rosmarin, who is also founder of the Center for Anxiety in New York City.

“When we let anxiety run its course in the moment without fighting it, ironically, that makes it less. On the other hand, fighting anxiety is what typically [triggers] a panic attack,” he says.

“And, if your only strategy is to distract yourself from your anxiety or to avoid things that cause it, you’ll always be afraid of it. It’s always going to be the bully in the schoolyard because you’ve never learned to deal with it.”

The Anxiety and Depression Association of America puts it this way: “The thoughts you resist persist. ”

Try these steps instead:

Recognize and understand your anxiety: Tell yourself, “My nervous system is kicking into high gear because I’m worried about [thing X].”

Don’t criticize yourself for those feelings: Instead, say, “This is a normal, healthy response by my body to these circumstances, which are complicated, stressful, or difficult. It’s OK to feel this way.”

Know that you can have anxiety and still function well: “You can perform very well with anxiety, and probably have done so before,” Rosmarin says.

Think back to a time when you were anxious but did what you needed to do anyway. Maybe you were filled with anxiety before an event or a meeting. But later, someone said you did a great job.

How to Stop Anxiety

When your anxiety feels overwhelming, these techniques can give you quick, short-term relief.

Do a reality check: Ask yourself these questions:

  • On scale of 1 to 100, how likely is it that the thing I’m anxious about will happen?
  • Do I have good reasons to think something will go wrong?
  • Is there a chance I’m overly worried?

Share your anxiety with someone you trust: Don’t avoid your anxious thoughts, which can make them worse. Talk them over with a friend or family member, who can help you put them in perspective. 

Remind yourself that you’re safe: “When anxiety kicks in you may feel scared or out of control, with your mind racing to all these uncertain future catastrophes,” says clinical psychologist Debra Kissen, PhD, chief executive officer of Light On Anxiety CBT Treatment Centers in the Chicago area.

“Ask yourself, ‘Is there a real danger in front of me, or am I actually safe at home and worried about something that’s no threat to me right now?’” she says. “This thinking can ground you in the moment and reboot your brain and body so you feel less anxious.”

Redirect nervous energy: Anxiety can be like a motor revving, says licensed professional counselor Lisa Henderson. “Take control of that energy and put it somewhere else,” says Henderson, co-founder and chief executive officer of Synchronous Health in Nashville. 

“If you’re sitting there worried, for example, get up and walk or pace,” she says. “Take a few minutes to clean something. Go outside for 5 minutes. Shorts bursts of activity can release that anxious energy.”

Take a mental break: “Use a guided imagery app or simply daydream on your own,” Henderson says. “A brief mental vacation can break the cycle of anxious thoughts.”

To try this on your own, set a timer for a few minutes, close your eyes, and picture yourself somewhere you feel peaceful or happy.

“Just letting your mind wander can work well if your anxiety comes from feeling controlled or managed,” Henderson says. “If your mind returns to its anxious thoughts, notice -- without judgment -- that it’s happened and mentally tell your anxiety ‘I’ll be with you in a moment.’ Then go back to your daydream.”

You may prefer an app that guides you through your thoughts to help you release anxiety. Find relaxation or meditation apps that appeal to you and give them try.

Just breathe: Inhale and exhale slowly, evenly, and deeply for several breaths.

Change your position: “Whatever you’re doing, do the opposite,” Kissen says. “If you’re hunched over with worry, stand up and take a Wonder Woman pose. If you’re under a blanket, go wash your face with cold water. Changing your sensory experience can ‘change the channel’ from anxiety.”

Use a mantra: A mantra can shift your mind away from anxious thoughts that play over and over in your head, Kissen says.

Two she likes are: “These thoughts are uncomfortable, but not dangerous,” and “This, too, will pass.”

Put your anxiety on a schedule: Pick a 15-minute window during the day to think about your anxieties. “During that time, tell your brain to just go for it and let the anxious thoughts come,” Kissen says. “But when they arise outside that time, tell them ‘I’m willing to hear you, but come back tomorrow at 3 p.m.’”

If anxiety keeps you awake, get up: “If you’re lying in bed worrying about things for more than 5 minutes, get up and go to another room and write down your anxieties,” Kissen says. “Go back to bed when you’re tired, but get up again if you feel anxious. It might take a few nights of going back and forth, but this exercise can train your brain that your bed is for sleep, not for anxiety.”

Do I Need Treatment for Anxiety?

There’s a lot you can do on your own to relieve anxiety, but sometimes you need help. Psychotherapy and medication are the two main treatments for anxiety disorders.

Signs that it’s time to talk to a mental health professional include:

  • Constant or nearly constant anxiety
  • Anxiety that gets in the way of your daily activities, like work or social life
  • Anxiety about things that don’t actually threaten you
  • Panic attacks

Check your health insurance policy to see what mental health services your plan covers. Then, review a list of your in-network providers to find one to connect with.

“You don’t want to add to your anxiety by paying big out-of-pocket fees,” Kissen says.

Your primary care doctor may also be able to recommend a mental health professional with experience treating anxiety and anxiety disorders.

Rosmarin notes that it’s important to find a provider you click with and trust. He also says therapy doesn’t need to go on indefinitely to be effective.

“A course of cognitive behavioral therapy for anxiety may be eight to 10 sessions,” he says. “There’s also data to suggest that people feel substantially better after just one therapy session for panic disorder.”

Align the background: how to reduce anxiety?

Psychologists call increased anxiety a problem of our time: chronic stress, haste, a huge flow of information, political and economic instability, personal uncertainty - all these factors make the nervous system work to the limit. Anxiety reduces the general background of life and has a bad effect on the professional sphere. Many companies today are concerned about the psychological state of employees and are actively implementing programs for psychological relief, organizing meditations in the office, yoga classes, etc. At the same time, the demand for corporate psychologists is growing.

Employees themselves can also help themselves, the first step is to understand how anxiety works.

Freud first spoke about anxiety. He saw her as a guardian on the border of the conscious and the subconscious: when repressed feelings and experiences tend to “break through” into consciousness, anxiety appears that prevents this from happening. That is, its task is to protect against secondary injury.

Now psychologists separate anxiety and anxiety .

Alarm is event specific, it has a cause, it is valid.

For example, you do not have time to make a report and are worried - this is normal. After the situation is resolved, the anxiety will go away.

A anxiety is a stable personality trait, it is largely determined genetically. This type of anxiety has no apparent cause, it does not go away for a long period.

For example, if you still have enough time to turn in your report, but instead of working, you worry that you won't make it in time, that you will be poorly evaluated, that you will be fired, this is anxiety. After the submitted report, the nervous background is likely to remain.

However, anxiety and anxiety are related . If you are a priori anxious, then you meet any situation in anticipation of a threat. You need to know this peculiarity of yours and consciously analyze whether your experiences are justified. And if you (or your environment, the work team) are used to making an elephant out of a fly on every occasion, then you generally become more anxious. The psyche works in the same way in the opposite direction: the more calmly you treat situations, the lower the overall level of anxiety will be.

Anxious people, as a rule, are very attentive, scrupulous, they double-check everything several times. They are diligent and strive to do their job well. They are very afraid of forgetting and confusing something, therefore they are obligatory, and in companies, as a rule, they are in good standing.

But over time, such employees can burn out. Severe anxiety in a long period depletes the resources of the body, reduces attention - as a result, the employee makes mistakes, which feeds his anxiety even more. Vicious circle.

Anxiety interferes with career growth. Anxiety goes hand in hand with fear of failure, avoidance of difficulties, fear of superiors. With such “baggage” it is difficult to build a career, these qualities seriously interfere with implementation.

Anxiety reduces the degree of satisfaction with life, including the professional area. Anxious people are less satisfied with their jobs because their focus is on risks and threats, and they often fail to see the bright side and opportunities.

1. Take an anxiety test.

For example, this one. If you see high numbers, know that you tend to overreact to stressful situations, and when they occur, analyze how justified your anxiety is.

2. Do breathing exercises when you are very anxious.

Take a 10-minute pause and breathe slowly and deeply into your belly. Walk, if possible, go outside. After the break, look at the situation or problem again with a cool head.

3. Keep a diary of your emotional state.

Write down what makes you anxious and what thoughts trigger the experience. For example, “a colleague didn’t greet me because I did something wrong. It seems to me that colleagues are discussing me behind my back, but I don’t know why.” Think about what objective factors indicate that colleagues do not like you. The rest is your fantasy, a colleague might not notice you.

4. Choose a creative hobby.

Art therapy helps relieve stress: drawing, pottery, sand techniques, knitting, embroidery and others are shown.

5. Rest.

Life-work balance is essential for everyone, and if work duties keep you in an anxious state, good rest is vital for you. Follow the regime, leave time for yourself on weekdays and weekends. Processing will not bring you peace, and in an anxious state, people are ineffective.

6. Go in for sports, walk more.

Physical exercise is good for resetting.

These recommendations will be useful for your health and your career, because as Haruki Murakami wrote: there is strength in calmness. Be stronger and more resilient!

✱ The opinion of the authors and experts may not coincide with the position of the editors hh.ru

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How to reduce anxiety

Anxiety can be caused by the fast pace of life, worries about the future, endless notifications in instant messengers. Anxiety over insignificant things leads to mental disorders. Therefore, it is necessary to recognize these states and learn to manage them independently. T&P tells what can be the cause of anxiety and how to get out of it.

Why do we worry?

In order to get out of an uncomfortable state, you must first understand how it is characterized, what is happening to a person at this moment and what are its causes. This is not about a certain emotion, such as the excitement that occurs before a speech or an important conversation, but about a state. You cannot get out of it in two minutes by taking a deep breath and exhaling. It needs to be worked out on a psychological level. Most often, anxiety is associated with cognitive attitudes that we create ourselves.

Anxiety is an active, agitated state, unlike depression, during which there is no counteraction to stress allows a person to react and adapt in a dangerous situation. American psychologist Charles Spielberger identifies two forms of anxiety: as a state and as a property. In the first case, this is a temporary reaction to external circumstances, in the second - a character trait, a person constantly reacts sharply even to minor interference.

Russian psychologist Yevgeny Ilyin in his book "Psychophysiology of human states" defines anxiety as a prediction of failures in a state of uncertainty. Most often, the cause of this state is the experience and thinking of negative scenarios for the future. However, this can be used for good and not just worry about failure, but think over and draw up a plan of action that you will take in this case.

It's normal to feel anxious about moving to a new place, starting a new job, or taking a test. This type of anxiety can motivate you to work harder. Ordinary anxiety is a feeling that comes and goes but does not interfere with your daily life.

If you have an anxiety disorder, fear can be with you all the time. This type of anxiety can make you stop doing what you enjoy. In extreme cases, it can prevent you from getting on an elevator, crossing a street, or even leaving your home.

Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age. According to the American Psychiatric Association, women are more likely than men to suffer from anxiety disorders.

Clinical psychologist Michael Tomek

Treatment of generalized anxiety disorder requires psychotherapy and medication. GAD may be accompanied by depression. If you notice for several months frequent excessive anxiety over minor things that is beyond your control and causes a physical reaction (for example, rapid heartbeat, spasms, muscle cramps), you should contact a specialist. Temporary anxiety can be dealt with on your own.

How to reduce anxiety in everyday life

Look for the cause of anxiety

Anxiety cannot be ignored, says psychologist Michael Tomek. Most often, the reason is thoughts about the future. If you have presented a negative scenario, consider how you will act in such a situation, which will help you solve this problem. So you will understand that you will be able to cope with possible difficulties, and therefore there is no cause for concern.

According to Stoic philosophy, all phenomena in the world are divided into controlled and not subject to man. The Stoics are sure that worrying about something that does not depend on us is pointless and it is better to direct all our efforts and attention to things that we control. “Of the things that exist, some are in our power, others are not. In our power is opinion, aspiration, desire, evasion - in a word, everything that is ours, ”says Epictetus in the book A Brief Guide to the Moral Life”

Focus on the body

The Anxiety and Depression Association of America (ADAA) claims that exercise helps a person reduce anxiety. During sports, you are focused on your physical condition and all resources are directed to maintaining it. A single workout can help relieve symptoms for a few hours, and regular exercise can significantly reduce them over time.

Reduce the number of alerts

One of the anxiety factors can be the frequent use of gadgets. You're stressed out if you keep getting alerts on your phone. Leave only the most important - the rest of the chats, news resources can simply be checked periodically.

Solve math problems and get creative

If anxiety keeps you from doing your normal activities, challenge your brain. It can be exercises in physics, mathematics or a game of chess. You can count backwards in your mind, add and multiply random numbers.

If you are less interested in math problems, take up drawing or playing music. The main thing is to shift attention to solving a specific problem and direct all other resources to it.

Watch your breath

Stanford University scientists have found a connection between breathing and our emotional state: the shallower we breathe, the higher the level of anxiety and worry. Therefore, deep breathing practices must be performed periodically.

Simple breathing exercises: