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What to do for high anxiety


11 tips for coping with an anxiety disorder

Speaking of Health

Topics in this Post

  • Behavioral Health
  • Anxiety
  • Balance your mental and emotional health

Having occasional feelings of anxiety is a normal part of life, but people with anxiety disorders experience frequent and excessive anxiety, fear, terror and panic in everyday situations. These feelings are unhealthy if they affect your quality of life and prevent you from functioning normally.

Common symptoms of anxiety disorders include:
  • Feeling nervous
  • Feeling helpless
  • A sense of impending panic, danger or doom
  • Increased heart rate
  • Hyperventilation
  • Sweating
  • Trembling
  • Obsessively thinking about the panic trigger

These feelings of anxiety and panic can interfere with daily activities and be difficult to control. They are out of proportion to the actual danger and can cause you to avoid places or situations.

You should see your health care provider if your anxiety is affecting your life and relationships. Your provider can help rule out any underlying physical health issue before seeing a mental health professional.

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes and coping strategies also can make a difference.

Here are 11 tips for coping with an anxiety disorder:
  1. Keep physically active.
    Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It can improve your mood and help you stay healthy. Start out slowly, and gradually increase the amount and intensity of your activities.
  2. Avoid alcohol and recreational drugs.
    These substances can cause or worsen anxiety. If you can't quit on your own, see your health care provider or find a support group to help you.
  3. Quit smoking, and cut back or quit drinking caffeinated beverages.
    Nicotine and caffeine can worsen anxiety.
  4. Use stress management and relaxation techniques.
    Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  5. 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, talk with your health care provider.
  6. Eat healthy foods.
    A healthy diet that incorporates vegetables, fruits, whole grains and fish may be linked to reduced anxiety, but more research is needed.
  7. Learn about your disorder.
    Talk to your health care provider to 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.
  8. Stick to your treatment plan.
    Take medications as directed. Keep therapy appointments and complete any assignments your therapist gives. Consistency can make a big difference, especially when it comes to taking your medication.
  9. Identify triggers.
    Learn what situations or actions cause you stress or increase your anxiety. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
  10. 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.
  11. Socialize.
    Don't let worries isolate you from loved ones or activities.

Your worries may not go away on their own, and they may worsen over time if you don't seek help. See your health care provider or a mental health provider before your anxiety worsens. It's easier to treat if you get help early.

Learn more about anxiety management:
  • 5, 4, 3, 2, 1: Countdown to make anxiety blast off
  • 9 ways to tame anxiety during the COVID-19 pandemic
  • Addressing your mental health by identifying the signs of anxiety and depression

Siri Kabrick is a nurse practitioner in Psychiatry & Psychology in Fairmont, Minnesota.

For the safety of our patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a non-patient care area where social distancing and other safety protocols were followed.

Topics in this Post

  • Behavioral Health
  • Anxiety
  • Balance your mental and emotional health

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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.”

How to reduce anxiety

The reasons for anxiety can be 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. nine0007

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. nine0007

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. nine0018

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. nine0018

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. nine0007

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

Frequent use of gadgets can be one of the anxiety factors. 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. nine0007

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 painting or playing music. The main thing is to shift attention to solving a specific problem and direct all other resources to it. nine0007

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:

  • Inhale and exhale deeply in 4 counts for 2 minutes. Engage in diaphragmatic breathing, which activates the entire body. nine0007

  • Inhale for 4 counts, hold your breath for 8, and exhale through your mouth for 16.

  • Close the right nostril and inhale through the left, close both nostrils and hold the breath. Exhale through the right nostril.

Write down your feelings

Describe how you feel and explain the reason for your anxiety. After re-reading this entry in a few hours, you will look at the situation from the other side, as if this is not happening to you. In this state, you may come up with new ideas and ways to solve problems. nine0007

Allow yourself to rest

Anxiety can arise from being in a hurry and thinking that you are not doing anything. A busy work schedule and multitasking can increase your anxiety levels. Accordingly, it is necessary to allow yourself to rest, and take short breaks during the working day. This way you can also strike a balance between work and personal life.

Evgeny Ilyin
Publishing house Peter, 2008

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we encounter anxiety, powerlessness, fear and panic - these feelings paralyze and do not allow breathing. How to distinguish anxiety from increased anxiety, to react sensibly to circumstances and get rid of constant anxiety? nine0114

The feeling of anxiety itself is natural for a person: experiencing it, our body suggests an approaching danger or a possible risk to life or health. Anxiety, tension, fear - these emotions are absolutely normal in a stressful situation, but at the same time, they, experienced regularly, can talk about more serious mental problems, including mental disorders.

Anxiety — this word can describe a complex of negative emotions, including stress, panic, fear, anxiety and more — is normal and not dangerous for a person. These emotions can go into a state of anxiety disorder with their regularity and constancy: anxiety itself becomes, as it were, “chronic” due to genetic factors or environmental conditions and can be expressed in several forms. nine0007

One form of "chronic" anxiety is adaptive anxiety disorder, in which a person experiences stress and tension while trying to adjust to a stressful situation. Here we are talking about adaptation to a new, unfamiliar environment or living conditions: the slightest changes cause feelings of panic, confusion, anxiety. Generalized anxiety disorder often accompanies diagnosed depression: a constant feeling of anxiety is inevitably associated with an irrational fear for one's life, work, and future. Finally, experts single out an anxiety-phonic disorder accompanied by panic attacks: fear of a large crowd of people, fear of death, fear of a serious illness, the threat of which in reality may not even exist - only part of the anamnesis of people suffering from this form of disorder. nine0007

According to the American Anxiety and Depression Association, about 40 million American adults suffer from an anxiety disorder. In Russia, there are 9 million such people. These are only diagnosed cases: the number of people who regularly experience anxiety, but do not turn to specialists, can be much higher not only in Russia, but throughout the world.

Increased Anxiety: Checklist and Problem Markers

American anxiety specialist Jill Weber in her book Be Calm divides the signs of anxiety into several criteria. They can be related to feelings, behavior or even thoughts of a person. The easiest way to define your own anxiety is precisely on the first point: emotions such as anger, irritability, sadness, feelings of hopelessness or despair can signal that you will experience anxiety. Feelings can be not only mental, but also physical: palpitations or indigestion, as well as dizziness are additional markers of anxiety that a person may experience. nine0007

Anxiety can also manifest itself in human behavior and negatively affect the quality of life. Giving up favorite activities that used to bring pleasure, avoiding meeting people or important work events are just some of the examples of how anxiety can affect the daily routine of a person. Because of anxiety, a person feels that he is no longer able to perform daily activities - go to groceries or drive a car, and even do things that are unusual for him, says Weber. For example, in a stressful situation, he may refuse to communicate with friends, even if he is in the same room with them. nine0007

Thoughts are also an important set of signals that a person is experiencing anxiety. They can manifest themselves in irrational attitudes - for example, the conviction that if you don’t return home now and don’t check the iron, then the apartment will certainly burn down, winding yourself up (constant concentration on the negative aspects of the probable future), self-abasement (diffidence in yourself and your own abilities) .

Accompanied by stress and fear, the listed symptoms directly indicate that a person experiences precisely an increased feeling of anxiety - this condition can be dangerous, because it directly affects many areas of everyday life. A sign of excessive anxiety can also be regular modeling of situations like “What if ...”: a person tries to predict the worst scenario for the development of events, which may not even be related to reality, and, therefore, worsen his condition, because thoughts in this case are constantly focus only on a supposedly inevitable and bad future. nine0007

However, the mere fact that there is a feeling of anxiety does not indicate any problem: it is important that it is not only compatible with the criteria described by Weber, but that it is in itself distinguishable from fear. It, unlike anxiety, comes from “real threats from the outside world” and is rather momentary: a person understands what caused it, and realizes that, having found a way out of a stressful situation, fear will come to naught. Anxiety, on the other hand, is based on possible events, it is irrational and may have nothing to do with the surrounding reality, but it risks becoming a problem if a person overestimates the likely threats. “Anxiety is natural and is an adequate response if provoked by fear of a real danger. But if anxiety negatively affects your life and health: it develops into constant tension, anxiety, or avoidance of certain contacts or situations, then it ceases to be justified, ”the psychologist writes. nine0007

Related material

Causes of anxiety and ways to deal with it

Stanislav Raevsky, a psychoanalyst and creator of the Anti-Panic therapy app, shares feelings of anxiety and anxiety. So, according to him, anxiety informs a person about a danger or threat to life, health or property that must be avoided. Anxiety is more likely a character trait of people in whom this anxiety is more often manifested and more pronounced. “Anxiety can be stimulated by situations that only in fantasy are a danger, but in reality they do not carry such a threat,” Raevsky says. nine0007

It is useless to drive away anxiety from yourself: if you close the door to your consciousness, it will come through the window, in your dreams or other symptoms and will only develop relatives, health and property. “Anxiety triggers can be different, the fact of the threat of war and the fear of it can be very strong - this is how it is in all of us,” the psychoanalyst emphasizes.

The media not only increase anxiety, but also exploit it. “Our psyche is so arranged that it is something terrible, disturbing that attracts us most of all. We are automatically included in this stronger than in some kind of sexual stimulus or food. We are interested in what can scare, so people cannot take their eyes off the conditional accident, the modern news feed consists of what exploits anxiety, what makes your anxiety turn on, ”says Raevsky. nine0007

“It is useless to drive anxiety away from yourself: if you close the door to your consciousness, it will come through the window, in your dreams or other symptoms, and will only develop. It’s just pointless to drive her away - it’s best to go to a psychologist, ”the specialist notes. However, in some cases, a person can overcome anxiety on their own, and Raevsky offers some tips for those who want to cope with this feeling on their own.

  • When dealing with anxiety, you do not need to calm yourself down. This rarely works out, so it's better, on the contrary, to imagine the worst thing that can happen, understand the consequences of this and accept them. If you are afraid that the current situation will hit your well-being, you need to think about how you can cope with this blow. By imagining a terrible situation and living it, we do not chase away anxiety, but, on the contrary, we accept it. nine0064
  • We worry not only with the head, but also with the body, so it is important to learn to relax and be aware of your breathing. It determines how much we worry. We breathe often - anxiety is present, we breathe evenly and calmly - it becomes less.

Raevsky and his fellow psychologists posted detailed instructions to help cope with anxiety in the Anti-Panic app. Breathwork will help you deal with panic, anxiety, and emotional stress, and experts suggest the following ways:0007

- through breath holding: slow inhalation - delay for 7 seconds - slow exit;

— by counting: while inhaling, count to yourself from one to four, repeat the same count while holding your breath and exhaling;

- through slow breathing: inhale slowly, exhale slowly, then hold for 7 seconds and repeat the steps.

Panic attack during anxiety is an absolutely normal and safe reaction of the body: you should not be afraid of it. It is important to remind yourself of this during such an attack: you need to say to yourself that the onset attack is not dangerous for your health, it will not last forever and will end in 20-30 minutes. When panicking, a person begins to breathe rapidly, so it will be effective to try to slow down breathing so that the blood is not oversaturated with oxygen and this does not lead to dizziness or numbness of the skin. After the attack, the psychologist recommends trying to analyze your emotions, trying to understand what exactly causes your fear, how rational it is, whether it can be realized right now - this will help you understand that what a person is afraid of will not happen at this very moment. It is important to write down the thoughts that are spinning in the victim’s head at this moment in order to analyze them again later. nine0007

Experts from the American psychological resource Mayo Clinic Health System also give their advice to those who suffer from anxiety. So, in order to defeat the regular feeling of anxiety, or at least reduce its severity, experts suggest:

  • increase physical activity - create a new habit of playing sports on a daily basis;
  • give up cigarettes or caffeinated drinks as they increase anxiety together with nicotine;