Do you often feel anxious or have times of panic? Does your anxiety overwhelm you or interfere with your work, friends, or family? If so, you’re far from alone. According to the National Institute of Mental Health (NIMH), approximately 19 million adults in the United States experience ongoing anxiety. It cuts across all ages, ethnicities, education levels, and socioeconomic levels. Most of us feel it at some point. Anxiety comes in many flavors; it may erupt only in social situations, manifest as an obsession or compulsion [1], as a specific phobia [2], or it may be generalized.
Below are signs of two types of anxiety:
- Generalized anxiety [3] symptoms: irritability/restlessness/worrying, muscle tension/fatigue, problems concentrating, sleep difficulties.
- Panic [4] symptoms: racing heart/trembling, fear of losing control or dying, shortness of breath/chest pains, chills/hot flushes (not due to peri- or menopausal phase), dizziness/light-headedness/nausea, numbness/tingling/sweating.
It’s common to feel embarrassed about your anxiety, to feel alone, and to keep it a secret. It’s scary to think of asking for help. You may have been feeling anxious for long enough that it’s hard to remember a time when you didn’t live with it. Your anxiety may feel like an unpleasant but “normal” part of you. You do not have to live with this ongoing pain: You’ll be reassured to know anxiety can be effectively treated.
Anxiety is caused by three overlapping events: a trigger or environmental cue (public speaking or party), mental reactivity (a negative thought/self-talk), and physical reactivity (breathing rapidly, clenching fists, etc.). These form a negative feedback loop, where one begets the other. In order to cope with their anxiety, most people avoid the trigger. Though avoidance helps in the immediate moment, it makes anxiety worse in the long term. Why? Two reasons: 1) It reinforces your belief that you’re helpless to deal with it, and 2) you don’t get positive experiences as basis for further success. Below are some basic strategies to help reverse the direction of the feedback loop, turning the dial from negative to positive:
- Consult your physician for a physical exam, including blood work, to rule out physiological causes—e.g., endocrinological imbalance such as hyperthyroidism.
- You need not suffer alone. Weighed down by anxiety, the burden of trying to deal with it alone makes it worse. Visiting a psychotherapist for guidance is optimal. If you cannot do this, confide in a trusted friend or family member. This will help ease any shame you may feel.
- Examine your thoughts about anxiety-provoking situations, such as going to a party. What are your thoughts and how do they make you feel? “They might not like me”; “I won’t know anyone”; “I won’t have anything to say.” Do you notice they’re negative, harsh, or critical? Ask yourself, “If a friend was voicing these doubts, asking for reassurance, what would you say to them?” You’d be encouraging, kind, empathic, positive, and balanced. “Even though this is hard for me, I’m not quitting; instead, I’m moving forward.” “I can meet new people and maybe make a friend.” “I can ask people about themselves.” “It’ll make me feel good to know I tried something new.” “I’m glad I’m trying my best—that’s the most I can ask of myself.” Apply this compassion to yourself. Repeat these thoughts aloud; write them as bullet points and read them throughout the day, record them on your smart phone as voicemail, or simply review them mentally. Remember: Keep your tone of voice soft and supportive, caring, patient, and kind!
- Pay attention to your physical sensations. Is your heart beating fast? Are your hands trembling? Do you feel hot? Are you sweating? To calm yourself, find a quiet place to sit. Place your hands on your thighs. Imagine a cooling breeze on your face and body. Visualize being pleasantly fanned. Murmur to yourself, “I’ll be OK, I’m doing the right thing and helping myself.” Closing your eyes, breathe deeply to a silent count of 10. Repeat. And again, until your diaphragm feels consistent. Your pulse will slow to a rhythmic beat. If you’re in a public space, excuse yourself to visit the restroom to practice these strategies. If you’re in a place without privacy, simply concentrate on your inhale and exhale. Repeat counting over and over. Nobody will guess you’re actively self-regulating your inner state!
- For mild/moderate anxiety, you can use a mindful approach. If you fight your anxiety, you’re making it the enemy, which builds a hostile energy between you and your symptom. Instead, befriend your anxiety. Try to be OK with its existence, and “sit” with the feeling. Hold it in your conscious awareness; you’re learning to observe it at a safe distance. By not participating in it, you’re not losing yourself. In doing this, most people report, “Whew, what a relief not to be held hostage to it; I don’t feel like a prisoner of it!” Where you were once in turmoil and anguish, with practice you’ll find oasis—soothing, peace, and calm.
- If you need more help, consult a psychiatrist for medication assessment. You may choose to use medications occasionally for severe anxiety, supplementing other therapy techniques.