How to Manage Your Anxiety: Strategies and Techniques
Anxiety is what we experience when we are afraid, worried, stressed or tense. Anxiety is a normal human response to situations in which we feel under threat or under potential threat. Anxiety is usually about the future and around uncertainty and unknown.
As humans, it is natural to worry about different things, and we all get caught up from time to time into negative thought loops that trigger our anxiety response and the experience of anxiety symptoms.
You might also have heard of what is called high functioning anxiety, a colloquial term used to describe individuals who experience anxiety but able to use it to motivate themselves and move towards their goals. These individuals might look very composed and calm on the outside but feeling very anxious on the inside.
In that case anxiety might not necessary be perceived so much of a problem, but an aspect of their personality that they can manage and use to their advantage. However, if the anxiety and worry become excessive, thus begins to interfere with our day-to-day life and normal functioning, it can create a lot of stress. This can also stop us from reaching our goals, keeping us from living the life we want.
What is the relationship between worry and anxiety?
There is significant research on the relationship between anxiety and worry. Worry was primary described and thought of as a central feature of generalised anxiety disorder (GAD), however new research contributed to consider worry as transdiagnostic feature (Kertz, Bigda-Peyton, Rosmarin, & Björgvinsson, 2012), a feature prominent in a variety of mood and anxiety disorders (Olatunji and colleagues, 2007). The way we think affects our behaviours and this will inevitably affect our mood and quality of life.
Therefore, learning to manage our worries and not spiral, it is an extremely powerful thing we can do to take care of ourselves and feel in control of our lives. Managing our negative thoughts will prevent in most cases the activation of our anxiety response, thus the experience of unpleasant anxiety symptoms and sensations, such as tight chest, difficulties breathing, increased heart rate and strength of beat, sweating and others.
Worry, anxiety symptoms and anxiety disorders
Constant worry results in unnecessary stress, wasting time and energy over things or situations that we can’t control or that will never happen. If we describe the ‘worrying process’, the first step is often characterised by the presence of negative thoughts followed by what we usually call as feeling worried or anxious.
These feelings manifest both mentally as well as physically, while mentally they can appear as worry loops, in the body they may manifest as shortness of breath, heart racing, feeling ‘restless and fidgeting’ muscular tension and many others.
In fact, when we perceive a threat -it does not matter whether the threat is real or imagined- the body triggers a domino reaction of hormones that impact many different systems in the body, from our metabolism to attention. This is to prepare your body for action and to respond to danger, a built-in important mechanism to ‘keep us alive’.
However, it is central to not unnecessarily activate our ‘anxiety response’ because a prolonged and excessive activation can have a detrimental effect on our health and wellbeing given the physiological mechanisms that are activated in our nervous system.
It is important to distinguish whether our worries are ‘justified and constructive’ or when they may become overgeneralised and excessive. If we realise that we worry about ‘everything’, that every situation we find ourselves in result in us getting stuck in worry loops, there are several things we can do to stop that as you can read below in the article.
Anxiety symptoms can vary from individual to individual, however there are general core features for different anxiety disorders. There are distinct types of anxiety, worry can be specific or general depending on the type of anxiety you are struggling with.
You might have come across different anxiety disorders such as panic disorder, characterised by the unpleasant experience of panic attacks, obsessive compulsive disorder (OCD) characterised by intrusive and obsessive thoughts and compulsive behaviours that are often difficult to control, specific phobias, health anxiety, social phobia, separation anxiety disorder, agoraphobia, and selective mutism.
Each of these has specific characteristics. For instance, if you struggle with social anxiety, you might be worrying about all the situations in which other people are present, all your social interactions may become quite difficult to cope with and the worry is generally related to fear of a negative evaluation by other people. The kind of worry present in social anxiety might be something like ‘what if I made a fool of myself? What will they think of me now that I said that?’
If you suffer from general anxiety disorder (GAD) instead, the worry might encompass all domains of your life, and thus is less about the ‘specific content’ of the worry and more about the ‘quantity’ of the worry.
Anxiety and thinking errors
There are several cognitive distortions that in psychology are known as thinking errors or thinking traps. These are very often responsible to contributing and maintaining your anxiety.
In fact, anxiety and thinking errors are very closely tied together. Every one of us will use one –or more- thinking errors from time to time; however, these are significantly more present in individuals who suffer from an anxiety disorder.
Real life strategies to let go of your worries
1) Identify your worries, start a journal!
The first thing to identify is the nature of your worry, whether it is focused on specific situations/people. This might seem easy to do, however, because our ‘patterns of thoughts’ have been with us usually for an exceptionally long time, thus have become ‘normal’ it might be harder than you think to recognise what is the thought that triggered your anxiety and why.
Further, if we panic or spiral out of control, which is quite common in cases where the worrying is excessive, identifying the original worry might be quite difficult.
Thus, it is helpful to write down your worries on a journal and write these exactly how they sounded in your mind. For example, ‘I will fail my presentation tomorrow’; then, write next to the worry what were you doing when the worry came, e.g., where were you, who were you with; then write what emotions is attached to that thought e.g., sadness, fear, anxiety etc, finally write an alternative and more balance perspective of that thought.
If you find difficult to identify your thoughts, start with identifying the feeling instead. For instance, write in your diary every time a strong feeling comes up or you notice a change in your mood, whether you feel sad, angry, anxious, and so on, and then write down the thought that came immediately before that feeling and the rest as before.
Writing down your worry thoughts has distinct functions. First, it helps to ‘map your thoughts’ and recognise any specific pattern, for example if the same content is coming up every time, or if your worrying is triggered by a specific situation instead e.g. being with friends/work.
Second, it helps your mind to ‘slow down’ that automatic response and with time, make this automatic thought response into a non-automatic one, one that you are more able to control, as at present it might seems like you do not have any other choice but to worry.
Third, it also helps with ‘stepping back’ and finding an alternative and more balanced perspective that can be achieve in different ways depending on the nature of the thought. Some of the most common strategies to develop a more balance perspective are ‘looking at the bigger picture’, ask yourself what would you say to a friend who had a similar worry and apply that view and reassuring tone of voice towards yourself, or ask yourself: is my reaction in proportion to the actual event?
In most cases, providing an alternative more balanced perspective, helps defuse the intensity of the original worry.
Finally, it helps putting the thoughts out of your mind and on a piece of paper.
2) Define if the worry is real or hypothetical
Another helpful strategy to stop your worrying, is asking yourself if the worry is real or hypothetical.
If the thought is hypothetical, for example if it starts with ‘What if’ -in psychology we call this catastrophising- probably we are falling into one of the most common thinking traps. When we ‘catastrophise’ we are entering a realm that is no longer linked to reality. It usually involves considering only the worst-case scenario. If left unchecked this thinking error can significantly impact on your mood and self-confidence. This is a very pessimistic view on things and is very unproductive.
Catastrophising is only one of the thinking traps in which we might fall that contributes to create or to maintain the worrying going, thus also maintaining our anxiety and anxious responses. Therefore, recognising which thinking trap we ‘fell into’ is the first step in knowing how to step out of that trap and get in touch with reality again.
One of the biggest secrets that we all keep forgetting when our worrying becomes excessive and insistent is that worries are just thoughts, no realities!
If the worry is real, and thus linked to a real situation that causes concern, you can then apply your problem-solving skills and find the best strategy that will allow you to solve your problem. Once you have your plan, you can put your worries aside as you have actionable steps to take!
3) Identify the thinking error that maintains or creates your anxiety
Here are some of the most common thinking errors that can fuel our worry and anxiety and what you could do if you identify any of these thinking errors:
Black-and-White Thinking: this occurs when you are thinking in terms of extremes, using often words as ‘never’, ‘always’, when something you did it’s either perfect or a failure.
Solution: Find the grey area! Remind yourself that there is a sea of outcomes in between perfection and failure. If you use terms as always or never, can you think of an exception?
Challenge your thinking error, ask yourself: is this really that bad? Are there other ways in which I can look at this situation?
Fortune Telling: This occurs when you jump to conclusions, and you are convinced you already know the negative outcome and there is nothing you can do to change that. When you say things like ‘I know I will make a full of myself tomorrow’
Solution: Step back and get in touch with the actual reality again, you don’t know how things are really going to go, so ask yourself: How do I know this is going to go this way?
Mental Filter: This occurs when you disregard the positive and focus only on the negative of a situation. You have ‘a filter’ where all you can see is the negative side of things, missing the actual positive aspects. You might risk of regarding a situation that is overall positive, as a negative just because you only see the few negative aspects and increase their relevance and importance.
Solution: Ask yourself, what are the positive aspect of this situation? And focus on the facts rather than on your interpretations of these.
Should Statements: This occurs when you talk to yourself using ‘should’ or ‘must’ and it is not how you actually behave or feel. For instance, you might recognise phrases like ‘I should never do anything wrong’ or ‘I should not feel scared’. Using this thinking error leads you to feel constantly disappointed and probably increasing your anxiety as you ‘should’ be different from how you actually are/feel or behave.
Solution: Remind yourself you are human! Accept and allow your feelings as they are. Remind yourself that there is nothing wrong with feeling scared or making a mistake. By giving yourself permission to be human, the pressure and thus the anxiety you feel will dissipate with time.
Overgeneralising: This occurs when you develop a wide generalisation out of an isolated, single situation/incident. For instance, if you fail one exam, you might start thinking that you will fail all your other exams.
Solution: Remind yourself that just because a negative situation occurred once, doesn’t mean it will occur again.
You can probably see how these thinking traps contribute to maintain your anxiety, limit your potential and risking of creating ‘a self-fulfilling prophecy‘ instead - Yes, these cognitive distortions are that powerful!
As you can imagine you can also use your thought journal to identify the thinking errors responsible for maintaining your anxiety, just write next to your worry the type of thinking error. Once you identified which one it is, remind yourself that these thinking traps are most likely irrational, no likely to be linked to any reality and are exaggerated. Thus, there is most likely no good reason to engage with or believe them!
These are just a few of the most common cognitive distortions we use.
4) Establish your worry time
When we spiral out of control and feel that worrying is taking a lot of space in our mind as all we do is worrying, we do not feel in control and might feel quite powerless to ‘make it stop’.
Now, the more we try to stop a worry, the more it will come back to us. For instance, if I say to you, ‘don’t think of a pink elephant’ most likely all your mind wants to do is thinking about a pink elephant, and you will notice this thought keep popping up in your mind! So instead of pushing the thoughts away or try to stop the worrying, we reduce the amount of time we spend doing so.
One helpful strategy to do this, is to establish a ‘worry time’ that is 15-20 minutes each day, entirely dedicated for worrying. That is all the time you can worry in a day, so every time that a unhelpful/hypothetical worry pops up during your day, you need to postpone it to your worry time instead of engaging with it. It might not be easy at first, and there are strategies that can help you do that - for instance mindfulness can be an effective one- but the more you do this, the easier it will get. So, once you establish the daily time and the place for your ‘worry time’ you are set to go!
You will probably notice that when you get to your worry time you do not find anything to worry about or very little and not as extreme as if you had engaged with it when the thought originally came. That is the all point. You begin to ‘control’ the worry rather than let the worry control you, popping up when no wanted at different points in your day and distracting you from the task at hand.
5) No control box technique
When the worry comes, ask yourself: can I control this? Is there anything I can do to affect this?
If the answer is YES, turn your problem-solving mode on and create a plan, but if the answer is NO, then put the worry ‘in the box’. Every time the thought pops up again –and it will- you need to continue putting it back in the box.
The aim of this exercise similar to worry time is to no engage with the thought in the first place, as it can be an extremely attractive hook for our anxiety. Like worry time, might be quite difficult at first, but the more you practice this, the more your mind will find easier to do so. Some people only visualise to put the thought in the box. Others, find helpful to write down the thought in a piece of paper and literally put it in a box or somewhere that represent the box. That is up to you.
What therapy can be helpful in treating anxiety and worry?
Cognitive Behavioural Therapy (CBT) can be an effective therapy in the treatment of anxiety disorders and can be helpful in developing an understanding of what thinking errors we use and how to challenge and manage these. However, longer term therapy such as Psychodynamic Therapy can be extremely helpful and effective in the treatment of anxiety.
Worry can be very unpleasant and significantly impact our quality of life and sense of self, fuelling and maintaining our anxiety. If not treated, and left unchallenged, our worries can spiral out of control and leave us feeling very anxious. It is very important to look for help from a qualified therapist that can help you manage and challenge your worries and reduce your anxiety.
References
Olatunji BO, Cisler JM, Tolin DF. Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review. 2007;27:572–581
Kertz SJ, Bigda-Peyton JS, Rosmarin DH, Björgvinsson T. The importance of worry across diagnostic presentations: Prevalence, severity and associated symptoms in a partial hospital setting. Journal of Anxiety Disorders. 2012;26:126–133.
