How to Manage Anxiety

If you frequently experience feelings of worry, tension, or anticipate negative or disastrous outcomes, you may be suffering from excessive anxiety. While the exact causes of anxiety remain unclear, individuals dealing with this condition often share similar risk factors, such as having a family member with an anxiety disorder, having experienced trauma, or suffering from other mental health issues. Fortunately, a combination of appropriate medications, cognitive techniques, and lifestyle changes can help reduce symptoms and manage anxiety effectively.

Seek support from the community. Those with strong social connections tend to cope with life's challenges in healthier ways compared to those without such ties. Building a new social network can greatly assist you in managing your anxiety. You could join a local support group for people with anxiety, become involved in a Buddhist or spiritual organization, or spend time with close friends.

• The sense of connection and reassurance provided by others can have a significant impact on your overall well-being. Research has shown that older adults who lack social support are at a higher risk of mortality.
• Loneliness is more dangerous to health than obesity and can shorten life expectancy just as much as smoking 15 cigarettes daily. Therefore, it is essential to make time for social interactions.

Prioritize sleep. Sleep and anxiety are closely connected. Lack of sleep can increase anxiety, and anxiety can disrupt sleep. To regain control over your anxiety, aim for at least 7 hours of sleep each night. Use these tips to improve your sleep quality:

• Allow your body to adjust to a consistent sleep schedule.
• Turn off all electronic devices 1 hour before bed.
• Make your bedroom a comfortable and exclusive space for sleeping.
• Exercise, but not 2-3 hours before sleep.
• Develop a relaxation routine and stick to it each night.
• Use aromatherapy, such as lavender scent, to promote relaxation.
• Quit smoking (nicotine affects sleep quality).
• Go to bed at the same time every day.
• Keep your room cool and turn off all lights.
• Avoid caffeine after noon.
• Don’t eat right before bed.
• Get some sunlight each day.
• Avoid alcohol within 2 hours of bedtime.

Exercise daily. In addition to maintaining overall health, regular physical activity significantly impacts mental well-being. Physical activity releases endorphins, which are chemicals that bring comfort to the body. As a result, regular exercise can relieve stress and prevent you from overthinking anxiety.

• Doctors recommend 30 minutes of exercise daily, five days a week. Walking, running, rowing, or cycling – the choice is yours. Just make sure you pick an activity you can commit to.

Maintain a balanced diet. You may not realize the connection between the food you consume and your mood, but they are closely linked. Certain foods and drinks, such as refined sugar or caffeine, can worsen anxiety. Instead, focus on drinking plenty of water and eating a healthy, balanced diet including fruits, vegetables, whole grains, low-fat dairy products, and lean proteins.

• Always choose fresh, whole foods, including produce, fish, legumes, beans, seeds, whole grains, and healthy oils that benefit your nervous system. Avoid processed foods and snacks as they are harmful to brain health.
• Prebiotics and probiotics are essential for gut health. While supplements can provide these, they are also found in everyday foods. Eating fiber-rich fruits and vegetables boosts prebiotic intake. For probiotics, consume live-cultured yogurt, sauerkraut, kimchi, kefir mushrooms, tempeh, and kombucha tea.
• Numerous studies show a link between caffeine and increased anxiety. Caffeine has been proven to elevate anxiety, depression, and hostility. It’s best to avoid caffeine-laden foods like soda, coffee, tea (opt for decaf), and even chocolate.

Limit alcohol and other depressants. You may feel tempted to drink alcohol to soothe your anxiety, only to find it actually exacerbates the problem. It's better to find healthier ways to manage stress and anxiety. Try listening to music or calling a friend instead of turning to alcohol or cigarettes.

Take care of yourself. When fighting mental health issues like anxiety, you may become so focused on improving your condition and meeting responsibilities that you forget to regularly care for yourself. It's important to do something for yourself every day to alleviate stress. Make it a special part of your routine to look forward to each day.

• Clean your living space weekly, and make sure to pay your monthly bills on a set day.
• Set personal goals every day, whether it’s chatting with a friend, soaking in a hot bath, enjoying your favorite tea, or watching a comedy you love. Take time for “you.”
• Do whatever it takes to reduce stress, remembering that each person’s needs are unique.

Find a quiet space where you can be alone and free from distractions. Close the door if possible. As you become more accustomed to this breathing exercise, you'll be able to eliminate distractions and practice even when there are people around you.

Sit up straight. Whether sitting in a chair or cross-legged on the floor, find a position that is comfortable for you.

• While lying down is an option if necessary, sitting upright allows your lungs to function at their best, which is ideal for deep breathing exercises.

Support your arms. Place your arms on the armrests of your chair or on your thighs. This action will help relieve tension in your shoulders and aid in relaxation.

Slowly inhale through your nose. Take a deep breath in for 4 seconds through your nose. Your lower belly should expand as you inhale.

Hold your breath. Simply hold your breath for 1 or 2 seconds.

Exhale. Now, release all the air in your lungs through your mouth. You’ll hear a "whoosh" sound as the air leaves your mouth. Feel your belly contract as you exhale.

Pause for a few seconds. To prevent breathing too quickly, take a brief pause for a few seconds before continuing.

Repeat the process. Continue this entire process for about 5 minutes. Performing 6 – 8 breathing cycles per minute is enough to soothe anxiety. However, you should find your own rhythm that feels most comfortable for you.

Practice twice daily. You should practice deep breathing at least twice a day for five minutes each session.

• Remember, deep breathing isn't just for moments when you're feeling anxious. Daily practice will help you manage anxiety symptoms and combat stress.

Combine deep breathing with other relaxation techniques. Deep breathing can be practiced on its own or combined with other relaxation methods like meditation and yoga as a complementary treatment for anxiety.

Recognize cognitive distortions. Cognitive distortions are unhealthy and irrational thoughts that make feelings of anxiety or depression worse. Consider some common cognitive distortions below and see if they appear in your self-talk.

• All-or-nothing thinking: Viewing situations in black-and-white terms – either all good or all bad, with no room for nuances, complexity, or gray areas.
• Mental filtering: Magnifying the negative while dismissing the positive.
• Jumping to conclusions: Assuming others' negative reactions are due to you; predicting negative outcomes in the future.
• Magnification or minimization: Either exaggerating or downplaying the importance of a situation.
• Overgeneralization: Viewing a negative event as part of an ongoing pattern.
• Using “should” statements: Judging yourself or others based on what they “should,” “should not,” “must,” “need to,” or “have to” do.
• Emotional reasoning: Relying solely on your emotions – “I feel stupid, so I must be stupid.”
• Dismissing the positive: Undervaluing your achievements or positive qualities.

Challenge the validity of cognitive distortions. To break the cycle of negative self-talk, it's important to recognize when you're engaging in it and then actively challenge those thoughts.

• First, acknowledge the negative thought: "I know people are watching me and thinking I'm weird".
• Next, challenge that thought by asking one of the following questions:
  • What would I say to a friend if they said this?
  • What evidence supports that this thought is true?
  • What evidence supports that this thought is not true?
  • Am I confusing “possibility” with “certainty”?
  • Is this thought based on my feelings or on actual facts?

Focus on changing negative thinking. The core of cognitive restructuring is to recognize when you're having unhelpful thoughts, challenge their accuracy, and shift them into more positive and life-affirming ones. Adjusting negative thinking is a way to think more realistically and reduce feelings of anxiety.

• For example, the thought "Everyone is watching me and thinks I’m weird" can be reframed into something that boosts your mood rather than makes it worse. Try turning it into: "I don’t know why others are looking at me; it could be for good or bad reasons. But I’m always confident and proud of who I am."

Set aside a designated "worry time" of 30 minutes each day. Complete this exercise during this time each day. Make sure to schedule this away from your usual bedtime so that worries don’t interfere with your sleep.

Identify and delay your worries. Become more aware of your own anxiety by recognizing how it manifests in your body. If any thought causes tension, raises your heart rate, clenches your fists, or triggers other signs of nervousness, label it as anxiety. Then, when you notice yourself worrying during the day, identify what you're worrying about.

• If necessary, jot down a list of worries and remind yourself that you can address them later. Try to clear your mind and continue with your daily activities.

Review your worries during the designated worry time. During your designated worry time, don't just focus on the issue that is bothering you at the moment. Grab a pen and your list of worries, and try to tackle each one with a solution.

• Research into stimulus control therapy has shown that the four-step process – identifying anxiety, setting aside time to address it, recognizing and delaying it during the day, and brainstorming solutions – is the best method to minimize anxiety.

Understand that you have control over your anxiety and negative thoughts. Initially, trying to delay your worries may seem impossible. However, with practice, you'll realize that you can choose when and where you want to worry. Therefore, your anxiety doesn’t have to dominate your entire day.

Schedule an appointment with your doctor. If anxiety is affecting your daily life and hindering your ability to function at work, school, in relationships, or in other activities, it may be time to consult with a physician. Your doctor can perform tests and examinations to identify the source of your anxiety.

• In many cases, anxiety is not just a sign of a mental health disorder, but it may be a precursor to other health issues. Anxiety can be the first warning sign (or a side effect) of cardiovascular disease, diabetes, asthma, and even drug abuse or withdrawal.
• In other instances, anxiety could be a side effect of medication. You should consult with your doctor to determine if this could be the issue you’re facing.

Consult a mental health professional. If your doctor does not find any medical causes for your anxiety, you should seek a referral to visit a psychiatrist, psychologist, or therapist who specializes in diagnosing and treating anxiety disorders. A doctor may prescribe medication to alleviate symptoms, but many people find that combining therapy and medication is the most effective approach for managing stress.

Request a clear explanation of your diagnosis from your therapist. Simply saying that you have anxiety will not provide you with all the answers needed for recovery. There are several other disorders within the field of mental health where anxiety is a key factor in diagnosis. Your psychologist may assess your personal history, manage evaluations, and ask questions to determine which type of anxiety is affecting you.

• You may be dealing with an anxiety disorder, such as panic disorder, phobias, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or social anxiety disorder.

Work with your therapist to determine the best treatment method for you. While self-help techniques can be useful in managing anxiety symptoms, this condition should be treated by a professional. Depending on the type and severity of your disorder, a mental health expert will use one of three methods to treat anxiety:

• Prescription medications. Anxiety is often misdiagnosed as depression, as psychiatrists frequently prescribe antidepressants to improve anxiety symptoms. A class of drugs known as selective serotonin reuptake inhibitors (SSRIs) has been proven effective in treating anxiety. Other options include serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and tricyclic antidepressants.
• Therapy. Cognitive-behavioral therapy (CBT) is an experimentally proven method for treating anxiety, focusing on recognizing and changing the irrational thought patterns contributing to anxiety. Other potential therapies include exposure therapy, acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
• A combination of both approaches.

Be patient. People often assume they are failing treatment or that it’s not working because they don’t allow enough time for interventions to take effect. Additionally, it's important to understand that individuals suffering from anxiety may need to try several different treatments to find the one that works best for managing their symptoms.

• You might need to wait several weeks for a therapy appointment, so don’t give up.
• Remember that some medications take up to 8 weeks to show their full effect.