7 steps to manage anxiety

Anxiety is a feeling that many of us struggle to deal with. The way it manifests in the body and mind can be so uncomfortable ​that many of us compound our anxiety by becoming anxious about being anxious! However, there are a few simple ways that you can get a handle on things.

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Anxiety is a feeling that many of us struggle to deal with. The way it manifests in the body and mind is so uncomfortable that many of us compound our anxiety by becoming anxious about being anxious! We can easily end up with multiple layers of anxiety which seem impossible to peel off. However, there are a few simple ways that you can get a handle on things.

Before we start, it's good to think about the kinds of anxiety you experience. Anxiety can be low-level, so much so you may not even feel anxiety very much at all. But that doesn't mean it's not running the show from behind the scenes. Rarely feeling anxious may mean that you've got a handle on anxiety, but it can also mean that you are deep within your comfort zone, and that you don’t feel anxious because you make sure to avoid anything that carries the risk of feelings of vulnerability such as intimacy, change or challenge. Your difficulties in managing anxiety are just as profound as someone who is experiencing high levels on a daily basis but you have structured your life in such a way as to avoid dealing with it.

For others, anxiety can be loud and dominating. This is the case for those who are crippled by panic attacks and preoccupied by anxious thoughts on a regular basis. The experience of high anxiety can take a lot of the pleasure out of life and lead to feeling overwhelmed. With the regular experience of anxiety comes the fear of even more anxiety and the escalation into panic. Anxiety - and anxiety about anxiety - can come to dominate life.

Both of these ways of being affected by anxiety are extremely common. In fact, how we tend to experience emotions in general can be a tendency to be overwhelmed or to disconnect and avoid. We call this emotional dysregulation and it often comes from how our emotions were responded to when we were children. Some of us learned to shut down to avoid upsetting others, or because we knew others weren’t able to respond to our distress in a helpful way.Others found that rather than eliciting comfort, our distress caused our carers to become anxious themselves. They responded to our anxiety with their own anxiety, so weren’t able to help us regulate our emotions (i.e. moderate them down). It’s very often the case that people have particular emotions that they are uncomfortable with, whether it’s anxiety or anger or sadness, and when that’s the case, it’s hard for us to help other people manage that particular emotion as well.

Here we’re not trying to get rid of anxiety. It serves a very important purpose. Instead, we want to work on recognising when your anxiety is helpful or unhelpful, and when it is unhelpful, develop flexibility in how you respond so you don’t end up stuck feeling either emotionally overwhelmed or emotionally disconnected.

Make friends with your feelings

Anxiety can be good for us! Let’s not think of it as the enemy. It’s our friend, but a friend that’s often stuck in the past. We need to know the difference between anxiety that is healthy and appropriate and anxiety that is disproportionate and destructive.

If we feel anxious it could signal that we're at the edges of our comfort zone. Going to the edges is how we expand our comfort zone and is therefore often a good thing for us if we’re trying to learn and grow. If we stay deep in our comfort zone, our comfort zone stays small. As we push at the edges gradually (without going way outside and freaking ourselves out) we continually shift ourselves into a wider tolerance of discomfort. We are uncomfortable for a while but the result is being more comfortable in the long run. An example would be giving presentation in front of a group of people for the first time. You feel anxious because this is not yet within your comfort zone. After ten presentations, it doesn't bother you. When you feel that twinge of fear at trying something new and uncomfortable you are extending yourself. It’s how you grow. It's normal to feel anxious in these contexts and you don’t need to give yourself a hard time about that. Doing something outside our comfort zone by definition is uncomfortable. You don’t need to add to the discomfort by telling yourself that there’s something wrong about having it. Instead, notice it and remind yourself it’s just a sign that you are doing something courageous and be proud of yourself.

Another positive version of anxiety is when it’s telling us something. The idea of anxiety is to alert us to danger and sometimes there really is danger and our anxiety is helpful to warn us to the fact so we can take precautions that keep us psychologically or physically safe. You’ve probably heard of the fight or flight response. It’s where our body gets into the physiological state to deal with imminent danger, usually (as the name suggests) by fighting or fleeing. This is helpful when we really are in danger. The problem though is that very often the risk assessment is flawed. Most unhealthy anxiety arises from over-stating the risk. How to know the difference is something we’ll cover later. But in the example above, our anxiety when we approach a new situation like giving a presentation can be useful to us. It reminds us that we are stretching into new territory and to keep ourselves psychologically safe we may need to take steps such as doing lots of preparation and practising so that we are as ready as we can be.

Relate to your anxiety in a new way

So it’s a good thing to be attuned to our anxiety when it's appropriate and proportionate. What about when it’s getting it wrong? When it’s responding in an out-dated way? Many of our anxiety responses were established when we were children. When we were children we really did need protecting as we weren’t able to look after ourselves. Sometimes our anxiety forgets that we are all grown up now and tells us to be careful even though as adults we have many more resources – including psychological resources – to protect ourselves. You'll probably notice that when you are anxious you feel very young.

In such a situation what you need to do is reassure that anxious child in you. The bit that's freaking out is like a little child version of yourself. How do you talk to that child? I'm guessing you say things like 'Shut up!' Hmm. Telling yourself off and giving yourself a hard time is unlikely to work. Talk to that bit of you in a loving way exactly as you would a small child. Acknowledge how it feels, give some reassurance. I remember as a little girl being frightened that a monster lived under my bed. Probably someone told me that was the case. You probably have similar memories of childhood fears. What would you say to your five-year-old self now when it's worrying about the monster under the bed (or whatever your example is)? You'd probably say something like: 'Wow, I'd be scared too if there was a monster living under my bed, but the good news is there is no such thing as monsters and also we can have a look under the bed and see for ourselves that there's nothing there!'

Now when you have an irrational fear in the present, remind yourself that it's basically the equivalent of the monster under the bed. The grown up in you needs to talk to the child in you and let you know the real story. BUT, the grown up you needs to also remember that regulation of emotions involves acknowledging the emotion rather than dismissing it. So, the starting point for responding to your inner self has to be to acknowledge the emotion and its validity, before shifting away from it.

Acknowledge but don't buy in...

The problem comes when we hear the anxious part of us and rather than responding from our more adult self, we BUY IN to what it's saying. That means we, as fully functional adults, effectively sitting down with a five year old who is claiming there's a monster under the bed and saying: 'I think you might be right.' When you’re having an irrational thought, recognise that it’s irrational and remind yourself that this is only another version of the monster under the bed.

Part of the reason we buy into our anxiety is because it 'feels' right, i.e. ‘I just have a feeling that something isn't right.’ Ask yourself: How reliable has that feeling been in the past? How many times in the past have you had this 'hunch' and it not been correct? Assuming the answer is a lot, then you need to re-evaluate. That feeling doesn’t mean what you think it means. Having the 'feeling' that something bad is going to happen doesn't mean something bad is going to happen. There is no relation between the feeling and a bad thing happening. It’s just a feeling.

Notice and let it pass

By all means when you have a feeling be curious about it, notice it. But then let it pass. When we have the anxiety feeling, we often attach ourselves to it and get busy worrying. Why do I feel like this? When is it going to stop? What if it gets worse? What if it’s the start of a panic attack? Instead, allow the feeling to just ‘be.’ It will pass. You do not need to engage with it. It’s something from the past that we recognise might pop up from time to time as it does for all of us. We might want to respond with curiosity and wonder about it. In this situation, minimise how much you engage with it. It’s like anxiety your old childhood friend wants you to come out and play. You don’t need to go running off together.

What about when anxiety isn't irrational?

Sometimes we are dealing with something that is genuinely risky rather than an irrational fear. While our fears are often disproportionate to the risk (such as fear of flying) what if you’re dealing with something that is genuinely high stakes? How do you manage your anxiety in those circumstances? Remember that anxiety is there to remind us to be vigilant. Once you have learned what it is there to tell you (such as doing lots of preparation for an interview or performance) you do not need to hold on to it. Whilst the initial anxiety is not unhealthy, maintaining it and growing it is not helpful. Think of your anxiety as a plant. Ask yourself: What am I doing to keep this thing alive? Chances are you are either filling your head with negative self-talk or imagining things going wrong. These are like sunlight and water to the plant that is your anxiety. Keep going like that and just see how it grows. BUT, the upside is your anxiety cannot grow in the absence of negative thoughts and images. So use your imagination to serve you in your goals by mentally rehearsing things going right and giving yourself a pep talk. Think of your confidence like another plant. Positive self talk and images are food and water to this plant! Grow your confidence rather than your anxiety!

When you're calm, reflect

So when you're worried about something irrational, what's behind that fear? To find out, ask yourself the question: If this thing I'm worried about came true, so what? The answer to this might reveal the fear behind the fear. Irrational anxiety can be thought of as the manifestation of the fear behind the fear, the way it makes itself felt. When we unpick it, it often boils down to something existential, like uncertainty (lack of control), mortality, being alone. We may not sit around worrying about uncertainty; instead we may irrationally worry about a bomb going off. We may not sit around worrying about death, but we may find ourselves paranoid about every ache and pain in our body. We may not worry about being alone, but we may often find ourselves preoccupied by the idea we have caused offence or been disapproved of. Getting under your fear lets you know the BIG fear underneath which it is your job to live with. Living with the big stuff is a job for life; part of the challenge of being human in this world involves living with uncertainty, mortality, aloneness, meaninglessness. The idea is that they are a backdrop and not front and centre too much of the time. If they are front and centre too much it’s unlikely you will feel good. But equally it’s no good to avoid these things altogether. If you can get your head around these issues, then you’ve gone a long way towards dealing with anxiety.

Don't forget the practical stuff

I've focussed here on dealing with anxiety in terms of what goes on in your head. There are also plenty of other practical things you can do to support yourself to reduce your anxiety. Exercise, meditation, mindfulness, yoga, and a good night's sleep all contribute to reducing activation of the amygdala - the part of the brain that is responsible for triggering the fight or flight response - meaning you can support yourself in these ways to be less prone to an anxiety response.

This is a brief self-help guide to give you some pointers in the right direction. If you want to work on this more, therapy can help! You can find me at www.sallyhiltontherapyonline.com.

Sally Hilton

I am an Integrative psychotherapist with 10 years experience of working with clients on issues including anxiety, depression and relationship problems. I work with clients from all over the world via my online practice offering psychotherapy via video call, voice call, email and instant messaging. I can be found at www.sallyhiltontherapyonline.com.