ANXIETY | May 31
A New Guide for Managing Anxiety
“Everyone experiences anxiety, and everyone experiences anxiety in their own unique way.” That’s what Illinois-based licensed clinical counselor Julienne Derish told me when I started researching tips for managing anxiety.
This made a lot of sense. Anyone who’s tried to research tips for managing anxiety on the web knows that hundreds of websites, from the Anxiety and Depression Association of America to Buzzfeed, offer lists, infographics and more to help the 42 million American adults who live with anxiety disorders.
The amount of information overwhelming, and because anxiety is such a personal experience, there’s no knowing that what one person recommends online might work for another.
What we really need to enable healthy and productive anxiety management is advice from real mental health professionals. No self-proclaimed theories. No clickbait. No BS.
So we asked 15 mental health professionals for their tips on managing anxiety, and put it all together in a helpful guide just for you. Here’s what they told us.
15 MENTAL HEALTH EXPERTS SHARE TIPS FOR MANAGING ANXIETY
1. IL-based counselor Julienne Derichs, LCPC:
Anxiety is real and not all "just in your head." You may feel anxiety in your chest, hands, eyes, stomach. Everyone experiences anxiety, and everyone experiences anxiety in their own unique way.
Get to know your early warning signs that you are becoming anxious. Do you feel it? Do your thoughts start to spin? Do you have trouble sitting still? Just because you are feeling anxious doesn't mean that you have to act on the anxiety. Instead focus your thoughts on your breathing and repeat to yourself "this feeling will pass" and it will. Emotions aren't built to last.
- Breathe. Try the "relaxing sigh" breathing technique (often called the "instant tranquilizer"). Inhale through the nose, hold for just a moment, then exhale out slowly through your mouth and nose. Repeat two or three times. As you let the air out, let go! Relax your muscles. Release as much tension as you can.
- Move your body. Release those anxiety-fighting endorphins that are produced when you move. Better yet? Take a walk in a park or forest preserve. There is growing research evidence that contact with nature has significant mental health benefits. Even looking at nature has been shown to effective at managing stress.
- Try the “Grounding 54321” strategy: This technique works by taking your focus off of your anxious feelings and turning it to your surroundings. This distraction habit takes your mind away from your feeling of fear, anxiety and panic by bringing your focus back to reality. Here’s how:
-Name five things you can see in the room with you.
-Name four things you can feel.
-Name three things you can hear right now.
-Name two things you can smell right now.
-Name one good thing about yourself.
- Anxiety can increase when you focus on things you cannot control. For example: the future. Put problems into perspective by focusing on the present moment where, most likely, everything is just fine. Remember the ways you have had successes managing anxiety in the past. This builds a hopeful and confident outlook.
- Eat well balanced meals. Avoid overuse of alcohol. Drink plenty of water, and focus on doing your best. Remember, you don't have to be perfect. But your can take steps to care for yourself everyday.
- Create a bedroom that is ideal for sleeping. Cool, dark and quiet. De-clutter your space so that you create a peaceful room that you can fall asleep in. The average person needs at least seven hours of sleep for mental and physical health. Before you go into your bedroom at night, jot down what is on your mind so that you can set it down for tomorrow.
- Write a letter to anxiety. "Dear Anxiety, I want you to know..." It could be a thank you letter, or a goodbye letter, or a "This relationship isn't working for me" letter. Getting your thoughts down on paper gives you an essential perspective about your beliefs about the anxiety you carry around.
- Relax with friends, family, or your significant other. There are many relaxation techniques that you can do together, such as the relaxing sigh technique mentioned above.
- Try not to buy into the stigma of mental health issues. Be kind, be compassionate and greet yourself with empathy. Try to be a role model of healthy behavior, rather than criticizing irrational fear, avoidance or rituals.
2. LMSW and NYC-based therapist Kimberly Hershenson:
Everyone experiences anxiety at some point whether it's due to an upcoming interview or public speaking engagement, but it becomes a problem when your anxiety begins taking a toll on your mental and physical health affecting work and relationships. Here are some tips to help you deal with anxiety:
- Make a daily gratitude list before bed by writing down 10 things you are grateful for. Anything from your family, the legs to you have walk on, or even reality TV. Focusing on what is good in your life, as opposed to what is going wrong with your life, calms you down before going to sleep.
- Read affirmations daily. Starting your day with positivity helps you begin your day with positivity.
- Have a daily routine that gives you alone time, whether it's having some tea/coffee while reading the newspaper or stretching for 10 minutes in the afternoon. Doing something just for yourself every day is crucial to mental stress.
- Start a meditation practice. Search “guided meditation” on YouTube or download a free app (such as 10% Happier, which teaches you meditation techniques) and meditate - even if it's for only 5 minutes.
- Practice acceptance. Make a list of what you can control in the situation that is causing you anxiety (your reaction) and what you can't control (i.e. your boss' or coworker’s behavior). Focus on what you can control to make changes, and accept what you cannot control.
- Reach out for help. Whether it's a friend, family member or therapist. Let others know how you're feeling so you don't have to cope with anxiety alone
3. Synergy eTherapy founder Dr. Lisa Herman, PsyD, LP:
Mindfulness exercises are amazingly helpful and slow your mind and body down enough to perform at more of an optimal level during the day. Even with only two minutes, one can learn to find inner peace and calm.
Close your eyes, get comfy, breathe in for four seconds. Hold it, then blow out steady for four seconds. Focus on your breathing and feel your body move with your breath. When thoughts come into your mind, acknowledge them and let them go, only to re-focus your energy back on your breathing.
Another tip is to wait two seconds before answering a phone call to breathe, or wait before replying to a text.
4. NY and NJ clinical social worker Maureen Clancy, MSW, LCSW:
Tips for managing anxiety on a short-term basis:
- Get out of your head by getting into your body. Do something physical: Go for a walk, a bike ride, a swim or have a dance party in your kitchen with your favorite tunes cranking. This has wonderful grounding effect, deepens your breathing (which is typically shallow when you’re anxious), and interrupts the anxiety alarm in your brain.
- Smell something you love. This couldn’t be easier. Get something you love to smell, hold it a few inches from your nose, and deeply inhale. Rinse and repeat. This also deepens your breathing and turns off the fear-based anxiety signal in the amygdala part of brain.
- Distract yourself. Absorb your attention in something else. A movie, a good book, baking cookies or even cleaning your bathroom can give you a break.
- Tips for managing anxiety on a long-term basis:
- Learn and practice mindfulness. This has the amazing ability to change your relationship with anxiety from hating it and trying to stop it to a more neutral stance, allowing it to be as it is.
- Get into therapy with an expert. I’m in the business, so I can vouch for this. Working with someone to help you manage anxiety (and heal the underpinnings of it) has resounding beneficial effects on your life.
5. NYC-based mental health counselor Jor-El Caraballo, LMHC:
One of my tried-and-true, short-term interventions is to have clients practice mindful breathing. By engaging in intentional, diaphragmatic breathing, we can consciously move ourselves from a heightened state of “fight or flight” to a more relaxed state.
When we inhale for 4 seconds, hold that breath for 7 seconds, and then exhale for 8 seconds, we start to engage a part of nervous system connected to relaxation. Taking just a minute (or two) to practice this in moments of heightened stress may create more space to engage in effective problem solving in regards to the concern at hand.
A daily tip that I find most helpful for clients who struggle with anxiety: At night, right before bed, engage in problem solving rather than concentrate on worries and anxieties. If you experience anxiety at night and having difficulty falling asleep, get out of bed and jot down your worries.
For the situations that are most concerning, take an extra moment to write out one small step that you can take the following day to address your concern. This allows you to focus on problem solving, instead of just rumination, and also may lessen the stress due to creating a concrete step or plan to address your concerns.
6. High Point Treatment Center Chief of Adolescent Psychiatry Dr. Joseph Shrand, MD:
Recognize, rate, remember and reflect: What you think affects what you feel. This means you are and have always been in control of your anxiety, just thinking thoughts that make it worse!
- Recognize you are anxious, not try to distract yourself.
- Rate your anxiety between one and ten, with ten being panic.
- Remember that anxiety always goes away. Chances are you did not rate what you’re currently feeling as a ten, although you know what that feels like!
- Reflect on what you were thinking to begin with that made you anxious. For every negative thought you uncover, you can create an opposite, positive one to replace it.
7. Mental performance coach Meg Waldron:
I work with a lot of athletes who need to manage anxiety, and the first thing I do is explain what anxiety is: an imagined threat to a given situation. Then I teach them how that affects their brain's flight or fight response.
Anxiety is often a fear that something bad from the past will recur, or a prediction of something negative in the future will happen. Either way, learning to stay in the present moment is essential to managing anxiety. That same imagination about the past or present can be used to stay in the moment and calm that anxious part of the brain.
Preparation to avoid anxiety, which can hit anytime (but often peaks at a big competition), is key. Through mental rehearsal, my athletes can calm their minds enough to realize that just as anxiety and nervousness lives in them, so does calm, and they can access the calm when need be.
During mindful visualization, I have athletes think of a word or phrase -- like a mantra -- that they can use to reach a calm place when they need it most. One athlete I worked with used the phrase, "fuzzy blanket," to remind herself of a childhood blanket and the feeling of safety. Another athlete used a hand motion of turning down a dial before a race to mimic "dialing down" his anxiety, so he could better direct his energy to the task at hand.
8. Washington-based clinical social worker Rachel Baker, LICSW, CDP, MAC:
The first tip is to belly breathe. When we are babies, we breathe with our bellies. But as we grow into adulthood, we start taking short breaths from our chest. This is only exacerbated by anxiety.
When you feel anxiety creeping in, place your hands on your belly and take a few slow, smooth breaths, feeling your abdomen expand and contract. By doing this, three things happen: Our bodies are able to take in vastly more oxygen; the diaphragm presses on the vagus nerve that sends a signal to the brain to release serotonin, which instantly calms down the mid-part of the brain where anxiety lives; by placing your hands on your belly and focusing on the breathe our thoughts are brought to the present moment.
A great way to reduce anxiety is to recognize those out-of-control “What If?” thoughts and bring them back to the present by replacing the thoughts with “Right here and right now, things are ok.” Remember that the only thing any of us can control in the whole world is ourselves. When we put too much energy into things that are outside of our control, we end up feeling more and more out of control, which increases anxiety.
Make a list of all of the things you think you are in control of. Then go back through the list and cross off anything that is not directly related to you actions, thoughts or feelings. It's amazing how much shorter that list will be.
9. Sibly mental health coach Mackenzie Kelly:
- Schedule time for self-care. Try to find 30 minutes each day that you can spend on yourself, doing something that you love. This could be walking, meditation, yoga, tai chi, or anything relaxing. If you can't find 30 minutes, start with 10 and move up from there.
- Ground yourself. When anxiety hits, do something that keeps you in the present. Regaining your mental focus can help ease your anxiety. Start by saying who you are and where you are, or what you have done for the day and what you'll do next. (Example: “My name is ____. I am 30 years old. I am in my office in Texas. I woke up on time and made it to work. I am going to turn in this report to my boss, then I am going to walk back to my desk...")
- Stop what you're doing and listen. Notice what you can hear nearby. Move your awareness of sounds outward so you are focusing on what you hear in the distance.
- Get up and walk around. Take time to notice each step as you take one and then another.
10. NYC-based psychotherapist and Columbia University psychology professor Laurel Steinberg, PhD:
- Unplug from news sources if you have trouble coping with the state of the world. Read top headlines to stay generally informed, but don't get bombarded all day.
- Move your body every single day to get fresh air and endorphins flowing.
- Strengthen meaningful relationships so you feel part of something bigger than yourself.
- Understand that goals are things you work towards a little at a time, as efforts toward goal achievement are cumulative. Keep working in the right direction. (Success = Effort x Time).
- Celebrate beauty in the world and your life by asking yourself "What's right with this picture?" several times each day, and whenever when you sense anxiety.
- Try your best and engage in values-driven behavior at all times to keep yourself out of harm's way. If something doesn't feel right, it probably isn't.
- Work harder to master your craft so that you feel confidence in a job well done and so that you don't have to rely on financial support from others.
- Remember that you are just as worthy of love and good things as everyone else.
11. NC-based professional counselor Kayce Hodos, MEd, LPC, NCC:
Anxiety is very common in our society and is typically rooted in fear. It’s classic fight-or-flight response: Our brain perceives something as threatening and responds accordingly. Our senses are heightened, heartbeat quickens, breath becomes more shallow, etc. But it isn’t productive to tell yourself to stop feeling anxious! It’s natural to worry; the key is to not allow the worry to control you.
Start with behavioral strategies, such as breathing exercises or progressive muscle relaxation, to send your brain the message that we are not actually threatened. These techniques can be done virtually anywhere (at a desk, sitting in your car, etc.). You literally slow down your breathing by counting to five as you inhale, and then slowly exhaling as you count from one to 10. Repeat several times. Your brain will get the signal that your breathing is slowing down and that there is no threat.
Progressive muscle relaxation is simply clenching and releasing each muscle group starting at the top of your head and working all the way down to the tips of your toes. Close your eyes and focus on each muscle as you work through your body, spending more time on the places you feel most tense. Once your body is feeling more relaxed, you can begin to employ cognitive techniques that will help you change the way you think about the problems that trigger your worry.
12. MA-based psychotherapist Angela Ficken, LICSW:
Common symptoms of generalized anxiety disorder include worry and anxiety over everyday life events, often leading to a racing heart, constant negative thoughts, extreme difficulty changing negative thoughts or reducing physical symptoms.
- Just breathe. Take five deep breaths from your belly. Breathe in, belly expands. Exhale, imagine bellybutton to spine. Breathing will reduce physical symptoms. Take 5-minute breaks - give your brain a break. It will help reduce racing thoughts.
- Day-to-day activities for managing anxiety: Exercise, staying in contact with important people in your life (Getting coffee, texting, or talking on the phone). Stay connected, and do something kind for yourself.
- Long-term strategies for managing anxiety: Work on changing thought patterns that make you feel anxious. Just because you have a thought that makes you anxious does not mean it's true.
- Practice mindfulness: Breathing, taking breaks, and asking yourself what you need in that moment to help anxiety de-escalate. Get help by seeing a therapist who specializes in anxiety. There are many skills out there that are effective in treating anxiety.
13. Executive life coach and former Federal Bureau of Prisons psychologist Bruce Cameron MS, LPC-S, LSOTP, PA
- Any form of exercise is better than none.
- If it is a specific issue, issue think of the best case scenario, then worst case scenario. Plan on the middle.
- Go to bed earlier for a while to get restful sleep.
- Try yoga and/or meditation, if possible.
- Employ cognitive behavioral strategies (identify distorted thinking or values that fuel the anxiety).
- Distract yourself. Go for a walk, make a phone call, text a friend etc.
- Write a journal. Sometimes writing out your thoughts and feelings can help alleviate stress.
14. TX-based psychotherapist and group psychotherapist Dr. Charlotte Howard, PhD:
Anxiety is often a defense against feelings. The fastest way to relieve anxiety is to get in touch with what you are actually feeling underneath the anxiety and make space for that experience. The anxiety will relieve itself naturally as you are able to face and process the feelings you instinctively avoided.
Deep breathing is one of our most powerful tools in facing anxiety. Our brain takes cues about how relaxed or threatened we are from the speed and depth of our breath. If we allow our breath to slow and deepen, we can send our body the message we are safe and create relaxation.
Mindfulness (non-judgemental awareness of what you are experiencing) is one of the most researched and proven ways to combat anxiety. You can practice mindfulness through meditation or through the practice of noticing and accepting your present sensations as you go about your day. Mindfulness, particularly, helps in protecting you from becoming anxious about your anxiety. Instead of creating a vicious cycle, you embrace your anxiety and all its sensations through mindfulness.
Notice the way you talk to yourself. Talk to yourself with a loving, nurturing tone if you want to calm down -- just as you would soothe a baby in distress. People often talk to themselves in a judgmental and pressured way that would make anyone anxious. Loving yourself and caring for yourself is the foundation of a peaceful center that will make you resilient and robust in a world with many stressors.
15. Psychology Life Well director Dr. Michelle Barton, PhD:
In order to manage anxiety on a day-to-day basis, it's most important to gain insight to your individual symptoms. These symptoms are very difficult to identify and have so many different expressions, it is important to consult with a doctor or psychologist to help determine which symptoms you will need to target.
Once symptoms are identified, you will need to use tools to manage the associated changes resulting from the anxiety. Awareness of small changes in your body and intervention can help prevent the anxiety from taking over the day. Eating a balanced diet, sleeping well, and exercising consistently all help more than anything else including medication and psychotherapy. If you start the day by taking care of the most basic bodily needs, it makes a huge difference in the ability to regulate anxiety levels throughout the day, and I strongly believe it also improves self-esteem.
Deep breathing exercises are fantastic for addressing anxiety in the moment and long-term. Deep breathing exercises serve to help the body return to normal functioning allowing reduction in sensations associated with the physiological changes of anxiety.
Find clothes and food that you are comfortable wearing/eating on a regular basis and have them readily available. For example, every time I go to the gym I wear a pair of yoga pants, a tank top and hoodie. It's like my gym uniform, and it makes it easy for me to get ready for the gym every time because I know what I'm going to wear when I go. This also can apply for work and other activities that you know are coming up, to have things ready that you like and fit well so that's not an issue while preparing for the day. Things like this reduce the possibility of anxiety entering into what can be an otherwise simple and not emotion-based activity.
The best strategy for anxiety management over the long term is being consistent and maintaining the habits developed to manage the anxiety on a day-to-day basis. This can be difficult and in some cases routines dismantle slowly and maybe we skip the gym once one week, and then a couple of days the next week… A month later we find ourselves feeling anxious again. What changed, why, and how can we get back to that routine in order to maintain reduced anxiety, promoting wellness.
What To Do With These Tips For Managing Anxiety
There’s a lot of information in this list of expert tips for managing anxiety. Don’t get overwhelmed - just start small. Pick the top three-to-five strategies listed above that you think will be most effective for you to start with and start incorporating them into your lifestyle. Be patient with yourself. Research shows that it takes an average of 66 days for someone to form a new habit, depending on the behavior the person and the circumstances.
Another way to incorporate these tips for managing anxiety is to find a tool or practice that lets you combine multiple strategies into one. Take Stigma, for example. It’s a supportive community and app that hundreds of thousands of people use to manage anxiety, depression and other mental health struggles. Stigma allows you to write journal entries and track your mood, as well as connect with friends who face similar challenges - all of which are listed above as helpful tips for managing anxiety.
You can check out Stigma for free here. But don’t just take my word for it. Check out the 2,300+ four- and five-star reviews from Stigma’s engaged and supportive community of people who deal with anxiety and other challenges to see what others are saying.