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Chronic anxiety can be debilitating if left untreated. The stress of it affects not just your mental health but your physical health as well.
Fortunately, anxiety has been extensively researched over the last few decades. While we can’t yet prevent excessive anxiety before it starts, we do have a pretty good idea of what interventions will help reduce it over time.
Let’s take a look at how to overcome anxiety both on your own and with the help of a healthcare professional.
What is anxiety?
Anxiety is the feeling of fear that your mind creates when it judges you might be in danger. This response helped your ancestors survive predators in the past, but sometimes your brain can overestimate the amount of threat a situation poses in the present day (Chand, 2020).
Researchers aren’t entirely sure why our brains trigger this unnecessary fight or flight response. Over time, this excessive alarm can lead to an anxiety disorder (Chand, 2020).
A 2019 survey found that over 15% of adults in the United States reported experiencing anxiety in the last two weeks before the survey (Terlizzi, 2019).
The percentage of adults who experienced some form of anxiety was highest among those aged 18–29 and decreased with age. Women were more likely to report experiencing anxiety than men (Terlizzi, 2019).
What causes anxiety?
Researchers don’t know what exactly causes anxiety disorders, but they think it involves a complex interaction of biological and social factors. Your genetics interact with the stressful or traumatic situations in your life to cause symptoms that can sometimes interfere with your physical and mental wellness (Munir, 2021).
Factors that can influence your level of anxiety include (Munir, 2021; Chand 2020)):
- Medical health conditions
- Substance abuse
- Childhood experiences
- Medications or supplements
- Your current job or home life
These factors all cause changes in your brain and nervous system, some of which can lead to mental illnesses. These are changes in the neurotransmitters that your brain uses to send messages and changes to the structures in your brain that control fear (Chand, 2020).
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How to overcome anxiety
Every person’s anxiety is unique, so there is no one right way to overcome it. In general, here are some methods that have been scientifically shown to help calm anxiety symptoms.
1. Grounding techniques
Grounding techniques are coping mechanisms that help you connect with the present moment and surroundings, pulling you away from negative thoughts, anxiety, or flashbacks. When used for anxiety, these techniques can be brief, such as taking a few deep breaths, or more formal exercises, such as a mindfulness meditation routine. They often involve the use of the senses or physical activity (de Tord, 2015).
Grounding skills can be emotional, physical, social, or sensory. They may be beneficial, especially in cases of (de Tord, 2015):
2. Breathing exercises
There are many different forms of deep breathing exercises. One commonly used is Box Breathing. It is particularly helpful with relaxation and doesn’t require a calm environment to be effective. You can perform it even if you are in a social situation since it’s not something anyone else would notice. During Box Breathing, you visualize a box with four equal sides and perform the exercise (Norelli, 2021):
- Breathe in through the nose for a count of 4.
- Hold your breath for a count of 4.
- Breathe out for a count of 4.
- Hold your breath for a count of 4.
Repeat for as long as needed to calm down.
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3. Progressive muscle relaxation (PMR)
PMR is a relaxation technique targeting the physical symptoms of muscle tension associated with high anxiety levels. It involves progressively tensing and releasing the muscles throughout your body. The main focus is on the release of the muscle as the relaxation phase (Norelli, 2021).
You can practice PMR individually or with the support of a narrated guide. Be sure not to tense your muscles to the point of physical pain and take slow, deep breaths throughout the exercise. Here’s a sample routine (Norelli, 2021):
- Sit or lie down comfortably in a space with minimal distractions.
- Starting at your feet, curl your toes under and tense the muscles in your foot. Hold for 5 seconds, then slowly release for 10 seconds. During the release, focus on releasing tension and experiencing relaxation.
- Next, move your attention up to your lower legs. Tense the muscles in your lower legs. Hold for 5 seconds, then slowly release for 10 seconds. During the release, focus on alleviating tension and feeling relaxed.
- Tense the muscles in your hips and buttocks. Hold for 5 seconds, then slowly release for 10 seconds. During the release, focus on letting the tension go and relaxation to flood the area.
- Tense the muscles in your stomach and chest. Hold for 5 seconds, then slowly release for 10 seconds. During the release, focus on fully relaxing these muscles.
- Tense the muscles in your shoulders. Hold for 5 seconds, then slowly release for 10 seconds. During the release, focus on relaxing the muscles completely as you fully let go of the tension.
- Tense the muscles in your face (e.g., squeezing eyes shut, scrunching up your nose). Hold for 5 seconds, then slowly release for 10 seconds. During the release, alleviate the tension by relaxing completely.
- Tense the muscles in your hands, creating a fist. Hold for 5 seconds, then slowly release for 10 seconds. During the release, pay attention to completely releasing the tension in the area.
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4. Guided imagery
Guided imagery is a type of relaxation exercise that can help you overcome anxious feelings by visualizing a calming environment. Imagining a tranquil setting can help distract you from anxious or intrusive thoughts (Norelli, 2021).
Often used as a part of psychotherapy, you can also practice it with the aid of widely available apps, podcasts, videos, or even just on your own. The basic premise is that you imagine a setting and use all five senses to create a sense of relaxation and wellbeing. An example of guided imagery might include the following (Norelli, 2021):
- Sit or lie down comfortably in a space with minimal distractions.
- Visualize a relaxing environment by either recalling one from memory or creating one through imagination (e.g., a day at the beach).
- Imagine various elements of the environment using each of the five senses using the following prompts:
- What do you see? (e.g., deep, blue color of the water)
- What do you hear? (e.g., waves crashing along the shore)
- What do you smell? (e.g., fruity aromas from sunscreen)
- What do you taste? (e.g., salty sea air)
- What do you feel? (e.g., the warmth of the sun)
- Sustain the visualization as long as needed or able, focusing on taking slow, deep breaths throughout the exercise. Focus on the feelings of calm associated with being in a relaxing environment.
Psychotherapy: everything you need to know
Cognitive behavioral therapy (CBT) is a short-term, structured psychotherapy often used to treat anxiety. In CBT, you and your therapist work together to identify and modify cognitions (patterns of thinking) and behaviors. Over time, this can lead to positive changes in your mood and improved quality of life (Chand, 2021).
Initially developed in the 1960s, CBT has become the most extensively studied of all mental health therapies. Evidence-based research shows CBT is very effective at helping participants learn how to overcome anxious thoughts (Chand, 2021).
6. Anti-anxiety medications
Some people struggling with anxiety may benefit from trying medication to manage their symptoms. Your healthcare provider can help you select a medication based on your personal health history and experiences with anxiety (Bandelow, 2017).
Several medications have been proven to help manage the symptoms of anxiety. These medications can be used alone or in combination with cognitive behavioral therapy (Bandelow, 2017):
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Buspirone (Buspar; see Important Safety Information)
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When to see a healthcare provider
Not everyone needs outside help for their anxiety. If your symptoms are only mild or occasional, relaxation or grounding techniques might be enough for you. However, if your anxiety starts interfering in your daily life, school, work, or relationships, you should reach out to a healthcare provider or mental health professional. They can help you access effective treatments to help you overcome anxiety.
- Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107. doi: 10.31887/DCNS.2017.19.2/bbandelow. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28867934/
- Chand, S. P. & Marwaha, R. (2020). Anxiety. [Updated 2020 Nov 29]. In: StatPearls [Internet]. Retrieved on Aug. 27, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK470361/
- de Tord, P. & Bräuninger, I. (2015). Grounding: theoretical application and practice in dance movement therapy. The Arts in Psychotherapy, 43, 16-22. doi: 10.1016/j.aip.2015.02.001. Retrieved from https://www.researchgate.net/profile/Iris-Braeuninger/publication/275208604_Grounding_Theoretical_application_and_practice_in_Dance_Movement_Therapy/links/5b180ca50f7e9b68b41fc59f/Grounding-Theoretical-application-and-practice-in-Dance-Movement-Therapy.pdf.
- Munir, S. & Takov, V. (2021). Generalized anxiety disorder. [Updated 2021 May 8]. In: StatPearls [Internet]. Retrieved on Aug. 27, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK441870/
- Norelli, S. K., Long, A., & Krepps, J. M. (2021). Relaxation techniques. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Retrieved on Aug. 27, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK513238/
- Terlizzi, E. P. & Villarroel, M. A. (2020). Symptoms of generalized anxiety disorder among adults: United States, 2019. NCHS Data Brief, no 378. Hyattsville, MD: National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db378.htm
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.