Don’t Let Anxiety Be the Boss of You!
Anxiety, a feeling of worry, nervousness, or unease about something with an uncertain outcome, is something we all experience at some point in our lives. However, when it becomes overwhelming and interferes with our daily life, it is important to seek help. Therapy is one of the most effective ways to manage anxiety and there are several tools that can be helpful in this process.
What is anxiety: Anxiety is a feeling that can create unease, worry thoughts, uncertainty and tension in the body. Brene’ Brown describes anxiety as the “Willy Wonka shit tunnel” relating it to the original movie scene where the characters are all on a boat ride that quickly turns into a scene of unknowns, darkness and dreadful anticipation. (Brene’ Brown’s book here!)
Two Different Types of Anxiety and How They Manifest:
Amygdala-Induced Anxiety:
The amygdala, two almond-shaped structures located deep within the brain, are constantly scanning the environment for potential threats faster than you can process. This process is essential for survival, but can also be highly active and overreact to situations that are not dangerous. For instance, when you walk into a room and jump with fright, only to later realize that the clothing on the floor is not a reptile coming after you. The amygdala rapidly detects potential threats leading to a cascade of internal reactions in your body. This can include the release of adrenaline and cortisol, resulting in physical sensations such as tension, stomach upset, shortness of breath, and rapid heart rate. Many people who experience persistent anxiety report physical symptoms such as upset stomach, headaches, tension in their jaw, back and other aches and pains.
Cognitive-Induced Anxiety:
This type of anxiety is often related to our thoughts. It can manifest as a constant worry about the future, an inability to let go of past mistakes, or a fear of the unknown. Unlike amygdala-induced anxiety, cognitive anxiety is not necessarily a response to an immediate threat, but rather a result of our thoughts and interpretations of the world around us. This type of anxiety can also lead to physical symptoms such as muscle tension and headaches.
How Amygdala and Cortex Interact to Cause Anxiety:
At times, the amygdala reacts first, resulting in body sensations of anxiety. In this situation, there is a potential for the cortex to interpret those sensations as an actual threat ("Oh no, my heart is beating faster, something is really wrong"). On other occasions, it's the cortex that has worrisome thoughts initially, which in turn activate the amygdala to increase the body's stress response.
Bottom-Up and Top-Down Approaches to Manage Anxiety:
Bottom-up (also called body-based) and top-down (aka cognitive) tools are helpful in dealing with anxiety. For amygdala-based anxiety, bottom-up or body-based tools are more useful than cognitive tools. The amygdala requires the body to send feedback that everything is alright. On the other hand, cognitive approaches are useful when one is experiencing cortex-based anxiety such as worry or dreadful thoughts. In many situations, it's helpful to use both approaches to manage anxiety effectively.
Top body based/bottom up approaches to treating your anxiety:
Diaphragmatic breathing: Also known as "belly breathing," this technique involves inhaling deeply through your nose and expanding your diaphragm so that your stomach puffs out. Place one hand on your chest and the other below your rib cage to monitor your breaths.
Prolonging your exhale: This can help balance oxygen levels in your body, as anxiety often leads to shorter, more rapid breaths.
Box breathing: This technique involves tracing an imaginary box with your breaths. Inhale for 4-6 seconds, pause for 4-6 seconds, exhale for 4-6 seconds, and pause again for 4-6 seconds. Repeat.
Grounding with senses: Focus on your sensations, such as what you see, hear, smell, feel, and taste.
Exposure: Avoiding situations that provoke anxiety only reinforces the idea that there's real danger. Instead, try to tolerate and move through your anxiety response, and recognize that you can handle it. For example, if social situations make you anxious, try practicing them and moving through your anxiety response.
Cold water: Splash cold water on your face, wrists, or the back of your neck, or gargle with it.
Warm beverage: Mindfully sip on a hot tea or water and take in the sensations.
Movement: Find ways to release anxious energy through stretching, singing, humming, walking, running, jumping, or dancing.
Getting on a consistent sleep schedule: Go to bed and wake up at similar times, and establish a routine before bed that relaxes you.
Eat regular meals: Practice intuitive eating to nourish your body and brain.
Engage in play and laughter: This is another way to release anxious energy stored in your body.
Physical touch (connection with others): Hugging, petting an animal, or snuggling can help release tension in your body and promote the release of oxytocin, the "love hormone."
Meditation: This approach can be both top-down and bottom-up. There are several apps available to help you get started, such as Insight Timer.
Effective Cognitive/Top-Down Approaches to Managing Anxiety:
Name it to tame it: Acknowledge and label your emotions, using an emotion wheel to diversify your emotional language.
Observe without judgment: Observe your anxious thoughts without judgment, treating them like passing trains or clouds.
Diffuse from those thoughts: Imagine the anxious thoughts are coming from a cartoon character, or that they come in the sound of a song. Or, try adding the phrase "I am noticing that I am having the thought that..." before your anxious thoughts.
Reframe those thoughts: Consider a more realistic, grounded, or helpful thought. For example, if the thought is the worst-case scenario, maybe say to yourself, "If the worst happens, I will figure it out at that time."
Practice self-compassion statements: Offer yourself words of kindness and support, such as "You're experiencing a lot of anxiety right now. You can handle this, and it's going to pass."
Worry time: Give yourself a specific amount of time to write out the things that are causing you anxiety, and once the time is up, be done with it.
Affirmation: Identify a statement you can tell yourself such as "I am focused on the here and now," or "I am capable of managing my anxiety."
Mantra: Repeat a calming word or phrase daily during a regular habit, such as "I am calm and peaceful," while showering.
Make a list: If your anxiety is focused on a to-do list, make a list and prioritize tasks. Remove items from the list if necessary.
Call out thinking traps: Identify recurring themes in your anxious thoughts like "what if" scenarios or worst-case scenarios. Reframe these thoughts using more realistic or helpful language.
There are several other options as you consider making changes to how you respond to your anxiety but these are my favorites and the ones I find most helpful. Experiment with a handful and make it a practice. Over time, they will become more automatic and you will be a pro at managing your anxiety!
