Anxiety is currently the most common mental health diagnosis. Despite many people feeling the symptoms of overwhelming fear, stress, heart pounding, and avoidance behaviors, it can be hard to know how to cope with these feelings. It should also be noted as well that there isn’t a single “anxiety” diagnosis. This refers to a broad range of concerns such as Generalized Anxiety Disorder (GAD), specific phobias (a specific fear such as hydrophobia or arachnophobia), and panic disorder.
While each is different in how they affect people and the treatment will be suited to fit the client and presentation, the following skills are helpful for all forms of anxiety. Read on to find out how to reduce your anxiety symptoms and to take control of your life.
1. Relaxation Techniques
Those who suffer from anxiety, whether it be anxious feelings or an anxiety diagnosis, are used to the fight-or-flight feelings their bodies have when encountering a feared stimulus. There’s the tightening in your chest and throat, your heart pounding, your joints feeling tense, and your breathing becoming shallow and rapid.
Relaxation techniques are aimed at reducing this response so that you can continue with your day without the fear weighing on your body and mind. This might come as a surprise, but some therapists consider relaxation techniques a double-edged sword and I’ll explain why.
The good news is that they physiologically reduce anxiety to a point where you can still function. The bad news is that this can reduce your ability to cope directly with the feared stimulus. Let’s say you have a fear of dogs. Instead of dealing directly with dogs, you’ll be using relaxation techniques to calm your body. This isn’t making it easier to approach dogs, but rather it’s making it easier to function despite being around dogs.
My personal opinion is that knowing relaxation techniques is the backbone of anxiety treatment. You will need these techniques in order to reduce anxious feelings, and they can be used in combination with exposure therapy (the next skill on this list) to conquer your fear.
There are many relaxation techniques. I will go over three of them here: Deep Breathing, Imagery, and Progressive Muscle Relaxation.
Anxiety grips you by making your heart pound and it turns your central nervous system to sympathetic mode. Our nervous system has two modes: sympathetic and parasympathetic. Sympathetic reduces digestion, pools blood to muscles, and prepares us to fight or run. It’s hard to think clearly when your brain is screaming DANGER at you.
Deep breathing is able to reduce your heart rate while also switching your nervous system back to parasympathetic mode, or a more relaxed state of being.
There are lots of breathing techniques out there. There’s the 4-7-8 technique where you breathe in for 4 seconds, hold for 7 seconds, and exhale for 8 seconds. There’s box breathing where you breathe in for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and then hold again for 4 seconds.
The important thing here is to ensure that the exhale is about twice as long as the inhale. Inhaling increases your heart rate while exhaling decreases it. Purse your lips with breathing out and make sure to fully empty your lungs before breathing in again.
Whatever breathing technique your choose, repeat it at least three times, but feel free to do it more if needed.
What is a place you love that makes you feel safe? Maybe it’s the beach, or a forest, or even your bedroom. We experience emotional reactions to places we see and invoking that imagery in our head is able to replicate that calm and safe feeling.
Closing your eyes tends to be helpful during this exercise, but you can do it with your eyes open as well.
Think about this special place. What does your body feel like when you’re there? Remember the smells, the calmness it brings, and what you would commonly do in this safe place. Activate all your senses and allow this image to relax you. Stay there for a few minutes until your body feels relaxed.
Progressive Muscle Relaxation
Your muscles and joints probably feel very stiff when you’re anxious. As I said above, anxiety makes blood pool in your muscles. That’s great for quick escapes or fighting off an attacker, but not so great when it happens regularly.
Progressive muscle relaxation is a technique that forces your muscles to relax. While you might have specific muscles that hurt (neck, biceps, abs, and shoulders are very common, but this can occur anywhere in your body), it’s best to do this on all your major muscle groups.
The technique is very easy. Start by tensing your feet for 5 seconds. Make the muscles as tense as possible and then release that tension. The area should now feel relaxed. Now do this to your calves, thighs, and just keep going up the whole body. You might need to tense an area one to three times before it feels fully relaxed.
2. Exposure Therapy
If you want to reduce your fears and anxiety, then you must be exposed to the fearful stimulus until your fear reduces. Sometimes the fear will go away, other times you will simply learn how to be around the stimulus without it activating your sympathetic nervous system. This is the ultimate goal of anxiety treatment.
As you might guess from the word “therapy” here, this is best done with the help of a therapist. I will give you a guide here on creating an exposure hierarchy and slowly leaning into the fear stimulus, but a therapist can give you the support you need to keep at it.
An exposure hierarchy is a graduated hierarchy of steps that cause you anxiety. Each step is graded from 0-100 with 100 being the most fearful step. This should also be the goal. For example, if you are scared of flying, then 100 would be getting on the plane and completing the trip.
A good exposure hierarchy has around 10-20 different steps. Staying with the fear of flying, the first step might be picking a destination. The second step might be looking at travel websites for pricing. The second step might be choosing between a flight with stops or one with no stops. The step after that could be actually buying a ticket. This goes on until we reach the goal of the most feared stimulus.
This is easier to specific phobias as generalized anxiety gives you a general sense of fear, but it can be done with any anxious feelings.
The best exposure hierarchy includes steps that are:
- Safe: the activities will be uncomfortable, but they should be realistically safe
- Controllable: you must be able to control the activity and not have it occur by happenstance. If you have a fear of strangers, then you can’t control whether someone on the street will talk to you. You can control if you speak to them though
- Specific: the activity should be as specific as possible. “Take a walk” is very general. “Talk a 20 minute walk right after work in the crowded downtown area” is much more specific.
- Repeatable: the activity should be repeatedly about 3-5 times a week
This will be uncomfortable work, and that’s exactly why you want a therapist with you. That being said, this is exceedingly important for true recovery from anxiety.
Grounding techniques are most commonly used with trauma as people tend to get sucked back into painful memories. However, grounding is also very useful for a variety of other conditions and concerns.
Let’s also look at it this way. Trauma used to be categorized in the DSM as an anxiety condition. It creates feelings of anxiety, fear, and avoidance. It was only recently separated from the anxiety family as of the DSM 5 largely because trauma is better understood and different than phobias and generalized anxiety, but it still creates feelings that are very similar to anxiety.
So, what are grounding techniques? These are skills that bring you back to the present and make you notice the world around you in a calmer way. Your ability to focus is diminished when you’re anxious. You’re thinking of fighting or looking for an escape. This will force your mind to slow down and bring you back to a relaxed state.
I’ve highlighted many grounding techniques on my website, so I won’t get too detailed here about that. You can read about 20 Mindfulness Activities. My favorite one is about awakening your senses.
Focus on your sight and label five things that you can see. These should be sights that don’t cause you distress. Then identify four sounds, three scents, two things you can feel (with your hands, or even what you are wearing), and then one thing you can taste (if there’s nothing edible, then simply notice your tongue and whether your mouth is dry).
The order can be rearranged as needed, but all five senses should be activated. This is a powerful grounding tool that can help you feel relaxed and bring you into the present moment.
4. Thought Challenging
This is another skill that can be tough to do on your own, so I suggest working on this with your therapist. Thought challenging is when you examine your thoughts and see how realistic they are. The problem with anxiety is that the fearful responses from your feared stimulus justify the thought that you are powerless in front of the feared object. However, this is emotional reasoning and not true.
Anxiety is part of the human condition. We need fear to tell us when something is dangerous and to be avoided. The problem is when non-dangerous thoughts create too much fear, which often leads to self-defeating thoughts. How often do you criticize yourself for not being able to reduce your fears?
Thought challenging is about examining your thoughts and seeing if they fall in line with reality. It’s also about being gentle with yourself and understanding how difficult this is, and that any progress should be celebrated.
The goal here is to challenge your thoughts and make them more realistic.
Tips for Thought Challenging
- If you’re thinking in absolutes (always/never), then your thought probably isn’t realistic.
- Be gentle with yourself. Everyone has shortcomings and it’s OK that you do too.
- Remember your progress. Maybe you have fear while others don’t, but are you better than the last time you faced the feared stimulus?
- Imagine someone outside of you saying these things to you. Do they seem like what a friend would say?
5. Avoiding Safety Behaviors
Anxiety conditions are a breeding ground for safety behaviors. I want you to know that safety behaviors are very common, and you will see them wherever people gather. Parties, stores, parks, and anywhere else you can think of.
These are behaviors that either remove you from the fear stimulus or take your attention away from it.
Sometimes these are very common and simple behaviors. Do you ever find yourself looking at your phone when passing a complete stranger? Or what about being glued to your social media whenever you’re around other people?
Another common variation of this is to suddenly become very preoccupied with an object you’re holding. It can be a book, bag, food, or anything else. It’s like nothing in the world matters more than that object.
Safety behaviors can go far beyond this. Those with specific phobias to common stimuli (such as germs or dogs) might change their entire routine to ensure they never encounter the feared object.
These safety behaviors feel good because they prevent you from feeling anxiety. However, they are also limiting. See more here: Safety Behaviors are NOT Saving You From Anxiety.
Instead of talking to other people, overcoming your fear, and living your life without making modifications, you are instead pouring energy into the safety behavior.
You can’t overcome anxiety if you’re willingly putting your energy into avoiding it. Avoidance coping doesn’t work, and really makes the main problem worse.
Noticing and Stopping Safety Behaviors
The first step is noticing your safety behaviors. When you consider your feared stimuli (being around people, failure, phobias, being overwhelmed, etc), what do you do?
What you think you do and what you actually do are often very different. You probably don’t notice yourself engaging in safety behaviors. Next time the situation comes up, notice what you’re doing. You don’t need to make any changes, but notice anything you’re doing that helps you avoid the stimuli.
Once we know what the safety behaviors are, then we can reduce them. Some people are able to immediately stop using their safety behaviors once they understand how unhelpful they really are. Most people need to gradually stop.
I suggest engaging the stimuli first before engaging in your safety behavior. For example, if you’re afraid of dogs and one is coming up, then walk by it and then pull out your phone. This allows you to overcome the fear all on your own.
Gradually reduce your time with the safety behavior until you no longer need it.
6. Planned Worry Time
Those with generalized anxiety often find themselves constantly worrying, but this can affect anyone with an anxiety condition. You often find yourself ruminating on choices to be made, failures, how wrong everything can really go, and so on.
Normally this worry is unstructured. It occurs throughout the day and might be about anything. It could be about real situations that might come up, or imagined ones that will never happen. In either case, it takes up a lot of your time and distracts you from your daily activities.
If you struggle to stop worrying but want to reduce the impact it has on your day, then planning your worry time might be the best strategy.
Pick a time and place that allows you to worry without restriction. Make sure you block out enough time as well. Some people will just need 15 minutes while others might need a full hour.
A supplemental strategy as well is writing down your worries throughout the day. This ensures that you still get the worries down and don’t forget them, but you can still go about your day.
Many people find that they really don’t need to worry time when they schedule it. This is especially true if you schedule it for later in the day when all the activities are done.
7. Understand Real Assets and Danger
The final essential skill for overcoming anxiety is to understand the real assets and danger around you. Those with anxious thinking often underestimate their assets (internal or external) while overestimating the danger.
Let’s talk about danger first. Anxiety tells you that the world is dangerous or that a certain feared stimuli will destroy you. Those with anxiety find themselves thinking that the stimulus will kill them, change their lives in irreparable ways, or otherwise do permanent and significant harm. This is almost always false.
Think of all the times you overcame the anxiety. The stimulus was probably little more than an inconvenience. Those who have realistic fears (dogs can bite, germs can kill, blood can be infectious, etc), would benefit from remembering that the chances of true harm are exceptionally low.
This puts the danger in a more realistic light.
Next, let’s consider our assets. Those who anxiety often believe they have no internal or external assets to help them. This probably isn’t true. Internal assets include resiliency, the ability to regulate your mood and emotions, your ability to get away from the stimuli if things actually do get bad, and anything else that can help reduce the anxiety.
External assets would be people who can help you with the stimuli. This often includes family and friends, but it might be formal supports like a therapist, group, or anyone else who can help you in times of need.
Instead of thinking that you’ll die from the anxiety and there is nothing you can do, take a more realistic look considering the danger and assets.
The feared stimuli might hurt you, but it’s very unlikely to kill you. There are also many things you can do. If the stimuli presents challenges (projects at work, having to deal with difficult people), you will get through them. There are coping skills you can use, people you can talk to, and relaxation techniques you can use to get yourself back to baseline.
So, what do you think of these 7 skills for reducing anxiety? Some of them require doing internal work and changing how you think, but they can all help you deal with anxiety in a better way. Please let me know which ones worked best for you, and let me know if you have any suggestions.