“Hello, Anxiety — my old friend!”
Yes, I am a therapist, and the above phrase is something I encourage my patients to tell themselves when anxiety appears.
I like to think I have many tools in my tool box to manage and reclaim calmness when I am in distress; however, the world as it sits right now has challenged even my own skillful resilience.
We all need skills to help us harness anxiety, manage fear, and gain control in what feels like an out of control situation
. It’s important to learn and practice these skills to reduce the risk of burnout, harmful levels of stress that reduce the effectiveness of our immune system, disrupted sleep, and a higher susceptibility to depression.
I write this blog for those who are feeling anxious right now. I want to help solve the problem of widespread anxiety rather than becoming numb, overwhelmed, or helpless.
What is anxiety?
I’ve asked many clients in the past, “What does anxiety feel like?” This is what they have told me:
- “It’s like living in a fish bowl, watching the world go on around you, while you’re suspended in motion.”
- “It’s like watching the Titanic sink in real time.”
- “It feels like you’ve lost touch with reality. Your brain takes over your thoughts and you believe them, even when you try your hardest not to. You feel like you’ll never win and be in control again.”
Statistically speaking, about one in three people in the U.S will (at some time in their life) suffer from an intense and persistent fear or anxiety (Kessler et al., 2005).
In a population of 300 million, this adds up to 87 million people, which makes “intense and persistent fear or anxiety” the most common form of human distress (Mineka and Zinbarg, 2006).
It’s important to know the difference between fear and anxiety:
is a present moment stress, due to a present moment threatening or harmful situation.
is a ruminative, future-focused emotion that prepares for the worst-case scenario.
For example, when you turn on the TV or go online and watch disturbing news footage, that can evoke fear
. When you turn off the TV or go offline and continue to ruminate about the footage, you are dealing with anxiety
It can be easier to manage fear
as opposed to anxiety
, especially if you know the source. When we watch or listen to disturbing news and feel fear
, the news report is the “threat.” We can turn off the news to help manage our feelings of fear
can be harder to cope with because it is ongoing worry, and it can be harder to pinpoint the precipitating factors.
Help for anxiety
Whether we are dealing with fear or anxiety, we can use tools from Dialectical Behavior Therapy (DBT) to help us manage our emotions and tolerate distress
DBT offers us the following tools to manage anxiety:
- First, we can name our emotions: “Hello, Fear!” or “Hello, Anxiety! My old friend.”
- Second, we can work to decrease the amount of unwanted emotions that we have. Ask yourself questions like, “What part of this fear or anxiety is unwarranted or unnecessary? How much do I know about the situation at hand? Is this a realistic fear or am I imagining things? Am I predicting the worst outcome?”
- Try to identify your interpretations, thoughts, and assumptions about the event. Is there a present threat? If so, what is it?
- Ask yourself: "What are the facts? Do my emotions or the intensity of my emotions fit the facts?”
Dr. Marsha Linehan, founder of DBT, suggests that, “if we change our assumptions and beliefs to fit the facts, we can help change our emotional reactions to the situation.”
Once you have done the above and taken some nice, even, deep breaths
, try this: if your emotions and reactions do not fit the facts, then it is important to do the opposite of what your emotions are telling you to do.
For example, if you find you are experiencing fear and anxiety when watching the news or reading your social media feeds, you may feel driven to watch more TV, google the things you are concerned about, and ruminate on worst case scenarios. This may lead you down an unproductive path, increasing your distress.
Instead, try to undo this spiral into fear and anxiety:
Repeat the steps above if necessary and continue to do the opposite of what your fear and anxiety are urging you to do
- Turn off the TV
- Log off social media
- Put down your phone
- Go for a walk
- Find support from a friend and talk through your concerns
- Problem solve the things that you can control
If your fear or anxiety is too much to contain or manage, it may be important to reduce the physiological
effects, which will also help to reduce the psychological
effects. You can do this by following the TIP skill from DBT.
- T — TIP the Temperature of your face with cold water (splash cold water or hold a cold wash cloth on your face)
- I — Intense Exercise (i.e. jumping jacks for one minute) or Sensation (for those on exercise restriction; i.e. take a cold shower for one minute)
- P — Paired Muscle Relaxation and paced breathing
Given today’s social and cultural environment, we often have more assumptions and worries than we do facts. Until we get the facts, we need to learn how to manage our reactions.
Give yourself a sense of control and mastery over your fears, continue to act opposite and face your fears.
Lara Schuster Effland is Regional Managing Director of Clinical Operations for ERC, Washington and Senior Clinical Director of ERC Insight’s Mood, Anxiety, and Trauma Related Disorders Program.