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5 Tips to Manage Anxiety


Most people have experienced anxiety to some degree, so I bet you have too. Perhaps you’ve experienced heart palpitations as you were preparing to give a presentation or speech. Perhaps you’ve felt that pit in your stomach as you began to think of possible reasons you can’t get in touch with your friend or loved-one. Perhaps worry about potential financial or other problems has kept you awake at night.


Sometimes the anxiety is purely situational and short-lived and other times the anxiety is recurring or even chronic. While anxiety can be useful by encouraging us to stay alert or by propelling us to take action, often times anxiety simply causes misery or sleepless nights. Although anxiety is a normal and common human experience, we can learn how to better manage anxiety. Learning to manage anxiety can decrease our distress, lead to shorter periods of anxiety, and in the case of anxiety that has negatively impacted our lives, learning to manage the anxiety can result in the anxiety losing its power over you.


Tip #1 - Understand the Facets of Anxiety and Anxiety Management


Before learning how to better manage anxiety, it is important to have a shared understanding of the facets of anxiety. Many people think anxiety is the feeling of a pit in their stomach or their heart racing. Others think of anxiety as that pesky worrisome thought in their mind. However, anxiety is much more than the feelings we experience in our body or the occasional worries that run through our minds. To truly understand and learn to better manage anxiety, we need to recognize that anxiety is multifaceted and impacts us in the following four areas: physiological, cognitive, emotional, and behavioral.


Physiological is the way anxiety impacts our body. In the case of panic attacks, these physiological responses can be extremely intense. Cognitive is the way we think about ourselves, the world, and our place in the world. Emotional refers to the emotions we experience and what we do or don’t do to effectively express those emotions. Behavioral is, obviously, the way we behave. Or, in the case of anxiety, the way anxiety pushes us to behave.


Some people are most bothered by the physiological impacts of anxiety. Others are kept awake or distracted by the cognitive aspects of anxiety. Some are negatively impacted by the negative impacts of failing to effectively express emotions. And others see avoidance behaviors as effectively strategies in dealing with the anxiety. Each of these facets can both contribute to, and be manifestations of, anxiety. Learning to manage anxiety requires becoming aware of and learning to manage all the facets effectively. Below, I’ll share brief descriptions of each facet and tips that can get you started on understanding and managing the anxiety you experience. Only you can know which facets impact you the most and will require the most practice and application in your life.


Tip #2: Manage the Physiological with Relaxation


The physiological response we have to anxiety can include:

- rapid heart rate or heart palpitations,

- sweating of the hands, armpits, or elsewhere,

- shallow or rapid breathing,

- shaking or trembling,

- nausea or stomach pain,

- loss of appetite,

- and more.


These uncomfortable bodily sensations can then lead to more anxiety if we worry that we are having a heart attack or that the sensations we are experiencing are signs of a medical condition.


The key to managing the physiological responses to anxiety is to learn how to relax yourself. It is

very difficult to be anxious and relaxed at the same time. So, learning various relaxation skills provides a set of tools to help manage the physiological impacts of anxiety. Thus, even when we begin to experience the physiological responses, once we learn how to relax, we know what to do to calm ourselves and those physiological responses are not as bothersome or long-lasting.


Learning how to relax ourselves might fall under the category of “simple, but not easy.” I’m guessing you understand the concept of relaxation and can see how learning to relax yourself can help manage a rapid heart rate and shallow breathing. Understanding these concepts is not enough. You must learn various relaxation skills and practice them over and over, so you are competent in using them when needed. In addition, it is important to understand that the goal is to manage the responses, not eliminate them. It is unreasonable to expect that doing a brief breathing exercise when anxiety hits will result in the symptoms disappearing immediately.


You might already know some relaxation skills and find

that using them does lead to a momentary reduction in anxiety, only to find that once you stop engaging in the relaxation, the anxiety returns. That is because relaxation skills target the physiological facet of anxiety and do not do much to help manage the other facets. Being aware of the other facets of anxiety and using skills to help manage each facet concurrently, can be much more effective.


Tip #3: Manage the Cognitive by Managing the Whats and When


The cognitive facet of anxiety includes what you think about yourself, what you think about the world, and what you think about yourself in relation to the rest of the world. Are the thoughts you have about yourself generally positive and encouraging or critical and undermining? How do you think other people see you? Do you think you have the knowledge and skill to meet the demands of your life?


In addition to these “whats”, the cognitive facet also relates to the “when”. Since anxiety is almost always related to fears and worries about events or outcomes that have not yet happened or of which we have no specific knowledge of their happenings, learning to focus on the present moment can reduce the frequency of anxiety. Remember, anxiety is not a present moment experience. So, either use the anxiety to help propel you to take action about things that are within your control, and otherwise let go of worry, it only brings misery into the present moment. And while you’re focusing on the present moment, you might take care to be aware of any thoughts associated with anxiety and ask yourself, are these thoughts accurate and are they useful to me right now? If they are not, identify more accurate and more useful thoughts to focus on in the moment.


Tip #4: Express Yourself Effectively to Manage the Emotional


As humans in contemporary society, we generally struggle with emotions. We are not tolerant of our negative emotions and often try to numb, ignore, or rationalize away our negative feelings. Others are also quite intolerant of our negative emotions, teaching us either overtly or inadvertently to NOT express our negative feelings. Perhaps you’ve had someone tell you, “It’s okay, don’t cry” when you were already crying. And I’ve heard some parents say to their children, “You’d better stop crying or I’ll give you something to cry about.”


So, we learn to not express our negative emotions and consequently, do not develop skills to effectively express our emotions. The result is that we tend to either bottle-up our negative emotions, often carrying the negative energy associated with those emotions in our chest or shoulders. Or we swallow down our negative emotions, carrying the negative energy in our stomach or bowels.

Either way, this build-up of negative energy associated with unexpressed, or ineffectively expressed, negative emotions can contribute to the anxiety you might experience. The negative energy can amplify anxiety or even create internal distress that can create anxiety. Thus, the key to managing the emotional facet of anxiety is to learn, practice, and implement effective ways to express emotion. This undoubtedly begins with learning how to identify and label the emotions you experience. Once again, this is simple and not easy. There are hundreds of words that could describe different emotions.


Tip #5: Use Your Management Tools to Approach Rather than Avoid


The behavioral facet of anxiety is most commonly avoidance. We have an urge to avoid things that lead to anxiety…because it works…in the short-term. For example, if I am preparing to give a presentation tomorrow and begin experiencing increasing levels of anxiety, the moment I decide I’m going to be “sick” tomorrow, the anxiety decreases. Of course, this is only a short-term solution because next week when I’m going to have to give the presentation anyway, the anxiety is back and maybe even more intense as it has more time to build. In addition, by avoiding the presentation, I have robbed myself of the opportunity to learn that I can make it through the presentation, and anxiety, and be okay.


Thus, the key to managing the behavioral facet of anxiety is to develop skills in managing the other facets of anxiety and then choose to approach situations that might create anxiety rather than avoid them. Use the skills you’ve learned and practiced to help manage the anxiety and then recognize that you can not only manage the anxiety, you can also stop avoiding and engage more fully with life.


Bonus Tip: Language Matters


Any time I meet with a client, I listen to the way they talk about their symptoms. All too frequently I hear people talk about “my anxiety” or that they “have anxiety.” This language suggests to me that they might over-identify with the symptoms they experience. From my perspective, you don’t “have anxiety”, you experience anxiety. Think of it this way, you have a certain eye color. It is part of who you are, and it is unchangeable, unless of course you buy those colored contact lenses, but you get the point. You don’t have anxiety, you experience anxiety. It is not a part of who you are, and you can change your experience with anxiety. Paying attention to and shifting your language can help you create a little distance between yourself and the anxiety you might experience. It isn’t “my anxiety” …you don’t want it, do you? So why take ownership of it? Learn to talk about the anxiety differently so you can begin to create a different experience with the anxiety.


- Dr. Mike Ghali, PhD



Dr. Mike Ghali, owner of Individual and Couples Therapy, has been practicing therapy for over 20 years. He is licensed as a psychologist in Colorado and Florida. While physically located in Colorado Springs, Colorado, where he holds in-person sessions, you can also schedule telehealth sessions with Dr. Mike from anywhere in Colorado or Florida.



If you’d like to schedule a free 15-minute consultation call with Dr. Mike at Individual and Couples Therapy, please visit www.inctherapy.org/contact-5, click on Schedule, and choose the available time that works best for you and your partner. If you have any questions, don’t hesitate to contact Dr. Mike at info@inctherapy.org. Please do not include sensitive clinical information in emails.

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