Anxiety is an exceptionally common mental health issue to struggle with. In this day and age, it is much less taboo to talk about anxiety on social media or during in-person conversations. I see people talking about tips and tricks to help manage anxiety symptoms all the time. A lot of techniques to help with anxiety are intuitive such as taking deep breaths or figuring out your problematic thinking patterns. However, as a psychologist that focuses on treating anxiety disorders, I also see a lot of mistakes. In this post, I’d like to walk you through a few common mistakes that could end up limiting your progress or even making your anxiety worse.
Getting Caught Up in What Ifs
At it’s root, anxiety is a mechanism to try to help keep you safe from danger. Because of that, it is always looking at the future and trying to determine whether something might be risky. This can cause you to fall into a loop of worry. Perhaps you can relate to the feeling of lying in bed at night trying to sleep but failing because you keep playing potential future scenarios in your head and thinking of terrifying ‘what if?’ scenarios. What if I wrote down the wrong time for my meeting tomorrow? What if I accidentally leave my phone at home? What if it rains?
Sometimes you can trick yourself into thinking that you are being prepared by coming up with all of these potential scenarios. But here’s the thing… usually you don’t answer the question. You don’t actually determine what would happen if your fear were true. You just think of the scenario long enough for it to scare the crap out of you and then leave it there.
Instead, try answering the ‘what if’ question. I call this defusing your dangerous thoughts. Rather than letting that potential sit like a pit in your stomach making you feel frightened and icky, call it out into the open and address it. So what if you wrote down the wrong time for your meeting tomorrow? Well, you would wake up unsure about whether you will be showing up at the right time. You could potentially be late to this important appointment, which would likely reflect poorly on you. Okay. Well what can you do about that? You could try to trust your gut and apologize profusely if you happen to accidentally miss the appointment. You could send off a quick email before bed or give a quick call in the morning to double check the time. You could talk to someone else who knows about the appointment time. You could show up an hour early just to be sure and have an alternate activity planned if you need to kill some time. The point is, you have options.
By answering the ‘what if’ questions, you prove to yourself that no matter what you always have options. Those options make the potential scenario a lot less scary. You don’t need to plan for every single possible thing, you just need to build the confidence in yourself that you will be able to find options when you need to.
Not Practicing Breathing Exercises
Let’s be clear about something. Deep breathing helps with anxiety. I even write in my book that “anxiety is fundamentally incompatible with deep breathing”. When you use your diaphragm to fill your lungs and take in deep restorative breaths, it’s engaging the part of your nervous system that counteracts the fight or flight response. That’s awesome.
What a lot of people don’t understand is that breathing exercises work best if you practice them. Deep breathing to combat anxiety is a skill just like any other skill. If you were a performance artist such as a singer or guitar player, you wouldn’t perform a song for the first time when you are in front of a huge audience right? Of course not. You would practice the crap out of that song in private, with your band mates, and maybe even for smaller crowds until the song was completely memorized to the point that it practically seeps into your bones. That way, when you have the added pressure of the crowd, the bright lights, and the nervous energy that comes from being on stage, you are able to rely on your training.
Breathing is the same way. For the most part, simply taking a deep breath will help a bit. But what happened when it doesn’t? Maybe you are starting to get a panic attack and you remember to try a deep breath, but then nothing changes. Oh shoot. That must mean something more serious is going on right? Maybe I’m actually having a heart attack if I can’t breathe my way through this. Wrong. You just haven’t rehearsed your breathing enough. You can’t count on it as a skill to pull you through.
The best strategy is to practice your favorite breathing exercises during times that you are not already stressed. When you are first getting the hang of it, practicing for 10-15 minutes several times per week can be an effective way of teaching your body what it feels like to engage the relaxation response and bring down your baseline anxiety down a few notches.
Avoiding Things That Make You Anxious
Look, I get it. It sucks to feel anxious. Nobody wants to feel that way. So, it’s a natural reaction to try to avoid situations that make you feel anxious. This can be a problem. As I mentioned, anxiety is, at its core, about trying to keep you safe. It stems from the fight or flight response that enables you to react quickly in emergency situations. But with anxiety, this response is triggered by your own thoughts or scenarios that might not actually be dangerous.
When you know that a certain event or activity is going to cause you anxiety, the natural inclination is to not do that thing because that will keep you from feeling bad. However, this only feeds anxiety. Your anxiety is trying to convince you that doing the thing will harm you in some way. In most cases, this is a lie that anxiety feeds you. And when you end up avoiding the situation because anxiety told you to, you are “proving” it right. It kept you safe from this imaginary scenario that probably would not have been dangerous in the first place. That gives anxiety more and more control over your behavior.
Instead, we want to work to avoid avoidance. Move toward what makes you anxious rather than pulling away from it. Anxiety fundamentally cannot hurt you. Even if you feel like you can’t breathe and your heart is going to explode out of your chest, barring any pre-existing physical health issues, you will not be physically harmed by your anxiety. By approaching rather than avoiding, you are essentially calling anxiety’s bluff. With practice, you can get better at tolerating anxiety rather than overreacting to it. This often has the happy side effect of making you feel less anxious in the first place. It also allows you to stop letting anxiety rule your life and determine what you are and are not allowed to do.
Doing Exposure the Wrong Way
In keeping with the last point, one of the absolute most effective strategies for combating anxiety is called exposure. It is a therapeutic approach that involves engaging in activities that generate anxiety in order to increase your tolerance and lessen the impact of anxiety. There are basically two main approaches to exposure work: flooding and gradual exposure. Flooding means you jump in head first into a situation that causes significant anxiety and wait out the significant anxiety symptoms to prove to your body that it won’t die. Gradual exposure is more… gradual. You take a small piece of your anxiety provoking situation and start with that before slowly working your way up to the real thing. I’m sure you can guess which strategy most people prefer.
Unfortunately, many therapists get gradual exposure wrong. Rather than following a clear research-supported protocol for helping someone work through their “courage ladder”, the therapist will briefly introduce the idea and hope that the client is able to take it from there. This frequently results in the client trying to take too big of a leap or fundamentally misunderstanding the concept behind exposure work. Then they come to me and say, “Oh. I’ve tried that and it didn’t work.” It’s not that it didn’t work, it’s that your therapist didn’t.
Without going into excruciating detail, the most common mistakes when it comes to exposure work are not giving it adequate time, not tracking progress, and not starting from the right step. Ideally, the person is starting from a small enough step that they only get a moderate amount of anxiety from the exercise and they are enduring it long enough to reduce their anxiety rating by half over multiple tries before moving on to the next step on their courage ladder. Instead, many will quickly jump into something that feels like torture to them before running away and saying it counted as exposure. That strategy isn’t likely to work.
Sleep is really really important. In general, but also specifically when it comes to anxiety. Having anxiety takes a lot of effort. Those little bursts of energy that you get from the fight or flight response are not meant to be sustained over time. They are meant to be temporary states that allow you to do what you need to do in the moment. But when you have anxiety, you tend to get into that mode more frequently, which drains your energy and causes fatigue. It’s also mentally exhausting to constantly be mentally searching for danger and worrying about what if scenarios. If you have anxiety, you can probably relate to the bone-tired soul-weary feeling of exhaustion that looms over you like a dementor. Therefore you need sleep to keep fighting.
Sleep also serves other vital functions. When you are in your deeper stages of sleep, your brain flushes out build ups of abnormal proteins to help things run more smoothly. You also transfer your memories to storage during deep sleep. This is massively important if you are currently plowing through self-help books, podcasts, videos etc. You are learning and practicing new techniques. Adequate sleep is required to consolidate all of this new information.
Here are a few quick sleep hygiene tips that can really make a difference:
- Avoid non-sleep activities in bed. This will help you build a strong association between the location of bed and the activity of sleep.
- Unplug from the world/social media one hour prior to bed. It can wait.
- Develop a relaxing, consistent bedtime routine.
- Keep a consistent sleep and wake time.
- Write down worries or “to do” items before bed so you aren’t rehearsing them in your sleep.
- Get your phone out of the bedroom. You can use a regular alarm clock. If you need to have a phone for emergencies, get a prepaid for or landline.
- Don’t fight a battle with sleep. If you find that you can’t sleep after 30+ minutes of trying, get out of bed, engage in a relaxing unplugged activity for a few minutes, and then return to bed to try again.
Tackle Anxiety the Right Way
I am very passionate about helping you take your life back from anxiety. As a first step, I’d like you to consider downloading my free Kick Anxiety’s Ass Quick Start Guide. It covers the fundamental information you need to know about anxiety and teaches you three awesome coping skills (one of which is my favorite breathing exercise). Let’s do this!