Understanding Anxiety & How To Manage It

Written By: Lexy June, MSW Intern

Anxiety is the most common mental health concern in the United States. Over 40 million adults, or 19% of the entire population, are affected each year. Despite its high prevalence, anxiety disorders are still largely misunderstood. Only 1 in 4 people diagnosed with anxiety disorders actually end up receiving treatment. While occasional anxiety is a normal part of being human, persistent or overwhelming anxiety can interfere with daily life, social connections, and physical health. Understanding what anxiety is (and what it isn’t) is the first step towards managing it effectively.

What is Anxiety?

The first misconception about anxiety is that its inherently “unnatural” or “wrong.” In fact, anxiety is a natural and necessary human emotion. Anxiety acts as your body’s built-in alarm system. It’s primarily designed to protect you by helping you to notice and respond to perceived threats. When your brain senses danger, whether it’s a wild animal attack or an upcoming presentation, it activates the fight-or-flight response.

This response is largely regulated by the amygdala, the part of the brain responsible for detecting threats, and the release of stress hormones like cortisol and adrenaline. These hormones prepare your body to react quickly.

In short bursts, this system is helpful and enhances our survival instincts. When it’s activated too often, however, or without a clear threat, anxiety can become distressing and disruptive.

If you’re interested in learning more about how anxiety works in the brain and body, the National Institute of Mental Health provides a helpful overview: https://www.nimh.nih.gov/health/topics/anxiety-disorders

What Happens in the Body?

Another common misconception about anxiety is that it’s “just a feeling” or “just in your head.” In actuality, the experience of anxiety causes a variety of physical changes in the body. As the hypothalamus responds to distress signals sent by the amygdala, messages are sent to the sympathetic nervous system causing a cascade of physical reactions as the brain prepares the body to act.  

Noticeable physical effects include:

·        Rapid heart rate

·        Shortness of breath

·        Muscle tension

·        Sweating

·        Dizziness or lightheadedness

·        Nausea or stomach pain

·        Tingling sensations

·        Fatigue

These symptoms are often misunderstood. For example:

·        A racing heart and chest tightness may be mistaken for a cardiac issue.

·        Chronic stomachaches may be labeled as digestive problems.

·        Muscle pain and jaw tension may be attributed to posture or sleep.

While it’s always important to rule out potential medical causes, anxiety frequently shows up physically before people recognize it emotionally.

Harvard Health offers additional information on the physical symptoms of anxiety: https://www.health.harvard.edu/mind-and-mood/recognizing-and-easing-the-physical-symptoms-of-anxiety

What Causes Anxiety?

Anxiety is often caused by a complex combination of factors, rather than one root cause.

These possible factors can include:

·        Genetics and family history

·        Chronic stress 

·        Trauma or adverse life experiences

·        Medical conditions

·        Substance use

·        Personality and temperament

·        Brain chemistry & biology

There’s rarely one single cause. Instead, anxiety often reflects a nervous system that has been on high alert for too long.

How is Anxiety Treated Clinically?

Depending on the individual client and context, anxiety can typically be treated using a combination of psychotherapy and/or medication interventions.  

In a clinical setting, treatment modalities for anxiety can include:

·       Cognitive Behavioral Therapy (CBT) – Generally a short-term treatment that focuses on teaching the skills needed to identify and challenge anxious thought patterns and avoidance behaviors.

·       Exposure Therapy – Gradual, supported exposure to feared situations to reduce avoidance and reactivity.

·       Dialectical Behavioral Therapy (DBT) – Builds distress tolerance and emotional regulation skills.

·       Medication – Used to help relieve symptoms, if appropriate, and in consultation with a medical provider.  

Research consistently supports CBT as a gold-standard treatment for anxiety. If you’re interested in learning more about the clinical treatment of anxiety, the American Psychological Association outlines evidence-based approaches here: https://www.apa.org/topics/anxiety/disorders 

Holistic Approaches to Managing Anxiety

Alongside psychotherapy, many people also benefit from the integration of holistic practices into their treatment for anxiety.

Holistic interventions for anxiety may include:

·       Mindfulness and meditation

·       Breathwork exercises

·       Yoga or gentle movement

·       Improving sleep hygiene

·       Balanced nutrition

·       Reducing caffeine intake

·       Increasing time spent in nature

Mindfulness-based approaches, in particular, have strong research support for anxiety reduction. The Ohio State University provides an introduction to breathwork for anxiety here: https://health.osu.edu/wellness/integrative-healing/how-breathing-exercises-can-calm-anxiety-effectively

Practical Tools You Can Try Today

If you’re ever feeling increased anxiety, here are a few exercises you can try out at home to calm your nervous system:

·       Box Breathing – Inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, hold for 4 seconds, and repeat. Continue this breathing pattern for 1-2 minutes.

·       Grounding (5-4-3-2-1) Exercise – Name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.

·       Thought Check – Ask yourself the following questions: What evidence supports this fear? What evidence contradicts this fear? What would I tell a friend in this same situation?

·       Avoidance Reduction – Avoidance temporarily lowers anxiety, but actually ends up reinforcing it in the long-term.

Taking small, manageable steps towards what you fear builds resistance. As author Glennon Doyle says, “if you can’t beat fear, just do it scared.”

When is it More Than “Normal” Anxiety?

As I mentioned earlier, anxiety is a normal and natural part of the human experience. Everyone feels anxious from time to time, whether it’s leading up to an exam, sitting in a job interview, waiting at the doctor’s office, or right before a huge life change. It’s normal to feel anxious at times, however, professional support may be helpful if you notice or experience any of the following symptoms:

·       Heightened feelings of anxiety most days for several weeks or more

·       Panic attacks

·       Avoiding places or situations you used to tolerate

·       Difficulty sleeping due to worry or ruminations

·       Persistent physical symptoms with no medical cause

·       Trouble concentrating at work or school

·       Anxiety interfering with relationship

If anxiety is affecting your daily functioning, you don’t have to manage it alone. Therapy can provide tools, insight, and support tailored to your individual needs and experiences.

Anxiety is common, but suffering alone in silence shouldn’t be. With the right support and coping strategies, anxiety is a highly treatable mental health condition. If you’re unsure where to start, reaching out to a mental health professional can be a powerful first step.