How Do You Treat Anxiety?

Anxiety is a common complaint, and given present circumstances, it’s not an abnormal response. We all have some anxiety at any given time, especially in performance situations like taking a test, a presentation, or a job interview. Anxiety can help you stay on your toes and pay extra attention to detail. It becomes problematic when all those neurotransmitters and hormones related to anxiety keep pumping through you when they aren’t needed.

What are we talking about when we talk about anxiety? It looks and feels a bit different for everyone, but in general, it is the byproduct of your sympathetic nervous system reacting to a perceived threat. In order to aid our natural “fight or flight” response, the body releases cortisol and adrenaline. While those are terrific chemicals to have flowing through you if you need to run from a lion, they have some unpleasant side effects, especially if stimulated on a near daily basis by activities like phone calls, delayed texts, or going into social situations you dread.

In general, “stress hormones” inhibit appetite, reduce your access to executive function, and stimulate the more “primitive centers” of your brain. This can interfere with your ability to make thoughtful decisions, access your long-term memory, and engage in creative problem solving.

Since we live in a world that usually calls for managing interpersonal stress rather than running from tigers, this is problematic. Also, not to add to the anxiety about anxiety, but stress hormones attack heart muscle.

The main treatment for anxiety is to encourage your body to activate the parasympathetic nervous system to calm your stress reactions. This takes practice a lot of practice with or without medication. Many clients with anxiety that they feel is “debilitating” or “paralyzing” at times find it helpful to consult with a psychiatrist about an SSRI to support their initial recovery. Even if you don’t want to take medication as part of your long-term plan, this is worth considering if you have severe anxiety as it can aid in your ability to master techniques you will need to manage anxiety symptoms.

Anxiety usually has cognitive, behavioral, and somatic components.

Cognitive components might include things like: if someone sends an email saying we need to discuss something by phone, I’m in trouble, or If someone is staring at me, I must have something on my face. This person hasn’t texted back in over an hour; maybe they hate me. Typically, they are negative thoughts carrying negative assumptions about yourself and or others.

Behavioral components might include pacing, skin-picking, ritualistic behavior, becoming impatient or irritable.

Somatic components usually include skin tingling, feeling hot and cold, muscle tension, light headedness, fainting, tension in the jaw, and stomach aches.

A lot of therapists have treated Cognitive Behavioral Therapy (CBT) as the gold standard for treating anxiety for a long time. Many of the self-guided worksheets and exercises can be helpful between sessions as well as for individuals with mild, temporary anxiety, but if you have been living with anxiety for a while, it probably has a strong enough grip on your mind and body that you need to process your emotions, bodily sensations, and thoughts.

Managing anxiety effectively involves building awareness of what triggers your anxiety and learning ways to manage that. Depending on the triggers and their origins, this can involve using mindfulness, CBT tools, or EMDR (eye movement desensitization reprocessing.)
Mindfulness and CBT both often involve practicing some form of breath work—deep breathing, controlled breathing, square breathing, etc. Regulating your breathing does help regulate your nervous system, but it’s something that takes practice, and you need to practice when you aren’t anxious.

Bottom line: it can take a while to find what’s right for you, but you have a lot of options available to you in managing your anxiety, and once you commit to working on it, you are already past the toughest part on your journey to healing.