5 helpful ways to manage anxiety

Worries, doubts, and anxieties are a normal part of life. “We can’t help worrying as a first response to unknowns, mistakes, or perceived threats or risks,” says Tamar E. Chansky, PhD. Chansky is the author of Freeing Yourself from Anxiety and founder of the Children’s and Adult Center for OCD and Anxiety.

But what we do next is key.

“Often, we know when we’re worrying, and we can catch ourselves,” says Dr. Chansky. “There’s a moment where we shake our heads and say, 'Enough!’ In that moment, we are ready to move into problem-solving mode.”

Other times, though, we can’t get past the worry. Instead, it sticks around and gets worse over time. When fear and anxiety last for up to six months, and when you’re anxious about several things, like health, work, and relationships, it’s a sign of generalized anxiety disorder. 

“When we feel anxious, our body goes into fight-or-flight mode. It readies itself for survival,” Dr. Chansky says. “The heart starts racing and the lungs pump harder, all to make us run faster from the enemy. Which is great if there’s a tiger or woolly mammoth. But when it’s a first date or a job interview, this over-the-top response becomes a problem rather than protection.”

That type of response comes from the activation of the sympathetic nervous system. “When this system remains activated chronically, it can lead to increased blood pressure and heart rate, and diabetes,” says Lana Watkins, Ph.D.. Dr. Watkins is a professor of psychiatry and behavioral sciences at the Duke University School of Medicine.

Here’s the good news: You have the power to dial down your anxiety. Dr. Chanksy says that anxiety disorders are typically caused by a combination of three things: genetics, situational stress, and the choices we make in response to stress. In other words, there’s a lot of room to take action that leads to less anxiety. Here are six steps to try.

1. Hit reset with mindfulness

Mindfulness meditation is a practice that teaches you how to stay present in the moment. It’s about noticing your feelings without judging them as good, bad, or anything in between. 

Research shows that practicing mindfulness meditation regularly can help you recognize your anxiety and accept it. And over time, it can reduce anxiety by acting on the parts of the brain that control those feelings.

Jonathan Kaplan, Ph.D., is a clinical psychologist and director of the SoHo CBT + Mindfulness Center. He recommends practicing this simple meditation daily:  

• Start by focusing on your breathing.
• Take several deep breaths.
• Allow yourself to feel the physical sensations that come with each breath in and out. Maybe you notice a subtle “breeze” around your nostrils or the gentle rise and fall of your chest and belly.
• Simply keep your awareness here for about five minutes, bringing it back any time your mind wanders.
• If you notice that you’ve become distracted from your breathing, simply notice it without judgment.
• Then bring your attention back to your breath.   

2. Work it out.

Lack of sleep can make anxiety even worse, Dr. Watkins says. To help you sleep more soundly at night, she recommends 30 to 45 minutes of medium-intensity exercise on most days of the week. Try brisk walking or biking, which can help release feel-good endorphins to fight anxiety. Or do yoga, which helps put your body into relaxation mode. It’s a good idea to talk to your doctor before beginning an exercise regimen. 

3. Rename your worry.

“Learn to recognize the ‘sound’ of worry and realize that it is unreliable,” Dr. Chansky says. Listen for that little voice in your head that makes worries sound bigger than they are. Then give it a name like “Miss Perfect,” “The Nag,” or “The Criticizer,” she says. Discounting it with a silly name can help you reduce the weight you give it.  

4. Fact-check your anxiety.

Dr. Chansky says it can help to write down what you’re worrying about. Next to each worry, write down what you believe will really happen or is true. Then make a comparison. When you see them side by side, it might become clear how overblown the worry is. “Remember: Worry is the story we are telling ourselves about the situation,” Dr. Chansky says. We can choose to tell the story in a more realistic and positive light.

5. Schedule worry time.

Just like you would with an overbearing friend or coworker, you might have to set boundaries and make “Miss Perfect” wait. “Make worry appointments with yourself every day,” Dr. Chansky suggests. “Rather than getting off track with worry throughout your day, choose five minutes when you are going to list your worries.” Then fact-check them (see 4, above). See if putting your worries to the test makes your mind be more honest with you.

If you still find yourself struggling with anxiety, talk to your health care provider or a mental health professional about how to manage it. Remember, anxiety isn’t all in your mind. It can harm your body, too. They can help you find solutions, such as therapy, medications, and lifestyle changes, to help give you much-needed relief.