9 Strategies for Managing Anxiety

In this extract from their new book, Good Thinking: A Teenagers’ Guide to Managing Stress and Emotions Using CBT, bestselling author of Change Your Thinking, Sarah Edelman, and Louise Rémond, a specialist in therapy for teenagers, look at various strategies that help to reduce anxiety and keep it in check.

1. Maintain a Healthy Lifestyle

Our minds and bodies are interconnected. The things that happen in our body directly affect our mind and vice versa (see Chapter 14 on Self-care). When we make the effort to look after our physical health through things like healthy eating and daily exercise, we influence our brain chemistry in a way that improves our mood, calms the nervous system and increases our energy levels.

On the other hand, anything that reduces our physical energy will negatively affect our mental health. For this reason, avoiding habits such as smoking, drinking alcohol, taking drugs and staying up too late will also help to protect your mental health.

Physical exercise is particularly beneficial because it triggers the release of brain chemicals that make us feel more positive and reduce arousal. Any activity that increases your heart rate, such as fast walking, jogging, swimming or cycling, is beneficial. Regular exercise for at least thirty minutes a day provides the greatest benefits, but even small amounts can help to clear your mind and decrease tension.

2. Communicate

During times of anxiety or stress, talking to people can be very helpful. Friends, family members, teachers or school counsellors can be a great source of support. Sometimes they can provide reassurance and moral support; at other times, they can provide practical assistance. Sometimes they can help you clarify what you need to do, or enable you to see things in a more positive way. Different people can provide different types of support, but your willingness to reach out to them during times of stress and tell them what is happening is the most important thing. If they don’t know what is going on, they can’t help.

3. Relax Your Body

We saw earlier that when you feel anxious, your body becomes tense. But have you ever noticed that reducing tension in your body also reduces anxiety? Even your thinking becomes less catastrophic when your muscles relax!

Our brain is constantly receiving feedback from our muscles. Tense muscles inform our brain that we are still in danger, and this keeps us in a state of high alert. Relaxed muscles, on the other hand, provide an ‘allclear’ message to the brain, causing anxiety to drop. In fact, it is impossible to remain anxious when your body is totally relaxed (although it is not always easy to relax when you feel anxious).

Try Progressive Muscle Relaxation

We can achieve a state of deep relaxation by doing progressive muscle relaxation exercises — consciously relaxing our muscles, one group at a time. This process produces a much greater level of relaxation than you might experience when you are ‘chilling out’ watching TV on the couch. You create a state that is exactly the opposite of what happens when you feel anxious: your muscles relax, your heartbeat slows, your blood pressure drops and your breathing becomes slow and rhythmic.

Now you might be thinking to yourself, ‘But deep relaxation will not solve my problems. I still need to get top marks in Year 12 to get into the uni course that I want’, or ‘I still need to get up in front of the class and give that speech’. It is true that learning to relax your body will not change the life situations you are dealing with. However, it will reduce the uncomfortable body sensations and catastrophic thoughts about those situations. Teaching your body to relax will allow you to think more clearly, and this will also make it easier to problem-solve, if that is what you need to do.

Progressive muscle relaxation involves sitting down and consciously working through a number of steps. The following describes the key steps involved:

  • Find a quiet place that is free of distractions and loosen any clothing that is tight or uncomfortable. Sit upright in a comfortable position, with your feet flat on the floor. Place your hands wherever they feel most comfortable. Close your eyes and take a little time to get in touch with the sensations within your body.
  • Breathe in and tighten the muscles of your feet. Hold your breath and tension for a few seconds, and then breathe out and relax your muscles. Observe the sensations within your feet as they relax.
  • Repeat this procedure for all the major muscle groups, in the following order: calves, thighs, buttocks, stomach, chest, arms, shoulders, neck and face.

Now observe your whole body. Notice any part that is still tense and consciously relax the muscles in that area. Sit quietly for a few minutes and enjoy the sensations of relaxation.

While some people like to do this exercise by themselves, having the direction of a spoken voice can make it easier. There are many apps and online audio downloads, which provide guidance on progressive muscle relaxation. If you search online for ‘progressive muscle relaxation audio’, you will find many options.

Do a Slow Rhythmic Breathing Exercise

Slow rhythmic breathing can help you feel calm when you are hyped up or experiencing the fight-or-flight response (pounding heart, tight chest, rapid breathing, etc.). It is particularly helpful if you are having a panic attack. By deliberately slowing down your breath, you also reduce other components of arousal, including elevated heart rate and blood pressure. Here is a simple technique that is very effective:

  1. Breathe in slowly (not too deeply) and hold your breath for a few seconds.
  2. Breathe out slowly, saying the word ‘relax’ inside your mind as you breathe out. Feel yourself releasing tension as you say the word ‘relax’.
  3. Breathe in slowly again, this time saying the words ‘breathe in’ inside your mind. Hold your breath for a few seconds and breathe out slowly, saying the word ‘relax’ with the out-breath.

Continue to breathe in a slow rhythm, saying the words ‘breathe in’ with each in-breath and ‘relax’ with each out-breath.

If you prefer to use an external guide, there are free apps available online, such as ‘Breathe2Relax’ and Reachout’s ‘Breathe’, which can guide you through slow rhythmic breathing.

4. Meditate

Meditation can be a useful tool for reducing anxiety and the unpleasant body sensations that accompany it (see also Chapter 10 on Mindfulness). While there are different ways of practising meditation, the most common involves focused concentration on the breath. (Other things, like sounds, a body scan or body sensations in motion can also be used as a point of focus.) By paying full attention to the present moment, the mind disconnects from the scattered or racing thoughts generated by anxiety. Some describe the experience as ‘allowing the mud to settle’. Most people feel a noticeable reduction in anxiety after five to fifteen minutes of meditation, and the feeling may last for hours afterwards.

Unlike the slow rhythmic breathing exercise described earlier, meditation does not involve changing or controlling the breath. You just focus your mind on the sensations of the breath, in its own natural rhythm. Whenever you notice that your thoughts have wandered, gently return your attention to your breath.

Many people find meditation a challenging skill to learn; however, it becomes easier with practice. It is worth the effort, as it is a powerful tool for managing emotions. There are many apps and online audio downloads that can guide you in the practice (see Chapter 15 for more information).

5. Problem-solve

While anxiety is often created by catastrophic thinking, there are some circumstances that would be considered stressful by most people. Doing exams, meeting tight deadlines, needing to confront someone or attending a job interview are often anxiety-provoking situations. When you are faced with these challenging situations, it is helpful to consider problem-solving. Ask yourself, ‘Is there anything I can do here?’ Look for solutions, or ways of exerting some control.

While sometimes the solutions are obvious, when facing more complex challenges, it may be worth brainstorming a number of possible solutions or getting advice from parents or teachers. A step-by-step problem-solving approach may sometimes be helpful (see Chapter 11 on Problem-solving).

6. Write a To-Do List

Do you sometimes find yourself feeling overwhelmed by having so much to do and so little time? Here is a simple, yet very practical strategy: write a list.

At the start of each day, write down all the things you need to do, and refer back to the list several times during the day. Cross off items once you have completed them and carry over any unfinished items to the following day’s list. Keeping a list helps you to feel in control, as you don’t need to carry all those jobs inside your head. Crossing off items as you complete them creates a sense of achievement and is likely to lift your mood.

With very big jobs, it is helpful to break them down into smaller tasks. Listing each of these (e.g. ‘Task one: …’, ‘Task two: …’, ‘Task three: …’) makes the job feel more manageable and creates a feeling of achievement when you check off each task.

7. Confront Your Fears – Avoid Avoidance!

Confronting, rather than avoiding, the situations we fear is one of the most effective ways to reduce anxiety over time. It is particularly helpful when we are dealing with ongoing fears that we know will not go away by themselves. These might include things like making potentially unpleasant phone calls, going to social events, approaching people in authority, learning to drive, spending time alone or starting a conversation with people to whom you are attracted. Confronting our feared situations helps to reduce anxiety, because we learn through experience that the situation is not so terrible. Even if it’s difficult, we can cope.

So where to start? When the idea of facing your fears feels totally overwhelming, it’s best to start with small, easy tasks and then gradually increase the challenge over time.

The more often we face our feared situations, the less scary they become. If you are anxious about giving a presentation to the class, practise with your family or a small group of friends beforehand. If you have a fear of using lifts, start by going up only one floor at a time, and gradually increase the time you spend in there. If you have a fear of social situations, start with getting involved in lots of ‘safe’ situations (e.g. doing organised activities
that bring you together with other teenagers) and gradually increase your exposure to other social situations.

8. Confront Your Fears — Drop Your Safety Behaviours

As we saw earlier, safety behaviours are specific things we do to try to make our world ‘safe’. These behaviours are driven by anxiety rather than rational decision making, and might include things like excessive checking, overplanning, perfectionistic behaviours, trying too hard to please people and reassurance-seeking behaviours.

9. Dispute Unhelpful Thinking

In Chapter 3, we looked at the various thinking errors that lead to upsetting emotions such as anxiety, sadness, anger, frustration and guilt. Thinking errors that often play a role in producing anxiety include black-and-white thinking, mind-reading, catastrophising and comparing.

Whenever you find yourself feeling anxious, it’s a good time to reflect on your self-talk. Remember, just because you think something, doesn’t mean it’s true! Writing your thoughts in a Stress Log helps you to break the habit of automatically ‘buying into’ any negative thoughts. Identifying these negative thoughts, recognising any thinking errors and coming up with more balanced, reasonable ways of seeing the situation gives you a different perspective.

Good Thinking is a practical help guide for teenagers navigating negative emotions, stress and self-defeating behaviour. This book will help young people and their parents learn to deal with issues including: stresses at school, sport and home; overcoming common thinking errors; anxiety; depression; low self-esteem; anger; relationship difficulties; problem solving; communication; and goal-setting.

Dr Sarah Edelman is a clinical psychologist with over 20 years of experience.  She conducts workshops on how to apply CBT skills at the Centre for Continuing Education at Sydney University, and is a frequent guest on ABC Radio.

Louise Rémond is a specialist in therapy for teenagers. She is a clinical psychologist at the Health Psychology Unit, University of Technology, Sydney. Louise helps teenagers and adults manage a range of personal and psychological challenges through individual therapy.

Picture credit: Christian Hagward

Posted on June 27, 2017 by

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  • John says:

    I can relate with the part where we should confront things instead of avoiding them. It truly helps us manage ourselves and become better.

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