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8 MIN READ

Anxiety Management 101

If you’re suffering from anxiety this year, you’re not alone. A once-in-a-lifetime global pandemic has made this year uniquely overwhelming and we are all worried about our health, careers, finances, and futures.

In response to continued uncertainty, it is natural to feel a heightened sense of unease. When that unease sticks around for a long period of time, it may become chronic anxiety. Dr. Gail Saltz is a psychiatrist, psychoanalyst, author, and host of the “Personology” podcast who can tell us how anxiety manifests in our minds and bodies – and share simple tips for managing it and moving forward.

What is anxiety?

Anxiety is a cascade of physical and mental symptoms in response to internal or external stressors. 

Anxiety isn’t always bad, says Dr. Saltz. Experiencing feelings of stress and fear when faced with real danger isn’t wrong – it comes from deep within our biology. When our prehistoric ancestors encountered a predator, it was the spike of fear they felt in their brain and body that saved them from an early end.

These days, we’re not facing down any dangerous predators. However, our sympathetic nervous system, the part of our body responsible for the “fight or flight” fear response, hasn’t quite caught up. It reacts the same way to an ongoing crisis like the pandemic as it would to a saber-toothed tiger – and when that fear is felt over and over, for months on end, it becomes chronic anxiety. 

Dr. Saltz describes chronic anxiety as a triangle with three categories of response: heightened fear, physical response, and avoidance. With chronic anxiety, you may feel, all, some, or just one of these feelings:

Fear

Existing in a heightened state of fear will make you think and act differently than usual. You may experience a spiral of “what if” thoughts that become progressively more fatalistic and irrational to an outside observer.

Physical Response

You may feel symptoms in your body like:

  • Quickened or shallow breathing
  • Chest pain
  • Nausea
  • Sweating
  • Jitters, shivers, or shakes

Avoidance 

When the idea of confronting a stressor becomes overwhelming, it is tempting to avoid it entirely to protect yourself. When you avoid a problem, you may feel better for a little while – but that better feeling provides positive reinforcement to keep avoiding it forever.

How can I manage my anxiety?

Dr. Saltz recommends several simple and easily accomplished strategies for reducing our anxiety. These strategies are built on reducing overactivity in the sympathetic nervous system and restoring our parasympathetic nervous system, which activates to make us feel safe, calm, and composed. 

      1. Try this breathing exercise when your heart is racing. 

Close your eyes and place a hand on your upper abdomen. Inhale through your nose while slowly counting to five.  Feel your abdomen rise. Purse your lips and exhale through your mouth while slowly counting to seven. Repeat.

It is important to exhale for longer than you inhale, because it is on the exhale that your heart rate declines. This pattern slows your heartbeat, lowers your blood pressure, and lowers your physiological response, which also helps calm the mind.

      1. Relax your muscles when you have trouble falling asleep.

Concentrate on the muscles in your toes and feet. Breathe in and contract or clench just those muscles. Hold your breath for a count of five. Breathe out, fully releasing and relaxing the muscles. 

Do the same thing with the muscles in your legs, then proceed up your body to the glutes, back, abdomen, arms, shoulders, and finally, the small muscles of your face. 

      1. Gain perspective by journaling. 

In the midst of a moment of high anxiety, it can be difficult to be objective. Find a notebook and jot down the thoughts swirling around in your brain. 

Come back to your entry the next day when you feel more clear headed to get a better sense of how rational or irrational your fears were. When you have those thoughts again in the future, remember the moment you acknowledged how irrational they were. 

      1. Boost your mood with exercise. 

Thirty minutes of aerobic exercise three to four times a week has been proven to reduce anxiety and stress, counteract feelings of depression, and lift your spirits. 

      1. Center yourself with mindful meditation.

Find a comfortable place to sit up straight with your hands in your lap or on your knees. Close your eyes and breathe deeply. 

Take note of the sounds, smells, and textures around you without judgement or particular focus. As thoughts appear in your mind, acknowledge them without rushing toward an immediate solution. 

Meditation takes practice. You won’t be a master on your first try. But if you find a moment amidst the chaos to just be, you’re on your way. 

      1. Decompress with your favorite music and a hot bath or shower.

Put a smile on your face with your favorite tunes while the hot water of a bath or shower relaxes your muscles. Add a little aromatherapy with your favorite body wash or by lighting a candle.

      1. Release tension by calling a friend.

When you experience chronic anxiety, it is easy to convince yourself you’re alone in the world. Pick up the phone and call a friend who you know is a supportive and attentive listener, but not a catastrophizer. Tell them how you’re feeling. Ask about their life, and really listen to their answers to zoom out and remind yourself that you are part of a loving support system. 

      1. Talk to a professional. 

How can you tell that it’s time to make an appointment with a therapist, psychologist, or psychiatrist? Dr. Saltz says it is all about personal functioning. If your anxiety has reached a point that it has affected your ability to function in the world – as a partner, parent, friend, or employee – it’s time to talk to someone. 

There is only so much that we can do on our own. Acknowledging when it’s time to reach out to a professional is not a sign of weakness, but of strength. 

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This article has been adapted from Dr. Gail Saltz’s conversation with Adrienne Gold Davis on the Momentum Boost “Anxiety Management 101 with Dr. Gail Saltz.” Watch the full Boost here: https://youtu.be/VqFoIi4ul3c 

Dr. Gail Saltz

Dr. Gail Saltz is a Clinical Associate Professor of Psychiatry at the New York Presbyterian Hospital, Weill-Cornell Medical College, a psychoanalyst at the New York Psychoanalytic Institute, and host of the podcast, “Personology.”

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