Strategies to Manage Anxiety

Anxiety typically occurs when we focus on things in the future (things that could go wrong) or things that happened in the past. “Mindfulness” refers to being in the present. One helpful mindfulness technique is called “5, 4, 3, 2, 1 grounding”. This is a technique to take your mind off of past and future events and, instead, bring it into the present. If you feel your anxiety building, bring your attention to and name (either out loud or in your mind) each of the following:

5 things you can see. It helps to be very specific – for example, rather than saying, “a door”, instead notice the door handle, including its colour (e.g., a silver door handle), instead of a window, notice a finger smudge on the window glass or a chip of white paint around the window frame.

4 things you can feel. Put your hands on the table and feel the smooth surface. Stretch your toes and feel the softness of your sock and the resistance of your shoe. Move your tongue in your mouth and notice the feeling of your gums.

3 things you can hear. That might include the humming of a refrigerator, or creaking floorboards.

2 things you can smell. That might include the smell of grass, traffic fumes, or hand soap.

1 thing you can taste. If you can’t taste anything, try to conjure the taste of something you enjoy, such as fresh bread or ice cream. It’s hard for your mind to be anxious when it’s so actively focused on other things. 5, 4, 3, 2, 1, relax.

Desensitisation is a term used to describe gradually increasing a person’s exposure to something that causes them anxiety – so that, over time, they become “desensitised” to whatever had been causing them anxiety. It’s also called “graded exposure” and is a technique that’s often used to manage phobias with great success – gradually getting closer and closer, for example, to a spider and not running away but, instead, allowing your body and mind time to calm down with the spider close by.

Desensitisation is actually an important part of managing most types of anxiety. One of the key factors that reinforces anxiety is when we avoid the things that make us anxious. This is counter-productive because the longer we avoid them, the harder it becomes to change your behaviour – and the more anxious you become about the idea of being exposed to whatever it is that causes you anxiety (school, work, social events etc).

Recurrent exposure, on the other hand, can gradually desensitise you to the anxiety these situations cause. It’s good to do this in a graded way – for example, if social events cause you anxiety, start with a brief gathering with a small number of people and build this up over time.

Exercise can play an important role in managing anxiety, regardless of the type of anxiety or whatever the triggers. Exercise helps to deal with stress, build in healthy routines, and manage unpleasant physical symptoms. The key is to find a type of exercise that you enjoy (or can at least tolerate!) – and one that you’ll keep doing. It doesn’t need to involve a gym – walking, swimming, cycling are all great exercises for your mental and physical health.

If you’re new to exercise, start small and build up over time. A starting point might be as simple as taking the stairs instead of the lift, getting off the bus one or two stops ahead of your destination, or parking further away from your workplace so you have to walk a bit more.

Take it step by step. If the idea of going for a 30-minute walk feels daunting, just push yourself to do 5 minutes. Often, it’s getting started that’s the most difficult part. So push yourself just to put on your runners and step outside for 5 minutes – often you’ll find that after 5 minutes you’re happy to continue anyway. If you find exercise boring, listen to a podcast, download an audiobook or play some music while you walk. It can help to visualise your goal in your mind as you get ready to start exercising. It can also help to find someone to exercise with – you can hold each other accountable.

It’s easy to carry tension in your muscles. Finding a quiet space for 5 minutes to work through actively tensing and then relaxing your muscles can help you to de-stress and let go of anxiety.

Start by gently squeezing your fists for 5 seconds, one at a time, before relaxing these muscles for 10 seconds. Then flex your biceps in turn by bringing your hands to your shoulders. Hold for 5, then relax for 10.

Work through tensing your facial muscles for 5 seconds: raise your eyebrows as high as they’ll go, then relax; squeeze your eyes shut tightly, then relax; open your mouth into a great yawn; then relax. Next tense your neck, shoulder and chest muscles each for 5 seconds before relaxing them again. Then onto your stomach, your buttocks and lastly your legs, working down to your toes.

Don’t wait until your really stressed to do this. Try to practice this regularly during calm periods – this will make it more effective than if you only try it when you’re actively anxious. Speak with your doctor first if you have musculoskeletal problems.

There are lots of different talking therapies that can help manage anxiety. Some examples include:

Cognitive behavioural therapy (CBT) involves helping you to recognise the thoughts and behaviours that contribute to your anxiety – and then finds ways to challenge and rebalance these. The “behavioural” part of CBT often draws on some of the techniques described above.

Interpersonal therapy (IPT) looks at how we interact and communicate with others, and how improving our relationships can also improve our anxiety.

Psychodynamic therapy looks at how our past experiences have contributed to the anxiety we face now, and how understanding patterns of behaviour throughout our development can help us to remedy this.

Lots of researchers are working to better understand how different types of talking therapies help different people but we know that a key factor in the success of any talking therapy is that you build a good working relationship with your therapist. Start by gently squeezing your fists for 5 seconds, one at a time, before relaxing these muscles for 10 seconds. Then flex your biceps in turn by bringing your hands to your shoulders. Hold for 5, then relax for 10.

Work through tensing your facial muscles for 5 seconds: raise your eyebrows as high as they’ll go, then relax; squeeze your eyes shut tightly, then relax; open your mouth into a great yawn; then relax. Next tense your neck, shoulder and chest muscles each for 5 seconds before relaxing them again. Then onto your stomach, your buttocks and lastly your legs, working down to your toes.

Don’t wait until your really stressed to do this. Try to practice this regularly during calm periods – this will make it more effective than if you only try it when you’re actively anxious. Speak with your doctor first if you have musculoskeletal problems.

Sometimes, despite our best efforts, anxiety can become severe and unmanageable. In those situations, medication might be able to help. The most commonly used medications are called SSRIs (selective serotonin reuptake inhibitors) but there are several other medications that doctors sometimes use too.

It would be unrealistic to expect medication to make your anxiety disappear altogether, but they can play an important role in managing anxiety for some people. Your GP can help you figure out whether medication is right for you.

It’s not always easy to perfect the above strategies on your own. Sometimes the support of a qualified therapist or counsellor can help us make the most of these strategies. Organisations like the Irish Association for Counselling and Psychotherapy maintain a list of therapists: www.iacp.ie