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Last Updated on January 12, 2021

How to Manage Anxiety: Sound Advice from a Mental Health Expert

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How to Manage Anxiety: Sound Advice from a Mental Health Expert

We all know what anxiety can feel like; it can be utterly debilitating and soul-destroying. Many of us are familiar with the pounding chest where you feel your heart is about to explode. Your face flushes or goes suddenly quite pale. You can feel the blood draining from your face.

The panic inside you says: “People are going to notice you experiencing this. Get out of here!” And the stinging fear of embarrassment and humiliation can overwhelm you to the point of tears.

Such experiences can be completely terrifying. We often want to stop feeling these symptoms altogether, however we need to recognize that in many cases, experiencing anxiety actually serves us well.

Our brains are biologically wired to help us survive. What’s happening here however, is our innate fear response has become hyper vigilant in a way that no longer serves us. It’s working in overdrive when we perceive (often subconsciously) there is a threat to our safety but there may not actually be a physical and real threat.

There are strategies you can use to regain control but you will need to consciously learn how to manage anxiety and reduce the emotional, mental and physical experiences you’re suffering.

1. Work with a Professional to Identify and Get Familiar with Your Triggers

Your experience of anxiety will be different to the next person and the next person after that. It’s important to recognize that the specific prescription of tools and techniques that work for you will be different to how they work for someone else.

Spending time to recognize patterns and common features of your anxiety should be a primary step in your management and recovery plan.

Despite popular belief that we need to go back to the root cause of how and why your anxiety started, it’s important to know that sometimes significantly traumatic events and/or experiences are better contained in the box with the lid on. In other cases, accessing the catalyst can be a lengthy and experience and near impossible.

Working with a qualified and trained mental health professional can greatly help you to gently and safely assess and determine things which can derail you. Doing so will not only help you protect your emotional and mental health, but add a greater sense of control in mapping and identifying graduated steps to work through as a treatment plan.

Look to partner with a supportive, empathetic trained professional in your corner who can see risks and help you develop suitable tailored action plans to manage and reduce symptoms that trigger your symptoms. You’ll increase control of your own progress, and your growing confidence can exponentially increase your recovery than trying to go it alone.

If you can’t access face to face or group workshops, online therapy (e.g. Better Help or Talk Space) is becoming much more widely available. There are options available for everyone.

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2. Have Breathing Techniques up Your Sleeve

The mistake often made by those in the throes of experiencing heightened symptoms, is trying to recall specific ‘helpful’ thoughts to eradicate the unhelpful ones in that moment. This doesn’t work very often. It’s like trying to open the door of a front loader washing machine just commencing a spin cycle to put more laundry inside!

If your symptoms are highly intense, such strategy is unlikely to succeed. Your mind is the washing machine, by the way.

The way we breathe has incredible power beyond simply inhaling oxygen and expelling it from our lungs. The rhythm, pace and depth all have significant calming and healing effects on us.

Neuroscience documents that by switching focus to managing your breath halts certain neurons sending panic signals throughout your body.[1] The result is calmer physiology.

Making it your job to calm your breath first helps reduce intensity of those tangible symptoms screaming at you.

We breathe in two ways: through our thoracic region and through our diaphragm. The latter is the one you want to focus your attention to:

  1. Place your non-dominant hand, palm down flat over your chest and place the other just under your ribs on your diaphragm.
  2. Either close your eyes or drop your gaze to a 45° angle and choose a spot to loosely focus on.
  3. Draw a breath in through your nose, gradual, slow and smooth as silk for three counts.
  4. Hold the breath for a split second.
  5. Purse your lips and expel your breath again for 4 or 5 counts, slow, smooth as silk. Control the exhalation.

The next breath cycle, you may want to breathe in for three counts and exhale for five counts. Practice this for at least 5 cycles or at least till you start to notice you are physically calmer in some respects.

If you suffer from panic disorder,[2] you can initially feel increased panic or anxiety doing this technique. Stop and practice again a little while later. You need to switch focus from thoracic (chest) breathing which is common during panic attacks, to diaphragmatic breathing.

Don’t wait until you’re in the heat of the moment to try putting the technique into effect. Practice during a time when you are calmer so your brain and body develop a familiarity of the process and what a reduction in your symptoms feels like.

Like a competitive sport, you practice off the court so that when you get on the court, you’re well familiar with what you need to do. You only need to press the proverbial button and let a more automatic, practiced process wield its magic. Practice.

3. Learn Grounding and Distraction Techniques Which Give Your Mind Something to Do

Such techniques are distractions. Do they get rid of your anxiety? Unlikely. Do they help to cope with and reduce the intensity of your symptoms? Yes, so that you can recalibrate yourself to a more organized mental state from which you can engage cognitive exercises that challenge and reframe unhelpful thoughts.

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If you’re never thought games such as eye-spy would ever come in handy in your adult years, here is news for you!

Start with the letter ‘A’ and look to name everything you can see around you starting with ‘A’. Move on then to the letter ‘B’ then ‘C’ and so on. Search as far, wide and deep as you can looking for objects that start with your letter of focus.

Or, use colors. Work your way through the colors of the rainbow sequentially identifying as many things as you can that showcase that color. Fully immerse into the exercise and give your mind something to focus on. Spend a few minutes to do this.

A tangible grounding technique is to focus on what you have physical contact with. Pay attention to the sensations; how your bottom touches and squishes into the chair or your back muscles press into the back of your seat.

How do your feet feel in your shoes? How do your clothes feel against your skin? You’re tasking your mind with an activity which decreases capacity for it to focus on your present symptoms of anxiety.

4. Try Cognitive Behavioral Therapy (CBT)

Professor Jasper Smits and Professor Stefan Hofman have conducted extensive research into the most effective treatments for managing adult anxiety. They published findings in the Journal of Clinical Psychiatry from an extensive meta-analysis which revealed CBT to consistently have strong impact in the treatment and management of anxiety.[3]

CBT involves addressing, challenging and reframing negative thoughts and re-shaping unhelpful behavior. A task-based, practical approach is applied to help clients recognize maladaptive thinking and habits, learn more helpful and positive ways to behave and think; and in turn, transform their symptoms.

For individuals to really experience benefit, undertaking regular applications of doable homework exercises is most effective. CBT is highly effective but requires individuals’ regular commitment.

Expect to work with a mental health professional on a weekly basis for three to four months. Find someone who won’t just give you homework sheets (that’s lazy therapy) but is closely attuned to providing you with good education, comfortably assess any resistance to change, and be able to modify and adjust exercises that best enable you to do them.

You won’t just experience a reduction in your symptoms because you develop such strong self-awareness and self-monitoring skills. You’ll learn mental skills that will strengthen your resilience and propel you further forward toward goals of how you want to feel, think and behave.

5. Try the Emotional Freedom Technique (EFT)

EFT which involves applying light repetitive pressure to meridian points, is becoming increasingly documented as an effective symptom reduction technique for anxiety.[4] Also known as ‘tapping,’ anyone can learn to self-administer it with the guidance of a practitioner.

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In collaboration with professional associate Gary Craig, Clinical psychologist Dr Roger Callahan[5] developed a simple yet effective self-administered process where individuals self-apply pressure to acupressure points on their body.

Using techniques from neuro linguistic programming and thought field therapy, individuals consciously lean into degrees of discomfort concerning their thoughts, feelings and physical symptoms.

Best learned under instruction and support of an EFT practitioner or trained professional, you initially apply mindfulness to consciously become aware of your anxiety symptoms – thoughts, feelings and physical sensations.

As you tap, you gradually start to experience relief and reduction in your symptoms. However, remember the level of impact felt will differ and progress at different rates from one person to the next.

Research shows that the positive effect of tapping is long lasting, particularly for anxiety disorders and post traumatic stress. It is becoming used more widely for other mental health challenges including weight loss, grief and loss, low self-esteem and confidence.

6. Use Imagery to Help Manage Anxiety

This is such an under-utilized but very powerful mechanism of our brain when it comes to directing our thoughts and behavior in a way to serve us, particularly in the context of anxiety.

Our brains are neuroplastic. We can train and rewire them to work better in our favor, yet we often live the majority of our day unconsciously by default.

Think about how many times you have day-dreamed today. When your tummy starts growling just before lunchtime, can you easily hook into images of what you want to satiate your hunger?

Often we engage imagery without thinking, but guided imagery is a key technique that helps with the reduction of anxiety with diagnoses of PTSD, social phobia and performance anxiety.[6]

Your brain’s amygdala plays a key role in emotional regulation[7] and hence those emotions connected with perceived fear responses when you feel anxious.

Imaginal exposure therapy (vividly imagining the feared object, situation or activity) works to dampen amygdala activity and reduce the intensity of emotions experienced in anxiety. You have the advantage of visiting memories in a safe, controlled space interspersed with grounding/relaxation, and gently exposing your mind’s eye to that which you feel anxious about. Starting this process should be done with a trained professional.

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7. Ensure Relaxation Techniques Are in Your Toolkit

Being anxious is exhausting. For those who suffer from general anxiety, your stress response mechanisms are constantly running, so you need to learn how to tell your body to relax.

Having a couple of meditative instructional relaxation apps you can instantly access through your phone should be on your list of essential management strategies.

In your choice of apps and relaxation techniques. consider choosing one which engages as many of your senses as possible. The more physical feedback you’re directed to notice a reduction in your physical symptoms throughout the relaxation exercise, the more likely you will stick to it and be motivated to repeat it.

Progressive muscle relaxation should be in your anxiety management toolkit. This method directs you to focus on noticing the different feeling between active tension and resulting relaxation when you release the tension of a muscle. Sequentially working through muscle groups in the body from head to toe, your mind is directing and telling your body to become calmer.

You need to be sensible with this one where you might be recovering from an injury or be at risk of developing a physical injury. Certainly avoid this exercise (and meditation) whilst driving.

Again, practicing this one at regular times throughout the day gives your brain and muscles a mental blueprint to relax such that it will be more effective in anxiety-provoking situations. Because you can also feel immediate tangible differences, it can boost your confidence earlier than starting with exercises that are purely cognitive.

The Bottom Line

Reviewing your diet and exercise regime is a given. Reducing caffeine intake, processed food and improving physical movement you engage in daily has incredibly strong impact and makes the strategies above even more effective when you do them.

However, for you to get a strong handle on how to manage and reduce your experience of anxiety, you’re going to have to develop a commitment to regularly applying changes.

If you don’t know where to start, get in touch with a therapist. Your first step is to develop a strong awareness of what you’re experiencing and what could be triggering it.

When you know and understand more, you can do far more in the pilot seat to land your anxiety back on the tarmac and potentially never let it take off from that runway again.

More Resources to Help Relieve Anxiety

Featured photo credit: Hector Gomez via unsplash.com

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Reference

More by this author

Helen D'Silva

Performance Psychologist for Business and Entrepreneurship, Sport and Personal Development

How to Improve Focus: 7 Ways to Train Your Brain How to Cope with Anxiety at Work: 5 Psychology Techniques How to Cultivate a Positive Mindset (A Step-By-Step Guide) How to Manage Anxiety: Sound Advice from a Mental Health Expert The Scary Truth About Nightmare Disorder And Top Treatments that Work

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1 Does Anxiety Make You Tired And Why? 2 Does Depression Make You Tired And How? 3 Overwhelmed at Work? 17 Ways to Manage Work Anxiety 4 Why Am I Depressed If My Life Is Fine? 5 How To Cope With Traumatic Events And Stress

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Published on October 15, 2021

Does Anxiety Make You Tired And Why?

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Does Anxiety Make You Tired And Why?

When you think of anxiety, several scenarios may come to mind: the endless tossing and turning of a restless night, dread over potential future events, pandemic-related overwhelm, or full-blown panic attacks. Even if you’re not diagnosed with an anxiety disorder, you’ve likely experienced anxiety symptoms at some point in your life. In these situations, you might feel a queasiness in your stomach, racing heartbeat, excessive sweating, chest tightness, some tension in your jaw/neck/shoulders, or worrisome thoughts as you prepare for the worst possible scenario. But does anxiety also make you tired?

After experiencing these symptoms, you may indeed feel fatigued. The sensation could fall anywhere on the exhaustion spectrum, from feeling like you just ran a marathon and need to sleep for two days, to just a little worn down and wanting a quick nap to recover.

Below are 7 ways anxiety zaps your energy and how to restore it.

1. Stress Hormone Overload

Anxiety can make you tired via overloading your body with stress hormones. The “fight or flight” response is a key connection between anxiety and fatigue. In fact, this process is made up of three stages: Alarm, Resistance, and Exhaustion. Anxiety triggers our body systems to go into high alert. This is a natural, involuntary reaction that developed in the human brain for survival.

When humans lived with the real, imminent threat of being attacked by a predator, it made sense for our bodies to spring into action without much preparatory thought. Such dangers are rare in modern times, but our brains continue to respond in the same way they did thousands of years ago.

The hormones and chemicals that flood our bodies to prepare us for safety can both affect and be affected by several body systems, and this interaction itself contributes to exhaustion. Adrenaline and cortisol are the two most notable hormones to address here. First, adrenaline is sent out, tensing the muscles and increasing heart rate and blood pressure in preparation to run. Later in the stress response, cortisol is released, enhancing the brain’s use of glucose. This is one of our main fuel sources, so it’s no wonder this contributes to fatigue (see #2).

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You can regulate baseline levels of these stress hormones by regularly practicing yoga, breathwork, meditation, and/or engaging in aerobic exercise.[1] It’s easier to lean into these routines for relief during stress when you’ve already mastered using them during times when you feel calm.

2. Elevated Blood Sugar Levels

Fatigue is one of the most common symptoms of hyperglycemia (high blood sugar), which is shown to be associated with anxiety in diabetic patients.[2] Many people who experience hyperglycemia report feeling tired all the time regardless of their quantity or quality of sleep, nutrition, or exercise.

Although this connection has shown more prevalent and prolonged effects in diabetics, it also occurs with nondiabetics exposed to psychiatric stress.[3] In fact, for all people, the natural stress response elevates blood pressure and heart rate as well as cortisol levels, all of which increase blood sugar levels.[4] This means that anxiety causes a double-hit of exhaustion related to blood sugar fluctuations.

Instead of reaching for comfort foods like chocolate during times of stress, take a calming walk around the block. Gentle movement alone is a great stress reliever that incidentally also helps to regulate blood sugars.[5]

3. Negative Mindset

Anxiety can also make you tired because of repetitive negative thinking (RNT), which is a common symptom of anxiety. RNT involves continuous thoughts via rumination (dwelling on sad or dark thoughts focused on the past) and worry (angst regarding the future). Some researchers argue that having a longtime habit of RNT can harm the brain’s capacity to think, reason, and form memories.[6] While the brain is busy using its energy stores to fuel negative thought patterns, the energy available for these other more productive endeavors is thereby reduced.

Negative thoughts can also disrupt or prevent healthy sleep patterns, keeping our minds racing at night and effectively wreaking havoc on daytime energy. (See #7)

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Reduce these patterns by reframing your feelings over anxious thoughts. Instead of staying stuck on “what if,” focus on what you can do in the here and now. What activity can you engage in for five minutes (or more) that brings you joy? What are you grateful for, no matter what’s going on around you?

4. Digestive Issues

It’s common for people to experience both intestinal and mental issues simultaneously. This suggests a strong connection between the central nervous system and the gastrointestinal (GI) tract, which is known as the gut-brain axis.[7] Simply put, what happens in our digestive tract (and as a result of what we eat) affects the brain and vice versa.

The gut microbiota is a complex population of GI tract microorganisms. When its balance is altered, the body can develop conditions that affect the gut-brain-endocrine relationship. The endocrine system produces and manages adrenaline, for starters. And the gut bacteria’s production of feel-good hormones (serotonin and dopamine—see #5) ties into this relationship as well.

GABA (gamma-aminobutyric acid) receptors are also found in gut bacteria. GABA is a natural brain relaxant that makes us feel good by helping the body to unwind after a stress-induced neurotransmitter release (e.g., cortisol and adrenaline). When GABA activity is low, it leads to anxiety, depression, insomnia, and mood disorders. These are just a few of the manifestations that demonstrate how gut bacteria influences behavior. All of these contribute to feeling both physically and mentally tired.

You can minimize the symptoms of depression and anxiety by keeping your gut microbiota balanced with probiotic-rich fermented foods. Yogurt with live cultures, sauerkraut, kombucha, kefir, kimchi, miso soup, and tempeh are great foods to include in your diet.[8]

5. Depression

Anxiety and depression often go hand in hand. Research continues to indicate a complex relationship between depression and decreased serotonin—a key neurotransmitter for regulating mood and feelings of wellbeing and happiness. Anxiety is also a direct symptom of serotonin deficiency. Serotonin helps with healthy sleep, mood, and digestion.

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Serotonin is produced in the gut, almost exclusively, at an estimated 90 percent. However, a small quantity is also produced in the hypothalamus, an area of the brain that is pivotal for transmitting energy balance signals. This small cone-shaped structure receives and relays signals transmitted via the vagus nerve from the gastrointestinal tract. It has a central role in mediating stress responses, regulating sleep, and establishing circadian rhythms. It senses and responds to a myriad of circulating hormones and nutrients, directly affecting our mood and energy.[9]

Dopamine is another mood-boosting neurochemical that is depleted in depression. It creates feelings of alertness and wakefulness and, when the body is operating normally, is released in higher amounts in the morning (allowing for daytime energy) and lower at night (preparing for healthy sleep). Stress is one factor that can deplete dopamine, thereby leading to depression, sleep disorders, and fatigue.

Studies show that dopamine levels in the brain can be elevated by increasing dietary intake of tyrosine and phenylalanine.[10] Both of these amino acids are naturally found in protein-rich foods like turkey, beef, eggs, dairy, soy, peas, lentils, and beans.

6. Breathing Problems

Breathlessness and anxiety are closely linked, and this is one of the ways anxiety can make you feel tired. Anxiety can lead to shallow breathing, which can cause shortness of breath while feeling breathless can exacerbate anxiety.[11] It’s a vicious cycle that often leads people to take rapid and shallow breaths, breathing into their upper chest and shoulders.

This type of breathing minimizes oxygen intake and usability. Despite comprising only two percent of the body, our brains consume 20 percent of the body’s oxygen supply. Oxygen is fuel for both mental and physical tasks. When breathing patterns compromise healthy oxygen levels, this can cause considerable fatigue.[12]

End the anxiety-fatigue cycle with focused breathing exercises. It’s important to practice this regularly while you’re not experiencing anxiety or stress, as this will help you to be prepared should a moment of breathless anxiety hit unexpectedly.

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There are several different styles of breathing exercises. There’s an easy one to try, called “Resonant Breathing.” Simply breathe in slowly through your nose as you count to five, then exhale for a count of five. Repeat this for a few minutes. It’s helpful to bring your awareness to any tension, deliberately relaxing your neck, shoulders, and jaw in particular.

7. Sleep Issues

Most of the elements we’ve already discussed inherently tie into sleep issues, which is often the reason why anxiety can make you feel tired. But it’s important to note that this is not always a directly linear cause-and-effect process. Much of it is cyclic. If we don’t get enough quality sleep, we increase our risk of excessive cortisol production, elevated blood pressure and blood sugar levels, depressed mood and mindset disorders, and dysregulation of appetite/craving hormones that affect our digestive health.

Sleep is obviously the number one antidote to feeling tired as a result of anxiety. But at the same time, many of these elements—including anxiety itself—lead to less-than-restorative sleep. We can improve our energy levels by addressing each element discussed here, as well as taking a proactive approach to our sleep health.

One simple habit to help recalibrate your circadian rhythm for healthy sleep patterns is to get outside in the morning. Sunlight exposure in the early hours of the day regulates melatonin production, helping us to feel sleepy at night.

You Don’t Have to Live Your Life Anxious and Exhausted

Times of extreme stress, like driving in heavy traffic or nerve-wracking situations like public speaking, can easily induce an anxiety response. Even “normal” everyday stressors, like feeling overwhelmed with work and home responsibilities, can build up to anxious feelings over time.

Our bodies’ response to stress and anxiety affects many of its functions in complex ways. When we unravel the interconnections of these processes, we can see how each part plays an intrinsic role in contributing to fatigue. By addressing each element individually, we can make simple lifestyle changes that resolve anxiety and diminish the ways it makes us tired as a result.

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More Tips on Coping With Anxiety

Featured photo credit: Joice Kelly via unsplash.com

Reference

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