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Last Updated on January 12, 2021

How to Handle Anxiety When It Hits You out of Nowhere

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How to Handle Anxiety When It Hits You out of Nowhere

Have you ever experienced shortness of breath, racing thoughts, or feelings of absolute panic that seem to come out of nowhere? That’s what anxiety can look like, and it’s important to learn how to handle anxiety when it surprises you and threatens to ruin a perfectly good moment or day.

Anxiety disorders are the most commonly diagnosed mental disorders. They fall into several categories: panic disorder, social anxiety disorder, generalized anxiety disorder, and specific phobias.[1]

Panic disorder is commonly associated with a feeling of anxiety that hits you out of nowhere. These are often referred to as panic attacks. This article will teach you how to handle anxiety associated with panic disorder and panic attacks.

What Are the Warning Signs of a Panic Attack?

Panic disorder is characterized by sudden and unexpected panic attacks. Panic attacks may feel like they hit you out of nowhere. However, there are common warning signs, and learning to identify them is the first step in learning how to handle anxiety.

Here are the common symptoms associated with a panic attack:

  • Difficulty breathing or tightness in the chest
  • Heart palpitations or rapid heart beat
  • Sweating, shaking, or trembling limbs
  • Feeling dizzy, nauseous, or faint
  • Perceived loss of control or becoming detached from the body
  • Fear of death

What Causes Anxiety?

Anxiety can have many root causes, and knowing them can help learn how to handle anxiety in a more comprehensive way.

The Fight-or-Flight Response

While an anxiety attack may feel debilitating, it is actually the body’s natural response to danger. The fight-or-flight response is activated rapidly by the amygdala, which is the brain’s threat detection center. This response happens suddenly and without warning to help you respond quickly to danger.[2]

However, the system may become overactive when you have a history of trauma, an abundance of stress, or excessive fears about the future. Your brain may become hypersensitive to potential threats and detect danger everywhere. As a result, seemingly harmless objects, places, or people may trigger sudden and intense panic.

Conditioned Fear

Psychological studies have also determined that fear and anxiety may be conditioned. For example, pairing a neutral stimulus with a negative experience may lead to the neutral stimulus becoming associated with fear.[3]

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Stated in simpler terms: a non-threatening situation, person, or object may become threatening after it is paired with anxiety.

For example, if you experience a panic attack while driving, you may start to associate driving with panic. As a result, driving may become a negative experience and general source of panic attacks.

Medical Conditions, Genetics, Stress, or Trauma

Anxiety may be the result of health conditions that mimic panic, such as heart arrhythmia or hyperthyroidism.[4] This speaks to the importance of meeting with a medical doctor at the onset of anxiety to rule out medical causes.

Genetics may also play a role in the development of anxiety. If you have a first-degree relative diagnosed with anxiety, you are 40% more likely to develop anxiety. Anxiety may also be the result of chemical imbalances in hormones such as serotonin, cortisol, or gamma-aminobutyric acid.[5]

Additionally, stress may play a major role in the development of anxiety disorders. You may be at an increased risk of developing an anxiety disorder if you have been exposed to catastrophic or ongoing stress.[6]

Lastly, anxiety is more common in individuals who have experienced Adverse Childhood Experiences (ACEs). ACEs include abuse, family challenges, and neglect. You can learn more about ACEs and find your personal ACE score on the Centers for Disease Control website.[7]

What Triggers Anxiety?

It may be frustrating to note that 53% of panic attacks occur in situations that are not threatening. The attack seems to hit out of nowhere. Alternately, the most common triggers for anxiety attacks in stressful situations are: work, driving, and shared public spaces.[8]

The crux of a panic disorder is that panic attacks lead to intense fears or avoidance of recurrent panic attacks. You may work yourself into a panic simply attempting to avoid experiencing panic. This can create a frustrating cycle if you don’t know how to handle anxiety and move away from panic when the first symptoms appear.

How to Handle Anxiety With Self-Help Techniques

Now that you have learned to identify the symptoms and causes of anxiety, you can begin to develop techniques to combat it.

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Practice Diaphragmatic Breathing

One of the most common symptoms of anxiety is difficulty breathing. Shallow breathing can limit airflow and increase feelings of stress and anxiety.[9] Diaphragmatic breathing (also known as deep belly breathing) taps into the full capacity of the lungs while restoring a state of calm.

To practice diaphragmatic breathing:

Begin by placing one hand on the belly and the other on the chest. Attempt to send the breath into the lowest part of the lungs. You should feel your belly expanding on the inhale and contracting on the exhale.

If you notice your chest rises more than your stomach, attempt this lying down. If you still have difficulties, try breathing into a paper bag. Alternatively, you can slowly inhale through the nose and fully exhale through the mouth.[10]

Diaphragmatic breathing takes practice. It’s ok if it doesn’t work on the first attempt. It is also important to practice when you feel calm.

Develop a Mindfulness Practice

Mindfulness simply means present-moment awareness. Mindfulness practices have been shown to decrease symptoms of depression and anxiety. Mindfulness practices have also been linked with increased quality of life.[11]

Utilizing the five senses can be helpful if you are new to a mindfulness practice. One technique that focuses on the five senses is called grounding. It is a simple and quick method for returning to the present moment and regaining a sense of calm.

Try this grounding activity:

  • Notice 5 things you can see
  • Notice 4 things you can touch
  • Notice 3 things you can hear
  • Notice 2 things you can smell
  • Notice 1 thing you can taste

Repeat this activity as often as you like when learning how to handle anxiety. Think of grounding like a grown-up game of I-spy with the added benefit of increased calm.

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Avoid Stimulants and Smoking

As you have learned, people with panic disorder are hyper-sensitive to bodily sensations that mimic panic. Stimulants may trigger the fight-or-flight response. Sources of stimulants include coffee, cold medicines, and some over-the-counter medications.[12]

Additionally, people with panic disorder are hyper-sensitive to breathing abnormalities. Smoking can restrict oxygen in the brain, which increases heart rate and may result in panic.[13]

Learn More About Anxiety

Bibliotherapy is often practiced along with therapeutic support. Bibliotherapy simply means reading self-help books as a complementary treatment.

The following list is an introduction to several helpful resources:

  • Don’t Panic (Third Edition): Taking Control of Panic Attacks by Reid Wilson, Ph.D.
  • Coping with Panic: A Drug-Free Approach to Dealing with Anxiety Attacks by George A. Clum
  • The Relaxation and Stress Reduction Workbook (Fifth Edition) by Martha Davis, Ph.D., Elizabeth R. Eshelman, MSW. & Matthew McKay, Ph.D.

Learn How to Handle Anxiety With the Help of an Expert

Only a licensed therapist, physician, or medical doctor has the authority to diagnose and treat a panic disorder. It may be helpful to visit an expert if you notice major changes in your behavior, thoughts, or mood as a result of anxiety.

Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy

(CBT) is commonly cited as the most effective treatment for anxiety. CBT can only be utilized by a trained professional and can be very helpful as you’re learning how to handle anxiety.

There are three components to CBT: Relaxation, Cognitive Restructuring, and Exposure Therapy.

1. Relaxation Techniques

Therapists may work with you to develop relaxation strategies. This may include working with your breath to create a sensation of relaxation. You will learn how to handle anxiety with coping skills, which you can utilize outside of therapy.

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2. Cognitive Restructuring

Within CBT, you can expect to explore triggers for panic, including thoughts, events, or bodily cues. A technique called cognitive restructuring helps to replace negative thinking around panic with more realistic and positive thoughts.[14]

3. Exposure Therapy (ET)

There are two forms of ET that are commonly practiced as you’re learning how to handle anxiety:

The first form of ET involves environmental exposure to panic-inducing situations. This is called in-vivo exposure.[15]

The second form of ET involves exposure to physical symptoms of panic. This is called interoceptive exposure.[16]

Working Through Therapy Anxiety

It is common to feel nervous about visiting a therapist. In fact, some people may experience increased panic symptoms at the mention of therapy. It may be helpful to practice self-help techniques before you attend your first session.

Many therapists are offering services online as a result of the Covid-19 pandemic. Studies have shown internet-based CBT is as effective as in-person CBT.[17] Online alternatives may also be helpful for people with limited mobility due to panic disorder with agoraphobia (fear of crowds, leaving the home, or entering a scenario where escape is difficult).

Final Thoughts

It is important to educate yourself on the warning signs, triggers, and causes of a panic disorder or panic attack. Anxiety can be frustrating to live with day in and day out, but it is possible to learn how to handle anxiety and live a calmer, more focused life.

You do not have to suffer in silence or live a limited life. There is a solution for your suffering whether you choose to start with self-help techniques or seek therapy. The most important thing is to simply get started on your path to healing.

More Tips on Handling Anxiety

Featured photo credit: Priscilla Du Preez via unsplash.com

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Reference

[1] Dialogues in Clinical Neuroscience: Treatment of Anxiety Disorders
[2] Harvard Health Publishing: Generalized Anxiety Disorder
[3] Dialogues in Clinical Neuroscience: The Biology of Fear- and Anxiety-Related Behaviors
[4] Pharmacy and Therapeutics: Current Diagnosis and Treatment of Anxiety Disorders
[5] Stat Pearls: Panic Disorder
[6] Pharmacy and Therapeutics: Current Diagnosis and Treatment of Anxiety Disorders
[7] CDC: About the CDC- Kaiser ACE Study
[8] Neuroscience Biobehavioral Review: Etiology, Triggers and Neurochemical Circuits Associated with Unexpected, Expected and Laboratory-Induced Panic Attacks
[9] Harvard Health Publishing: Relaxation Techniques: Breath Control Helps Quell Errant Stress Response
[10] FRAN K M. DATTILIO , Ph.D. : Crisis Intervention Techniques for Panic Disorder
[11] Trends in Psychiatry and Psychotherapy: Mindfulness in Mood and Anxiety Disorders: A Review of the Literature
[12] Harvard Health Publishing: Combination Therapy for Panic Disorder
[13] Harvard Health Publishing: Combination Therapy for Panic Disorder
[14] American Psychological Association: Answers to Your Questions About Panic Disorder
[15] BMC Psychiatry: Interoceptive Hypersensitivity and Interoceptive Exposure in Patients with Panic Disorder: Specificity and Effectiveness
[16] BMC Psychiatry: Interoceptive Hypersensitivity and Interoceptive Exposure in Patients with Panic Disorder: Specificity and Effectiveness
[17] Cureus: The Effectiveness of Internet Based Cognitive Behavioral Therapy

More by this author

Olivia Schnur

Olivia is a Clinical Mental Health Counselor and Registered Yoga Teacher. She writes about healing, health and happiness.

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Last Updated on September 23, 2021

Overwhelmed at Work? 17 Ways to Manage Work Anxiety

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Overwhelmed at Work? 17 Ways to Manage Work Anxiety

Sadly, being overwhelmed at work has become commonplace in many industries in the United States, with an astounding 83% of US workers reporting that they are suffering from work-related stress. The US has been deemed the most overworked developed nation on the planet.[1]

Some of you are nodding your head knowingly, while others might be doing a questioning head tilt right now. Here’s the deal—data provided by the U.S. Bureau of Labor Statistics indicate that the average productivity of American workers has increased since 1950.[2] Unfortunately, since that time real wages have remained largely unchanged (adjusted for cost of living and inflation), meaning that to earn the same amount that we did in 1950, we have to work approximately an extra 11 hours each week—and an unthinkable 572 hours a year. Sounds a little bit stressful, doestn’ it?

To put things into perspective, here are a few statistics to chew on:[3]

  • People are so overwhelmed at work that it’s costing American companies over 300 billion dollars a year and over $190 billion in healthcare costs.[4] This is partly because feeling overwhelmed at work manifests itself in increased sick days, decreased productivity, poor mental and physical health, more errors on the job, and increased turnover.
  • Moreover, stress at work is not just costing us money but also our lives. With a staggering 120,000 deaths annually attributed to work stress, something needs to change.

If the external demands are not enough to raise your blood pressure, we are also unwittingly making our situations more challenging by perpetuating an ideology that would stress out even the coolest cucumber. Let me explain.

The idea that’s been drilled into us for most of our American lives has been this: hard work and working hard is to be admired while admitting something is too much is being a lazy wimp. This underlying attitude we’ve all been spoon-fed is called Internalized Capitalism. According to Anders Hayden, a political science professor at Dal Housie University in Nova Scotia,[5]

“Internalized capitalism is this idea that our self-worth is directly linked to our productivity.”

Someone struggling with internalized capitalism might look like any or all of the following:

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  • Putting work before their health and well-being.
  • Feeling guilty when resting or participating in a leisure activity.
  • Feeling lazy and/or anxious when sick, hurt, or otherwise dealing with personal or physical adversity that delays them from doing their job.
  • Feeling that whatever they do it’s never enough.

Now, don’t get me wrong, it is admirable to be a hard worker. But here’s the caveat—when our self-worth and lives suffer because of the overwhelming and relentless demand for productivity, profit, and performance, we need to start reconsidering what’s going on. And here’s the real kicker: this attitude plays right into the hands of the few who are profiting from the many. It’s almost like we have been brainwashed to police ourselves against our self-interest.

Now that we are all on the same page about how we got here, the question is this: How can we overcome a difficult system and dysfunctional thinking?

Honestly, we didn’t get here overnight, and there is not a magic wand to wave that will change things for the better instantly. True change will occur with a blend of systemic and individual tweaks—or overhauls. Okay, it’s really “overhauls” that we need, but I didn’t want to scare anyone so I said “tweaks.”

Let’s start by taking a look at some of the solutions and changes we can make as individuals. Let’s just be frank and put it out there that these problems won’t be fixed only by reminding people to take better care of themselves. Taking personal responsibility for your self-care is part of it, yes, but this runs much deeper than that. We are talking about undoing deeply held beliefs that govern our self-esteem and self-worth.

1. Process Your Emotions

“So, if you’re mad, get mad!” Isn’t that how the song goes? (I’ll Stand by You by the Pretenders.) Finding healthy outlets for our emotions is a key aspect of processing and being able to truly move on.

“Name it to tame it,” is a phrase coined by Dr. Dan Siegel about the power of labeling an emotion to reduce its impact. Examples of this could be journaling or talking things out with someone. Honestly, this step really needs to come first as it is extremely difficult to think clearly when we are feeling very emotional.[6]

2. Be Aware of Negative and Judgmental Self-Talk

Are you staying late at the office and missing time with friends (or your dog) because your internal critic is telling you that if you don’t get this project done, you are a lazy, underperforming blob of an employee? This type of self-talk is not productive or healthy.

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You can overcome this by becoming aware of the story you are telling yourself and the judgment that accompanies it. This is the most important step by far. These stories and criticisms we tell ourselves that keep us working crazy hours and provoke toxic anxiety are the same cockamamie stories that prevent us from taking the time we need to take care of ourselves.

3. Question Your Beliefs

Once you notice the narrative you are telling yourself, take a step back and try to see it for what it is. “Is this really true? Why do I believe that? Is there any evidence to the contrary?”

4. Make New Beliefs

Rewrite your story with what feels right to you. Luckily, we are our own authors, and we get to choose the things we tell ourselves. It doesn’t sound like much, but the power of perspective and authentic positive thinking can be monumental. It’s healthy to evaluate our internal beliefs and self-talk from time to time.

5. Be Clear on What You Want

Be clear on what you want and how you’d like things to be different. Do I want to work a zillion hours a week and then be too tired/anxious/grumpy to do anything else in my life? What are my priorities and does my situation now reflect that?

6. Talk to Your Supervisor

Talk to your supervisor to clarify expectations. Are you holding yourself to implied or self-imposed expectations? Or have they explicitly been set by your employer?

7. Have a Solid Support System

Having a solid support system helps prevent you from being overwhelmed by work anxiety. They can be your friends, family, life coach, psychologist, teammates, social groups—whoever feels supportive, positive, and encouraging.

8. Brutally Assess What You Can and Can’t Control.

This step is important as it dictates the actions you have to choose to move forward. I used to wish I would win the lottery, but the time and energy spent on that didn’t get me anywhere. Changing my work hours, taking some classes, and cutting back some expenses did.

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9. Develop an Action Plan

Develop an action plan based on your findings in #8. It’s not all going to change at once. Start with one small thing, and keep chipping away until you get wherever you want to go.

10. Talk to Someone in HR

Talk to your supervisor or someone from HR about your concerns and struggles. Find out about your options and any assistance they may be able to offer.

11. Set Boundaries and Limitations.

Just because you can work from home and check your email at 2 am doesn’t mean that you should. Learn to set your boundaries. Limit digital contact. Limit work to work hours and stick to it.

12. Complete One Thing at a Time

We are only neurologically capable of doing one thing at a time. Multitasking is a myth and, when attempted, has been shown to take up to 40% longer to complete a task.[7] Don’t waste your precious time and energy doing many things at once. Instead, focus on one task at a time.

13. Be Organized and Timely But Also Realistic

Don’t set yourself up for increased stress and overwhelming work anxiety by putting an unreasonable amount of things on your “to-do” list over a short period of time. Prioritize what needs to be done, and set realistic time frames for completion.

14. Good Enough Is Sometimes Good Enough

Don’t get bogged down in the minutia and cost yourself hours of needless work by re-reading an email 14 times before sending it. Read through it twice and hit send.

15. Don’t Compare Yourself to Others

There is a saying I like: “Comparison is the thief of happiness.” I have no idea who originally said it, but they are brilliant, and most of all, correct. Wasting time and energy comparing ourselves never leads us to a good place. Instead, ask yourself if you are doing the best you can given your own set of circumstances.

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16. Take Time to Fill Your Tank

Meditation, yoga, quiet time, exercise, breaks, breathing, quality sleep, good nutrition, and hydration—just to name a few—are all scientifically proven ways to reduce our internal stress and better manage our energy.[8] On top of good self-care habits, taking the time to do whatever it is that fills your individual tank is crucial to feeling less overwhelmed with work anxiety. I frequently ask my clients which car will make it on a cross-country trip: the car you stop and put gas in, checking the oil and tires intermittently, or the car that you just keep driving?

17. Reframe Your Perspective

We all get caught in the habit of seeing things from only one perspective. A friend of mine used to always tell me, “there are three sides to every story: yours, theirs and something in the middle.” She was right, and honestly, there are many more sides than that.

Critical coaching moment here: Take a step back and try to think outside the box to see the vast expanse of options available to you. Try not to discount them right off the bat as they might not readily fit into the narrow view or expectation that you previously held. Allow your mind to run free, be creative, and find solutions.

What Organizations Can Do About It

As we mentioned earlier, this problem of being overwhelmed with work anxiety is not one-dimensional. Much of the onus falls on the system itself. Not ready to make the full commitment necessary, many organizations encourage their employees to “take care of themselves” or “prioritize work-life balance” while, at the same time, covertly/overtly making unrealistic demands in workload and time.

The positive side is that there are companies who have truly taken the task of supporting their employees as people with personal and professional lives to heart.[9] These organizations stand at the forefront with fair wages, employing enough staff, and setting realistic work expectations, boundaries, and goals. Some top organizations employ life coaches, psychologists, and other support staff, offer employee wellness programs, encourage good nutrition through free healthy meals at work, provide access to fitness and game rooms, and provide unlimited paid time off, flexible schedules, the ability to work remotely, as well as resources to assist with daycare, legal issues, and in-home care to name a few.

Lastly, solid training for managers and HR in addressing employees as “whole” people and taking some of the onus off of the employee to find their own solutions to problems that stem from the workplace is another critical component to successfully supporting employees.[10]

Final Thoughts

Improving support for people in the workplace is good for everyone. It’s better for people’s health and well-being, it’s better for productivity and making fewer errors, it’s more cost-effective for companies and our healthcare system, and it increases the bottom line for companies.

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As we discussed earlier, the big picture will not change overnight. For now, take control of what you can and evaluate ways to better manage your end of things. If these changes are not enough to make the difference you are looking for, then a change of environment or to a company that holds the same beliefs that you do may be in order.

More Tips on How to Manage Work Anxiety

Featured photo credit: Elisa Ventur via unsplash.com

Reference

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