Why We Worry: Understanding Anxiety And How To Help It

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Most of us are familiar with the dry mouth, racing heart and knotted stomach that are the hallmarks of feeling anxious. Usually this is a fleeting response to danger and uncertainty. In some people, however, the state of high alert won’t switch off. Their anxiety becomes so draining it is impossible to leave the house or function in daily life.

One woman feels agitated and lightheaded each morning when she wakes. She worries about the accidents that might befall her if she travels to work, but also about what would happen if she had nothing planned for the day. Another avoids work, friends or even walking her dog in case it triggers another panic attack. One man finds it difficult to pick up the phone for fear he will mash his words and be misunderstood.

These are real cases of people who have sought help for their anxiety. Their experiences aren’t unusual. Anxiety disorders – including generalised anxiety, panic attacks, social anxiety and phobias – are the most prevalent mental health problem in the US and Europe, and a growing number of reports from other regions suggest they could be a global concern. In the West, they cost healthcare systems more than $40 billion each year. On average 1 in 6 of us will contend with an anxiety disorder at some stage in our lives – women more than men.

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The damage is real. Anxiety disorders have been linked to depression and increased substance abuse, particularly of alcohol. A recent study found that men who have anxiety disorders are twice as likely to die from cancer as men who don’t, even when factors such as drinking and smoking are taken into account.

So what is the cause of all this anxiety? Is there more of it about, and what is the best way to tackle it?

How much anxiety is normal?

Anxiety is a natural response that evolved over millions of years to make us more vigilant and prime our bodies to flee danger. But feeling anxious because you heard a noise on a dark street isn’t the same thing as having an anxiety disorder. “The key thing we look for in the clinic is whether anxiety is interfering with a person’s day-to-day life, or causing them a lot of distress,” says Nick Grey of King’s College London.

To clinical psychologists like Grey, “maladaptive beliefs” are a hallmark of anxiety disorders and are often used to diagnose the type of anxiety someone has. In social anxiety disorder, the most common anxiety disorder, you might believe that blushing will result in people laughing at or shunning you. People with this type of disorder experience persistent and overwhelming fear before, during and after social events.

If you have panic disorder, you might assume that you are having a heart attack if your heart starts to race. The physical symptoms of anxiety – a pounding heart, difficulty breathing, feeling dizzy or flushed – will then come on in a rush. Everyone can experience such panic attacks from time to time, but in panic disorder the attacks are regular and become a source of anxiety themselves.

Other maladaptive beliefs are less specific. Generalised anxiety disorder is characterised by chronic worrying about a range of different events or activities, for at least six months. If you have this condition, the belief driving your anxiety could, for example, be the feeling it’s your job to take care of other people, or that you have responsibilities that you must meet at all cost. To decide who to refer for further treatment, doctors might use a tool called the GAD7 test.

“Anxiety disorders are the most prevalent mental health problem in the west“

Are we more anxious than we used to be?

The Roman politician and philosopher Cicero was among the first to define anxiety as an illness, in the 1st century BC. Our current medical definition dates to 1980, when the American Psychological Association estimated that between 2 and 4 per cent of people in the US had an anxiety disorder. Today, some studies suggest it’s more like 18 per cent in the US and 14 per cent in Europe.

Such figures have led some to conclude we are in the midst of an anxiety epidemic, fuelled by factors such as economic anxiety, social media and the rise of the 24-hour society. The reality is more complex. The apparent increase is probably due to changes in diagnostics over the years, which make long-term comparisons difficult. “I think we are becoming more stressed and that has to do with having a lot of demands on our time,” says Jennifer Wild of the Oxford Centre for Anxiety Disorder and Trauma in the UK. “But if you’re looking at the prevalence of anxiety disorders, they haven’t gone up.”

There is tentative evidence to support this conclusion. For instance, Olivia Remes and her colleagues at the University of Cambridge found little overall change in the number of people around the world affected by anxiety disorders between 1990 and 2010. Their meta-analysis, published earlier this year, found that roughly 1 in 10 people experience anxiety at any given time, and about 17 per cent are likely to experience it at some stage in their lives.

Remes found that adults under the age of 35 were disproportionately affected by anxiety. Similarly, Borwin Bandelow and Sophie Michaelis at the University Medical Centre in Göttingen, Germany, found evidence that the prevalence of most anxiety disorders peaks in 18 to 34-year-olds before dropping off again. Specific phobias were the exception, peaking in 35 to 50-year-olds.

Even if the overall prevalence of anxiety disorders hasn’t increased, anecdotal evidence suggests that the type of anxiety people are experiencing is changing. When Nicky Lidbetter, chief executive of Anxiety UK, joined the charity 20 years ago, the majority of queries they received were from people with panic disorder or agoraphobia, an extreme fear of open spaces. “Nowadays it is health anxiety [hypochondria] and social anxiety,” she says.

What causes the symptoms of anxiety?

Although we are still a long way from fully understanding what is going on in an anxious brain, recent studies offer some insights into why anxiety seems to take over in some people. Central to it all is the amygdala, a brain region that processes our emotions and triggers the release of the hormones responsible for the fight-or-flight response.

The amygdala is linked to parts of the prefrontal and anterior cingulate cortex that process social information and help us make decisions (see diagram). During bouts of everyday anxiety, this brain circuit switches on and then off again – but Oliver Robinson at University College London and his colleagues have shown that in people with anxiety disorders it seems to get stuck in the on position. “We think it might be amplifying negative information in your surroundings to make sure you pay attention to it, and triggering a fight-or-flight response so you’ll run away,” says Robinson.

Studies suggest that fear memories stored in the amygdala prime us to respond to threats we have previously experienced. This response is normally kept in check by a parallel circuit: in healthy people, inputs from the prefrontal cortex can temper our learned response and even overwrite it with new memories. Occasionally the system fails, however. Psychiatrists have found that war veterans with post-traumatic stress disorder – a kind of anxiety disorder – have abnormally low levels of activity in their prefrontal cortex, and unusually high levels in their amygdala.

Ultimately, an overactive amygdala appears to hype up the familiar symptoms of the fight-or-flight response by stimulating a network of hormonal glands and brain regions called the “HPA axis” – causing rapid heart rate and breathing, a dry mouth, shaking and tense muscles. The fight-or-flight response also has less obvious effects, like slowing digestion and making us more susceptible to pain.

Understanding these interactions will help design better treatments. For instance, Robinson’s circuit switches on when levels of the neurotransmitter serotonin are low, which could explain why a class of antidepressants known as SSRIs can reduce anxiety levels: they increase the availability of serotonin in the brain. “Maybe serotonin is applying the brakes to this particular circuitry,” says Robinson.

Are some people naturally more anxious than others?

Do you calmly navigate life’s bumps or agonise at every turn? Psychologists have long argued that people have innate dispositions that explain how we act, one of which is neuroticism – or proneness to anxiety. A recent study of more than 106,000 people identified nine regions of the genome that seem to correlate with neuroticism. Some of these contain genes previously linked to anxious behaviour, such as CRHR1, which regulates release of the stress hormone cortisol. The same gene has also been associated with anxiety-related behaviour in mice, and panic disorder in humans.


Philippe Lesprit/Picturetank

Some people are therefore naturally more prone to anxiety. But even if you are a natural-born neurotic, this doesn’t mean you will develop an anxiety disorder. “Having a high level of dispositional anxiety is a risk factor for developing an anxiety disorder, but you can be highly anxious and completely healthy,” says Marcus Munafo, a behavioural neuroscientist at the University of Bristol, UK.

Your age (see “Are we more anxious than we used to be”) and sex are factors at play. Population studies show that women are about twice as likely to develop an anxiety disorder as men. In part, this may be down to hormones and their influence on the brain. The surges in oestrogen and progesterone that occur during pregnancy, for instance, have been linked to obsessive compulsive disorder, an anxiety-related condition. Remes points out that there may be other explanations too, such as the fact that women tend to cope with stressful situations differently. “They worry a lot more about what’s going to happen, which can increase their anxiety,” she says. “Men tend to take a more problem-focused approach.”

“Being a natural-born neurotic doesn’t mean you’ll develop anxiety disorder“

The anxious brain

What’s the best way to tackle an anxiety disorder?

If you have an anxiety disorder, cognitive behavioural therapy (CBT) is likely to be the first recommended treatment. Considered the gold standard in treatment, it aims to address the maladaptive beliefs that drive your anxiety. Once they have been identified, CBT helps you challenge them. “If someone is worried about blushing, we might put blusher all over their face and make them have conversations with people to see that they generally don’t even notice,” says Wild. “For panic disorder, you might get someone to run up and down the stairs, to show them that even if they do an extreme behaviour, they aren’t going to have a heart attack.”

A shortage of therapists has spurred the development of online delivery of CBT. In a pilot study of 11 people with social anxiety disorder, Wild found that nine of them responded to online CBT and seven achieved remission, although it is too early to say if this is better or worse than face-to-face therapy.

Therapy isn’t for everyone, however. Some people don’t respond well to therapists or analysing their own behaviour. In this case, a second line of attack is drugs, which can redress chemical imbalances in the brain.

Several studies have shown that people with panic disorder and generalised anxiety disorder tend to have lower levels of a neurotransmitter called GABA, which is thought to help the amygdala filter out unthreatening stimuli. Blocking GABA production in rats has been shown to trigger anxiety-like symptoms.

Benzodiazepines, a class of common anti-anxiety drugs which includes Valium, work on this system but are highly addictive. Doctors may feel more comfortable prescribing antidepressants, says Lidbetter. These can help with the physiology of anxiety as well as the secondary symptoms, which often include depression. However, Lidbetter believes that this is a field that needs to move on. “We need a new benzodiazepine-type drug – something which isn’t addictive,” she says.

Exercise can help with day-to-day anxiety and is a helpful additional strategy for people with anxiety disorders. It triggers the release of mood-boosting endorphins, and forces you to concentrate on something other than your own thoughts. Then there’s diet. A team led by Phil Burnet at the University of Oxford has found that taking a fibre-rich supplement to encourage the growth of beneficial gut bacteria for three weeks caused people to pay more attention to positive words on a computer screen and less attention to negative ones. Upon waking each morning, the volunteers also had lower levels of the stress hormone cortisol in their blood. “We saw a small but significant effect on the underlying psychological mechanisms that contribute to anxiety,” says Burnet.

Modern life may be packed with events outside your control, seemingly designed to foster anxiety and self-doubt. The important thing is to recognise the symptoms and do something about them.

This article appeared in print under the headline “Worry…”

6 Signs It’s Time to Seek Help for Your Anxiety

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Like all emotions, anxiety is healthy, and we’re all prone to feeling it sometimes. Anxiety can become a debilitating problem, though, when the stress you feel is no longer in proportion to the situation. An upcoming test, jobinterview, or first date may make you feel anxious, and that’s healthy. But, if you feel symptoms of anxiety absent any apparent reason, or everyday things make you anxious—leaving your home, for example—it may be time to see a mental health professional. To know if your anxiety is unmanageable, you have to know the symptoms.

1. Physical Symptoms

The physical symptoms of anxiety may include an upset stomach, excessive sweating, headache, rapid heartbeat, and trouble breathing. If you get a stomach ache every time someone invites you to a social function; if you sweat through your shirt whenever you leave the house, even in the middle of winter; or if you feel like your heart is beating so fast it might burst when talking to a stranger on the phone, you may be unhealthily anxious. If your body regularly reacts to everyday stressors the way a caveman would if a lion chased him, your anxiety is no longer healthy.

2. Cognitive Symptoms

Memory issues, trouble concentrating, and insomnia are also symptoms of an anxiety problem. If you can’t fall asleep or wake up repeatedly during the night because you can’t stop thinking about things that stress you out, anxiousness is ruling over you. The same goes for if you can’t focus on work, or sit through a movie, or read a book, or if you seem to be continually forgetting things that happened even recently. When you’re severely anxious about something, even if the thing is “irrational,” it can be hard to function normally.

3. Procrastination and Avoidance

Whether it’s procrastinating about doing the thing that triggers your anxiety—like putting off an errand or not reading an important email until you’re “ready to deal with it”—or avoiding doing just about everything, excessive procrastination and avoidance are both signs of an anxiety issue. We all put off starting unpleasant or difficult tasks sometimes, but when you spend more time avoiding than doing, it may be time to seek outside help.

4. Overthinking and Constant Worrying

If worrying keeps you from functioning or you’re overthinking so much that you can’t focus on important work or sleep at night, you may have an anxiety problem. Your mind races, you lose track of your surroundings, and you’re so caught up in a storm of stressful thoughts that you miss your freeway exit. Anxiety tips over from healthy to unhealthy when it disrupts your life. If a recent health diagnosis has you worried, that’s totally normal. If you’re afraid that you’re dying every time you sneeze, that’s not.

5. Feeling Agitated and Restless

If you feel on edge, you can’t stop moving, and you’re quick to anger, you may be anxious. I’ve written before about how anger can disguise itself as anxiety, but did you know that anxiety can also disguise itself as anger? Anger can be a way to shield you from stressful thoughts. By raging at someone else, you can blame your anxious feelings on an outside force. And if you’re always moving, you don’t have time to ruminate on anxious thoughts. But neither response is healthy or helpful in the long term. When you feel agitated and restless more often than not, when you can’t stop moving and get easily annoyed or are prone to snap at people, you may have a serious problem with anxiety.

6. Panic Attacks

Often people mistake a panic attack for a heart attack. Tightness in your chest, rapid heartbeat, sweating and shaking, shortness of breath, and an upset stomach can easily be mistaken for a heart attack. It’s important to know the symptoms of a heart attack so that you don’t dismiss one by thinking it’s a panic attack or do the opposite and call 911 when you should call a psychologist. Frequent panic attacks are a sign you may have a panic disorder.

To differentiate between healthy and unhealthy anxiety, ask yourself: Is this manageable? If your anxiety keeps you from sleeping, working, social interactions, or errands, you may want to reach out to a therapist. If you feel anxious more than half the week for six months or longer, it’s probably time to seek help.

How to Beat Anxiety in 1, 5, or 10 Minutes

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Beat anxiety in 1 minute

  1. Practice belly breathing
  2. Picture your favorite spot in the world
  3. Peek at a positive photo

Have you been running from meeting to meeting at work and now you feel anxiety creeping up on you? These coping mechanisms are for times like that in which it feels like you don’t have a second to breathe. Head to the bathroom if it’s the only way you can get privacy and allow yourself a minute to recoup. You’ll be surprised at what a difference 60 seconds can make.

Practice belly breathing

Take breaths that fill you up. “Belly breathing or diaphragm breathing [is what] settles our system and slows our minds, not the shallow breathing filling our lungs. We actually breath shallow and quick when we get anxious. Slow that down and, if you don’t know what belly breathing is, watch a video and practice before you need it,” Kevin Gilliland, a clinical psychologist and executive director of Innovation 360 tells Healthline.

How to do one cycle of belly breathing

  1. Sit down on a comfortable, flat surface.
  2. Release your shoulders into a relaxed position.
  3. Place one hand on your chest and the other on your stomach.
  4. Breathe in through your nose for two seconds, feeling the air push your stomach outwards. Your chest should remain still while your stomach expands.
  5. Purse your lips while pressing lightly on your stomach. Then, exhale for two seconds.

Picture your favorite spot in the world

Going to your happy place really does work. Gilliland suggests you “picture it in as great of detail as you can, and imagine the last time you were there.” Directing your mind to focus on a pleasant memory can reduce the anxiety it’s creating.

Peek at a positive photo

Quickly scanning a photo you enjoy can make a real difference when it comes to anxiety, according toGeorgia Foster and Virginia Alexandra, co-authors of “The 3 Minute Anxiety Fix.” Whether it showcases a great memory with your friends or is a screenshot of an inspirational quote, finding pictures that quell anxiety allow you to quickly counteract it.

How to beat anxiety in 5 minutes

Beat anxiety in 5 minutes

  1. Try a relaxation app
  2. Listen to a song
  3. Get your body moving

So, you’re anxious while your meal is cooking or a few minutes before you need to leave. With five minutes, there are more ways to beat your anxiety.

Try a relaxation app

You know those mindfulness apps you keep getting ads for? They actually can help you. From Headspaceto Calm, there are plenty to try out. While there are longer exercises to explore, many apps feature meditations lasting from just one to five minutes.

While you may wonder how much can be accomplished in such a short time, Gilliland assures us that a few minutes can be all it takes. If you’re unsure about using a relaxation app, test a few out with a free trial.

Listen to a song

Everyone has that great song that makes them feel on top of the world. Try creating a playlist filled with ones that ignite joy inside of you. This way, the next time anxiety rears its ugly head, you’ll be armed. Music really is as powerful as you think: According to Gilliland, it can help slow your heart rate and lower your blood pressure.

Get your body moving

A 2017 study found that 77 percent of participants were inactive for about 12 hours per day. While being sedentary most of the day is physically unhealthy for a lot of reasons, it can also impact your mental health.

If you become anxious, think about how much you’ve moved around that day. Take five minutes to get your heart rate up. “Any form of rigorous exercise works to lower anxiety by burning off excess mental energy used for worrying”, psychologist Gregory Kushnick tells Healthline.

Even a 5-minute release can restart your body.

How to beat anxiety in 10 minutes

Beat anxiety in 10 minutes

  1. Call someone who understands you
  2. Write down how you’re feeling
  3. Turn off your phone for at least 10 minutes

If you can step away and take 10 minutes to work through your feelings, it’s definitely worth trying one of these coping mechanisms.

Call someone who understands you

Take a walk and call your best friend, your mom, your partner, or whoever you feel most comfortable talking to.

“Call someone who you feel really knows you and you can count on for honest input. Tell them what you are worried about and why, and see what they say,” Gilliland says. “Or, when you call them, talk about something completely unrelated to your fears. Get caught up in another conversation and you will worry less because you are caught up in something else. Distraction works wonders.”

You’re looking for the person who will help you sort through your anxious thoughts, not the person who is going to tell you to calm down.

Write down how you’re feeling

“Jot a few notes to yourself… about the things that you have done, not the things you worry about or where you have struggled,” Gilliland suggests. Remembering those things help to counter what worry says, which is always negative and catastrophic. We have to balance the conversation so start talking back to anxiety as if it was a person. You have to represent the things you are good at, the things you have done. We need to remember that at times when we are anxious.”

Remembering the good is a great way to combat anxiety, as is writing down what you’re experiencing.

Dr. Kushnick’s suggestions on what to track during anxiety episodes:

  • the triggering event
  • the physical symptoms of anxiety
  • the troubling thoughts you had
  • how you handled the moment
  • a label associated with the distorted thoughts

Turn off your phone for at least 10 minutes

You may be thinking, it’s just 10 minutes, right? Try keeping track of how many times you check your phone in a 10-minute period and then you’ll see why turning it off can do you so much good.

Try even longer if you can. As Kushnick says, “The simplest possible technique for anxiety is to turn your phone off for 20 minutes and sit with your own thoughts, without any other form of stimulation. Whether you admit it or not, your phone is worsening your anxiety.”

Practice these techniques before use

The old adage “practice makes perfect” made be a cliché, but it’s true. The first time you try some of these techniques, it may seem awkward or pointless. Implementing them regularly is the key to fighting back against your anxiety.

Don’t wait until you’re anxious to try them out. “Let me state the obvious – You have to master techniques before you need them. When we are anxious, we don’t learn. We actually use what we have learned and practiced. You need a plan and you need to have practiced it,” Gilliland says. “One of the best quotes about what this looks like in life is from Mike Tyson, ‘Everybody has a plan until they get punched in the face.’ Anxiety will punch you in the face. Punch back with some techniques.”

Getting to the root of what is causing your anxiety is so important when working to manage it. If these coping mechanisms aren’t doing the trick, try speaking to a professional about other options you can explore.

Does Anxiety Cause PTSD or Does PTSD Cause Anxiety?

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This question came up in conversation when I was speaking with someone who has experienced severe panic attacks to the point of calling them “debilitating”, requiring inpatient care.  As they were sharing about the ordeal, they told me that when they contemplate the time spent seeking treatment and the aftermath, it ramped up both the anxiety and PTSD symptoms. Even as a career therapist with decades of experience treating people with stand-alone anxiety, with no overt PTSD symptoms, I had not considered that remembering the anxiety was re-traumatizing. I have heard clients share that anticipating panic attacks was in and of itself anxiety provoking. For this person and so many others, it is hard to determine the line between the two.

As is the case for many who struggle with this condition, they experienced body memory, flashbacks and tremors, as if the events of the past were recurring. Reminding themselves, “I am here and now, not there and then,” alleviated some of the more intense indicators.

This person is also intent on taking on challenges and resilience is one of their superpowers. Overcoming life changing physical conditions were part of the symbolic exercise equipment that helped them to become stronger and more flexible. They were aware that life events happen, unbidden at times and all they can do is ride the waves, sometimes treading water, until things settle back into place. Having solid support from family, friends and professionals keeps them afloat.

Although it might be hard to acknowledge an upside to anxiety or trauma, this person and others I have encountered in both personal and professional realms have been grateful for accompanying lessons. Keep in mind, that no one is sugar-coating it, nor are they denying the pain. They are making a conscious decision to face what comes their way. Paradoxically, the one certainty of life is uncertainty. A catch-22, since anxiety thrives on unpredictability.

The field of Positive Psychology, which offers a strengths-focused perspective to recovery from traumatic experiences, was pioneered by psychologist Martin Seligman, who directs the Positive Psychology Center at the University of Pennsylvania. One concept in this approach is post-traumatic growth, which reflects counterintuitive responses to horrific circumstances. Research from Lawrence G. Calhoun and Richard G. Tedeschi of the University of North Carolina Charlotte found that survivors of trauma often experienced profound healing, a stronger spiritual faith and philosophical grounding. One powerful reframing is referring to the outcome as Post Traumatic Growth.

The 21-item Post-Traumatic Growth Inventory examines responses to painful event in five areas:

  • Relating to others
  • New possibilities
  • Personal strength
  • Spiritual change
  • Appreciation for life

When survivors view themselves in that light and additionally as thrivers who give back or pay it forward, rather than as victims who have no choice but to feel as they do, healing is possible. One such thriver is Michele Rosenthal, a keynote speaker, award-winning blogger, award-nominated author, workshop/seminar leader and certified professional coach. Michele is also a trauma survivor who struggled with posttraumatic stress disorder (PTSD) for over twenty-five years. She calls herself Chief Hope Officer (CHO) of Your Life After Trauma, LLC.

Her trauma came in the form of a condition called, ToxicEpidermal Necrolysis Syndrome (TENS), which she describes as “a freak allergy to a medication that turned me into a full-body burn victim almost overnight.” This horror was followed by a series of physiological and psychological conditions that would flatten even the strongest of people. It took years of determination to recover that led her to be symptom free and now she guides others to overcome their own trauma-trials.

What helped her see her way clear to the other side of suffering is what she refers to as a “healing rampage.”

Rosenthal says, “It is an approach to recovery that is, 1) committed — we keep going no matter what; 2) consistent — we work at it every day; 3) creative — we look for new options and healing opportunities; and, 4) complex — we do the deep work rather than skim the surface as we seek relief.

These are important resiliency building skills regardless of diagnosis or symptomology, whether it falls under the umbrella of anxiety or PTSD.

  • Learn relaxation and breathing techniques to center yourself in the here and now.
  • Do grounding exercises such as walking barefoot on the grass or sand or tapping the bottoms of your feet.
  • If possible, avoid people, places or things that may overtly trigger reaction. Some PTSD survivors may steer clear of fireworks or large numbers of people if loud noises or crowds are related to the initial events.
  • Contemplate an exit strategy if you get inadvertently triggered.
  • Breathe in relaxing aromas, such as lavender, chamomile, vanilla or bergamot.
  • Listen to music that is soul soothing.
  • Seek support from family and friends who may understand your situation and if not, offer a listening presence.
  • Engage in therapy with a licensed professional.
  • If medications are indicated, work with a Psychiatrist or CRNP (Certified Registered Nurse Practitioner) who can prescribe.
  • Attend a self-help group.
  • Utilize the therapeutic modality of EMDR (Eye Movement Desensitization and Reprocessing).
  • Exercise, whether it is in a gym, or a dance floor or basketball court assists in moving the energy. I think of emotion as ‘e-motion’ or ‘energy in motion’.
  • Spend time in nature which is restorative.
  • Dig in the dirt, and plant seeds for new beginnings.
  • Avoid self-medicating with drugs, alcohol, gambling, work, shopping or food.
  • Indulge in healthy hobbies, such as reading, crafts, music, playing board games, putting together puzzles or models.
  • Volunteer your time in your community.
  • If you have a spiritual practice, use it as an additional therapeutic modality.
  • Determine your passion and live it as fully as you can.
  • Spend time with children and learn how to be silly from them.
  • Lighten up by experiencing Laughter Yoga.
  • Enjoy a pampering therapeutic massage.

The Way You’re Talking About Anxiety is All Wrong

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We’re finally talking about anxiety, and mental health as a whole, but the problem? Most of you are saying the wrong thing.

I’ve come to this realization after seeing the countless articles on mainstream sites (who shall remain nameless) tout the latest, buzziest ways to overcome your anxiety.

But the straw that really broke the camel’s back was this headline: “This Simple Mental Hack Could Help You Overcome Anxiety.”

This seemingly innocuous headline is actually incredibly harmful. But before I get into the “why,” I think it’s important we all get on the same page when it comes to anxiety.

(If you feel pretty confident in your understanding of anxiety, feel free to skip down about three paragraphs.)

[Related: How My Emotional Support Animal Helped My Anxiety]

Often, articles will equate anxiety with stress but they are not the same thing at all (although they often go hand-in-hand). We all know what stress feels like — it’s a pretty universal human reaction.

Anxiety, on the other hand, is excessive and doesn’t necessarily correlate with specific events in your life. It’s overwhelming and can be debilitating.

There are obviously varying degrees of anxiety, but for millions, anxiety can severely interfere with their lives. Generalized Anxiety Disorder (GAD), Social Anxiety, Panic Disorder, Post-Traumatic Stress Disorder (PTSD), and Obsessive-Compulsive Disorder (OCD) can often be very serious, lifelong disorders.

anxiety stats
Source: National Institute of Mental Health

Ok, so back to the headline: “This Simple Mental Hack Could Help You Overcome Anxiety.”

For anyone who has suffered from true anxiety, the idea of “a simple fix” is not only insulting but stigmatizing. Those with mental illness have probably already tried anything and everything to deal with their anxiety. So implying that there’s a “simple” solution can make someone feel like, Well if the solution is so simple, why aren’t I fixed yet? What’s wrong with me?

I’ll be honest: I’ve had these thoughts. I have both GAD and social anxiety under my belt. I’m on medication (no shame in my pill game!) but that isn’t a magic fix. I’ve tried everything on every list to deal with my anxiety. So when I run down the list and still find myself struggling, I sometimes think, What the hell is wrong with me? Why isn’t this working?

We need to stop acting like there’s an easy fix to mental health. There are no amount of listicles that can help you beat a life-long disorder. Yes, there can be helpful ideas somewhere among the list of garbage. But we need to recognize that anxiety is complex and it needs a complex solution.

So if you struggle with any form of anxiety, ditch the articles written by novices like me and start seeking out professionals. The National Alliance on Mental Illness (NAMI) is a good place to start.

Photo by Thnh Phng


Dealing with Free-Floating Anxiety

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One of the Greatest Challenges

One of the greatest challenges to keeping an empty head is maintaining the drill of processing our interactions to closure. In the course of our day, we often generate much more value-added thinking and agreements with ourselves and others than we realize, especially in the context of conversations and communications.

Whom have you talked with in the last 24 hours—personally and professionally? What did you tell yourself (or any of them) that you or they would/could/should/ought to do, in any of that? Any ideas, information or perspectives show up that could be important downstream?


Sources of Free-Floating Anxiety

I still have to work with myself to ensure I’ve captured, decided, and tracked all the commitments and creativity that happen with phone calls, meetings, social interactions, and even random communications in passing. I do know that this is one of the sources of much of the free-floating anxiety many professionals experience relative to the gnawing sense of overwhelm that is so pervasive. It seems that there is an unconscious part of us that hangs onto all of those incomplete creations. It is a part that will not let go until it can trust those agreements have been kept or re-negotiated with ourselves.

At this moment I notice in my in-tray two pages of random notes I took on a conference call yesterday, regarding our upcoming GTD Summit in June. There’s a little part of me that resists engaging with them, because I know it’s going to require thinking (which is hard!). But because I’ve got the habit of getting “in” to empty, those notes will trigger the things I need to do, to get that sucker empty! I hate it, and I love it.


Take Time to Process

And, the number of interactions we handle in a day is more than ever. This is why it is critical that we all take time every day to process this stuff. What did I tell Luca I was going to do? What did Kathryn say I should bring back from the store? Who’s got the next action on the project we decided needed doing at the last marketing meeting? Review the day, capture what needs tracking, and then get some sleep.

Help For Introverts Who Have High-Functioning Anxiety

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IntrovertDear.com high-functioning anxiety help
High-functioning anxiety is often called a “secret” anxiety, because on the outside, people who have it seem to be doing just fine. What no one knows is that on the inside, they’re driven by nervousness and fear.Although high-functioning anxiety is not an official diagnosis, it’s something that many people identify with. It’s closely related to Generalized Anxiety Disorder, a condition affecting 6.8 million adults in the U.S., with women being twice as likely to suffer from it as men. Although both introverts and extroverts experience anxiety, introverts are more prone to it, according to Dr. Laurie Helgoe, author of Introvert Power.

Living With — and Controlling — Your Anxiety

Anxiety is a normal part of life, and having some measure of it can actually make you perform better and keep you safe. But, for some introverts, it’s debilitating. Anxiety shrinks your world and makes you miss out on opportunities that would be really good for you.

Personally, I’ve struggled with anxiety in many forms throughout my life, from panic attacks to the hidden “high-functioning” kind. Once, I snuck out the back door of my office when my anxiety exploded over an upcoming meet-and-greet with a returning coworker. Other times, I’ve checked and re-checked my luggage almost obsessively before a flight to make sure everything I would need was there.

So, how do you get rid of anxiety? Research suggests that people who have anxiety see the world differently and can’t just “turn it off.” But, even though it may always be a part of your life on some level, there are ways to control your anxiety — and feel better.

If you’re struggling with high-functioning anxiety, here are seven ways to calm it, based on recent research and my own experiences.

How to Calm High-Functioning Anxiety

1. Know the symptoms of high-functioning anxiety.

Symptoms include being over-prepared, constantly feeling the need to stay busy, being deeply afraid of disappointing others, perfectionism, and more. To determine if you have it, check out my article, 15 Signs That You’re an Introvert With High-Functioning Anxiety. The more signs you identify with, the more likely it is that you suffer from anxiety.

2. What’s the real reason behind your fear?

Before anxiety strikes again, take some time to reflect. As an introvert, self-analysis probably comes naturally to you. Journal about the last time you felt anxious, or if you feel comfortable, talk to a trusted friend or therapist. For me, I’ve determined that my anxiety often stems from wanting others to like and approve of me. If I can do everything perfectly, no one can criticize me! (At least that’s what my anxious brain thinks.) If you can get to the root of your anxiety, it will have less power over you.

3. Observe your mental state like you’re someone else.

This one will take time to master, but you can train yourself to look at your mind from the perspective of a neutral observer. As your yoga teacher might say, “bring your awareness” to your mind. What’s happening in there right now? Are you having dark thoughts? Negative thoughts? Anxious thoughts? Rather than labeling those thoughts as good or bad, beating yourself up about them, or choosing to act on them right away, simply become aware of what you’re experiencing. 

Then, name those feelings. Is it anxiety? Sadness? Worry? Fear? Research shows that you can lessen what you experience simply by recognizing a negative emotion and calling it what it is.

4. Your inner thermostat isn’t always right.

The heating/cooling system in my apartment drives me crazy, because it isn’t always accurate. It can say that it’s 70 degrees in the room, but it feels much, much cooler. I suspect that due to its location in the apartment, the thermostat sometimes produces false readings.

Many times, our brains are like my apartment’s thermostat — they produce false readings. They tell us to be afraid or anxious in situations that aren’t actually threatening. This response likely has something to do with the amygdala, the primitive part of the brain associated with processing emotion. Studies have found that animals subjected to chronic stress developed larger and more connected amygdalae, and that in children and adults, a large amygdala is a predictor of anxiety.

It doesn’t mean that we should never trust what our feelings tell us. On the contrary, our emotions provide us with valuable data. But sometimes, the data is off, through no fault of our own. When you feel anxious, remind yourself that your feelings may not be accurately reflecting the situation.

5. Change your surroundings or your activity.

Sometimes, no matter how much mental effort I put into soothing myself, my body refuses to calm down. My brain gets stuck in a loop of anxious thinking, playing frightening scenarios or negative thoughtsover and over. That’s when I need a change. And by that, I mean a change in my environment or the activity I’m doing.

Making a change will force your brain to move down a different track. Stop whatever you’re currently doing, get up, listen to a podcast, go to your favorite coffee shop, do a household chore, or run some errands. If you’re at work or school, if possible, take a break, go to the bathroom, put on your headphones and listen to music, start working on a different task entirely — or anything that’s different from what you’re doing at the moment.

When your schedule allows, do some aerobic exercise, like fast walking or jogging. After only five minutes of aerobic exercise, your brain will start to stimulate anti-anxiety effects. Some studies have even found that regular exercise works just as well as medication for some people to reduce anxiety symptoms — and it has long-lasting effects.

6. Have a mantra, and use it regularly.

You might try:

“I’m doing my best.”

“It’s only a moment. This too shall pass.”

“I may not be okay right now, but I’ll be okay soon.”

“I’m calm. I’m loved. I’m at peace.”

Mine is, “Things will not be as bad as you think they’ll be.”

7. Spend a little time each day unwinding and relaxing.

As an introvert, you already know that you need downtime to feel at your best. If you’re an introvert who has anxiety, that downtime is even more crucial. According to psychotherapist Linda Esposito, you can proactively tackle anxiety by intentionally setting aside time each day to relax. This will help you practice calming techniques before your anxiety gets the best of you.


Researchers Describe How People With Anxiety Perceive the World Differently

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Unfortunately, a lot of people still believe that those claiming to have mental illnesses just make them up and it’s “all in their head.” However, a new study in the journal Current Biology might finally put the stigma to rest. Researchers found that people who have anxiety perceive the world differently because of differences in their brain. Therefore, the sufferer doesn’t choose to have anxiety; it just happens to them based on genetics and past experiences.

Researchers from the Weizmann Institute of Science in Israel discovered that it boils down to the brain’s plasticity, or its ability to change and form new connections based on exposure to different stimuli. This will determine how a person reacts to that stimuli. In their study, researchers found that people diagnosed with anxiety can’t distinguish between safe and threatening stimuli as well as people who do not have anxiety.

Scientists found that those suffering from anxiety had lasting plasticity in their brains long after coming into contact with a stimulus, meaning that the brain couldn’t differentiate between new, non-threatening situations and familiar ones. The inability to distinguish between the two stimuli, in turn, causes anxiety. Anxious people tend to put all experiences in one category, in other words, due to their inability to distinguish between safe and unsafe situations.

Researchers noted that people with anxiety cannot control this reaction to stimuli since it’s due to a fundamental difference in their brain.


For the study, the participants were trained to associate three specific sounds with one of three outcomes: money loss, money gain, or no consequence. In the next part of the study, participants listened to approximately 15 tones and researchers asked if they had heard them before or not.

To “win” the tone-identifying game, participants would have to differentiate between the old and new sounds, and not overgeneralize them. The study authors found that anxious participants had a higher likelihood than non-anxious individuals of confusing the new sounds with the old ones.

This didn’t happen due to a learning disability or hearing problem, but rather a misperception in the tones they heard. They simply linked the sounds associated with money loss or gain to the new sounds, resulting in confusion.

Researchers also found that, during the exercise, people with anxiety showed differences in the amygdala, a part of the brain that governs our response to fear. According to the authors, the results of the study may explain why some people develop anxiety disorders and others don’t.

“Anxiety traits can be completely normal, and even beneficial evolutionarily. Yet an emotional event, even minor sometimes, can induce brain changes that might lead to full-blown anxiety,” lead researcher Rony Paz said.

The new research provides further proof that no one asks for mental illness, and people shouldn’t have to apologize for having them. Mounting evidence shows that mental illnesses have genetic and psychological causes, and that those suffering have dramatic differences in their brains.

Despite all the research continuing to show the mechanics behind mental illness, the stigma is still very much alive. According to the U.S. Centers for Disease Control and Prevention, only 25 percent of people with a mental health disorder feel like others understand what they go through on a daily basis.



People with anxiety disorders tend to have a hard time with social cues and might misinterpret facial expressions or body language. Here are just a few ways that people with anxiety perceive social situations differently:

  • They might think that people are talking about them behind their back (even if they aren’t).
  • They may have a difficult time reading facial expressions.
  • Starting and keeping a conversation going may seem impossible.
  • Social situations can feel downright draining.
  • They will judge themselves too harshly most of the time. You might hear them say things like, “I’m not funny/smart/interesting enough to hang out with these people.”
  • They may avoid social outings as a result.

For a lot of people with anxiety, the world can feel overwhelming. With so many people to see and places to go, the choices seem endless. For people without anxiety, this fact might seem exciting. However, those with the disorder would rather keep their choices slim and stay inside. Too much stimuli can quickly overwhelm someone suffering from anxiety, especially if they also identify as an introvert.

Many people with anxiety greatly benefit from a calm environment. A relaxing night curled up on the couch with some hot tea and a good book will often suffice.


For someone with anxiety, it can feel like having energy locked up in your body with nowhere to go. This pent-up energy can wreak havoc on the body, causing symptoms such as heart palpitations, sweaty palms and feet, stuttering, and difficulty focusing. Exercise and/or meditation can help a lot of people, but others benefit from therapy as well.

People without anxiety might come home from work and shut their brains off from the day behind them, but the mind of the anxious never stops. People with anxiety may feel like their brain controls them, and often look forward to bedtime when they can finally catch a break.


Those with anxiety often have a hard time trusting people. Even for those without social anxiety, starting and maintaining friendships doesn’t happen easily for anxiety sufferers. Some of them might feel like people have bad intentions for them and will take advantage of them if they get too close. Their brains are always on the lookout for the next threat, and this includes people as well.

If they do have friends, it will take a long time for them to feel comfortable getting close to them.


People with anxiety have a tendency to hold themselves and others to impossible standards. They are vulnerable to both internal and external pressures and will try endlessly to achieve perfection. Of course, some stress and anxiety can help us achieve goals, but too much can cause our plans to backfire. If an anxious person doesn’t reach their goal, they might give up entirely. Or they may fail to see their own limits and push themselves past their comfort zone.

Perfectionism is a dangerous characteristic of anxiety; though it might seem harmless, it can cause people to develop distorted and obsessive thinking patterns. Those with anxiety have a hard time accepting defeat and will stop at nothing to reach their self-imposed goals.


Because people with anxiety have an overactive fear response, they may react as if the world hangs in the balance of a decision they’ve been asked to make. In other words, they may seem highly frazzled or stressed out when doing something as simple as talking; they’re just reacting based on their perception of the world. Since those with anxiety have a hard time relaxing, the world can seem overwhelming with all of the stimuli and triggers.


Loud sounds, bright lights, or chaotic environments might stress out some people with anxiety. Others might respond negatively to conversations, while the decision of what to eat might trigger someone else. In other words, people with anxiety already feel on edge, so the slightest thing might set them off. They have a very thin emotional skin, if you will, so they can get wounded quite easily.


No matter if it’s their job, relationship, friends, or a social event, they never feel good enough for the life they lead. They will be overly critical of their job performance and might constantly feel like they’re being scrutinized by their coworkers. They might feel like they’re failing their partner due to self-perceived flaws and a distorted self-image. Friendships may seem unstable due to feeling inadequate in their social life.

In the eyes of someone with anxiety, what they do and say will never measure up. They’re on a constant quest for perfection. This incessant need to become better might stem from a verbally abusive parent or bullies at school. Likewise, similar experiences may have molded their image of themselves. No matter where the feeling comes from, people with anxiety have a hard time changing their view of themselves. They tend to have a negative self-image, and likely need more encouragement and support due to this.


For those with anxiety disorders, daily life can feel like hell on Earth. They have to try to make it through the day with their brains on overdrive. Additionally, they must constantly defend themselves to people who have no idea what they deal with. We hope this article shed some light on the battles that people with anxiety disorders face. The world needs a better understanding of this potentially debilitating disorder.

15 Signs That You’re An Introvert With High-Functioning Anxiety

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Anxiety is the voice in the back of your head that says, “something bad is going to happen.” It’s what keeps you awake at 2 a.m. thinking about something embarrassing you did — five years ago.

Not all introverts have anxiety, and extroverts and ambiverts can struggle with it, too. To be clear, introversion and anxiety aren’t the same thing. Introversion is defined as a preference for calm, minimally stimulating environments, whereas anxiety is a general term for disorders that cause excessive fear, worrying, and nervousness.

However, for many introverts, anxiety is a regular part of their lives. And indeed, anxiety is more common among introverts than extroverts, according to Dr. Laurie Helgoe.

What Is High-Functioning Anxiety?
Sometimes anxiety is obvious (think: panic attacks and sweaty palms), but that’s not always the case. Many people live with a secret form of anxiety called “high-functioning anxiety.” Outwardly, they appear to have it all together. They may even lead very successful lives. No one can tell from the outside that they’re driven by fear. Sometimes they don’t even realize it themselves.

Do you have high-functioning anxiety? Although not an official diagnosis, high-functioning anxiety is something countless people identify with. It’s closely related to Generalized Anxiety disorder, which affects 6.8 million adults in the U.S., women being twice as likely to experience it as men.

Symptoms of High-Functioning Anxiety
Here are fifteen common symptoms of high-functioning anxiety.

1. You’re always prepared.
Your mind frequently jumps to the worst-case scenario in any given situation. As a result, you may find yourself over-preparing. For example, you might pack underwear and makeup in both your checked luggage and your carry-on, just in case the airline loses your suitcase. People see you as being the reliable one — and often your preparations do come in handy — but few people (if any!) know that your “ready for anything” mentality stems from anxiety.

2. You may be freaking out on the inside, but you’re stoic on the outside.
Interestingly, many people with high-functioning anxiety don’t reveal just how nervous they are, which is another reason why it’s often a secret anxiety. You may have learned to compartmentalize your emotions.

3. You see the world in a fundamentally different way.
Your anxiety isn’t “just in your head.” Researchers from the Weizmann Institute of Science in Israel found that people who are anxious see the world differently than people who aren’t anxious. In the study, anxious people were less able to distinguish between a safe stimulus and one that was earlier associated with a threat. In other words, anxious people overgeneralize emotional experiences — even if they aren’t threatening.

4. You constantly feel the need to be doing something.
Which can be a real problem if you’re an introvert who needs plenty of downtime to recharge. This doesn’t necessarily mean you’re attending lots of social events; instead, you may feel a compulsion to always be getting things done or staying on top of things. Staying busy distracts you from your anxiety and gives you a sense of control.

5. You’re outwardly successful.
Achievement-oriented, organized, detail-oriented, and proactive in planning ahead for all possibilities, you may be the picture of success. Problem is, it’s never enough. You always feel like you should be doing more.

6. You’re afraid of disappointing others.
You might be a people-pleaser. You’re so afraid of letting others down that you work hard to make everyone around you happy — even if it means sacrificing your own needs.

7. You chatter nervously.
Even though you’re an introvert who prefers calm and quiet, you chatter on and on — out of nervousness. For this reason, sometimes you’re mistaken for an extrovert.

8. You’ve built your life around avoidance.
You’ve shrunk your world to prevent overwhelm. You stick to routines and familiar experiences that give you a sense of comfort and control; you avoid intense emotional experiences like travel, social events, conflict, or anything else that might trigger your anxiety.

9. You’re prone to rumination and overthinking.
You do a lot of negative self-talk. You often replay past mistakes in your mind, dwell on scary “what if” scenarios, and struggle to enjoy the moment because you’re expecting the worst. Sometimes your mind races and you can’t stop it.

10. You’re a perfectionist.
You try to calm your worries by getting your work or your appearance just right. This can bring positive results, but it comes at a cost. You may have an “all-or-nothing” mentality (“If I’m not the best student, then I’m the worst”). You may have unrealistic expectations of yourself, and a catastrophic fear of falling short of them.

11. You have aches, repetitive habits, or tics.
According to psychotherapist Annie Wright, your anxiety might manifest physically in your body as frequent muscle tension or aches. Similarly, you might unconsciously pick at the skin around your nails, tap your foot, scratch your scalp, or do other repetitive things that get your nervous energy out — even if you appear composed in other ways.

12. You’re tired all the time.
Your mind is always going, so you have trouble falling asleep or staying asleep. Even when you sleep well, you feel tired during the day, because dealing with a constant underlying level of anxiety is exhausting.

13. You startle easily.
That’s because your nervous system is in over-drive. A slammed door, an ambulance siren, or other unexpected sounds really rattle you.

14. You get irritated and stressed easily.
You’re living with constant low-level stress, so even minor problems or annoyances have the power to frazzle you.

15. You can’t “just stop it.”
Anxiety isn’t something you can tell yourself to just stop doing. In fact, the above-mentioned researchers from the Weizmann Institute of Science found that people who are anxious have somewhat different brains than people who aren’t anxious. They noted that people can’t control their anxious reactions, due to a fundamental brain difference. (However, you can learn to cope with your anxiety and greatly lessen it — see the resources below).

How Anxiety Can Transform Normal Into Extraordinary

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People often wonder if they can live a normal life with anxiety. Dealing with anxiety isn’t easy. Living with that tightness in your throat, those butterflies in your stomach, those racing thoughts of “what if’s” spinning through your mind, and the constant feeling that something just isn’t right can be miserable. Anxiety can be overwhelming when it strikes, feed on itself, and leave you wondering if you’re losing your mind.

Close to 40 million Americans live with some form of anxiety in their lives. And while those numbers may seem unreasonably high, anxiety symptoms are highly treatable, and moderate anxiety can actually enhance your life when you think about it positively, and know how to harness it for good in your life.

My new book, Hack Your Anxiety, lays out the science and sense of using anxiety to your advantage. And while there can be many downsides to anxiety, and its discomfort, there can be powerful upsides too.

One thing anxiety does exceptionally well is harness your attention; it simply refuses to be ignored. There is no escaping anxiety’s grip once it starts, and fighting anxiety is almost always in vain, more often escalating its symptoms than deescalating them.

The key to knowing how to use anxiety effectively and keep it fueling growth, is to recognize it as a fundamentally normal – even helpful – part of a full life.

Normalizing your anxiety, and even using it to moderate levels to inspire you to be your best self, is absolutely possible. Keeping these 10 anxiety facts in mind can help you maintain a more positive mindset that in turn can help you access this powerful resource.

1. Anxiety is an expression of how much you care.

As if to highlight our highest priorities in life, anxiety helps bring our focus and energy to protect the things that matter most to us. We worry because we care, not because we are crazy. Anxiety can’t happen without caring. Thinking about anxiety as a reflection of our top priorities can help us embrace it as a resource.

2. Anxiety is uncomfortable for a reason, forcing you to focus.

Like an alarm clock that won’t turn off until we wake up and deal with it, anxiety keeps hassling us to pay attention and tend to the problem at hand…until we do. It plays dirty this way. We can distract ourselves, even ignore it temporarily, but ultimately it will keep coming back until we allow it to direct and keep our attention.

Contrary to popular beliefcurrent science suggests anxiety may have more to do with harnessing attention and focus, than promoting fear. In this way, anxiety can be a huge help when it comes to managing our increasingly distracted attention, and forcing us to pay attention to the things we care about most. Anxiety reminds us when we start to slip, and nudges us to stay focused on our top priorities.

3. Beware of the quicksand of resistance

It’s natural to resist anxiety, but beware of the boomerang effect of actively resisting it. The more you worry about your anxiety, the harder it becomes to manage, and the more acutely you will feel it. Even trying to suppress anxious thoughts can have the effect of raising anxiety levels in experiments. There is simply no effective way to avoid anxiety, and its effects.

4. Name anxiety to tame it.

Naming how you feel can deliver control over your experience. The simple act of naming our emotions is a well-documented, powerful tool in gaining control of them. And while you’re at it, why not label it as positively as possible? How you label your anxiety actually defines how you will experience it – if you label it as terrible and miserable, it will feel terrible and miserable. Whereas if you label it as positively as you can (i.e., excited, fired up, or ready to focus), you will likely experience it more positively.

5. Anxiety can be good for your brain.

Stress hormones can facilitate optimal performance, and also help us learn from our experiences so that we can do it again, with increasingly less effort. Acute bouts of stress can help boost neural growth and memory, according to recent research from Berkeley. Just as straining muscles and bones are how we build strength, working with stress helps us get stronger and better at it.

6. Anxiety fuels needed motivation and solution-finding energy.

Anxiety is energy waiting to be utilized. Thanks to its activation of our threat response, anxiety grabs our attention and stirs our motivation to act. Can’t stop worrying about those bills that need paying, or that yardwork that keeps waiting? You probably won’t until you actually get to them. This is your anxiety nudging you to take care of the tasks of life that matter to you, even if you might not feel like it.

7. Optimal sleep helps you use anxiety effectively.

Research keeps coming how important sleep is to function at our best. Our brains need sleep to absorb new information as well as flush toxins. Sleep allows for recovery, and thus prepares us to make the most of stress and anxiety in our life. Inadequate sleep does the opposite, and has been shown to exacerbate anxiety. 7 – 9 hours per night is the recommended amount of sleep that allows you to use anxiety most effectively.

8. Healthy anxiety can fuel optimal performance

Anxiety offers within it the seeds of our deepest desires and values. Worrying about doing your best at work or home can fuel you doing your best. Mihaly Csikszentmihalyi, researcher and positive psychology expert, coined the term flow to describe a state of mind where your actions, thoughts and bodily responses are aligned, tasks are done with ease and clarity, and there is a feeling of effortlessness and utmost concentration. It is also a state of moderate arousal and stress – an uncomfortable place – where we actually experience our highest achievements in life.

Stress – even anxiety – is always part of our best effort, creating the focus, drive, and energy to take action. Action creates momentum that in turn channels more productive action. Being in flow promotes a powerful sense of positivity and well-being, but importantly, such a state is not comfortable: it is born of stress, and often anxiety.

9. Anxiety Can Give You A Competitive Edge (even when you think it can’t)

Athletes know this feeling as well, as do high level performers, describing an experience of being “in the zone” when they are most likely to achieve their goals. The beloved fable of the tortoise and the hare illustrates the fuel anxious feelings can bring to our lives. So confident and relaxed in his race against the tortoise that the hare allows himself to stop trying, and take a fateful nap. Meanwhile the slow, steady, and undistracted tortoise channels the stress of his disadvantage into momentum that ultimately wins the race. Stress and anxiety can provide the energy and focus we need to try our best – using its fuel can help us stretch for our best.

10. How you think about anxiety controls how it affects you

Perhaps the most important fact about anxiety to know is the power we all have to control our thinking about it. In fact, a large scale study has found that how you think about stress actually defines the impact it has on your life; the more you see it as a positive resource, the more positive it will be, and visa versa. People with a healthy relationship with anxiety tend to view anxiety and stress as a normal part of life, and appear to bounce back from stressful times more easily than those who worry about their worries. Not only is it healthy to keep a positive attitude about anxiety, a healthy attitude can actually help keep anxiety’s impact healthy.

Dealing with anxiety isn’t easy and it can be hard to feel normal when you struggle with it. Not only is anxiety both a normal emotion and a normal part of life, it can be a powerful resource to channel our best effort. Thinking about it this way allows it to be.

If you want anxiety to be a healthier part of your life, changing how you think about it is a critical first step that can allow you to harness its energy and motivation toward your highest goals. This is how anxiety can fuel the extraordinary.

This post originally published on Dr. Clark’s blog