Everyone is affected by anxiety at some level. Most people will experience short-term anxiety when they are confronted by a stressful situation, but some people will develop a longer-term anxiety disorder such as generalised anxiety disorder, social, health or peri-natal anxiety, post-traumatic stress disorder (PTSD) or panic attacks.
In 2017, the Institute for Health Metrics and Evaluation estimated that 284 million people (2.5% to 7% of the population) worldwide were suffering from a form of anxiety. The physical and mental symptoms caused by anxiety can be overwhelming and seriously interfere with daily living and quality of life.
Although some people might need pharmacological or psychiatric treatment as well, organisations like the Anxiety and Depression Association of America, the UK-based mental health charity, MIND, and the Royal College of Psychiatrists recommend a number of self-help techniques for reducing anxiety levels and alleviating symptoms.
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Talking to Others
When the anxiety is related to a specific situation, such as the breakdown of a relationship, problems at work, financial troubles or a serious health issue, it can often help to talk it over with someone.
As well as helping to put things in perspective, frequently just talking about things can make you feel better, and your listener can provide emotional support. In some situations, there might be local or online support groups of people facing the same challenge you do with whom you can connect.
Relaxation and Breathing Exercises
Back in the 1970s, Dr Herbert Benson, a cardiologist at Harvard Medical School proposed a method of coping with stress by triggering a relaxation response in the body.
Described as ‘a state of profound rest’, this can be achieved in several ways including progressive muscle relaxation, mindfulness meditation and guided imagery. Common to all these approaches is breath focus. In their article, ‘Relaxation Techniques’, Harvard Health Publishing, identify the first step towards breath focus as learning to breathe deeply. Deep breathing is effective as a calming technique.
It is known in medicine to positively affect heart rates and a 2005 Japanese study indicated that deep breathing also lowers blood pressure, possibly by reducing stress and inducing calm.
The standard deep breathing exercise can vary slightly. The one described below is from the UK’s National Health Service.
- Make yourself comfortable, standing up, sitting with your back supported or lying on a bed or on the floor.
- Let your breath flow as deep down into your belly as is comfortable, without forcing it.
- Try breathing in through your nose and out through your mouth.
- Breathe in gently and regularly. Some people find it helpful to count steadily from 1 to 5. You may not be able to reach 5 at first.
- Then, without pausing or holding your breath, let it flow out gently, counting from 1 to 5 again, if you find this helpful.
- Keep doing this for 3 to 5 minutes.
Other relaxation-promoting activities include Yoga, aromatherapy and massage, and the importance of getting a good night’s sleep should not be under-estimated.
The link between physical activity and improved mental health is long-established. Among the conclusions of a 1985 review of earlier studies (The Relation of Physical Activity and Exercise to Mental Health – Barr Taylor, James, Sallis, Needle) was an association between exercise and a reduction in symptoms of anxiety.
More recently, a 2018 study (Chekroud et al), published in the The Lancet Pyschiatry journal, which had explored the association between physical exercise and mental health in the USA, also found a clear association between exercise and improved mental health.
There are several reasons proposed for the positive effect of exercise on mental health; primarily:
- Social interaction associated with many forms of exercise
- Sense of achievement
- Release of endorphins (‘feel good’ hormones)
These are still being studied, but the effects on mental health are likely to be caused by a combination of factors, rather than a single factor.
Exercise can also help you sleep better, which in turn improves overall wellbeing.
Walking, cycling or swimming on your own, or with friends, are good forms of exercise, and activities like Zumba can be a fun way of combining exercise with socialising.
It can be difficult to embark on an exercise routine if you’re feeling anxious, particularly if you suffer from social anxiety and find it hard to go out. Start small if you find it daunting; maybe by walking instead of driving when you do go out or going for a short walk at quiet times of day. You only need a moderate amount of exercise to reap the benefits.
In fact, a 2005 study by the Institute of Psychiatry at the University of Sao Paulo (Physical activity and mental health: the association between exercise and mood.) found that, while exercise was beneficial for mental health disorders, over-exercising worsened symptoms. Avoid frequent or prolonged intense, or excessive exercise.
Using Cognitive Techniques
Anxiety can make it hard for you to stop or control worrying. MIND recommends several methods of managing your worries.
Even if you feel you need to think about the worries, it’s important not to let them take over your mind all the time. Instead, set aside a specific time to think about your worries. Each time you start worrying, remind yourself that you will think about it later during your worry time.
You can also try writing down your worries. Many people find it calming to ‘remove the worry’ from their minds by transferring it to a paper. MIND recommends keeping a notebook or a jar with slips of paper for the worries.
Cognitive behavioural therapy (CBT), described by Medical News Today as ‘a short-term therapy technique that can help people find new ways to behave by changing their thought patterns’ is a standard form of effective treatment for a range of mental health disorders, including anxiety.
It does require commitment, but the results can be life-changing. If you aren’t able to access this via your health providers, there are several programmes available online, or workbooks you can purchase.
Keeping a Diary
Keeping a diary can help you identify what triggers your anxiety symptoms. These could be places, people, situations or activities. Once a trigger is identified, you can look for ways to address it.
Eat a Healthy Diet
Omega 3 supplements are often recommended for those with anxiety or depression, and there are studies which appeared to show benefits.
However a 2019 systematic review by the UK’s University of East Anglia of 31 studies, ‘found that there is no demonstrable value in people taking omega-3 oil supplements for the prevention or treatment of depression and anxiety’.
Caffeine has been demonstrated to increase symptoms of anxiety in some people. If you are affected in this way, try to avoid or reduce tea, coffee, chocolate, cola and energy drinks.
It can be tempting to turn to alcohol to try and dull the feelings of anxiety. While an occasional glass of wine shouldn’t do any harm, the calming effect will only be brief and there can be significant long-term physical and psychological harm from regular heavy drinking, including a susceptibility to anxiety, trapping you in a vicious circle. To avoid making your situation worse, minimise your alcohol intake.
If the symptoms of your anxiety include diarrhoea, you need to remember to drink plenty of water to replace lost fluids.
Nutritional psychiatry is an emerging field, studying the possible effect of different foods on mental health. Certain types of foods are believed to potentially improve mental wellbeing by creating more regular blood sugar levels or by affecting gut bacteria, but there is no definitive evidence yet.
Studies such as the 2010 study by researchers at the Department of Clinical and Biomedical Sciences, University of Melbourne, have found an association between a typical western diet of processed or fried foods, refined grains, sugary products, and beer and poorer mental health but they acknowledged that the mental health disorders might be causing the dietary choices and more study is needed.
Regardless of these findings, a healthy diet is vital for overall wellbeing and optimal physical and mental health and your body and mind need sufficient energy to function properly. Although your appetite might be affected by feelings of anxiety, you should try to maintain a varied and well-balanced diet which provides the right amounts of carbohydrates, proteins, fats, fibre, vitamins and minerals. The Anxiety and Depression Association of America also recommends not skipping meals and always having healthy energy-boosting snacks on hand.
Hopefully you will benefit from implementing some, or all, of the techniques described in this article. However, if you have not already been seen by a doctor, and your symptoms are still severe enough to interfere with your function or affecting your mood, it is important that you see your doctor as you may need medical or psychiatric intervention.