4 Ways to Change Your Relationship with Anxiety

Some people are so good at avoiding their anxiety that it doesn’t appear they are anxious at all. Others show signs of being panicky. Some people are anxious about a very specific thing (such as a health issue) and others are anxious about their place in the world, how they are doing in life, the security of their relationships, or when the next disaster is going to happen and how they will cope. Some people are able to function well despite their anxiety and others feel frequently distracted, distressed, and can’t sleep well. Some repeatedly seek reassurance from friends and family while others become more introverted and avoidant.

Anxiety is definitely not one size fits all.

There are many techniques and approaches to address anxiety and different things work for different people. Some people really benefit from using counseling or psychotherapy to explore and process why they are anxious and to gain insight into the underlying factors that keep them feeling this way. Others benefit from tools and exercises that teach them to manage their anxious thoughts and feelings in a new way. I’ve found that many people need both of these approaches.

Some tools my clients have found helpful in managing anxiety are:

1) An Appointment for Anxiety

Schedule a regular time for worrying. With this tool, you find 15 or 30 minutes (or even an hour depending on how significant the issues are) and you schedule that time daily for worrying, just like any other appointment you might schedule. For example, everyday at 5:30pm for 30 minutes. Once you’ve set this schedule, every time you catch yourself worrying, you tell yourself you must wait until 5:30 to think about this concern any further. You can keep a list of your worries throughout the day if you feel you will need to reference it at 5:30. When 5:30 comes, you focus on your worries for 30 minutes (or whatever time frame you set), no matter what. A journal can be helpful if you’d like to write them out. You commit to this schedule every day until you begin to feel you don’t need it anymore (a sign that you don’t need it anymore may be forgetting more frequently about the worry or becoming bored with the worry and more relaxed about the concern). This creates a container for your worries so that they bleed less into the rest of your day. For many people it provides some comfort to know they have a time and place to worry and don’t have to resist their worries entirely. You may find this is a helpful way to manage concerns as a permanent, fixed part of your regular schedule or if it is an isolated worry, you may find that it begins to pass after some time and you no longer need to think about it.

2) “What Else Would I Be Worried About?”

If you are focused on one particular worry that is difficult to get over and it is a worry that you can’t do much about, it can be helpful to begin asking yourself “What would I be worried about if I was not worried about this?” You might find that your anxiety is a defense mechanism to avoid something else that is actually a problem that needs addressing. For example, if you are obsessed over a body part and feel it is not good enough, you might ask yourself: “If I wasn’t worried about my thighs/stomach/nose/fill in the blank, what would I be worried about?” It may be that you’re worried about failure in some other capacity, if you’re going to lose an important relationship, or if you’ll always be lonely. These are deeper questions that could be pursued and worked on in a more meaningful way, because fixing the body part is probably not going to solve these problems. Anytime you notice your thoughts ruminating on the issue, ask yourself this question.

3) The Self-Compassionate Approach

Sometimes it can be helpful to get more at ease with the anxiety itself. For instance, if you tend to be an anxious person, when you recognize that you are engaging in anxious thinking or behavior, say to yourself in an easy going, kind manner, “Of course, you’re anxious about this. That’s what you do.” The hope is that by accepting your anxiety, changing your relationship to it (rather than resisting it or punishing yourself for it), it allows you to be more comfortable with it, and your anxiety may diminish as a result. You can say, “Ok, so you’re anxious about this. It’s ok. You’re just trying to keep yourself safe.” This is an inner-compassionate approach to your anxiety.

4) Anxiety is Valuable Information

Anxiety is not a wrong feeling. It is information. Many people learned over time to deny or resist certain feelings or they never learned to understand what their feelings or instincts were trying to tell them or how to care for and respond to these feelings. For instance, if you feel angry at someone, but learned as a child that you weren’t allowed to be angry or were never taught how to respond effectively to your anger, your psyche may have compensated by becoming anxious instead. One example is: if I’m angry at you but I’m scared of confrontation or don’t know how to get my needs met by you, I might become more passive and my attempt to control these feelings might lead me to become anxious (about our relationship, about myself and my worth, or about something unrelated because that will distract me). This can become so automatic that you never identify the underlying feeling (in this example, anger) because you have learned to immediately feel anxiety instead, which, despite the distress it causes, may feel better than grappling with a more foreign, unfamiliar, scary feeling. So, remind yourself that the anxiety your feeling is information and see if you can figure out what legitimate information the feeling is trying to give you. You can then ask yourself whether the anxiety is out of proportion to the actual problem (maybe your anxiety has become louder over the years because you haven’t been able to respond to this information effectively). Journaling can be very helpful in trying to understand the feeling/information and to respond accordingly.

A Resource: Feeling Good

If you are interested in cognitive behavior therapy, which offers a lot of tools for managing anxious thoughts and feelings, many of my patients have found the book Feeling Good very helpful.

It’s an oldie but a goodie! You’ll see from the many positive reviews!

Counseling for Anxiety in New York CIty

Therapy can be really helpful with anxiety. It can provide a space to talk it through as well as some direction on what tools might be helpful for you. A pattern of anxious experience is usually not solved overnight, but learning more about yourself, gaining insight into the underlying factors that contribute to your anxiety, nurturing unmet needs, and gaining new tools to address the problems and manage the anxiety can help you make meaningful progress.

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About Melissa King

I am a licensed mental health counselor in New York City with a psychotherapy office in the neighborhood of Murray Hill in Manhattan. Find out more about me here. I'd love to hear from you. Email me if there's a topic you'd like to read about here.

**Information on this site is not intended to replace medical advice and does not constitute a psychotherapeutic relationship with the reader.

5 Ways We Stay Stuck in Cycles of Anxiety and Depression

Some experiences of anxious or depressed feelings are normal. You notice the feeling but have a sense of being in control of it; it doesn’t interfere with your ability to take action, handle your responsibilities, or participate in activities you enjoy--at least not for long. You might even see the sadness or nervousness as a natural part of the circumstances, of healing, moving forward, or being challenged. You cry it out or give yourself a pep talk and then find yourself moving on.

But sometimes anxiety and depression can become more significant, either in intensity, frequency, or duration.

Both can leave you feeling stuck and uncertain about the way out. Sometimes it’s hard to know where the dip or hurdle began or why it seems to be sticking around.

Most people struggling with feelings associated with depression and anxiety want to understand why it is occurring and want to gain some control over these feelings rather than feeling controlled by them.

Below are 5 areas that could be keeping you stuck in a cycle of depression or anxiety. Often depression and anxiety are complex. Solving one issue doesn’t always solve the whole problem. But if you identify with one or more of these, you may be able to start unraveling the tangles.

Procrastination

Procrastination can really make you feel heavy. It’s like carrying a bag on your shoulder and never taking it off or unpacking it to lighten your load. You know you have to do something, whether it’s complete a project, make a decision, or confront someone. You know that completing the task will offer some relief but something is holding you back. Perhaps addressing the matter makes you uncomfortable or maybe you’re afraid of not doing a good job.

If this is you, ask yourself

What is standing in the way?

Is there an additional problem to be solved or do I need more information?

What action do I need to take today?

Sometimes we have really good reasons to procrastinate, but being aware of and conscious about what you are doing is valuable for ultimately moving forward.

Avoidance

Avoidance is similar to procrastination except that with procrastination there is something you know you need to do, but you perpetually put it off for later. You can avoid without procrastinating because you may not have any intention of facing the issue. 

Avoidance is when you go out of your way to evade something uncomfortable. Maybe you’re avoiding someone you feel intimidated by, someone who has hurt you, something that scares you, or the possibility that you might fail or won't live up to others’ expectations.

Addressing avoidance begins with acknowledging what you are avoiding. It can be really helpful to face the circumstance you're avoiding in your mind. Ask yourself about the worst case scenario and how you might survive it.

You can also avoid thoughts. For instance, you might worry that someone doesn’t like you, so you try to think of ways to get them to like you or reassure yourself rather than truly accepting the possibility that they might not like you.

If it's thoughts you are avoiding, you can ask yourself

What if this were true? 

What would it mean?

How might I cope with that?

Exploring the thought doesn't make it true, it just helps you to face the thought and make some peace with it if it is true.

It’s easy to spend a lot of time avoiding uncomfortable feelings, but uncomfortable feelings are a normal human experience. Learning to tolerate those feelings and understand what they are trying to communicate is a valuable life tool.

Thoughts and Beliefs

There are a lot of messages in our society to “think positive,” but sometimes the issues we worry about are realistic. Bad things do happen.

“I’M A FAILURE”

”I’M UNLOVABLE”

But often there are beliefs and thoughts present in anxiety and depression that aren’t exactly accurate. Thoughts like, “I’m a failure,” or “I’m unlovable.” These thoughts and beliefs can make us miserable despite often having some evidence to the contrary. Anxiety and depression can also lead you to falsely predict negative outcomes for situations that are truly unpredictable—and even cause you to self-sabotage in order to make the prediction come true. 

Surprisingly, despite causing pain, we can be really committed to these beliefs and thoughts. They are often a way we try to protect ourselves from being vulnerable to what we think might be greater pain.

Take a moment and reflect on the thoughts that lead to your negative beliefs. Ask yourself if you can really say that each of these thoughts are factually true. Are there any exceptions that prove your belief/thought wrong? Are there realistic possible outcomes besides the negative one you are presuming?

If you find that something really has some evidence to support your concerns, then you can ask,

What can I do about this?

What are some ways I can get through this if my fear is true?

Is there something I can change or improve?

Is there someone who I can talk with about how I’m feeling?

Fear of Conflict

Ugh! That feeling in the pit of your stomach when you know you need to address something with someone but you are sure the outcome is not going to be good (which, by the way, may not be an accurate belief).

So you keep stuffing it.

You don’t say how you really feel and you don’t ask for what you need. Leaving things unsettled and accepting less than what we deserve can create a heavy emotional burden. It can also lead us to stay in all kinds of relationships that aren’t great for us. Learning some skills for addressing conflict can make a big difference. Garnering up support and a pep talk from a friend or family member before addressing the conflict can also be helpful. In addition, it also takes some self-esteem and self-compassion—believing that your thoughts, feelings, and needs deserve to be voiced and heard. 

Conflict is uncomfortable, so being willing to accept and tolerate the discomfort can be helpful.

If you fear for your safety when it comes to conflict, pay attention to that signal and don’t move forward without talking it over with a professional who has experience with relationships that can feel threatening at times.

Fear of Loss

This is a big one. It’s really easy to get stuck in a depressive or anxious pattern because we are afraid of facing a loss.

Fear of loss can be paralyzing.

You might be afraid of losing the admiration or affection of someone. You might fear someone finding out you aren’t perfect after all and rejecting you. You might fear facing the loss of a dream or losing your health. Identifying what you are really afraid of is really important.

Acknowledging sadness about the loss or potential loss is important, while also identifying how you will get back on your feet despite it being tough.

Fear of loss calls for a lot of self-compassion. It also calls for you to give yourself some credit. Most people are more resilient than they think. If you are reading this, that shows you have some resourcefulness in you. Embrace that belief in yourself.

Be Kind to Yourself

You might notice that all 5 of these have a thread of avoidance running through them. Sometimes we avoid things because we need extra support, new skills, or we just have too much on our plate.

Try not to judge yourself. 

Avoidance just describes a behavior. It can be an effective coping tool for a period of time. But at some point it usually needs to be addressed. I hope that this post helped you identify some areas where you can get brave and take some action.

If you just can't get going or feel overwhelmed by the challenges you need to solve, you don’t have to do it all alone. Even if you are not widely connected, there are places to go for support, whether it be a church, community group, or online support group.

If you'd like to talk with someone in a safe, confidential, and therapeutic space, I am here for you. Individual and group therapy are a great resource for navigating anxiety and depression. 

Most importantly, know that you are not alone. Life is challenging to navigate. But keep going! Be brave!

Melissa

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About Melissa King

I am a licensed mental health counselor in New York City with a psychotherapy office in the neighborhood of Murray Hill in Manhattan. Find out more about me here. I'd love to hear from you. Email me if there's a topic you'd like to read about here.

Anxiety and Solvable vs. Unsolvable Problems

Anxiety can feel debilitating and paralyzing.

You have knots in your stomach. Your thoughts are racing. You toss and turn, wishing you could sleep. Maybe you feel other things too: anger, sadness, self-doubt. 

Anxiety can be difficult to shake. It can become consuming and sometimes lead you to tears.

But anxiety serves a purpose. It often happens when something important to you is threatened. We wouldn’t survive well without it. We need it.

But you might be frustrated with yourself and wish you could take things more in stride. Maybe you feel insecure about something you said to someone, worried about your future, or distressed over a decision you have to make. You might think, “If I were more confident, this wouldn’t bother me so much.”

Pushing anxiety away is often not the answer.

Although anxiety can sometimes seem to get out of control, the more we avoid anxiety and judge ourselves for having it, the more likely it’s going to stick around. 

It can be helpful to find some space for yourself to stop and be with the anxiety for a moment. Notice what you are feeling. Notice the thoughts you are having. This might sound cheesy, but for just a moment, welcome the anxiety and thank your body for alerting you that something is wrong. I say this because if you judge your anxiety or judge yourself for having anxiety, it can’t do it’s job. Making peace with it’s presence in your life can have a lot of value.

Now ask yourself what the anxiety is trying to tell you. Is it alerting you to danger (a problem)? What is the danger? Maybe it’s worry about rejection. Maybe it’s fear of losing your job. Maybe it’s concern about losing an opportunity or concern over risk of embarrassment.

Once you have a sense for what the danger is, 

take a breath. 

Now ask yourself if there is something you can do about the danger (about the problem). If there are a number of issues building up into a larger problem, it can be helpful to list the various concerns. Sometimes we become anxious because we’re not looking at the little solvable pieces but are only looking at the big picture. 

Once you’ve identified each of the problems, ask yourself if there is anything you can do about them. Maybe some of the pieces are solvable and some aren’t. You can create two columns, one for solvable worries and one for unsolvable worries. 

For the solvable worries, you can begin listing potential solutions or next steps. Sometimes the next step for a particular problem or worry is simply, “I need to get more information about this.”

Sometimes you might find that your anxiety is actually centered around only one small piece of what feels like a large problem. For instance, maybe you feel fine about solving most of the problem except that in order to do so, you need to have a conversation with someone you don’t like and that is really the only part causing the anxiety. 

And the unsolvable problems.

If there is nothing you can do about the problem, sometimes it means having to sit with pain or uncertainty. Sometimes it means accepting ourselves and our emotions as we are. We can’t always avoid pain. We can’t always get the things we desperately want when we want them. Sometimes we lose...and it hurts.

Anxiety is sometimes a result of avoiding our pain.

In this instance, it’s ok to shed a few tears, nurture yourself with a good film, or a night out with a friend. You can also try a mindfulness exercise, which I wrote about last week.

If the pain feels overwhelming, it’s really important to get help. Talk to a friend. Call a family member. Find an online or in-person support group. Or seek out a therapist.

We all have to face uncertainty and pain. You are definitely not alone, although I know it can feel that way when you are in it. In American culture, we tend to run from pain and uncertainty, doing whatever we can to solve problems even when they are unsolvable. But we can miss out on valuable elements of humanity and even spirituality when we do this and we miss out on the opportunity to make peace with our anxiety and to connect deeply with others who share our experience.

 

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About Me

I am a licensed mental health counselor in New York City with a psychotherapy office in the neighborhood of Murray Hill in Manhattan. Find out more about me here. I'd love to hear from you. Email me if there's a topic you'd like to read about here.

The Counterintuitive Way to Cope with Anxiety

You know that moment, when your thoughts start racing and your body tenses up? You feel restless and you can’t focus on anything else because you are so overcome with worry, fear, or nervousness. Your stomach might even feel a little queasy.

Anxiety has helped human beings survive since the old ages. It has a purpose. It's there to warn us of danger and to physically prepare us to run or fight. Sometimes the experience of anxiety does it’s job and leads you to act on a problem. Mild anxiety can even help us do better on exams, performances, or presentations.  

But for many people, anxiety can become consuming amidst uncertainty, loss, conflict, vulnerability, or fear. It can feel out of proportion to the context and be paralyzing, leaving you feeling lost at how to manage it. 

When anxiety hits, you might be compelled to do anything to escape it, which can lead to avoiding situations you'd like to be involved with or issues you need to address. This can hinder your ability to enjoy life, take on challenges, socialize, address conflict, or be effective in relationships. If you avoid or escape and then feel calmer, this teaches your brain that avoidance must be the answer to your anxiety. But then you stay stuck in a cycle, always avoiding in order to control the anxiety.

“Avoidance reinforces anxiety.”

It’s common to want to get away from anxiety. No one likes it. But if you notice in the title, this post is about coping not avoiding.

Coping means facing your anxiety head on. Rather than push it away, it’s important to sit with it, to welcome it, to be aware of it. This is imperative if you want to face the things that trigger an anxious response.

I know. This feels so counterintuitive! 

This is where the popular term “mindfulness” comes in. Many people think mindfulness means emptying your thoughts and clearing your mind.

Nope!

In fact, it’s actually the opposite. It’s about ADDING to your thoughts.

Thank God because emptying your mind is incredibly difficult when you’re feeling anxious!

How Do You Do It?

When you’re feeling anxious

1. Take a moment (or some moments) to notice what’s happening. 

2. Name what you’re feeling emotionally. For instance, you might say, “There’s that anxiety again. I’ve felt this before. It’s familiar. I also notice I feel sad and even a little angry.” 

3. Notice the sensations in your body. Name them (tense shoulders, topsy turvy stomach). 

4. Observe your worrisome thoughts. Imagine them on a ticker tape, scrolling by as you read them. What are they? Are there many worries or just one? What do they say you’re most afraid of?

5. See if you are aware of what you are avoiding. Just notice it. Try not to make judgments about your feelings or thoughts.

6. Now, begin to be aware of your five senses. What do you see in the room around you? What do you hear? What does your skin feel? (a cool breeze, a soft fabric?) What do you smell? Take a breath and notice your body sensations again.

7. Now take note of what thoughts are present besides the anxious ones. Is there anything that feels stable in your life? Anything that you are interested in? A book you are reading? A good friend?

Do this all while allowing the anxiety to be present.

If it helps, you can write down your observations while you’re making them—as a journal entry or even as a more visual/artistic collage of words. You can even draw your body and position the words across your body where you feel them or use colors to represent your emotions.

Allowing yourself to be exposed to the feelings of anxiety without trying to avoid them, without telling yourself you shouldn't have them, allows your brain and your body to learn that the feelings themselves aren’t dangerous. With practice, you can learn to feel more in control when anxiety exists. By incorporating awareness of your environment, you exercise your brain into thinking more flexibly. You teach it how to be aware of other things while anxiety is present so that anxiety doesn’t become the full focus, blurring out the rest of your life.

Be careful not to use this exercise to continue avoiding situations you need to address or would like to engage in. If your anxiety really is warning you of danger, by all means listen and stay safe. But if your anxiety is just saying, "Hey, this is a little uncomfortable and I'm nervous," but you know moving forward is necessary for progress, then use the skills to step toward the challenge or difficulty and let anxiety tag along, knowing that it has it's place and purpose. 

Usually, anxiety will come in waves and it will eventually dissipate on it’s own. Allowing the anxiety to be present is the only way to learn this. The more comfortable you get with it’s presence, the less it will take over your life.

There are other approaches to addressing anxiety and if you need support, please reach out to your doctor or a therapist. Also, some anxiety can be caused by medical conditions or medication, so it's good to rule that out. 

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About Me

I am a licensed mental health counselor in New York City with a psychotherapy office in the neighborhood of Murray Hill in Manhattan. Find out more about me here. I'd love to hear from you. Email me if there's a topic you'd like me to write about.