Anticipatory Anxiety: Symptoms, Causes, and Treatment

Picture this: it’s the night before you have to present to your colleagues and you can’t sleep. Instead, you lay in bed and obsessively think about all the scenarios that could pop up during said meeting. 

Or maybe you have a blind date and, in the lead up to it, you find yourself completely consumed with nerves and unable to think about anything else. 

Of course, in either of these situations, a little nervousness is a completely normal and common symptom. But, if you find yourself feeling overly worried about future events you may be dealing with anxiety. More specifically, it could be what some people call “anticipatory anxiety.”

Intrigued? Read on to learn more.

What Causes Anticipatory Anxiety

The idea of anticipatory anxiety is predicated on the fact that uncertainty causes people to feel anxious — some people more than others. While it’s not its own condition, it’s a common aspect of many anxiety disorders, such as generalized anxiety disorder (GAD) and panic disorder.

Again, it’s totally expected to feel some amount of nerves before a future event (like a big meeting or if you need to have a tough conversation with someone or any other momentous upcoming event).

Anticipatory anxiety goes beyond this — it can trigger a panic attack or obsessive thinking.

A panic attack brings with it an intense and sudden feeling of fear, along with physical symptoms (more on those soon!). 

Sometimes, even the thought of having a panic attack can induce one. Yes, there is anticipation in anxiety.

For example, you may start worrying about a doctor’s appointment you have, but then the worry turns into having a panic attack at the doctor’s office — which triggers a panic attack to happen right then.

Anticipatory Anxiety Symptoms 

Because anticipatory anxiety is most closely connected to GAD and panic disorder, the symptoms associated with these two disorders are what you may notice most. 

Symptoms of GAD include: 

• Obsessive thoughts

• Dry mouth

• Heart palpitations

• Sweating

• Trouble sleeping

• Excess worry

Symptoms of panic disorder include:

• Chest pain

• Chills

• Trouble breathing or shortness of breath

• Overwhelming fear

• Nausea

• Racing heart

• Sweating

• Feelings of panic

• Shaking

As you can see, there are many shared symptoms between the two conditions. So, if you’re experiencing one common symptom.

Ways to Treat Anticipatory Anxiety

So, you’re starting to suspect you may be suffering from anticipatory anxiety. Or, better, you’ve already spoken to a healthcare professional and you’ve both come to the conclusion that you’re prone to it.

Either way, your next step is figuring out a plan of attack. 

Luckily, treating anticipatory anxiety doesn’t stray too far from treating more traditional forms of anxiety. Here are a few of the most common ways to treat anticipatory anxiety:

Try Therapy

Cognitive behavioral therapy (CBT) is suggested as a way of treating both panic disorder and GAD, so it may help to reduce anticipatory anxiety.

In CBT, a therapist will work with you to identify patterns of thought and behavior that cause anxiety. Then, they’ll work with you to find ways to change those things.

Within CBT, a therapist will usually work with you to develop specific skills — like social skills — to help reduce anxiety pertaining to certain situations.

There are a number of studies that have found that CBT can be useful for people who are dealing with generalized anxiety disorder, specific phobias, social anxiety disorder and panic disorder.

Look Into Medication

There are a few different types of medications used to treat anxiety. They may not “cure” it, but they can help you get a handle on the symptoms and make anticipatory anxiety way less overwhelming in things like social situations.

Medications used to treat anxiety include:

• Selective serotonin reuptake inhibitors (SSRIs): Also used to treat depression, these work by increasing the level of the neurotransmitter serotonin (which helps regulate your feelings) in your brain. Sertraline (the active ingredient in Zoloft®), citalopram (Celexa®), escitalopram (Lexapro®) and fluoxetine (Prozac®) are all SSRIs approved to treat anxiety disorders.

• Serotonin-norepinephrine reuptake inhibitors (SNRIs): These medications work by increasing the levels of serotonin and norepinephrine in your brain. SNRIs approved to treat anxiety disorders include venlafaxine (Effexor®) and duloxetine (Cymbalta®).

• Benzodiazepines: This type of medication boosts the effect of the neurotransmitter GABA, which is responsible for controlling brain activity and regulating sleep, muscle relaxation and feelings of calmness. Benzodiazepines approved to treat anxiety disorders are alprazolam (Xanax®), diazepam (Valium®) and lorazepam (Ativan®) and others. They tend to work quickly, but are usually only prescribed for short-term use because they carry a high risk of physical dependence.

• Beta-blockers: These slow down your heart rate and relax your blood vessels, which helps to control physical symptoms of anxiety (like a rapid heartbeat). Sometimes, a healthcare professional will prescribe a beta-blocker, like propranolol, to control anxiety symptoms during an event (like a job interview or important meeting). 

Practice Mindfulness

Staying present in the moment may help you deal with anticipatory anxiety. The thinking here is that if you’re living in the moment, you won’t be able to think about what’s coming up and worry about it. 

There’s even some research to back this up. A small study of 15 people done in 2014 found that 20 minutes of mindful meditation may reduce overall brain activity and, in doing so, lower anxiety. 

Researchers at The Johns Hopkins University looked at 47 randomized clinical trials and determined that meditation assists people in navigating stress and anxiety.

Downloading an app focused on guided mindful meditations is an easy way to try this tactic out. 

Navigating Anticipatory Anxiety 

When thinking about specific future events, it’s natural to feel a certain level of nerves. Whether it’s having to end a relationship, going to a social event, telling a pal bad news, or presenting in front of a large group, it’s normal to feel anxious. 

However, if that anxiety becomes overwhelming or makes it difficult to function in your daily life, it’s gone beyond normal nerves and it can lead to negative outcomes. So, you’re going to need to find a way to handle it.

While anticipatory anxiety is not considered its own classification of anxiety, it’s commonly associated with both generalized anxiety disorder and panic disorder. 

Thankfully, there are treatments available. Medication, therapy and mindfulness can all help. 

If you are experiencing anticipatory anxiety, it is a good idea to check in with a mental health professional. He or she will be able to help you navigate your anxiety and find a way of dealing with it.