Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 11/18/2020
Fear and anxiety are natural and adaptive parts of being human — our fight or flight reaction evolved early as a survival mechanism.
The pounding heart, tensed muscles, shallow breaths and sweaty palms alerted us to danger, heightened our senses so we could react quickly, and, in the long run, prevented us from taking unnecessary risks.
Today, we rarely face down dangerous animals in pursuit of our next meal, but there are plenty of situations that can make us understandably anxious — whether it’s being late to an appointment, being tapped to give a presentation in front of a large audience or worried about an upcoming life event.
But for many people, anxiety can become intense and persistent.
In fact, it’s estimated that 33 percent of people are affected by an anxiety disorder at some point in their lives.
Some experience mild symptoms while others have full-on panic attacks that include heart palpitations, chest pain, dizziness, nausea, shortness of breath, trembling or the chills.
Anxiety can be unsettling and disruptive, but there are things that we can do to get back to a sense of calm and well-being. This article looks at some strategies that can calm anxiety, from making sound lifestyle choices to popular anti-anxiety medications.
This may sound obvious to the point of being annoying, but healthy lifestyle choices may help keep anxiety at bay. Decreasing caffeine, increasing exercise and staying in the moment are all things that can help us stay calm.
People worldwide consume an estimated 1.6 billion cups of coffee each day. Many of us feel like we can’t start our day without it, which isn’t surprising, considering the caffeine in coffee is a stimulant that perks up our central nervous system and makes us feel alert.
While this can feel like a good thing, it can also mimic some symptoms of anxiety, such as increased heart rate.
Researchers have also found that individuals who do suffer from panic disorders or social anxiety disorder are particularly sensitive to the effects of caffeine and may benefit from reducing their intake.
Moreover, there is evidence that consistent consumption of caffeine — which can also be found in teas, sodas, chocolate and energy drinks — can lead to withdrawal symptoms when we start skipping our ritual afternoon latte. Caffeine withdrawal can feel like a panic attack with symptoms such as increased heart rate, sweating, nausea, agitation and tremors.
The link between alcohol and anxiety is a little more complicated.
Alcohol has depressant effects, so it can make us feel calmer in the moment. Many of us use it as a way to cope with an anxious situation or a generalized feeling of anxiety.
But research has found that many people suffer concurrently from anxiety and alcohol use disorders..
There are different theories about why people often have problems with anxiety and alcohol simultaneously. It may be that people with anxiety use alcohol to self-medicate and become dependent on it.
But it may also be that the anxiety symptoms actually come from the overuse of alcohol and possibly from repeated alcohol withdrawal.
Of course, it’s also possible that the relationship is less direct — the same underlying issues that cause anxiety also cause problems with alcohol.
There is a growing body of research that shows that exercise isn’t just good for our physical health, but for our mental health, as well.
It releases endorphins (some of those feel-good chemicals our brains make) which can reduce our feelings of stress, anxiety and depression.
One systematic review of research on exercise and anxiety found that exercise appears to lower symptoms of anxiety in people who have panic disorders. The review found that exercise alone was not as effective as antidepressant medication but concluded that exercise was a good complement to other treatments including medication and cognitive therapy.
And, the mood benefits of exercise do not require anyone to become a gym rat or a marathon runner. It is reasonable to believe that every little bit of movement helps both in improving mood and reducing anxiety.
Yoga has become one of the most popular forms of exercise known for helping us stretch our muscles, build our strength and relax our bodies and minds all at once.
Research seems to suggest that while the evidence is not conclusive, yoga may be effective for people who suffer from anxiety.
A systematic review published in 2015 looked at 25 randomized controlled trials focused on yoga and mood.
It found evidence that yoga can lower blood pressure, heart rate and cortisol levels (a brain chemical released during our fight and flight reaction).
The review concluded that there is, “preliminary evidence to suggest that yoga practice leads to better regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system, as well as a decrease in depressive and anxious symptoms in a range of populations.”
Anxiety is rarely about the present because it is rare that we are in imminent danger.
Instead, we tend to feel anxious when we ruminate about the past and focus on what we could have or should have done, or when we fast-forward to the future and start imagining worst-case scenarios about nothing in particular.
Mindfulness is a practice for keeping us in the now. We often associate mindfulness with meditation, which is certainly one way to practice this skill. But there are other ways to make sure you’re staying in the moment.
Research has found that things like listening to music (which has been associated with positive effects on mood), getting outside, count breaths (which has the added benefit of helping to slow them down) or even naming things we can see, touch or smell in a given moment can help at least temporarily relieve symptoms of anxiety.
Focusing on current sensations (other than anxiety) can help us calm down. There is some research that says mindfulness-based therapies work, and a recent systematic review concluded that “…mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.”
If anxiety remains persistent, it can help to talk to a trained mental health professional.
They can explain the most effective approach or combination of approaches to treat generalized anxiety or address specific fears or phobias.
There are some methods that are frequently used to treat anxiety because they have evidence of success.
CBT focuses on identifying the unhelpful and distorted thoughts that are at the center of our anxiety.
It trains individuals to identify not just the situations that cause anxiety, but the ways in which our own pattern of thinking can make things worse.
Patients then work with a mental health professional to develop new thoughts, behaviors and coping skills.
There is research dating back to the mid-1960s that suggests this is an effective strategy for managing anxiety.
Exposure therapy is a form of CBT that has people face their fears as a way of overcoming them — this can be done in real life (bringing a dog to a session) or as guided visualization.
People who have specific anxieties often work very hard to avoid their personal anxiety trigger to the point that it takes over their thinking and disrupts their life.
There is now also substantial work exploring the possibility of virtual reality as an effective form of exposure therapy.
DBT is focused on teaching the idea that two things that seem inherently opposite can actually be true at the same time.
Most notably, we can be feeling anxious and be safe at the same time.
DBT is grounded in mindfulness and sessions help patients develop skills for how to control their emotions, manage stress and be effective in interpersonal situations.
DBT has been shown to help people regulate their emotions, including anxiety.
There are a number of medications that have been proven to provide relief from anxiety.
Some work in the moment to alleviate the physical symptoms while others work over time to alter brain chemistry.
There are decades of research to suggest that these medications are safe, but they do have side effects you should be aware of.
This class of drugs, sometimes referred to as “benzos,” includes Xanax®, Valium® and Ativan®.
These medications are actually sedatives; by slowing down the brain and body, they can provide relief for the typical symptoms of anxiety.
Benzos are usually used for a short period of time or prescribed for a patient to use on an as-needed basis when anxiety symptoms become acute.
Long-term use of these medications can lead to addiction. Side effects typically include things like dizziness, tiredness and slow reaction time — among others.
The exact way that this medication works is still unknown, but scientists believe that it binds to serotonin receptors in the brain.
Serotonin is a neurotransmitter, a chemical in the brain that is known to help regulate mood, social behavior, appetite, digestion, sleep, memory and sexual desire and function.
Low levels of serotonin are associated with depression and anxiety.
By bonding to serotonin receptors, buspirone may increase the activity of serotonin in the brain.
Buspirone is often taken instead of — or in conjunction with — another class of medications known as selective serotonin reuptake inhibitors (SSRIs). Common side effects include dizziness and headaches. Buspirone is not addictive.
Selective Serotonin Reuptake Inhibitors are technically antidepressants, but are sometimes used to treat anxiety, as well.
This class of drug — which includes brands like Prozac® and Lexapro® — increases levels of serotonin in the brain. Higher levels of this neurotransmitter are associated with better moods and less anxiety.
SSRIs are not addictive and can be taken for the long term but can cause withdrawal symptoms if someone abruptly stops taking them.
Common side effects include nausea, dry mouth and dizziness.
These drugs are also known to cause sexual side effects. People taking these medications may notice a decrease in sexual desire, have trouble becoming aroused, or have difficulty reaching orgasm.
Anxiety is a common of being human. But when it becomes persistent or intense it can disrupt our everyday lives.
The good news is that there are many proven strategies for coping with – and moving past — anxiety.
Everything from everyday lifestyle changes like yoga and mindfulness exercises, to different types of therapy and even prescription medications are all ways to help treat persistent symptoms of anxiety.
If you’re looking to do something about your anxiety, the best thing to do is contact your healthcare provider. They’ll be able to help you figure out your best course of action.
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