Anxiety: How to cope and when to get help

We all feel the effects of anxiety from time to time — perhaps a fluttering in the chest before a job interview or insomnia in the face of a major life decision.

As unpleasant as the effects of anxiety can be, this emotion does serve a purpose.

“Anxiety is an evolutionary response that is designed to protect us from threats that could cause physical or emotional harm,” says Lauren Baker, MS, LMHCA, a mental health therapist with the MultiCare Behavioral Health Network. “It can also give us that extra boost of motivation we need to get something done, but too much anxiety can be harmful.”

How much anxiety is too much, and what can you do when anxiety morphs from a useful emotional tool into a major roadblock?

When anxiety becomes a problem

Anxiety can affect the way we think and feel, and people may experience it differently. Some may find themselves obsessively speculating about the future so much that they can’t focus on the present.

Others may experience the physiological symptoms of anxiety, such as restlessness, stomach pain, sweating, trembling, shortness of breath, heart palpitations, muscle tension or insomnia.

“Anxiety isn’t a problem until it causes a problem for you,” says Mark Ingoldby, LICSW, a clinical social worker and supervisor of the primary care behavioral health program with the MultiCare Behavioral Health Network. “Anxiety can rise to the level of a disorder when it’s persistent and it interferes with some aspect of your life — your relationships, your sleep or your ability to function at home, work, school or in the community.”

What causes an anxiety disorder?

Anxiety disorders can be triggered by distressing events or big changes in our lives, such as the death of a loved one, a divorce, the sudden loss of a job, retirement or an illness. Our genes and the environment in which we grew up can also play a role.

“The kinds of behaviors that were modeled for us as children, particularly around managing stress and confrontation, shape how we respond to these situations as adults,” Ingoldby says. “People who endured trauma in childhood may also be more likely to develop anxiety disorders later in life.”

Anxiety disorders affect 40 million U.S. adults every year, according to the Anxiety and Depression Association of America, and this family of disorders are the most common psychiatric conditions among children and adolescents.

“It’s common for people with a lot of anxiety to think that what they are experiencing falls within a healthy range, and often it does not,” Baker says. “If you experience anxiety about certain things more than half the days of the week, or if your symptoms are making it difficult for you to fulfill your roles or leave the house, then that’s not within a healthy range.”

The core symptoms of anxiety are largely the same for adults and children, but some symptoms are more common in youth.

“Kids tend to hold anxiety in more because many don’t have the tools to talk about it or process it,” Ingoldby says. “As a result, they may have more reactive symptoms like being quick to anger, to lose focus, to get tired or to withdraw.”

Excessive worrying is a symptom of anxiety across both populations, but what adults and children worry about is likely to be different. While adults tend to hyperfocus on job performance, finances, their own physical health or household issues, kids tend to worry about performance in academics or recreational activities, and many experience fears around catastrophes — like earthquakes, wars or illnesses — that would disrupt their family lives.

“It’s important to ask yourself ‘What’s my coping strategy when I get anxious, and does it provide long-lasting support?’ If the answer to the second part of that question is no for any given strategy, it’s probably time to look for an alternative approach.”

Treating anxiety disorder 

Living with an anxiety disorder can be a challenge, but there are treatments that can improve symptoms, and in some cases provide full remission from symptoms. The two main treatments for anxiety disorder are psychotherapy, where a person works one-on-one or in a group setting with a counselor, and medications. Support groups may be helpful as well.

“Evidence shows that patients who receive a combination of therapy and medications tend to experience the most success,” Baker says. “When looking for a therapist, I recommend searching for someone who specializes in cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), which are the two therapeutic models most commonly used to treat anxiety.”

Recovery from an anxiety disorder is highly individual and depends on several factors, including the root causes of your anxiety, the severity of your symptoms, trauma history, current stressors in your life and your level of social support.

“If anxiety symptoms are disrupting your life, talk to your primary care doctor or seek out a mental health professional,” Baker says. “Sometimes symptoms of anxiety disorders can overlap with symptoms of other conditions, so it’s important to get evaluated.”

Coping with anxiety 

Whether you’ve been diagnosed with an anxiety disorder or are dealing with troubling symptoms of anxiety, you can take steps in your daily life to help manage anxious thoughts and feelings when they occur and support your long-term well-being.

Don’t go it alone. It’s a common myth that a person should be able to deal with anxiety themselves — that they can “tough it out” alone — but rarely, if ever, is that effective.

“We need other people,” Ingoldby says. “Find someone in your life who really listens to you, that accepts you for who you are without passing judgment, whether that’s a friend, a family member or a therapist, and open up to them about what you’re going through.”

Find an activity that helps you focus. Activities like coloring that require attention to fine details can be helpful in reducing symptoms of stress and anxiety and keeping us anchored in the present moment.

Eat, sleep and hydrate consistently. Both lack of sleep and unhealthy eating patterns can increase anxiety levels. Eating regular nutritious meals with protein-rich foods and getting between seven to nine hours of sleep each night can support your ability to effectively manage stress.

Monitor your caffeine intake. Caffeine is a stimulant that can make us feel alert and ready to tackle the day ahead, but it can also trigger symptoms of anxiety, making us feel tense, restless or jittery if we ingest too much. Take a look at how much caffeine you’re consuming on a daily basis and how it’s affecting you, and consider cutting back.

Move your body. Exercise is a powerful tool for managing symptoms of anxiety. It can reduce muscle tension, distract the worrying mind and support your respiratory health.

“When we feel anxious, our breathing is often shallow and sometimes too fast,” Ingoldby says. “Exercise forces us to breathe deeply, which activates the part of our brain that can help us calm down.”

Check in with your body frequently. Take a moment at some point during your day to scan your body from head to toe, noting places of discomfort or tension. This activity fosters the mind-body connection and can help you understand how stress and anxiety are affecting your body.

Evaluate your current coping strategies. Some coping strategies are more helpful than others. For example, turning to substances or spending excessive amounts of time on a screen may momentarily distract you from anxiety symptoms, but aren’t likely to be beneficial in the long run.

“It’s important to ask yourself ‘What’s my coping strategy when I get anxious, and does it provide long-lasting support?’” Ingoldby says. “If the answer to the second part of that question is no for any given strategy, it’s probably time to look for an alternative approach.”