Category: Anxiety

The very best panic attack treatment is revealed by large studies that compare meds and CBT.

Cognitive behavioural therapy (CBT) is the best treatment for panic disorders, multiple studies finds.

In addition, most people prefer therapy over taking anti-anxiety medication.

Panic attacks involve an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Dr. Barbara Milrod, a professor of psychiatry at Weill Cornell Medical College, said:

“Panic disorder is really debilitating — it causes terrible healthcare costs and interference with functioning.

We conducted this first ever large panic disorder study to compare therapy types and see if one type of therapy is preferable over another.”

Panic attacks involve suffering from an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Panic attacks can also be triggered by many things, including irrational fears such as phobias.

During panic attacks people can tremble, become sweaty, feel sick and may experience heart palpitations.

Panic attack treatment studies

One panic attack treatment study randomised around 200 people with panic disorders to various different commonly-used therapies (Mildrod et al., 2015).

Therapy lasted for around three months and involved one 45-minute session each week.

Across the two different sites where the therapies were tested, cognitive behavioural therapy was the most effective, and only one-quarter of people dropped out.

Professor Milrod said:

“If patients stick it out and continue with therapy rather than drop out, they have a far greater chance of seeing positive results or getting better.”

The best therapy for panic attacks

Another panic attack treatment study has found that two different types of psychotherapy are effective at treating panic disorder, (Svensson et al., 2021).

People with panic disorder showed marked improvements after some received psychodynamic psychotherapy and others cognitive-behavioural therapy (CBT).

Psychodynamic styles focus more on revealing the unconscious conflicts in the person’s mind that are causing the problems.

In contrast, treatment with cognitive-behavioural therapy does not delve into the unconscious, focussing more on conscious thoughts and behaviours.

Panic disorders involve suffering from an extreme feeling of anxiety and fear, sometimes for no apparent reason.

Panic attacks can also be triggered by many things, including irrational fears such as phobias.

During panic attacks people can tremble, become sweaty, feel sick and may experience heart palpitations.

These disorder often begin in adolescence or early adulthood and can leave people isolated.

Mr Thomas Nilsson, study co-author, said:

“Many people adapt to their panic disorder by various restrictions in their daily living.

Treatment is crucial as the disorder often leads to a downward spiral in which the margin for everyday life activities becomes increasingly narrow.”

The panic attack treatment study included 221 people with panic disorder who were tracked over 10 years.

The results showed that two years after treatment, 70 percent of patients had improved and 45 percent were in total remission.

The researchers also tested whether people did better if they chose the therapy they preferred rather than being randomly assigned to it.

The results were somewhat confusing, showing that this worked for psychodynamic therapy but not for CBT.

In other words, people did better if they specifically chose psychodynamic treatment but worse if they specifically chose CBT treatment.

Mr Nilsson said:

“Perhaps those who chose psychodynamic therapy had a more accurate perception of what they needed.”

Overall, though, whichever treatment they chose, they improved, said Dr Martin Svensson, the study’s first author:

“The patients felt better in many ways.

For instance depressive symptoms, that often accompany panic disorder, were significantly reduced and quality of life improved.”

→ Read on about panic attacks:

• Read more about typical panic attack symptoms.
• Anxiety Attack Symptoms: 2 Signs People Usually Ignore
• For more on how to deal with anxiety using techniques from CBT, find out about PsyBlog’s anxiety ebook, “The Anxiety Plan”.

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People are often unaware of the symptoms of an anxiety attack coming on, psychologists have found.

The two main bodily symptoms of an anxiety attack are breathing too fast and increased heart rate, research finds.

These symptoms can begin up to an hour before an anxiety attack, although people often do not notice them until the last moment.

One of the best ways of dealing with an anxiety attack is by controlling breathing.

Breathing more slowly helps to lower the heart rate and reduce the feelings of losing control and unreality.

With anxiety attacks, people often report that they happen spontaneously, without being cued by anything specific.

But this research suggests they are a result of being very vigilant to relatively small fluctuations in heart rate and breathing that build up over up to an hour.

For the study, 43 people with panic disorder were monitored around the clock — these are people who often have anxiety attacks.

Portable recorders measured their heart rate, respiration, skin conductance and so on.

When they had a panic or anxiety attack, the results showed exactly what happened in the body leading up to it.

Dr Alicia E. Meuret, who led the study, explained:

“The results were just amazing.

We found that in this hour preceding naturally occurring panic attacks, there was a lot of physiological instability.

These significant physiological instabilities were not present during other times when the patient wasn’t about to have a panic attack.”

People reported that the panic or anxiety attacks were spontaneous, but there were actually many warning signs.

Dr Meuret said:

“The changes don’t seem to enter the patient’s awareness.

What they report is what happens at the end of the 60 minutes — that they’re having an out-of-the blue panic attack with a lot of intense physical sensations.

We had expected the majority of the physiological activation would occur during and following the onset of the panic attack.

But what we actually found was very little additional physiological change at that time.”

Anxiety attack symptoms

When people talk of an anxiety attack, they usually mean a panic attack.

The classic psychological signs of an anxiety or panic attack are:

• feeling of unreality,
• fear of losing control,
• and fear of dying.

The physical signs  of an anxiety or panic attack are:

• shortness of breath,
• heart racing,
• dizziness,
• chest pain,
• sweating,
• hot flashes,
• trembling,
• choking,
• nausea,
• and numbness

Dr Meuret said:

“Most patients obviously feel that there must be something going on physically.

They worry they’re having a heart attack, suffocating or going to pass out.

Our data doesn’t indicate there’s something inherently wrong with them physically, neither when they are at rest nor during panic.

The fluctuations that we discovered are not extreme; they are subtle.

But they seem to build up and may result in a notion that something catastrophic is going on.”

• Read more about typical panic attack symptoms (the same as an anxiety attack).
• For more on how to deal with anxiety using techniques from CBT, find out about PsyBlog’s anxiety ebook, “The Anxiety Plan”.

The study was published in the journal Biological Psychiatry (Meuret et al., 2011).

The common signs of anxiety disorders are both psychological and physical.

Anxiety comes in many forms, but the different types often have certain core features.

Like many mental health problems, almost everyone experiences anxiety from time-to-time.

Whether it is a problem all depends on the amount and nature of the anxiety.

Everyday anxiety in response to stressful events is normal, but severe anxiety in response to relatively minor events can be seriously disabling.

Bear that in mind when reading the signs of anxiety.

For example, a lot of people have problems sleeping and muscle tension every now and then.

This might happen before a job interview, when going into hospital or before a stressful event.

But experiencing signs of anxiety frequently and intensely over smaller matters can be a sign of something more serious.

◊ My anxiety ebook contains 42 strategies for dealing with signs of anxiety.

Signs of anxiety

Here are four typical psychological signs of anxiety:

• Feelings of panic, fear and uneasiness.
• Feeling constantly ‘on edge’ or restless.
• Having a frequent sense of dread.
• Problems concentrating.

And here are six typical physical signs of anxiety:

• Muscle tension.
• Problems sleeping.
• Dry mouth.
• Shortness of breath.
• Heart palpitations.
• Dizziness.

More subtle symptoms of anxiety

These ten signs of anxiety do not cover the full extent of what people experience.

People often report a very wide range of different physical and psychological signs of anxiety.

I have seen lists of signs of anxiety with at least 50 items.

Some people have many symptoms of anxiety, others have fewer.

Here are some of the more subtle symptoms and signs of anxiety:

1. Disappearing is a sign of anxiety

Anxiety can make people feel they want to escape or run away.

One of the signs of anxiety is that people experiencing anxiety may find it hard to continue doing the things they used to do.

For example, they may avoid contact with others in many subtle ways such as avoiding public transport or only going to deserted places.

They may also make excuses to avoid social occasions.

2. Change of eating habits

People experiencing anxiety may start eating more or a lot less — it takes people in different ways.

The important sign of anxiety is the change.

Some people who are anxious eat less because they don’t feel hungry or feel too sick to eat or find it hard to keep food down.

Other people may use food as a distraction from their worries.

They might experience constant cravings for sweet foods or anything that redirects their attention away from worries.

3. Physical symptoms are signs of anxiety

While we tend to think of anxiety as being something that is primarily mental, it actually has many physical manifestations.

Indeed, the physical symptoms of anxiety can be extremely varied.

For example, someone experiencing anxiety may complain of headaches or stomach pain.

Some people experience a dry mouth and throat, others feel nauseous, others still might grind their teeth or have the urge to urinate constantly.

4. Difficulty focusing

Constant worrying makes it hard to focus, which is one of the signs of anxiety.

People describe being a fog, or feeling dizzy or experiencing giddiness.

The swirl of anxious thoughts easily distracts from the task at hand.

The symptom of anxiety can make doing your job or even carrying out regular household chores much more challenging.

5. Signs of anxiety: poor sleep

Worries can keep people experiencing anxiety awake at night because they are exhausting.

Imagine drinking a double espresso and getting straight into bed.

With all that stimulation running around mind and body, it is difficult to drop off.

Similarly, when waking in the night, all those same anxieties are likely to come to the fore.

6. Change in appearance

Like weight, the appearance of people experiencing anxiety can be one of the signs of anxiety.

Some might start to lose interest in maintaining their physical appearance.

Clothes are not washed or ironed, hair unkempt and personal hygiene can suffer.

Alternatively, anxious people can become even more obsessed with their appearance.

People who are anxious are often perfectionists and their appearance is no different.

Again, a change in this other together with other signs could indicate excessive anxiety.

7. Need for excessive reassurance

Anxiety is frequently linked to difficulties making decisions or the avoidance of decisions.

Someone who is unusually anxious may request a lot of reassurance or help with their decisions.

Again, the thing to look for is a change in a person’s normal tendencies.

8. Anxiety literally makes everything stink

This is perhaps one of the most unusual signs of anxiety.

As people get more anxious, they are more likely to label neutral smells as bad smells (Krusemark & Li, 2013).

So, anxiety literally makes the world stink.

The reason, explains Professor Wen Li is:

“In typical odor processing, it is usually just the olfactory system that gets activated.

But when a person becomes anxious, the emotional system becomes part of the olfactory processing stream.”

And as people get more anxious they become better at distinguishing between different bad smells (Krusemark & Li, 2012).

9. Anxious people jump to conclusions

One of the signs of anxiety is that highly anxious people jump to conclusions more quickly when judging facial expressions.

A study by Fraley et al., (2006) suggests that anxious people may have problems in their relationships because they jump to conclusions too quickly about facial expressions.

Professor Fraley explained:

“This ‘hair trigger’ style of perceptual sensitivity may be one reason why highly anxious people experience greater conflict in their relationships.

The irony is that they have the ability to make their judgments more accurately than less-anxious people, but, because they are so quick to make judgments about others’ emotions, they tend to mistakenly infer other people’s emotional states and intentions.”

10. Poor balance is a symptom of anxiety

People who experience more severe levels of anxiety also often have problems with their balance.

They sometimes feel dizzy for no apparent reason and sway more than others while standing normally.

This often starts in childhood and, because symptoms of anxiety can be difficult to treat in children, psychologists have started trying to treat the balance problems.

Studies have shown that treating the balance problem can help with the anxiety (Bart et al., 2009).

11. Personal space changes are signs of anxiety

We all have an invisible field around us that we dislike other people invading.

In front of the face it’s generally about 20-40cm; if others get closer without our permission, it feels weird.

But, researchers have found that one of the signs of anxiety is that for anxious people, their personal space is larger (Sambo & Iannetti, 2013).

So, don’t charge up too close to anxious people, their ‘safety margin’ is larger.

Causes of anxiety

Like many things, high anxiety is partly in the genes, but part of the reason anxious people are anxious is because of their parents’ behaviour.

Children are more likely to experience signs of anxiety when their parents direct criticism at them, display high levels of doubt and are emotionally cold (Budinger et al., 2012).

Other factors that might cause signs of anxiety include an underlying health problems, a traumatic experience or it could accompany another mental health problem, such as depression.

Apart from ‘generalised anxiety’, symptoms of anxiety can also be triggered by all sorts of different things.

Many of these are familiar terms nowadays: phobias, PTSD and social anxiety.

Anxiety disorder treatment

Anxiety disorders are diagnosed on the basis of the extent of the symptoms and how they affect everyday life.

People experiencing severe or disabling symptoms of anxiety most days should consider seeking some kind of help.

1. Therapy reduces signs of anxiety

Psychological therapies (including self-help) are particularly good at treating signs of anxiety disorders.

One approach psychological therapies use to reduce signs of anxiety is to think about situations differently.

For example:

• It’s not an exam; it’s a fun little quiz.
• It’s not a scary presentation; it’s a little chat with a few colleagues.
• It’s not a job interview; it’s a chance to meet some new people.

Most situations can be re-framed in this way and studies show that people who do this naturally — as opposed to trying to suppress their anxiety — feel less anxious in stressful social situations (Llewellyn et al., 2013).

2. Exercise reduces signs of anxiety

Generally, when people get a little exercise they feel fewer signs of anxiety in their lives.

As little as 20 minutes can make you feel calmer right now.

The benefits of a little workout extend beyond the gym, though, into everyday life.

One study has found that although simply resting reduces anxiety, it doesn’t help protect against stressful events (Smith, 2013).

Exercise, though, seems to have a more lasting effect, helping to reduce anxiety when faced with stressful situations afterwards.

Indeed, many think exercise should be prescribed for depression and anxiety instead of drugs.

3. Meditation reduces signs of anxiety

On top of exercise and thinking differently, those experiencing anxiety can also try meditation.

To pick just one of many recent studies, Zeidan et al. (2013) found that four 20-minute meditation classes were enough to reduce anxiety by up to 39 percent.

→ For more on how to deal with signs of anxiety, find out about Dr Jeremy Dean’s anxiety ebook.

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Phobias are irrational fears that induce an intense emotion when a certain situation or object is encountered.

A phobia is an irrational fear of something that is unlikely to be dangerous.

People with phobias experience an intense fear when they encounter a certain situation or object.

Naturally, people with phobias do their best to avoid situations in which they might come into contact with the object of their phobia.

Some of the most common phobias are of heights, public speaking and snakes (see below for a long list of phobias).

Phobias are a type of anxiety disorder, which are extremely common, affecting almost one-third of people at some point in their lives.

Types of phobias

The Diagnostic and Statistical Manual of Mental Disorders puts phobias into three broad categories:

1. Agoraphobia: A generalised fear of leaving a safe, comforting place, such as home, while fearing contamination, embarrassment or other trauma while out of doors.
2. Social phobia: fearing the judgment of others in social situations.
3. Specific phobias: fear of a specific situation or object that results in anxiety and can lead to a panic attack.

Psychiatrists and psychologists typically put specific phobias in to these general categories:

• fears related to animals (dogs, spiders, insects)
• fears related to the natural environment (darkness, heights, thunder)
• fears related to blood, injury, or medical issues (broken bones, injections, falls)
• fears related to specific situations (driving, flying, riding an elevator)
• other (drowning, choking, loud noises)

The most common phobias

Heights, snakes and public speaking top the list of things of which people are most afraid.

That is according to a survey of 2,088 British people who were given a list of 13 phobias and asked how fear-inducing each one is (YouGov, 2014).

It was women who were more afraid of each item on the list than men — or perhaps men just won’t admit to their fears.

The widest gender gap was seen for spiders, which scared 52 percent of women but only 33 percent of men (or so they said).

Here is the full list of phobias and the percentage of people that said they were “very” or “a little” afraid of them:

Age also played a role in what people were afraid of.

Younger people were more petrified of public speaking than older people:

• 59% of those between 18-24 said they were afraid of public speaking.
• 32% of people over 60 said they were afraid of public speaking.

Older people meanwhile, were more afraid of heights and snakes.

Unsurprisingly there’s no place on the list for one of the most common fears which most people have never heard of: the fear of holes.

Technically it’s called trypophobia and, according to a recent study, it may result from the visual features of certain poisonous creatures (Cole & Wilkins, 2013).

The study found that around 1 in 7 had some trypophobic reactions.

Like all the fears on the list, arachnophobia, the fear of spiders, varies a lot between people, with some just being ‘scared’ of spiders to others being so terrified they can’t even look at a picture of one.

Of course people in this survey could only respond to the thirteen phobias they were asked about, they might have had other ones.

Here are a few personal favourites:

1. Nomophobia: fear of being out of phone contact (no–mobile-phobia: it’s bad Latin, but easy to spell compared with the others…)
2. Omphalophobia: fear of bellybuttons; of having one’s own bellybutton touched or pulled or seeing another person’s bellybutton.
3. Lipophobia: fear of fat in foods.
4. Oikophobia: fear of the home and/or household appliances.
5. Hexakosioihexekontahexaphobia: fear of the number 666.
6. Sesquipedalophobia: fear of long words (oh, the tremendous weight of irony).
7. Panphobia: fear of everything (Woody Allen has this).

The most common phobia you’ve never heard of is…

…the fear of holes.

Technically it’s called trypophobia and, according to a study, it may result from the visual features of certain poisonous creatures (Cole & Wilkins, 2013).

The study found that around 1 in 7 had some trypophobic reactions.

The lead author Dr Geoff Cole explained:

“We think that everyone has trypophobic tendencies even though they may not be aware of it.

We found that people who don’t have the phobia still rate trypophobic images as less comfortable to look at than other images.

It backs up the theory that we are set-up to be fearful of things which hurt us in our evolutionary past.

We have an innate predisposition to be wary of things that can harm us.”

Should your fear of holes be getting the better of you, then use a classic psychological technique: desensitisation.

That means looking at lots of pictures of holes.

Apparently it worked for Dr Cole.

Longer list of phobias (A-Z)

A

• Achluophobia – Fear of darkness
• Acrophobia – Fear of heights
• Aerophobia – Fear of flying
• Agoraphobia – Fear of open spaces or crowds
• Aichmophobia – Fear of needles or pointed objects
• Amaxophobia – Fear of riding in a car
• Androphobia – Fear of men
• Anthrophobia – Fear of flowers
• Anthropophobia – Fear of people or society
• Aphenphosmphobia – Fear of being touched
• Arachibutyrophobia – Fear of peanut butter
• Arachnophobia – Fear of spiders
• Astraphobia – Fear of thunder and lightning
• Autophobia – Fear of being alone

B

• Bacteriophobia – Fear of bacteria
• Bathmophobia – Fear of stairs or steep slopes
• Bibliophobia – Fear of books
• Botanophobia – Fear of plants

C

• Chionophobia – Fear of snow
• Chronophobia – Fear of Time
• Claustrophobia – Fear of confined spaces
• Coulrophobia – Fear of clowns
• Cyberphobia – Fear of computers
• Cynophobia – Fear of dogs

D

• Dendrophobia – Fear of trees
• Dentophobia – Fear of dentists

E

• Elurophobia – Fear of cats
• Entomophobia – Fear of insects
• Equinophobia – Fear of horses

G

• Gamophobia – Fear of marriage
• Genuphobia – Fear of knees
• Glossophobia – Fear of speaking in public

H

• Haphephobia – Fear of touch
• Hemophobia – Fear of blood
• Hypochondria – Fear of illness

I

• Iatrophobia – Fear of doctors

K

• Koumpounophobia – Fear of buttons

L

• Lockiophobia – Fear of childbirth

M

• Mageirocophobia – Fear of cooking
• Microphobia – Fear of small things
• Mysophobia – Fear of dirt and germs

N

• Necrophobia – Fear of death or dead things
• Noctiphobia – Fear of the night
• Nyctophobia – Fear of the dark

O

• Octophobia – Fear of the figure 8
• Ophidiophobia – Fear of snakes
• Ornithophobia – Fear of birds

P

• Pathophobia – Fear of disease
• Pedophobia – Fear of children
• Philematophobia – Fear of Kissing
• Philophobia – Fear of love
• Phobophobia – Fear of phobias
• Pteromerhanophobia – Fear of flying
• Pyrophobia – Fear of fire

S

• Scolionophobia – Fear of school
• Sociophobia – Fear of social evaluation
• Somniphobia – Fear of sleep

T

• Technophobia – Fear of technology
• Trypanophobia – Fear of needles/injections
• Trypophobia – Fear of Holes

V-Z

• Verminophobia – Fear of germs
• Wiccaphobia – Fear of witches and witchcraft
• Xenophobia – Fear of strangers or foreigners
• Zoophobia – Fear of animals

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1. Green, black and oolong tea may help fight Alzheimer’s

Drinking tea is linked to a dramatic reduction in the risk of cognitive impairment in older people (Feng et al., 2016).

A single daily cup of tea reduces cognitive decline in those over 55 by 50 percent, the Chinese study found.

Among those with a genetic susceptibility to Alzheimer’s, though, this risk reduction increased to 86percent.

It did not matter which type of tea people consumed: green, black or oolong.

Scientists have also found that a natural component of green tea may eventually provide a way of curing Alzheimer’s disease (Rushworth et al., 2013).

Early-stage research has found that a component of green tea — epigallocatechin-3-gallate (EGCG) — can disrupt the build up of plaques in the brain, which is what causes the cells to die.

Eventually this may help lead to a cure for the crippling disease.

2. Tea benefits older brains

While we’ll have to wait for the Alzheimer’s research to progress, tea has been shown to have more immediate effects.

A study of 2,031 people aged between 70 and 74 found that those who drank tea — which contain micronutrient polyphenols, like EGCG — had better cognitive performance (Nurk et al., 2009).

Polyphenols are also contained in red wine, cocoa and coffee.

3. Matcha tea benefits anxiety

A type of green tea called matcha benefits anxiety, research finds (Kurauchi et al., 2019).

Matcha green tea, which has a long history of medicinal use in Japan, has a calming effect, the mouse study shows.

The tea has an active ingredient that stimulates both dopamine and serotonin receptors — both of which are linked to anxious behaviour.

Matcha comes in the form of a finely ground powder derived from the same small tree that all teas come from: camellia sinensis.

4. Black tea benefits creativity

Drinking hot tea instantly increases a kind of creativity called ‘divergent thinking’, a study has found (Huang et al., 2018).

Divergent creativity refers to creating lots of potential answers to a problem.

For example, try to think of as many uses as you can for a brick.

Building a house is the obvious one, but you might also list sitting on it, using it to smash open a coconut, or painting a face on it and using it as a puppet (admittedly not a very expressive puppet!).

The more you can come up with, the more divergent creativity you display.

5.Black, green and oolong tea benefit brain efficiency

People who habitually drink tea have more efficient brains, research concludes (Li et al., 2019).

The study found that people who drank tea more than three or four times a week have better organised brains.

Drinking tea has previously been linked to better mood, reduced mortality and protection against cognitive decline.

These benefits included all kinds of teas, such as oolong, black and green tea.

The results showed that people who drank tea had better functional connectivity within a circuit in the brain called the default mode network.

6. Many teas benefit cognition

You hardly need me to tell you that tea makes you feel alert, but it’s down to more than just the caffeine…

Many different teas, including green tea, matcha tea, black tea and oolong tea, also contain high levels of theanine, a psychoactive amino acid almost unique to tea.

Although we know much less about the effects of theanine than we do caffeine, there are multiple studies connecting it with enhanced cognitive performance (Einother & Martens, 2013).

7. Green tea improves working memory

For one thing, we know that green tea extract can improve working memory (Schmidt et al., 2014).

Working memory is vital to holding pieces of visual, verbal or other information in your mind while you manipulate them.

Better working memory has been linked to improved learning, attention and other vital outcomes.

Not only did people in the study do better on the tests after ingesting the green tea, but that it enhanced the connections between the frontal and parietal regions of the brain.

8. Chamomile tea calms while peppermint tea excites

Both chamomile tea and peppermint tea affect mood and memory.

Peppermint tea can improve alertness while chamomile does indeed provide a calming effect, a study finds.

Dr Mark Moss, one of the study’s authors, explained:

“Peppermint has a reputation for being psychologically or mentally alerting.

It picks you up and makes you feel a little bit brighter, so we endeavoured to test this out by giving people peppermint tea, or chamomile tea, which is a more calming drink and then put them through some computerised tests.

We found that those people who had drunk the peppermint tea had better long-term memory.

They were able to remember more words and pictures that they had seen.

9. Theanine linked to calming effect of tea

The famous calming effect of chamomile tea and many other types partly comes from theanine.

When theanine is given to people, their brains exhibit more α-waves, which are indicative of relaxation without drowsiness (Juneja et al., 1999).

10. Green tea benefits memory

Theanine, along with EGCG, has also been implicated in improvements to memory.

Korean research by Chung et al. (2011) has found that green tea extract and L-theanine can produce memory improvements in people suffering from mild cognitive impairments.

Mouse studies on EGCG suggest that it helps memory by increasing the production of new brain cells (Wang et al., 2012).

11. Black tea and green tea benefit mental health

All the benefits of drinking tea mean it could be a factor in improved overall mental health.

Hozawa et al. (2009) tested this in a population study of 42,093 Japanese.

This study found that drinking green tea was associated with less psychological distress.

The same positive effect of drinking tea has been found in 1,058 elderly Japanese people (Niu et al., 2009).

Theanine has even been tested in the treatment of schizophrenia with some success in reducing anxiety and other symptoms (Ritsner et al., 2011).

Raising a cup of tea

Of course, tea is a relatively benign substance and most of the effects described here are small.

But when you add these potential benefits to its other pleasures, tea becomes just that little bit more enjoyable.

And, as Henry James said:

“…there are few hours in life more agreeable than the hour dedicated to the ceremony known as afternoon tea.”

I’ll raise a cup to that.

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It can be difficult to calm down: we worry about work, money, our health, our partners, children…the list goes on.

And let’s face it, there are plenty of things to worry about, and that’s even before you’ve turned on the news.

This means that when the mind is given an idle moment, often what it seems to fill it with is worrying rather than calming down.

Worry can be useful if it’s aimed at solving problems but less useful when it’s just making us unhappy or interfering with our daily lives and making it difficult to calm down.

The standard psychological methods for calming down pretty simple.

But, just because they’re simple and relatively well-known doesn’t mean we don’t need reminding to use them from time-to-time.

So here is a five-step plan to calm down called “The Peaceful Mind” that was developed by psychologists specifically for people with dementia (Paukert et al., 2013).

Because of this it has a strong focus on the behavioural aspects of relaxation and less on the cognitive.

That suits our purposes here as the cognitive stuff (what you are worrying about) can be quite individual, whereas the behavioural things, everyone can do.

1. The first step to calming down is awareness

When trying to calm down, this is the step most people skip.

Why?

Because it feels like we already know the answer.

You probably already think you know what makes you anxious.

But sometimes the situations, physical signs and emotions that accompany anxiety aren’t as obvious as you might think.

So try keeping a kind of ‘anxiety journal’, whether real or virtual.

When do you feel anxious and what are the physical signs of anxiety?

Sometimes this stage on its own is enough to help people with their anxiety.

As I never tire of saying, especially in the area of habits, self-awareness is the first step to change.

2. Calm down your breathing

The mind and body naturally each feed back to the other.

For example, standing confidently makes people feel more confident.

Mind doesn’t just affect body, body also affects mind.

It’s the same with anxiety: taking conscious control of breathing sends a message back to the mind to calm down.

So, when you’re anxious, which is often accompanied by shallow, quick breathing, try changing it to relaxed breathing, which is usually slower and deeper.

You can count slowly while breathing in and out and try putting your hand on your stomach and feeling the breath moving in and out.

In addition, adopt whatever bodily positions you associate with being relaxed.

Typically these are things like relaxing muscles, adopting an open stance to the world (unfold arms, hint of a smile).

It will do wonders to help you calm down from anxiety or anger.

3. Prepare calming thoughts to fight anxiety

The injunction to ‘think calming thoughts’ is very trite, but no less true for that.

Here’s the problem: it’s all very well saying: “Think calming thoughts”, but who can think of any calming thoughts when stressful situations are approaching and the heart is pumping?

The key is to get your calming thoughts ready in advance.

They could be as simple as “calm down!” but they need to be things that you personally believe in for them to be most effective.

It’s about finding what form of words or thoughts is right for you to calm down from anxiety or anger.

4. Increase activity to calm down

It might seem strange to say that the answer to calming down from anxiety or anger is more activities, as we tend to think the answer is relaxation and that involves doing less.

But, when unoccupied, the mind wanders, often to anxieties; whereas when engaged with an activity we enjoy, we feel better, so it is easier to calm down.

Even neutral or somewhat wearing activities, like household admin, can be better than sitting around worrying.

The problem with feeling anxious is that it makes you less likely to want to engage with distracting activities.

You see the problem.

One answer is to have a list of activities that you find enjoyable ready in advance.

When anxiety hits at an inactive moment, you can go off and do something to occupy your mind.

Try to have things on your list that you know you will enjoy and are easy to get started on.

For example, ‘invent a time machine’ may be biting off a tiny bit more than you can chew, but ‘a walk around the block’ is do-able.

5. Self-compassion can calm you down

Most people can benefit from a little more self-acceptance — especially the anxious and angry.

One way to achieve that is through self-compassion exercises, which have been shown to make people feel relaxed and safe (Kirschner et al., 2019).

Being more accepting of the self helps lower the heart-rate and turns off the body’s threat response — both keys to calming down.

One exercise entails thinking about yourself and a loved one with kindness and soothing thoughts.

Another exercise is a “compassionate body scan”, which involves paying attention to different parts of the body with an attitude of loving kindness.

First author of the study, Dr Hans Kirschner, said:

“These findings suggest that being kind to oneself switches off the threat response and puts the body in a state of safety and relaxation that is important for regeneration and healing.”

6. Learn calming sleep skills

Often when people are anxious and find it difficult to calm down they have problems sleeping.

Sometimes when you feel anxious there’s nothing worse than lying in bed, in the dark, with only your own thoughts to occupy your attention.

And lack of sleep leads to anxiety about sleeping which can lead, paradoxically, to worse sleep.

Breaking out of this loop can be hard, but practising ‘sleep hygiene’ can help — it is all about getting into good sleeping habits.

This is covered in How To Fall Asleep Fast: 6 Science-Backed Steps, so check out that article for the details.

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Stress and anxiety are normal parts of everyday life.

It is not normal for people to feel relaxed and calm at all times — stress and anxiety are part of everyday life.

However, stress and anxiety can play a positive role in our lives, if they are approached in the right way.

So says psychologist Dr Lisa Damour during a presentation at the annual convention of the American Psychological Association.

People tend to feel stressed, she says, when they are working at the edge of their abilities.

Although stress is a given, working through it can increase people’s resilience.

Similarly, anxiety, while also common in everyday life, can be protective.

Being aware that anxiety can motivate positive behaviours helps people make good use of it.

For example, anxiety can stop procrastination or help people take protective measures against threats.

Unfortunately, many find that the very idea of stress makes them feel stressed, said Dr Damour:

“Many Americans now feel stressed about being stressed and anxious about being anxious.

Unfortunately, by the time someone reaches out to a professional for help, stress and anxiety have already built to unhealthy levels.”

Anxiety has a vital, positive function, explains Dr Damour:

“Anxiety is an internal alarm system, likely handed down by evolution, that alerts us to threats both external — such as a driver swerving in a nearby lane — and internal — such as when we’ve procrastinated too long and it’s time to get started on our work.”

Naturally, stress and anxiety can be harmful if they reach chronic levels, says Dr Damour:

“Stress causes harm when it exceeds any level that a person can reasonably absorb or use to build psychological strength,.

Likewise, anxiety becomes unhealthy when its alarm makes no sense.

Sometimes, people feel routinely anxious for no reason at all.

At other times, the alarm is totally out of proportion to the threat, such as when a student has a panic attack over a minor quiz.”

Stress and anxiety levels that are too high, and remain untreated, can lead to psychological and medical problems:

“Anyone feeling overwhelmed by stress should, if possible, take measures to reduce his or her stress and/or seek help from a trained professional to learn stress management strategies.

For the management of anxiety, some people find relief through workbooks that help them to evaluate and challenge their own irrational thoughts.

If that approach isn’t successful, or preferred, a trained professional should be consulted.

In recent years, mindfulness techniques have also emerged as an effective approach to addressing both stress and anxiety.”

The research was presented at annual convention of the American Psychological Association (Damour, 2019).

Deal with anxiety and stress using ten techniques that psychological research has shown to be highly effective.

The best way to deal with anxiety and stress is, of course, to identify the source and get rid of it.

If only this were possible.

You can try to avoid people who stress you out, say ‘no’ to things you know will cause you anxiety and stress, and generally do less stuff.

Unfortunately, this is often out of the question or you would have already done it.

So, here are 19 techniques you can use to deal with anxiety and stress that you can’t avoid.

Also, consider Dr Jeremy Dean’s anxiety ebook which contains 42 strategies for dealing with anxiety and is based on the principles of CBT.

1. Develop awareness to deal with anxiety

This is the step most people skip.

Why? Because it feels like we already know the answer.

But sometimes the situations, physical signs and emotions that accompany anxiety aren’t as obvious in the moment.

Here are a few common symptoms of stress and anxiety:

• excessive sweating.
• dizziness.
• tension and muscle aches.
• tiredness.
• insomnia.
• trembling or shaking.
• a dry mouth.
• headaches.

So, try keeping a kind of ‘anxiety and stress journal’, whether real or virtual.

When do you feel anxious and stressed and what are those physical signs of anxiety?

When you can identify what’s stressing you out and how you react, you’ll know when to use the techniques below to deal with anxiety and stress.

2. Breathe to cope with anxiety

The mind and the body each feed back to the other.

Taking conscious control of breathing sends a message back to the mind and helps you deal with anxiety and stress.

So, when you’re anxious or stressed, which is often accompanied by shallow, quick breathing, try consciously changing it to relaxed breathing, which is usually slower and deeper.

You can count slowly while breathing in and out and try putting your hand on your stomach and feeling the breath moving in and out.

Research has shown that deep breathing helps people deal with anxiety and stress.

Diaphragmatic breathing — colloquially known as deep breathing — involves contracting the muscles underneath the lungs.

Sometimes it is called ‘belly breathing’ because it feels like breathing from the belly.

In contrast, ‘chest breathing’ — using the muscles around the upper body — is less efficient.

This sort of shallow breathing is linked to anxiety, fatigue and muscle tension.

Belly breathing is best done by breathing in steadily for four seconds from the diaphragm, then exhaling for six seconds.

3. Avoid venting emotions

Some of the ways we react to stress are built on false conceptions of how the mind works.

‘Venting’ — letting your emotions out in an angry, tearful and emotional rush — is a good example.

It’s commonly thought that emotions have to be ‘let out’ in order to reduce them.

This simply isn’t true and is not a good way to deal with anxiety or stress.

Venting emotions can actually cause them to become more powerful, rather than allowing them to subside or reduce.

None of this is to say that you shouldn’t talk to others about what is happening, it’s just that the form it takes shouldn’t be a blast of raw emotion.

4. Think differently to cope with anxiety

One way to deal with anxiety and stress is to change the way you think about stressors.

You can do this by reframing the stressful tasks you have to do.

For example, giving a presentation is stressful but, on the other hand, it’s a chance to demonstrate your expertise to others and to network.

One study on how to beat stress had bankers watching a ‘stress-is-enhancing’ video which suggested that some people do their best work under pressure.

For example, Captain “Sully” Sullenberger landed his stricken airliner on the Hudson River and Winston Churchill successfully led Britain through WWII.

Those who’d seen the ‘stress-is-enhancing’ video did develop a more positive stress mindset.

This led to them reporting better performance at work and fewer psychological problems over the subsequent two weeks.

In addition, thinking that stress is enhancing was associated with lower levels of cortisol, a hormone closely associated with the stress response.

In other words, people’s physiological reaction to stress and anxiety was better when they endorsed the idea that stress is enhancing.

5. Accept anxiety to deal with it

Sometimes, though, trying to find the upside of a stressful situation can be hard.

Some situations are what they are and there are no ways to fool yourself into thinking about them differently.

In that case it’s better just to accept the situation to cope with anxiety and stress, rather than fighting it.

Acceptance doesn’t mean it’s right, that you’re happy about it or that you ignore it.

It also doesn’t mean that you give up.

Rather it’s acceptance that something can’t be changed and it is wasted effort trying to work out how it can be changed, or how it could have been different.

6. Keep busy to handle anxiety

The problem with feeling anxious and stressed is that it makes you feel less motivated to engage with distracting activities.

When unoccupied, the mind tends to wander, often to anxieties.

One answer is to have a list of activities that you find enjoyable ready in advance.

When anxiety hits at an inactive moment, you can go off and do something to occupy your mind.

Try to have things on your list that you know you will enjoy and are easy to get started on.

(A word of caution: being too busy is not a good idea, you want to be occupied, but not creating even more anxiety and stress for yourself.)

7. Dealing with intrusive thoughts

Much of the everyday anxiety and stress we face results from unwanted intrusive thoughts going around in our heads.

They could run from things as simple as “Did I turn off the cooker?” up to persistent worries about the future.

There are a number of techniques to get rid of intrusive thoughts, here are a few:

• The worry period. Researchers have tried asking those with persistent anxious thoughts to postpone their worrying until a designated 30-minute ‘worry period’. Save up all your worrying for this time and it may ease your mind the rest of the time.
• Write about it. Writing about your deepest thoughts and feelings may help to reduce recurrent unwanted thoughts.

There are six more in this article on intrusive thoughts.

8. Muscle relaxation technique

The most common type of relaxation therapy which psychologist teach may be familiar to you.

It involves mentally going around the muscle groups in your body, first tensing then relaxing each one. It’s as simple as that.

And, with practice, it becomes easier to spot when you are becoming anxious and the muscles are becoming tense.

The next stage is to cut out the tensing phase and move straight to relaxing each muscle.

Next, you learn to associate a certain cue, say thinking ‘be calm’ with a relaxed state.

You then learn to relax really quickly.

Finally you practise your relaxation technique in real-world anxiety-provoking situations.

Read more about relaxation techniques for anxiety.

9. Exercise to cope with anxiety

One of the best ways to deal with anxiety and stress is to exercise.

Studies on mice, for example, have shown that exercise reorganises the brain so that it is more resistant to stress (Schoenfeld et al., 2013).

It does this by stopping the neurons firing in the regions of the brain thought to be important in the stress response (the ventral hippocampus).

Studies in humans show that exercise has a relatively long-lasting protective effect against anxiety (Smith, 2013).

Both low and medium intensity exercise have been shown to reduce anxiety.

However, those doing high intensity exercise are likely to experience the greatest reduction in anxiety, especially among women (Cox et al., 2004).

Exercise can reduce anxiety symptoms by 20 percent compared with those who do not exercise (Herring et al., 2010).

As little as 20 minutes can make you feel calmer right now — and it works on just about everybody.

More than around 30 minutes of exercise, though, seems to provide the best dose for anxiety.

Up to 80 percent of people experiencing depression say exercise improves their mood and anxiety most of the time, another study has found.

10. Sleep to combat anxiety

Stress and anxiety can lead to lost sleep.

So learn the most successful single intervention psychologists use to help people sleep well.

It is called Stimulus Control Therapy (Morin et al., 2006).

You’ll be happy to hear it consists of six very straightforward steps.

If you follow these, it should improve your sleep which, in turn, should help you deal with anxiety and stress.

Here they are: how to fall asleep fast.

11. Reframe anxiety-provoking situations

One of the best ways to deal with anxiety and stress is to think about situations differently.

Most situations can be re-framed and studies show that people who do this naturally — as opposed to trying to suppress their anxiety — feel less anxious in stressful social situations.

For example:

• It is not a scary presentation; it is a little chat with a few colleagues.
• It is not a job interview; it is a chance to meet some new people.

Reappraisal can be beneficial when anxiety becomes persistent and gets in the way of everyday life.

12. Safety signals to deal with anxiety

Using safety signals helps people to deal with anxiety and stress.

Safety signals can be anything from a picture linked to relaxing thoughts, to a piece of music or a place.

When in a situation that provokes anxiety, thinking about these safety signals can help.

Safety signals access a totally different network in the brain to those usually targeted by therapy or medication.

Therefore, they may help people who do not respond to other methods of treatment.

13. Lavender reduces anxiety

The smell of lavender can be effective to deal with anxiety and stress.

Lavender also has practically no side-effects in comparison to drugs like benzodiazepines and SSRI antidepressants.

Benzodiazepines, in particular, can cause headache, dizziness and an effect like being drunk.

Lavender, meanwhile, has a relatively quick relaxing influence and no other side-effects.

14. Improve gut bacteria

Improving gut bacteria decreases anxiety and helps people deal with anxiety and stress.

Both a balanced diet and using probiotics can help improve gut bacteria.

Foods that may help to improve gut bacteria include those high in fibre, such as vegetables, beans and legumes.

A diverse range of foods can also help many different types of ‘good’ bacteria grow in the gut.

It is better to avoid sugar, alcohol and artificial sweeteners as these can be detrimental to gut bacteria.

Prebiotics also improve gut bacteria.

15. Fruits and vegetables

Eating more fruits and vegetables lowers the risk of anxiety by almost one-quarter.

The study also found that anxiety disorders are more common in women, in those with low household income and those with other health problems.

Higher amounts of body fat were also linked to anxiety, Mr Jose Mora-Almanza, study co-author, said:

“This may also partly explain the findings associated with body composition measures.

As levels of total body fat increased beyond 36%, the likelihood of anxiety disorder was increased by more than 70%.”

16. Personality change

Two different types of psychotherapy for anxiety disorders can change people’s anxious personalities dramatically which helps them deal with anxiety.

The study included 60 patients with generalised anxiety disorder who received either cognitive-behavioural therapy (CBT) or metacognitive therapy.

Metacognitive therapy involves targeting basic thinking processes, in contrast to CBT which concentrates on the content of thoughts.

A simple example of metacognition is realising one is prone to repetitive thinking of depressive thoughts — what psychologists call rumination.

The results showed that just 12 sessions of psychotherapy was enough for people to make large changes to their personalities and improve their ability to deal with anxiety and stress.

17. Yoga to cope with anxiety

Yoga is an effective complementary way to deal with anxiety.

Yoga and breathing exercises reduce the symptoms of anxiety in both the short and long-term.

In fact, the more yoga practice people in the study did, the more their depression and anxiety improved.

Another study has also shown that practising yoga reduces the symptoms of generalised anxiety disorder.

18. Matcha tea

A type of green tea called matcha reduces anxiety.

Matcha green tea, which has a long history of medicinal use in Japan, has a calming effect, a mouse study has shown.

The tea has an active ingredient that stimulates both dopamine and serotonin receptors — both of which are linked to anxious behaviour.

Matcha comes in the form of a finely ground powder derived from the same small tree that all teas come from: camellia sinensis.

19. Therapy to deal with anxiety

Cognitive-behavioural therapy (CBT) is currently the best treatment for anxiety.

It is better than just taking drugs and better than taking drugs as well as having therapy.

Cognitive therapy results in either a cure or significant improvement in 85% of patients and online CBT is also effective.

It is probably the ultimate way to deal with anxiety.

→ Dr Jeremy Dean’s anxiety ebook contains 42 strategies for dealing with anxiety and is based on the principles of CBT.

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