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4 Steps to managing anxiety

Learning to rein in the runaway horse of anxiety

Ann was looking up online for pet medications for her dog. Three hours later she was still at it – website after website – brands, cost, ingredients – trying to find the Right one. Finally, at 11:00 her husband had to come in a pull her away from the computer.

Tom used to have a checklist of what to bring before he went on a trip – now he has 3, a checklist of a checklist of a checklist. Part of him knows it’s a bit crazy but can’t quite give them up.

Sara woke up at 2 am, not only staring at ceiling but obsessing that she hadn’t filled out one of the business forms correctly on her tax return. She never did go back to sleep.

Jake thought he was doing well on his job. His last evaluation was good, but lately his supervisor has been more withdrawn in interactions, less vocal in his feedback. He’s worried that something is wrong that he supervisor is not talking about.

Ah, our old friend anxiety, the Big A. The stuff of living in the future, expecting the worst, pit in the stomach, and obsessing, obsessing. Sometimes anxiety is like an early warning system preparing us for read dangers ahead, but sometimes it’s like a runaway horse. It gallops off – dragging us where it wants to go – and most of us simply hold on. And that’s a problem. If we let the runaway horse go where it will, if we listen to what it says – tracking down that perfect pet med, checking everything off the list – our world will eventually get smaller and smaller. The 3 hours online will become 4, the 3 trip lists will become 4.

The key to managing anxiety is reining in the runaway horse. Here are the 4 steps for taking control:

#1. Realize when your anxious mind is taking over. The first step is to know when the runaway horse is starting to run. What are the signs and symptoms for you – a tightness in your chest, the obsessive what-ifs, the same old garbage can issues – money, your job, that your thighs are too big – that flare up in full force telling you that you are feeling insecure and anxious? You don’t need to get into the weeds of all these thoughts – deconstructing everything you think, old school cognitive-behavioral therapy – but rather simply recognize that your anxiety, for whatever reason, has now taken over and is running your mind.

#2. Decide if the problem you’re obsessing about is rational or irrational. Ann could probably stay on the computer till she dies trying to find the best pet med – at a certain point she needs to give it up. Tom did well with one checklist for awhile, and the others are anxiety overkill like washing your hands 5 times instead of once. For Sara, who rarely worries about taxes, anxiety is doing its job. She may have a real problem on her hands that she needs to follow up on. Ditto for Jake – though he did well on his evaluation, his supervisor’s behavior is unusual and leaving him rattled; he needs to do something to put it to rest.

Though anxiety is an early-alert warning system, the software running the system can be easily out -of-date. Most of it got wired in our brains when we were kids. It kept you safe by keeping you hyper-alert to little things that then were potentially big things -- your dad's anger, your mom's drinking, your brother's constant criticism. Now it’s still working, but can easily go into overdrive, not discriminating between old dangers and new. This is where your adult rational brain needs to take hold. Take the time to decide if there is a real problem to fix – the taxes, the supervisor yes; the pet meds, the checklists no.

#3. Take action. Sara goes back and checks her tax return as soon as she gets out of bed. Jake mentions to his supervisor during his next supervisory meeting that he has noticed his supervisor being quiet and wondering if there is anything wrong; the supervisor apologies, says that he has just been preoccupied with some personal issues of late and that Jake has been doing fine. Concrete action to put the problem to rest puts the anxiety to rest as well.

If there is no real problem to fix in the present – worries of things way down the road (single at 50, all alone at 80), the garbage-can issues – then it’s time to rein in the horse with refocusing. Deep breath, be mindful as possible (feel your hands on the car steering wheel, say the license plate numbers in front of you aloud), meditate, exercise, do things that can totally occupy your attention, write down what you are thinking. The more tools you have in your toolbox that better. It is the knowing that there are active steps you can take that will help you push back and actually rein in the horse.

#4. Build confidence by doing what scares you. At some basic level anxiety is about being afraid in the world. The good news is that you can rewire your brain to make your early-warning system be less reactive. The bad news is that you in order to do that you need to practice doing things that scare you; you need to essentially build up your self confidence by desensitizing yourself to anxiety.

What this means is initiating what I call "acceptable risks:" Those that are outside your comfort zone but not entirely overwhelming. You are training yourself to approach anxiety rather than avoid it, and it doesn’t matter where you start or what you do as long as you feel that twinge of nervousness. Do, try it, don’t worry about doing it right; it is about patting yourself on the back for taking the risk. By finding out that what your anxiety tells you will happen doesn’t happen (you don’t get fired on your job, your pet doesn’t die from the wrong meds, you forget something on your trip but manage anyway, you don’t get audited by the IRS), that your overall level of fear will decrease, and your faith in your ability to handle situations as they arise (and live in the present instead of the furture) will increase.

It’s all a matter of practice. So rein in the horse, push back against the Big A.

More from Robert Taibbi L.C.S.W.
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