- Identifying the current level of anxiety can help you seek tools to feel relief.
- Grief can cause anxiety and fear; differentiating the two helps us seek appropriate coping strategies.
- Fear and anxiety are healthy responses we experience, despite causing uncomfortable feelings.
All at once
The world can overwhelm me
There's almost nothin' that you could tell me
That could ease my mind.
–"All at Once," Jack Johnson
The hold that grief can take over our emotions, identity, and ability to engage in life is clear, as we’ve seen in previous posts about grief. In addition, we’ve learned that grief can shift and transitions into fear and anxiety as we progress through grief, as outlined in my book It's Grief: The Dance of Self-Discovery Through Trauma and Loss.
Fear and anxiety are partners that feed off each other; differentiating them is difficult. The physical experience of both states is similar, and the dance can feel like a nightmare. Anxiety and fear may be speaking to you if you wake up with a pounding heart, experience trembling, or believe that even minor stressors will result in a “worst-case scenario.”
Fear and anxiety can overwhelm you, taking over your thoughts and wearing you down physically. But running from the discomfort of fear and anxiety can exacerbate the feelings. Instead, we must confront fear and anxiety directly.
“The only way out is through.” – Robert Frost
Embracing Fear and Anxiety
Building a reliable self is a commitment. It’s painful and uncomfortable work that will lead past the rollercoaster of fear and anxiety.
The task ahead is adjusting your perception of the pain you’re enduring in grief. This helps to distinguish between fear and anxiety and normalize your experience, particularly when relating to grief.
Fear is an acute state of mind that occurs when imminent threats arise. “Fight-or-flight” is a programmed response activated if your life is in danger and you enter survival mode. Your brain is working to protect you and redirects your physical and mental resources toward keeping you out of harm’s way. For example, a healthy fear response would likely occur if someone broke into your home when you would seek help or hide to keep safe.
Anxiety is more of a chronic state of being than fear. Feelings of worry or dread that something will happen, regardless of whether that event will likely occur, characterize anxiety. The concern is mentally distressing and can lead to physical symptoms like increased tension and heart palpitations. Anxiety feels like fear; however, it is an aroused state meant to propel you into action rather than protect you in the moment of danger or potential harm.
Anxiety is uncomfortable by design: An increased heart rate and jitteriness are present to push you to take action and protect whatever you care about that’s in harm’s way. For example, worrying about a potential home burglary could direct you to install a security system to ease your mind. It is when anxiety is too pervasive that it becomes an issue.
Learning How to Cope
Both anxiety and fear are demanding, creating chaos we want to control to find inner peace and calm our emotional turmoil. You want to feel like yourself again.
It may help to rate the intensity of your anxiety on a scale of 1 to 10 (10 is the most anxious). From here, you can more easily determine what action plan is needed to feel better. The first step, regardless of how severe your anxiety is, is to decide if your experience is fear or anxiety.
Emerging Anxiety (Rating of 1–4)
Suppose you feel that your anxiety is subtle enough that you can continue to function, feel aware of your surroundings, and make simple decisions. In that case, you’re likely experiencing emerging anxiety. You have a chance here to prevent your anguish from climbing further up the intensity scale, but you’re feeling uncomfortable in your body. You’re possibly on edge and feeling “off.”
Tools for managing emerging anxiety:
- Alternate nostril breathing: This exercise allows your body to begin to regulate. To do this, gently close the right nostril with one finger and inhale through the left nostril. Now close the left nostril and exhale through the right side. Repeat this cycle, breathing slowly, up to 10 times.
- Mindfulness: Write down what you’re experiencing that could be triggering your fear or anxiety. Your thoughts are likely based on “what ifs.” You must find the present moment. For example, you might try to listen to music or look around you to note what you can see or touch.
- Sip water to remind your anxious brain that you can swallow and alleviate the dry mouth that often accompanies anxiety and fear.
- Go for a walk to change your scenery and move your body.
Moderate Anxiety (Rating of 5–7)
This level of anxiety is characterized by hyperawareness and heightened alertness. Your body sends signals to push you to fix the situation: sweaty palms, increased heart rate, and wanting to run away. You may want to isolate. Your brain is also sending signals in this level of anxiety, which could look like a cycle of negative self-talk and shame. Distrust of others and difficulty sleeping are often issues here.
Tools for managing moderate anxiety:
- Try a new breathing exercise. Slowly inhale and hold your breath for a few seconds. Then exhale slowly, aiming to breathe out for twice as many seconds as the inhale (e.g., breathe in for four seconds, breathe out for eight seconds).
- Check out your surroundings. Try counting patterns or details to focus on something aside from your racing thoughts.
- Listen to music and move your body, sing, clap—engage your senses with the help of music. The vibration of your singing voice has a calming effect.
- Move away from where you are sitting to engage your physical body and change scenery, as in emerging anxiety.
Extreme Anxiety (Rating of 8–10)
This level of anxiety and fear is comprised of distinct symptoms of distress. You may feel like you’re going to pass out or like you can’t breathe. The sensations may be so intense that you fear you’re having a heart attack or you’re convinced you’re dying. It can be terrifying, and the help you need is immediate. Self-loathing could be part of this experience, and it can feel too challenging to pull yourself out of this moment alone.
Tools for managing extreme anxiety:
- Try any of the tools already listed—they build on each other, and any one of them can help reduce your extreme anxiety even just a bit.
- Seek help. Call a trusted family member or friend. It’s OK not to feel capable of doing this on your own.
- If extreme anxiety is reached frequently, seek out your primary doctor, a therapist, or a provider who can discuss medications to help manage your anxiety. Medication can be a temporary means to reduce anxiety enough to begin to focus on your healing, particularly during the grief process. Your brain is struggling, and you deserve to take a break from feeling like you’re always in “fight-or-flight” mode.
- Acknowledge your anger safely. Anxiety and anger are intertwined, as unreleased anger in our body can present as anxiety symptoms. Express these emotions safely by journaling or hitting a pillow or punching bag.
- Self-compassion. Remind yourself that you’ve endured intense pain through this season of grief. Be kind to yourself as you continue to move through intense feelings and anxiety.
Vickhoff B et al. Music structure determines heart rate variability of singers. Front Psychol. 2013 Jul 9;4:334. doi: 10.3389/fpsyg.2013.00334. Erratum in: Front Psychol. 2013 Sep 05;4:599. PMID: 23847555; PMCID: PMC3705176
Nathan E. It's Grief: The Dance of Self-Discovery Through Trauma and Loss. 2018.