1. Practice relaxation techniques

For mild and sometimes moderately severe anxiety, learning various relaxation techniques counteracts the symptoms of anxiety.  This may involve learning simple muscle relaxation exercises, learning Yoga, learning meditation, learning Tai Chi or learning self-hypnosis.  These are useful skills, and you may need to find one that suits you.  Also, they do need to be practised reasonably often, so that you can in effect, re-programme your brain to take this alternative approach to life.   When anxiety is severe, you may find you cannot concentrate enough on the relaxation techniques to gain benefit.  However, if medication can reduce your symptoms to be mild or moderate in severity, relaxation techniques may then be useful, and will allow earlier withdrawal of the medication.

2. Use the “Relax 100 times a day” approach

This involves 10 seconds of taking one or two deep breaths, and consciously relaxing your whole body, as often as you can during the day, such as every five or ten minutes. This again is attempting to re-programme your brain into a calmer approach.

3. Think about how you can stop worrying

This is easier said that done of course.  Unfortunately, worrying repeatedly over the same issue makes your brain think something constructive is being done.  Of course, nothing constructive is achieved by worrying, and it becomes a time-consuming and distressing situation.  The core issue is that we cannot control the future;  worrying more and more about what may or may not happen, actually has no influence on the future.   We all have to learn to wait and see what is going to happen, and deal with it when it does happen.  Rather than endlessly going over the same “what if” scenarios, it may be useful to write down what issues are relevant to a particular problem you are worrying about.  If you then find yourself going over the same problem at a later date, check that there is nothing you have left out of your written material and accept that you will inevitably come to the same conclusion as you came to the first time you wrote it all down, just like coming to the same conclusion in a mathematical formula using the same numbers. 

4. Schedule a time to worry!

Research indicates that people do indeed get short-term relief from worrying, and many people find it impossible to stop worrying.  What can be useful is allocating a certain time period in your day to do this worrying !   When the thoughts intrude at other times of the day, try to tell yourself that you will indeed allow them to intrude, but only at the allocated time.  Once you have spent 10 or 20 minutes worrying, you can then allocate a time to worry again the next day if this is what you want to do.   Phrased like this, it helps the logical part of your mind to see the pointlessness of worrying, while allowing your emotions some outlet. 

5. See anxiety as a separate object

If you understand that the physical manifestations of anxiety, together with the mental manifestations of anxiety, are in effect inappropriate bursts of adrenalin, which have nothing to do with your real life, you are well on the way to separating normal logical you from the emotional over-reaction that is going on. Yes, this over-reaction is happening inside your brain and your chemistry, but try to tell yourself that it has nothing to do with the real you, who simply wants to get on with life and whatever you are doing. Trying to see the anxiety as an alien being to be ignored, allows you to see it as a separate object, which you are determined to ignore as much as possible. Accordingly, when you get symptoms of anxiety you can see them as simply symptoms which have got nothing to do with the real you, and these symptoms cannot harm you.

6. Don’t give your anxiety the attention it needs to survive

Your brain tries to decide what is important, based on how much attention you give various things in your life. If you give the anxiety symptoms a lot of attention, they become more frequent and stronger. Conversely, if you ignore the symptoms as mentioned, and dismiss them as a glitch in your biochemistry, and refuse to think about them, your brain slowly gets the message.

7. Tell yourself what you would tell a friend

This is one of the fundamental principles in CBT (Cognitive Behaviour Therapy).  We are all very good at giving sensible advice to other people who are distressed, so try to think what logical cross-questioning and persuasion would you apply to a friend who had anxiety symptoms.   For example, someone who was very afraid they might have a serious illness because of a few minor symptoms, would be told by friends that this was theoretically vaguely possible, but extremely unlikely.  Similarly, someone who is afraid to go out of the house alone, or get into a lift, would understand that they would not apply the same advice to their family and friends, so the dangers the patient anticipates must really not be that likely.  A core phrase in overcoming anxiety about bad things that might happen is “play the odds” accepting that bad things do happen from time-to-time, but in reality they are statistically rare events.  Many people worry about bad things that might happen, when the statistical reality is that they are just as likely to win Tattslotto! 

8. Make your brain focus on something else

In theory, the human brain can only focus on one issue at a time, so focussing on the practicalities and realities of life will prevent the brain from getting carried away with intense anxiety and worry. If anxiety and worrying continue to intrude into your mind, you can try mental problem solving, such as doing mathematics in your head, or spelling words backwards.

9. Practice thought stopping

This technique comes in two forms.  The first technique is to shout “Stop” (either out loud or in your own mind) at the recurring intrusive anxiety thoughts.  The second technique involves wearing a rubber band on your wrist, and springing the rubber band back against your wrist, as pain has priority in the human mind, and may break the intrusive cycle of thoughts. 

10. Don’t seek reassurance from others

If you become reliant on other people for help in overcoming irrational thoughts and irrational worrying, you will always need to have somebody in this role for you. Apart from this being impractical, it is very likely to strain relationships with other people, if you are frequently asking for reassurance about the multiple possible anxious scenarios that your brain can dream up. It is far better to see your anxiety and worrying as a bad habit your brain has developed, with or without associated chemical changes in your brain, and tackle those symptoms along the lines described in this paper.

11. Try an app

The App Calm has thousands of positive reviews, and patients of mine find it the best of the available Apps. I understand there is a free version or a $5 a month trial version