By Melissa Welby, MD
Do What You are Afraid of!
If you didn’t have anxiety what would you do differently? How would you live your life? Without anxiety would you pursue different careers or hobbies? Would you try to get that promotion you deserve even if it requires travel and public speaking? Would you fly in a plane or go back to school to complete your degree? Would you drive on the highway so you can take road trips? Would you go to a party at a friends house? Or a work gathering? Would you go to a store instead of ordering everything online? Let me tell you how to deal with anxiety and how to stop anxiety from affecting your life.
Anxiety can be healthy!
Anxiety can be a healthy and normal feeling. It’s a motivator! Anxiety is our body’s way to remind us we need to pay attention. If we are anxious about something we may try harder to be prepared. We may study a few more hours until we are confident we can pass the test or use extra caution when doing something that we perceive has some risk. Anxiety can be a helpful tool for our success and survival.
Anxiety can get in the way!
But sometimes anxiety stops being helpful. It almost forgets its place as a background motivator and thinks it runs the show. We forget that anxiety is a message we can choose to accept or ignore. Anxiety doesn’t make the decisions for us but is just one of our many advisors. We start to overvalue our anxiety and stop looking at all the other evidence when we assess a situation. We begin to only pay attention to our anxious feelings and start to avoid the things that make us anxious.
Example: Fear of driving on the highway
What if we get anxious and pass out?! Our anxiety tells us we MUST avoid the highway so we can be safe. Anxiety causes us to imagine every catastrophic outcome possible for what will happen if we drive on the highway.
But what about the years and years of evidence that negate that fear? We may have driven on the highway for 20 years and have never passed out. Yes, there was that one time we were really anxious and started to feel a little woozy but we had plenty of time to get off the highway and collect ourselves before continuing our drive. We have no evidence that we were actually ever close to passing out.
Is the conclusion valid then? We feel less anxious by avoiding the highway but what have we given up? We have given up some of our freedom. Our world becomes a little smaller everytime we decide we can’t do something due to anxiety.
Every time we avoid we make our anxiety more powerful.
What happens when we avoid something that makes us anxious? We feel better, relieved…. but only temporarily. We give power to our anxiety every time we choose not to do whatever it is that makes us anxious. We internalize the anxiety and lose our self-confidence. We make associations between our anxiety and certain events and accept them as facts. Example: I felt anxious on the train once so, therefore, I will always feel anxious on the train. I can never take a train again.
So what happens if we stop avoiding?
When we face something that makes us anxious our anxiety will build. It will keep building until it peaks but then it starts to come down on its own. When we avoid, we never experience anxiety resolving itself. We prematurely end the experience, feel a relief of the anxiety, and therefore draw the conclusion that avoidance is the treatment. However, with avoidance, we never get better.
If we continue to do what is making us anxious we experience a success and shift the feeling of control back to ourselves. Every time we repeat this process we lessen the anxious associations we have made. We gain our confidence back and learn that we can do the things we previously feared.
What are you avoiding?
Make a list of things that make you anxious. Rate your anxiety for each item on your list on a scale of 1 (no anxiety) to 10 (the worst anxiety). Start with something small and push yourself to do that first. Tackle your anxiety bit by bit by bit. Keep challenging yourself. Don’t let fear cloud your honesty. Even if you are absolutely unwilling to challenge yourself with something put it on your list anyways. It is important to take an accurate snapshot of all of the things you avoid. Every time you push yourself through you will gain confidence and be able to tackle bigger items.
Example: Fear of driving over bridges
If fear of driving over a highway bridge is rated as 10/10 but driving over a town bridge is 7/10 then start practicing driving over the town bridge.
You can’t just do it once!
It takes repeat performance to outdo your anxiety. You will not be anxiety free after driving over a bridge once. Go out and drive over a bridge repeatedly- do it for 30 minutes at a time if it takes that long for the anxiety begin to resolve.
What happens to your anxiety as you keep crossing the bridge. Does it creep down a notch every time you go over the bridge? The first time you cross it may be a 10/10 but the 7th time is a 4/10? The next day, go back and do it again. This time did you start at a 6/10 and end at 3/10? Keep practicing this until the anxiety no longer is the ruler.
You may never like driving over bridges but that is OK. You don’t have to like it but you need to stop changing your life to avoid it. Your anxiety may also never go to 0/10. But that’s also ok. We can be anxious and still do things.
Anxiety doesn’t need to rule your life!
Anxiety is only one part of your life. It can be a helpful signal and enhance your life. But it is a problem when it begins to rule your decisions in life. Start dealing with your anxiety now!
Do you need anxiety medication?
Some people with anxiety conditions are too anxious to even get started tackling their anxiety and may benefit from medication to help lower their anxiety first. Speak with your doctor if you think you may need medication to help your anxiety.
Unfortunately, even if the medication works, the anxious associations and avoidance patterns have already been ingrained. We can lower the powerful drive of your anxiety with medication but cannot break habits. Worrying becomes a habit when you do it for years and avoidance will remain if it isn’t directly challenged.
You can recover fully from anxiety!
As anxiety begins to decrease, continue to push yourself forward to do the things that make you anxious. This is the way to recover fully. Once you stop being ruled by anxiety, keep anxiety in check by practicing the skills you have learned.
We all know that if we get in shape physically we have to do maintenance to stay in shape. It would be fantastic if we could just get physically fit once and maintain that shape forever without additional exercise. We can recognize the absurdity in that expectation.
It is the same with conquering anxiety. Hard work can produce lasting benefits but it will also take ongoing maintenance to remain free of unhealthy anxiety.
Start to do what you are afraid of!
Get started now! What will be your first challenge? Make your list of avoided items and pick the one with the lowest anxiety rating. Do it over and over again. Experience the success of conquering the anxiety that used to be triggered by this item. Once the anxiety is manageable, move on to the next item on the list. Keep pushing yourself until you work through your whole list. You can do it!
Are you looking for additional resources to help master your anxiety?
Visit my Mental Health Bookstore for a list of highly recommended books to help with anxiety. You will also find many other mental health resources at this site.
About the Author
Melissa Welby is a Harvard trained, board certified psychiatrist with private practices.