Understanding anticipatory anxiety and how to cope with it

Medically reviewed by Andrea Brant, LMHC
Updated January 8, 2024by BetterHelp Editorial Team

Anticipatory anxiety describes when a person experiences worry and apprehension for a future event that may or may not occur. People can experience this when awaiting an upcoming interpersonal task, like a job interview, or when thinking about unforeseen dangers, like natural disasters. This type of anxiety can begin anywhere from minutes to years before an anticipated event.

Its intensity can vary from person to person and event to event. Onset can happen at any time in an individual’s life. Anticipatory anxiety is not its own condition, but instead is a symptom of other mental health conditions like generalized anxiety disorder, social phobia, or panic disorder. While anticipatory anxiety may begin over a one-off event like a panic attack, it can transform into fear of having another panic attack, prompting a continuation of anxious thoughts. 

Navigating anticipatory anxiety is possible through a variety of coping tactics, but some people may benefit from the assistance of a professional.

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Understanding anticipatory anxiety

Individuals experiencing anticipatory anxiety can be overwhelmed by negative thoughts and what-ifs. They often expect the worst and sort through every possible bad outcome, becoming unable to focus on anything else.

When approaching an important event like a big speech, job interview, or MRI, many individuals experience common side effects: a racing heart, sweaty palms, or butterflies—all signs of anticipatory anxiety. However, when these symptoms are a daily or hourly occurrence, they can become a significant disruption. 

Those experiencing more severe anticipatory anxiety might react by avoiding participation in activities (even favorite hobbies) or seeing friends and family. In addition to this avoidance, also often present are jumpiness, stomach pain, nausea, irritability, restlessness, muscle tension, and trouble concentrating. Other symptoms include shortness of breath, dizziness, or even numbness. 

Conscious versus unconscious anticipatory anxiety

Anticipatory anxiety can exist both in the conscious and unconscious. Sometimes, people will go through their days consciously feeling anxious about what is to come, fearing negative outcomes, imagining worst-case scenarios, or worrying about the existence of an unpredictable life-changing threat. But other times, anxiety can be more complicated. Tension can unconsciously creep into dreams or manifest itself in outbursts. In both circumstances, we can try to understand the underlying anxieties to address them head-on. 

Overcoming anticipatory anxiety

Almost everyone fears some of life’s future events. However, for those experiencing anticipatory anxiety, it can be helpful to face these potentially overwhelming fears. You may find that therapy is one part of a successful treatment plan. In fact, one study shows that 64% of online therapy participants made significant progress in addressing and reducing symptoms of anxiety. 

In addition to working on symptoms through therapy and self-care, sometimes medication may be required to successfully manage anticipatory anxiety. You can work together with a professional to determine what approaches might reduce your anxiety symptoms. For more information on anxiety disorders and how to manage them, take a look at these medically reviewed articles.

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Coping tactics

There are several coping strategies available for those who experience anticipatory anxiety. Psychotherapy, relaxation techniques like progressive muscle relaxation, and other treatments for underlying anxiety disorders may help reduce symptoms. Here are some tips and tools that may help get you through anticipatory anxiety:

  • Have A Support System. As human beings, we are hardwired to seek social support, and it's no different for those with anticipatory anxiety. You can try talking about your concerns with a trusted loved one.

  • Relax. Coping strategies that help you relax can keep anxiety at bay and might even work to defuse panic attacks. Find relaxation techniques that work for you, whether they are practicing yoga, meditation, journaling, progressive muscle relaxation, or using deep breathing exercises. Anything that helps you stay in the present moment and mediates anticipatory processing, which occurs when we experience extreme apprehension, can reduce symptoms. It is also important to remember that not getting enough sleep can make anxiety worse.

  • Practice Gratitude. Practicing gratitude can retrain your brain away from anxious thoughts and negative input to focus instead on positive emotions and thoughts. Actively finding things to be grateful for and focusing on the positive might reduce the anxious thoughts and uncomfortable feelings that come with anticipatory anxiety.

  • Have Compassion For Yourself. If you find yourself struggling with anticipatory anxiety, try to be gentle with yourself. Consider treating yourself with love and kindness and talking to yourself in a soothing manner to help quiet the inner conflict.

  • Seek Professional Help. While the above tips might help, developing a plan to manage your symptoms and the intensity of your anxiety may require the help of a professional. Cognitive behavioral therapy (CBT), exposure therapy, and panic-focused psychodynamic psychotherapy have proven beneficial in coping with and overcoming anticipatory anxiety.

With CBT, a mental health professional helps you identify and change the thought processes and behaviors that are playing a role in your anxiety. Panic-focused psychodynamic psychotherapy involves a therapist working with you so that you become aware of unconscious conflicts and defense mechanisms that play a role in your anxiety.

Therapy can be a direct, effective treatment for chronic anticipatory anxiety. Peer-reviewed studies have shown that online therapy is useful for reducing anxiety and a variety of other mental health conditions. Connecting with a mental health professional online means you have a chance to discuss your concerns in the comfort of your own space, on whatever device you choose. Set up your appointment at a time that works for you, and then communicate with your therapist via texting, email, voice chat, or video chat. Read below for some reviews of BetterHelp therapists, from people experiencing similar challenges.

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Counselor reviews

"This is my second time working with Alex and although we are only a few sessions in, I'm so grateful that I was able to reconnect with her. She challenges me to re-frame my negative and anxious thoughts and I've seen my anxiety improve significantly over the past year. I would highly recommend Alex. She is truly amazing!"

"I've been talking with Emily for a couple of months now. She has been amazingly supportive and thoughtful during our sessions. The tools and techniques she has taught me for managing my anxiety have been incredibly valuable and will bring me benefits for the rest of my life."

Takeaway

The feeling of being overwhelmed by anxious apprehension can be navigable with the right set of tools and support system. A combination of self-care techniques and in-person or online therapy can play a major role in getting you to a point where you can manage and overcome your anticipatory anxiety.
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