How to manage anxiety?

Hello and thank you for your question about anxiety. I am sorry that this has been a struggle for you most of your life.

Anxiety is very common and is something many people deal with. You are not alone and it’s very normal to be faced with this. Anxiety is currently the most common mental health condition in the United States. It affects about 18.1% of the population in any given year. And as it’s become more common, there has been much work done to help us all learn how to better cope with it. At present, there are definitely many strategies which you can employ that will be helpful both in the short term (immediately and in the moment) as well as in the longer term.

Anxiety is a natural response to a stressor. Experiencing anxiety is actually a part of being human. We will all deal with it. In fact, it sometimes can be a good thing. It can, for example, be an alert system that keeps out of danger. However, as you seem to know, it can also become problematic and disruptive to our lives.

So, what are some things you can do to help yourself when anxiety begins to overwhelm you?

1. Try nasal breathing - Close your mouth, place your tongue on the roof of your mouth, and take some calm, quiet, and slow breaths. Nasal breathing stimulates your parasympathetic nervous system, which is known as the rest and digest system.
2. Get active – try getting outside for a walk. Even just a short one will help. The fresh air and sunshine will benefit you. And movement will help ease your nerves. Exercise is a really powerful stress reducer.
3. Think about what you’ve had to eat or drink - Caffeine has a tendency to make us nervous and irritable. Spend some time becoming more aware of what you are eating or drinking  - these things could be to blame, to some degree and maybe plan to gradually reduce your intake going forward.
4. Massage yourself - Grab some lotion and give your hands a massage. We can carry lots and lots of tension in our hands. This is an easy way to self-apply the art of reflexology. Start with the large muscle below your thumb and massage in a circular motion. Move upwards on your body, too - release stress in your shoulders and neck by giving yourself a massage in these areas as well.
5. Question your thoughts - Be curious about your thoughts - ask “is this true, or could there be something else I’m missing?” Reflect on whether your thoughts are extreme – are you perhaps missing other alternative possibilities. Could you be catastrophizing – jumping to worst case scenario instead of being more realistic? Not every thought we have is true. And buying into false ideas that pop into our head can cause a great deal of stress and anxiety.
6. Make positive affirmation flash cards - Write out encouraging, calming phrases on flash cards (or make a list on your phone) and break out your cards when anxiety hits. You can include phrases like “I have the ability to get through this,” “I may be feeling anxious, but I can choose to make myself calm,” and “I am going to be okay, and I can feel myself relaxing.” It’s a distraction activity which will help lower stress. And the phrases will help re-train your brain to learn a new language – one that’s more positive and relaxed. Sometimes we do need to teach our mind to think in a new way.
7. Become more accepting and recognize that you’ll be okay - Don’t have the expectation that you’re going to get rid of anxiety. It’s part of being human. We all get anxious sometimes. You will, over the course of your life, have some experiences of anxiety. Appreciate that anxiety happens and it’s okay. You will be okay.
8. Seek out support – I know you said your boyfriend is the only person you are talking to about any of this. It’s great that you have a person there for you. And it’s a good thing to recognize that he’s your only support – because here we find an opportunity. Knowing this is the case, it’s a great time to begin expanding your circle. Maybe you know someone you could begin connecting with more. Or perhaps it’s time to begin seeking out some new friends. Having a good support system in place is valuable. I would encourage you to begin building one. It can take time, but it’s worth the effort. Is there a class you could take or a club you maybe want to join? Think about where and how you might find others so that you can start developing some new relationships. It’s wonderful to have your boyfriend there, but it’s good to have others you can turn to as well. 
9. Additionally, it might benefit you to speak with a therapist. A therapist can help you work more on your anxiety. They can help you learn more skills and create a more individualized plan. And they can help you understand what might be causing your anxiety – which can also help you form a unique plan for dealing with it.