From Overwhelmed to Okay: A Therapist’s Guide to Managing Anxiety

It seems like everyone I meet these days has anxiety. Our nervous systems are on overload — some more than others, but there is a lot of fear in the world right now. A lot of uncertainty.

At its simplest, anxiety is worrying about the future. If you’ve seen Inside Out 2, you watched anxiety take over while all the other emotions huddled in the corner, frankly scared. But what anxiety really needs is to be seen and understood.

When anxiety escalates into PTSD (Post-Traumatic Stress Disorder), the brain becomes overwhelmed and is unable to piece together what happened. What therapy does is help put those pieces back together. It helps the person suffering understand things like: It wasn’t my fault. There was nothing I could have done. I’m not a bad person. I did the best I could with the information I had. I was only a child. Therapy puts shame to rest.

If you’re experiencing anxiety, how is it impacting your life? In what ways is it throwing you off balance? We are out of balance when anxiety takes over. We tend to isolate and lose sleep. Depression and anxiety often travel together. When anxiety becomes part of everyday life, it’s difficult to enjoy even the simple things. We want to escape — and we often turn to addictions like alcohol, drugs, pornography, or binge-watching Netflix. Anything to get away from the pain. It can be all-consuming, and we numb out.

What the Brain Needs

The brain needs to settle down, and the only way that happens is when it feels safe. Retraining the brain is not as complicated as you might think, but it does take discipline, consistency, and awareness. Simple — but not easy. As with anything worthwhile, it helps to enlist support: anxiety therapy, friends, online support groups.

Mindfulness

Many people say, “I’ve tried mindfulness and it doesn’t work” or “Meditation makes my anxiety worse.” Here’s why that happens: when an anxious brain tries to relax, it can sometimes become even more wound up. The anxious brain feels it must stay hypervigilant — which is also why sleep can be so difficult. Sleep is probably the most vulnerable thing you can do, according to an anxious brain. So when you try mindfulness or meditation, the brain resists letting its guard down.

Here’s the key: anxiety and depression do not exist in the present moment. Anxiety is worrying about the future; depression is dwelling on the past. When you’re fully in the present, your body can calm down.

This is why mindfulness takes practice. The brain needs to learn that it’s safe. Doing it once or twice won’t create meaningful neurological change — but a consistent practice will. It literally changes the neural pathways of your brain and begins to heal anxiety from the inside out. Slowly, the feeling of I don’t feel safe begins to shift to I’m okay.

Think of it like anything else worthwhile: going to college, building strength at the gym, even learning to drive. It takes time and consistent effort. And the beauty of it is — it actually works. It’s difficult to do alone, but your willingness to seek support in this process can dramatically change your results.

What to Do During a Panic Attack

A panic attack is the body taking over. The brain begins to override rational thought and sends the message that you are going to die. It shuts down the frontal lobe — the logic and reasoning center — and instead floods your body with adrenaline, increases your heart rate, and can even produce chest pain that mimics a heart attack. Many people have ended up in the emergency room during a panic attack, not knowing what was happening.

This is why grounding techniques are so important — and why you should write them down on a notecard and keep it with you at all times. When the frontal lobe is offline, you can’t think clearly enough to remember what to do in the moment.

The 5-4-3-2-1 Grounding Technique

This technique works by tapping into your senses to bring you back to the present moment:

• 5 things you see
• 4 things you hear
• 3 things you feel (touch)
• 2 things you smell
• 1 positive affirmation — I can do this. I am okay. I am safe.

Practice this daily, even when you’re not in crisis, so that your brain knows where to go when you need it most.

Other Helpful Grounding Techniques

• Hold an ice cube
• Place an ice pack on the back of your neck
• Walk barefoot on the grass
• Play a categories game with a friend

Mindfulness Practices

• Box breathing
• Meditation