Anxiety, like depression, is a normal human emotion. Is the goal to get rid of the anxiety or to learn to tolerate it? Well, that depends on the situation.

If I am driving down the parkway and all of a sudden a car cuts out in front of me and I narrowly avoid a major accident, and I get a rush of anxiety, my heart starts pounding, and I have trouble breathing, that is an anxiety reaction that is perfectly normal, given the situation.

Now, let’s say it’s a beautiful day on the road without another car in sight and I have the exact same response. That would be called a panic attack.

In the first example, the brain sends out appropriate signals of anxiety. In the second example the brain sends out the same signals, but this time for no reason.

The panic attacks are biological and are caused by a chemical imbalance in the brain. Having a panic attack can be very frightening. Then if you have another one a few days later, you start to anticipate the next attack. This anticipatory anxiety can be quite debilitating. The panic attacks can be treated with medication while the anticipatory anxiety is dealt with through psychotherapy.

We don’t want to mask all the anxiety with medication. One needs to be able to deal with stressors and confront situations that make us anxious.

In general, there are two main ways to deal with anxiety: exposure and avoidance. Both are appropriate in different situations.

If I am afraid of elevators, for example, and I want to get over my phobia, then exposure therapy is the way to go. I need to get into that elevator, briefly at first, and expose myself to the source of the anxiety. In the beginning, that will increase my anxiety but if I do it repeatedly, my anxiety will gradually diminish and I will have desensitized myself from responding with anxiety to elevators.

The point is you have to let your anxiety get worse before it gets better. We all do this all the time. The first day of a new school year, the first day of a new job, or trying something that we have never done before; all things that might make us anxious but then resolves with repeated exposure.

I am hiking down a mountain trail and I see a grizzly bear up ahead. I get anxious! Here, I do not want to use exposure therapy, as I have no desire to get rid of my  grizzly bear phobia! I will use avoidance: get away

from the source of the anxiety. I will turn slowly around and get the heck out of there.

After I have removed myself from the source, my anxiety goes away. I did not desensitize myself with avoidance, but in this case, that was perfectly ok. In the previous example, if I had just decided to avoid elevators, my anxiety would have gone away, but my fear of elevators would have remained.

Anxiety is not all bad. Sometimes it warns us of impending danger. Anxiety also occurs every time we try something new and when we try to expand our comfort zone. The trick is to know when to listen to the anxiety and say, “OK, I’m not going to do that,” and when to experience the anxiety and do it anyway.

Think about it. If every time something made us anxious, we said we weren’t going to do it, we wouldn’t do anything. First day of the school year, first day of a new job: all things that make most of us anxious.

Another way to deal with anxiety is to give ourselves permission to have it. Let me give you an example. If I have a job interview tomorrow and I start to get anxious about it, I can deal with it in one of two ways. I can tell myself I better calm down because I have a job interview tomorrow and I can’t be nervous for it. The second way is to tell myself, “of course I am nervous, I have a job interview tomorrow and anyone would be nervous.”

Which one do you think would make me less anxious? I would say the second one. In the first one, I now have two things to be anxious about: the job interview and the fact that I’m anxious. So, now my anxiety will increase and I will get anxious about that. You can see the cycle.

The second way I have only one thing to be anxious about: the job interview. No cycle. I don’t have to be anxious about being anxious.

We can’t just change our feelings, but we can change our thoughts. If we can identify our thinking patterns that fuel our anxieties, then we can examine these thoughts and see if they are rational. If they are not rational, we can change our thoughts and then our feelings will change also.

The concept, I know, sounds simple but putting it into practice can be difficult. Psychotherapy can help with this and many other methods to control anxiety.

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