How to Deal with Severe Anxiety

Co-authored by Trudi Griffin, LPC, MS

Last Updated: March 29, 2019 References

Experiencing severe anxiety can be very unsettling, making you feel panicky or terrified for no obvious reason. The symptoms of severe anxiety may be so intense that you find it hard to lead a satisfying life; however, you definitely can by taking the right steps. Cope with your severe anxiety by working with your healthcare providers to develop a proven treatment plan. You can also improve your quality of life by implementing self-soothing strategies, supporting your physical health, and reaching out for support.

Method 1

Method 1 of 4:

Calming Yourself

1
Ground yourself. If you're in the middle of a panic attack, try grounding yourself by identifying 5 things in your environment you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.^{[1]
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- Other ways to practice grounding include splashing water on your face, planting your feet on the bare earth, or drinking a hot or cold beverage.^{[2]
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2
Breathe deeply. Take a deep breath in through your nose. Hold the breath for several seconds. Then, release the breath slowly from your mouth. Repeat the cycle again until you start to feel calmer.^{[3]
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- Deep breathing is a wonderful tool for relieving anxiety symptoms in the moment, such as during a panic attack. It works by sending more oxygen to the brain. As a result, you jumpstart the body’s natural stress response and become calmer.
- Try several rounds of deep breathing to reduce acute anxiety, but you can also do this exercise regularly to keep at anxiety at bay.
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3
Do progressive muscle relaxation. Working your up through the body, gradually contract then relax each muscle group. While contracting, hold for a few seconds and notice how the tension feels. Then, release the tension and notice how that feels before moving on.^{[4]
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- This relaxation exercise helps you recognize where you are holding tension in your body so that you can effectively release the tension.
4
Journal. Jot down your anxious thoughts by recording the situation, your reaction or thoughts about it, and how you feel as a result. Try to spot recurring thought patterns or even problem-solve these stressful situations. ^{[5]
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- For example, if you notice you seem to write about feeling anxious frequently on Thursdays, you might analyze that day to determine what's happening to make you anxious. Maybe you are coming in contact with a trigger without knowing it, such as a demanding class or a toxic person.
Grab a pair of headphones and drown out the anxious thoughts. Listen to your favorite music, podcasts, or audiobooks. Many people find they can sleep easier by distracting their thoughts. You can also try singing out loud, even if it’s just very quietly to yourself. This will engage your voice, another part of your body, which can help ground you.^{[6]
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6
Recite affirmations. Repeat an encouraging affirmation, such as “Anxiety feels bad, but I know how to cope.” You might also talk yourself down, per se, by saying something like, “I am the picture of calm.”^{[7]
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- Positive, empowering statements can help you feel more capable of coping with your anxiety.
7
Take a short time-out or a full mental health day. If you’re stressed out, your anxiety is likely to be high. Schedule some time off of work or school after intense periods. That could mean taking at 20 minute break during a stressful day, or calling in sick for a full day if you really need to unwind.
- Don’t feel bad about taking breaks from your work. Remember that you’ll perform at your best when you’re not stressed or anxious, and that you’ll be able to be productive and relaxed when you come back.
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Method 2

Method 2 of 4:

Treating Severe Anxiety

1
See a mental health provider if you don't have one. If this is your first time experiencing anxiety, you probably don't have a team of mental health providers on call. Find a psychiatrist or psychotherapist in your area who has experience treating severe cases of anxiety.^{[8]
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- You may have to go through your family doctor for a consult or referral before you can get an appointment.
2
Consult with your healthcare providers. Talk to your doctor about your severe anxiety. Record the symptoms you are experiencing and be sure to mention any aspects of your lifestyle that have changed. Symptoms of severe anxiety may include chest pain, dizziness, numbness, intense fear, avoidance behaviors, or compulsive behaviors.^{[9]
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- If your anxiety has only recently gotten more severe, be sure to alert your healthcare providers (i.e., family doctor, psychiatrist, therapist, etc.) of this sudden change.
- If your severe anxiety is an ongoing issue, schedule regular appointments so that your healthcare providers can help monitor your condition.
3
Identify your triggers. Carry a notepad around with you for a week or so and jot down the people, places, and things that tend to make your anxiety worse. Triggers for anxiety may include illness, work or school stress, relationship troubles, and even aspects of your environment such as clutter.^{[10]
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- Once you identify your triggers, you can work with your therapist to come up with ways to avoid or limit these situations.
- Anything in excess can be a trigger, including too much light, loud background noise, too many people, too much to look at, and overpowering odors.
4
Decide if medications are right for you. See if you need to be taking medications for your severe anxiety. If you’re already taking meds and your symptoms have suddenly worsened, talk to your doctor about making an adjustment to your current regimen.^{[11]
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- A wide range of medications are used for the treatment of severe anxiety, including anti-anxiety drugs in the class known as benzodiazepines as well as antidepressant drugs such as selective serotonin reuptake inhibitors.
- If you are prescribed benzodiazepines, be aware that they aren’t recommended for long-term use due to the bad side effects they can cause. You also shouldn’t stop using them suddenly, as this can cause a bad reaction.
- Medications may offer temporary relief from severe anxiety and improve your quality of life. However, medications do have side effects, so ask your doctor whether they are right for you.
5
Figure out which type of therapy can help with your anxiety. Therapy is a safe environment in which you can address the underlying cause of your severe anxiety. But, different anxiety disorders respond to different therapies, so ask your therapist which type of therapy is most proven to help you.^{[12]
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- For instance, cognitive behavioral therapy involves changing the thought patterns that contribute to anxiety. CBT is useful in treating most anxiety disorders.^{[13]
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- Treatment for phobias, post-traumatic stress disorder, and obsessive-compulsive disorder may also benefit from exposure-based therapies, which involve gradual exposure to the events or situations causing anxiety.
- Somatic therapies, including somatic experiencing, train you to work through stress and trauma through your body’s reactions, restoring your nervous system to its natural cycle. You’ll use guided physical exercises to help your body heal.^{[14]
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6
Try alternative treatments that you can perform at home. Ask your healthcare providers for recommendations of complementary treatments for severe anxiety if you want to self-treat severe anxiety at home or in conjunction with medications. Some complementary treatments for anxiety include meditation, biofeedback, hypnosis, and acupuncture.^{[15]
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- These treatments may be helpful to do when you are waiting for the effects of medication to set in or if you prefer not to take medications at all.
- You may have to try various approaches to find the one that best helps your case.
7
Try natural remedies. Some natural herbs have been shown to relieve anxiety. Kava and passionflower, for example, have been used to ease the symptoms of anxiety. These herbal remedies may be a great supplement to other formal treatments like medication and therapy.^{[16]
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- Although these herbs are natural, they may still react to your medications, so ask your doctor before taking them.
- Never self-medicate with drugs or alcohol. They come with their own side effects and can make your anxiety worse.
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Method 3

Method 3 of 4:

Supporting Your Body

1
Do 30 minutes of aerobic exercises daily. Aerobic exercise in particular is a known stress-reliever because it releases special chemicals that improve your mood. Try to get at least 30 minutes of physical activity each day.^{[17]
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- Many people with anxiety enjoy calming exercises like yoga or stretching. However, you can also try a soothing hike through nature, a swim in the nearby pool, or a run through the park.
2
Get 7 to 9 hours of rest each night. Sleep is the time when your body (and brain) heals and repairs itself. Start winding down earlier to ensure you get at least 7 hours each night.^{[18]
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- Create a relaxing nighttime routine, including activities like taking a warm bath or shower, lighting a scented candle, listening to music, or light reading.
3
Avoid processed or junk foods. Food acts as fuel for the brain and the body, which means making healthy dietary choices can improve your anxiety symptoms. Avoid eating simple carbohydrates like sugary or processed foods. Eat nutrient-rich meals every few hours to help control anxiety.^{[19]
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- Relieve anxiety with foods high in magnesium, zinc, omega-3 fatty acids, and probiotics. These nutrients are found in foods like spinach, beans, nuts and seeds, fatty fish, eggs, asparagus, avocado, yogurt, and sauerkraut.
Certain substances can actually worsen your anxiety. To effectively deal with severe anxiety, stop consuming caffeine and alcohol. You should also cut out smoking.^{[20]
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Method 4

Method 4 of 4:

Finding Support and Meaning

1
Keep a positive outlook by practicing gratitude. Try your best not to dwell on the negative aspects of your life. Each day, write out 3 things that went well or that you are grateful for to maintain a positive point-of-view.^{[21]
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- Focusing on the positive will help you get perspective and may even help you ease severe anxiety.
2
Join an anxiety support group. Anxiety can feel isolating, but you’ll feel less disconnected if you purposely seek out others with your condition. Anxiety support groups offer a safe and supportive environment to talk about your symptoms and get advice for coping with them.^{[22]
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- Ask your mental health provider for a recommendation to a support group in your area.
3
Designate an “emergency” contact. Cope with severe anxiety by reaching out to close friends and family. Identify a few people you can call who will help talk through anxiety-provoking situations and help you calm down.^{[23]
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- You might say, “Lisa, is it okay if I call you before my test? I need your help staying calm.”
- Establish boundaries with your emergency contact so that you're not violating their time and space. For instance, you might call this person if you're feeling anxious in the mornings, but they may not be available in the evenings. In such a case, you might have to call your therapist or a different contact for support.
4
Connect with others through volunteerism. Dedicating your time to an important cause can help distract you from anxious thoughts and help you feel less isolated when dealing with anxiety. Look up volunteer opportunities in your local community to find out how you can give back.^{[24]
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- Good volunteer opportunities may include reading to children in the library, helping out at a nursing home, or caring for pets at an animal shelter.
5
Accept that you won't always be in control. If you have severe anxiety, it will interfere with your life from time to time. Resisting this fact or trying to "cure" your anxiety may only lead to more frustration and anxiety. Come to terms with your situation and accept the days when you won't be in complete control of everything.^{[25]
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- Participating in support groups can be a great way to accept your condition.
- Accepting anxiety doesn't mean you won't take active steps to minimize it, but it does mean that you won't beat yourself up for having it.
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