Someone to talk to about anxiety, without feeding the worry

Breathe out longer than you breathe in

Anxiety speeds up your breathing. In a month-long randomized study, five minutes a day of "cyclic sighing," a pattern built around long exhales, improved mood and slowed breathing more than mindfulness meditation did. ⁵ It was one study in healthy adults, but slow, exhale-heavy breathing is a low-risk thing to try.

1. Breathe in through your nose. When your lungs feel full, take one more short sip of air.
2. Breathe out slowly through your mouth, for as long as is comfortable.
3. Repeat for one to five minutes.
4. If you feel lightheaded, stop and breathe normally for a bit.
5. Use it to settle, not to fight off every flicker of anxiety.

Ground yourself with 5-4-3-2-1

Anxiety pulls your attention into the future. Grounding brings it back into the room through your senses. Think of it as a way through a hard few minutes, not a treatment on its own.

1. Name five things you can see.
2. Name four things you can feel: your feet on the floor, the chair under you, your sleeves.
3. Name three things you can hear.
4. Name two things you can smell, or two smells you like.
5. Name one thing you can taste, or take one slow breath.
6. Go slowly. The point is noticing, not finishing.

Postpone the worry to a set time

Worry postponement limits worrying to one window a day. In a small randomized study of people with high levels of worry, two weeks of a daily 30-minute worry period reduced worry, anxiety and insomnia more than a comparison approach. ⁶ The technique goes back to research from the early 1980s. ⁷

1. Pick a 20 to 30 minute worry time each day, in the same place. Not in bed, and not right before sleep.
2. When a worry shows up outside that window, write it down in a few words and tell yourself, "Not now. At 6."
3. Bring your attention back to what you were doing.
4. At worry time, go through the list. Some items will have shrunk. For the rest, write one next step or "nothing to do."
5. When the time is up, stop, even if you're mid-worry.

Call the thought what it is: a prediction

Anxious thoughts feel like facts, but they're forecasts. CBT treats them as predictions you can test, not truths you have to obey or argue with forever. ⁴

1. Write the thought down exactly: "I'll freeze in the meeting and everyone will think I'm incompetent."
2. Put "I'm predicting that" in front of it.
3. Rate how strongly you believe it, from 0 to 100.
4. Ask yourself what happened the last few times, and what you would say to a friend who predicted this.
5. Rate it again. You're not aiming for zero, just enough room to act anyway.

Run a small experiment instead of avoiding

Avoiding brings quick relief and keeps the fear intact, because you never find out what would have happened. Facing feared situations step by step, called exposure, is a core part of CBT for anxiety, and behavioral experiments are built into CBT for social anxiety. ^{4 8}

1. Pick something you've been avoiding that's a 4 or 5 out of 10 on the fear scale, not a 9.
2. Write your prediction: what you think will happen and how bad it will feel.
3. Do it, without your usual escape hatches if you can.
4. Afterward, compare what happened with what you predicted.
5. Repeat it, then move one step up.

Why is my anxiety worse at night?

At night there's less to distract you, nobody to check your thinking against, and nothing you can do about most worries until morning, so they circle. Tiredness makes it harder to step back from them. If it's keeping you awake, the steps on our page about not being able to sleep, like getting out of bed and writing tomorrow down, are built for that.

Should I take medication for anxiety?

It's a decision to make with a doctor, not one to make alone. For generalized anxiety, guidelines include medication as an option alongside CBT, and some people use both. ³

How do I help someone with anxiety without making it worse?

Listen and take their fear seriously, but go easy on repeated reassurance, since reassurance seeking is part of what keeps anxiety going. ² Instead of "it'll be fine" for the tenth time, try "that sounds scary, what would help you do it anyway?" Encourage small steps toward what they avoid, and support them in getting professional help if it's affecting their life.

Is it social anxiety or am I just introverted?

Introversion is a temperament: a preference for quieter settings and time alone to recharge. Social anxiety is fear of being judged, embarrassed or rejected, and it often means avoiding things you'd actually like to do. You can be introverted without social anxiety, and outgoing with it.