Most people experience feelings of anxiety before an important event such as a big exam, presentation or social event. Anxiety disorders, however, are illnesses that interfere with daily activities and are characterized by chronic, unremitting anxiety and fear.
Anxiety is a feeling of tension or apprehension in response to a perceived threat. The anxiety reaction is part of the “fight or flight” response that enables you to respond rapidly when faced with danger, and also occurs when the demands of life feel greater than your ability to cope and deal with them. Most people feel some anxiety in their daily lives and shouldn’t be concerned about experiencing a moderate amount. Many students, for example, experience some level of tension or nervousness before tests or other important events. A little anxiety can actually help motivate us and make us more alert, but too much anxiety can interfere with our ability to prepare for and perform on tests.
People with an anxiety disorder have persistent, intense and irrational feelings of anxiety that are uncontrollable. When anxiety leads to significant distress or disturbance in academic, social, or other important areas of functioning, it may be an anxiety disorder, and a health professional should be consulted to determine if an anxiety disorder exists. Anxiety disorders, as a group, are the most common mental illness in America and often accompany other disorders such as depression, eating disorders, substance abuse, or phobias.
Symptoms of anxiety disorders
- Repeated, random panic attacks, feelings of terror or impending doom
- Chronic worry or anticipation about having another panic attack
- Embarrassment, humiliation, or concern over everyday social situations that pose little or no threat of danger
- Fear or avoidance of an object, place or situation that poses little or no threat
- Constant, chronic and unsubstantiated worry
- Uncontrollable, repetitive action, such as washing one’s hands repeatedly or checking things over and over
- Nightmares, flashbacks, or emotional numbing related to a traumatic event
In general, two types of treatment are available for an anxiety disorder: medication and specific types of psychotherapy – most commonly, cognitive behavioral therapy. Both approaches can be effective for most anxiety disorders. The choice of one or the other, or both, depends on individual and doctor preference and the particular anxiety disorder.
The choice of one or the other, or both, depends on individual and doctor preference and the particular anxiety disorder. However, research shows that psychotherapy, particularly cognitive behavioral therapy and interpersonal therapy, is more effective than medication alone in treating anxiety disorders and medication does not significantly improve the outcomes of psychotherapy.
To begin, increase your awareness of your feelings of anxiety and pay attention to the coping methods that work best for you. There are some things you can do to help prevent normal anxiety from developing into a full blown anxiety disorder:
- Work on control issues: Trying to exert control over things you can’t possibly control (other people’s thoughts or behaviors, deadlines, traffic) can produce feelings of anxiety. Let go of what you can’t control and focus on what you can (your own perceptions, behaviors and responses).
- Breathe well: “Deep” or diaphragmatic breathing stimulates the parasympathetic nervous system, lowers blood pressure and reduces the pulse rate, leading to increased relaxation. Shallow chest or thoracic breathing increases blood pressure, respiration and pulse rates, leading to increased anxiety. For short-term benefit, practice this technique when you are beginning to feel anxious. For long-term benefit, practice daily when you are not anxious.
- Manage the symptoms of anxiety: In addition to diaphragmatic breathing, learn and practice meditation, progressive muscle relaxation, yoga, or other relaxation techniques to manage or reduce the physical manifestations of anxiety.
- Change negative thinking: Negative or distorted thinking patterns are a major cause of anxiety (seeing things in black or white categories, using “what ifs” or “shoulds,” catastrophizing, jumping to conclusions, or blaming). Use thought stopping (saying “stop” when you find yourself thinking this way) and work to re-direct your thoughts towards a more rational response.
- Exercise: Exercise is a healthy outlet for physical and emotional release. Taking a brisk 20-30 minute walk is an easy, effective strategy for immediately reducing anxiety.
- Watch what you put in your mouth: Eat a balanced diet and avoid or eliminate stimulants such as caffeine and nicotine, which increase anxiety. Check your medications and talk to your doctor to determine if you are taking a medication or supplement that may be causing or worsening your anxiety.
- Improve your sleep: An anxious or worried mind can cause insomnia, making it more difficult to feel rested and capable of coping. If daytime worries or stressors keep you awake, try reducing some of what is on your mind by writing down your thoughts or making a to-do list before you go to bed. In the morning, you can review your notes and try to figure out ways to deal with each stressor more effectively.
- Focus on the present: Anxiety is often characterized by future-oriented thoughts of worry or fear about what might happen. Try bringing your attention to what is happening in the present moment and ask yourself if worrying about the situation will help. If not, focus on what you can do now.
- Manage your time more effectively: Trying to “get it all done” can increase anxiety. To decrease feeling overwhelmed or anxious by all you have to do, prioritize your tasks. Then try breaking each task into small manageable parts. Set clear goals to make sure each task is doable. Be flexible and willing to alter your plan as new tasks are added to your list.[/accordion-header]
- Test anxiety
Everyone experiences some level of nervousness or tension before tests or other important events. A little anxiety or stress can actually help motivate us and make us more alert. However, too much of it can interfere with our ability to prepare for and perform on tests. Test anxiety can be caused by a fear of failure or of being evaluated, difficulty coping with internal and external pressures to succeed, or difficulty handling time pressure.
Tips for Taming Test Anxiety
One of the most common ways that we cope with anxiety is to avoid the problem. However, avoidance often makes matters worse and creates more anxiety. It may be more helpful to work on improving your coping strategies:
Before the Test
- Organize your materials and then talk with the professor or TA to see if you are using your time efficiently and focusing on the key points.
- Familiarize yourself with the test setting. Take a practice test in the room where the exam will be held (or visualize that room).
- Exercise! Get your heart rate up for 20-30 minutes prior to the exam. It quells anxiety and improves blood flow, priming your brain for optimal performance.
During the Test
- Expect and accept that you’ll be feeling some anxiety and reframe it as being “psyched up” for the big game (fear and excitement often feel the same psychologically).
- Breathe and re-focus your attention back to the test if your mind gets hooked by thoughts of, “Oh no! I don’t know this!” Keep bringing your attention back to the test instead of following anxious thoughts.
- Keep perspective. Forget “perfect.” Focus on what you know, not what you don’t know.
After the Test
- Stop for 10 seconds and savor what went right (it takes longer to imprint positive vs. negative experiences on the brain).
- Acknowledge the anxiety that may follow as you “wait out” the period until you get your test results. Remind yourself that you have options for dealing with whatever the outcome is (vs. getting stuck on the one catastrophic outcome). Success is about resilience, not perfect performance.
- You might be able to reduce your test anxiety by learning effective test-taking and preparation techniques at The Learning Center. You can call them at 314-935-5970.
- Uncle Joe’s Peer Counseling and Resource Center has a 24-hour hotline at 314-935-5099. If you wish to speak with someone in person, their office is in the basement of Gregg Hall, 10 p.m.-1 a.m. nightly.
- Screening for Mental Health has information on self-evaluation for an anxiety disorder, as well as other mental health resources.
- Anxiety Disorders Association of America Promotes professional and public awareness of anxiety, depression and related disorders, and helps people to find treatment and develop self-help skills.
- For more resources and programming on anxiety, depression, sleep and stress, or to meet with a stress management specialist to learn skills for coping with stress and managing anxiety, contact Health Promotion Services at 314-935-7139.
- Deep, diaphragmatic breathing, practiced for a few minutes each day, can impact and decrease your physical responses to stress.
- Incorporate meditation into your daily routine.
- Sleep sufficiently and regularly.
- Exercise can elevate your general mood and improve cardiovascular health. Try walking briskly for 30 minutes each day, or practicing yoga, which combines exercise and meditation.
- Keep your body well nourished with a variety of fresh fruits, vegetables and whole grains to improve your feeling of well-being and, in turn, your ability to cope with stress.
- Consider reducing or eliminating caffeine, tobacco and other drugs from your diet as they can often increase feelings of anxiety and stress.