Are you or your loved ones feeling anxious lately? It's normal.

Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical symptoms. It often occurs due to a perception of being threatened or concern of a threat in the future. This may sound familiar, because it’s a survival mechanism that’s hardwired into our bodies. 

Our brains have developed a process of scanning our environment for things that are threatening. Each time the brain is presented with a new situation it attempts to provide a solution. When faced with something that may inspire danger, real or perceived, it reacts with an anxiety response, traditionally known as a fight or flight response. 

Your body responds in similar physical, emotional, and behavioral ways for risks that are immediately dangerous (like encountering a vicious animal) and those that are mental or social in nature, like unpredictable life changes, financial stress, fear of illness, or even public speaking. Our body’s responses can come on quickly and can linger even after what inspired the anxiety has passed. The physical symptoms of anxiety can be so pronounced they can be mistaken for other serious physical conditions. For example, in a study of people with chest pain – a sign of heart disease – nearly half were found to actually have intense anxiety, not a heart-related condition.

It’s important to recognize that anxiety is completely normal and wired within each of us. It’s a normal, relatable response when we perceive that something may cause harm to us or those we care about. This is especially relevant now, as we’re all navigating an environment that is new and highly unpredictable. According to the CDC, the COVID-19 pandemic has greatly increased self-reported anxiety and depression. With so much change and uncertainty swirling around us it’s common for many, from children to adults, to experience anxiety.

But just because anxiety is normal doesn’t mean it’s something we must live with. There are three simple steps to help navigate and manage anxiety for ourselves, our families, and those we care about.

Start by talking to someone you trust about where your anxiety comes from and how it makes you feel. Anxiety is a normal survival mechanism and an integrated part of our bodies. Different people have unique sources of anxiety and experience different symptoms when facing something that makes us anxious. The things that inspire anxiety, as well as our individual symptoms and their severity, vary based on our unique physiologies and life experiences. What may be an incapacitating source of stress for one person might not affect someone else at all, and two people who experience anxiety over a similar topic may have completely different symptoms. Recognize that no matter what causes our anxiety or its effects on our bodies, these experiences are normal. The chart below includes common sources of anxiety and the symptoms they often inspire.

Children aren’t immune to feeling anxiety, but they might have a harder time describing their experiences. During conversations with kids it’s important for parents and guardians to help children label their emotions and connect them with a specific concern. This validation is made easier if we provide a child-accessible language to help kids define how they’re feeling, such as the facial expressions chart below. When children feel heard and safe, they can react by affirming or denying their experiences by pointing to the appropriate face that describes their emotion. “No, I’m not feeling mad, I’m feeling sad.”

Now that you’re aware of the sources and symptoms of anxiety, it’s easier to spot them when they appear in ourselves and those we care for. Be on the lookout for known anxiety triggers and the symptoms that may indicate a rising concern. When triggers or symptoms are identified, the in-the-moment strategies identified below can help restore calm.

These tactics are also useful for moments when symptoms increase to higher levels. When we’re in the grips of anxiety our mental processes can change dramatically. During these moments the part of our brain that processes emotions, the amygdala, is hyperactive, flooding the body with endorphins and overriding the cerebrum, which is the thinking part of the brain. In these moments it’s important we give permission to ourselves and those we love to not make big decisions or hold highly logical conversations until calm has returned. Doing otherwise will likely only make the experience worse. The best thing we can do in these moments is to attempt to restore tranquility to our mind and body.  

In-the-moment strategies

• Take a quick mindfulness break. Mindfulness is a practice that can reduce stress and help you relate to your stress in a healthier way. Mindfulness is a quality we all possess and is a helpful tactic against anxiety for people of all ages. Even a 30 second mindfulness break can inspire renewed peace. Intermountain Healthcare offers free and convenient online meditation and mindfulness classes.
• Breathing exercises. Long, slow deep breaths lower heart rate and provide a greater sense of a calm, a helpful antidote to the Fight or Flight response induced by anxiety. Try these simple breathing techniques to improve symptoms and start feeling better.
• Count to 10 slowly
  When you feel or observe anxiety rising, find a peaceful place to sit. Close your eyes and slowly count to 10 in time with your breathing. If necessary, slowly count backyards to zero and repeat if necessary until you feel your anxiety subsiding.
  Example:
  Slow inhale through the nose: “One”
  Slow exhale out the mouth: “Two”
  Slow inhale through the nose: “Three”
• Take a walk. Psychologists have demonstrated that even a 10-minute walk can swiftly improve your mood. Though benefits may be temporary, the act of walking (or other simple physical activities) can offer several hours of relief and renewed resilience.

Lifestyle strategies

• Get plenty of sleep and exercise. Sleep and exercise reduce stress and fatigue and improve concentration and alertness. In addition to reducing tension and elevating mood, rest and physical activity are wholly beneficial for other elements of your wellness, including improved cardiovascular health, weight control, and strengthening your immune system. 
• Develop a balanced diet. Diet can play a helpful role in anxiety management. Healthy, balanced meals with ample fruits, veggies, proteins, and complex carbohydrates can help maintain energy and focus throughout the day. Staying hydrated and avoiding excessive caffeine and sugar is also helpful. High doses of caffeine are known to induce anxiety symptoms, while added sugar can cause spikes and crashed in energy and mood. 
• Monitor alcohol and substance use. Stress and anxiety can encourage coping through alcohol and/or recreational drugs. Alcohol sales have increased as much as 262% during the COVID-19 pandemic, prompting the World Health Organization to warn that excessive alcohol use during the pandemic may potentially exacerbate health concerns and risk-taking behaviors. Similar coping tactics have been noted for cannabis. Some studies show relieving effects of such use, yet research published in 2020 indicated that relief may be only temporary and that long-term use of recreational cannabis to cope may ultimately relate to higher levels of depression. Until additional research can provide clarity, it’s suggested you limit intake and speak to your physician about long-term coping strategies.
• Stay connected to what fulfills you. Determine and prioritize the activities that add positivity to your life and make conscious efforts to stay connected to the relationships that matter to you. Regularly set aside time for these sources of fulfillment and be present in those moments by reducing distractions such as phones, screens, or multitasking.

Ask for help when needed

It's ok to ask for help. Reach out to friends, family, or loved ones for support. Not only can this help you manage and navigate your own anxiety, it may unknowingly open the door for them to share similar experiences or tactics.

Intermountain’s Behavioral Health Navigation Service is available for anyone in need of free emotional support, self-care tools, treatment options, crisis services, and more at (833) 442-2211 from 7 a.m. to 7 p.m., 7 days a week.

Anxiety is uncomfortable, but isn’t always avoidable. In some instances, the circumstances that trigger anxiety may also represent opportunities for growth or enhanced resilience, such as a public speaking opportunity or the start of a new job. The third step in affectively navigating anxiety is finding the balance between acknowledging and validating feelings and fears and encouraging healthy behaviors to face these triggers in a positive way.

During a moment that is free from stress, consider the common sources of anxiety identified in Step 1. Then make a strategy with your support network for how you’ll face these circumstances together. Once a plan is developed, commit to executing that plan in a supportive, unified way. Be patient, particularly with children. Anxiety responses are powerful and can take time and practice to improve. 

If these tactics fail to offer relief or if symptoms are severely impairing or persist for weeks, it’s appropriate to consider professional support. Contact your primary care provider or pediatrician for information related to behavioral health support, including psychiatric and counseling services.

Urgent support available in your moment of need: 

The COVID-19 Behavioral Health Navigation Service: 1-833-442-2211
The Suicide Prevention Lifeline: 1-800-273-8255

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