How to talk to children about COVID-19 and help them feel less anxious

Anxiety is everywhere right now, and, like our fears about COVID-19, it can feel inescapable. Everyone is talking about it. Constantly. And for a good reason: our lives have been upended, and uncertainty surrounds us. Children can sense the anxiety about coronavirus COVID-19 even if they don’t know the details. In “normal times,” having a predictable schedule can reduce anxiety. But now, for many children, schools and activities that provide structure are indefinitely on hold. So how can we talk to kids about COVID-19 and reduce their anxiety at the same time? 

 



6 Steps to talk to children about Coronavirus COVID-19 and lessen their anxiety:

Anxiety about COVID-19 is everywhere and children are worried. Here's 6 steps to talk to children about COVID-19 that lower anxiety and help keep them safe

Ask your children what they know about the coronavirus COVID-19:   

Your children may know more about what is going on with COVID-19 than you think. Start the conversation by letting them tell you what they’ve heard. Ask if they know what can help reduce their risk of getting (or spreading) the virus. Can they explain why these interventions help?

 

My kids know exactly which towns have positive cases in our state, and it’s not because I’m telling them. As soon as their friends hear anything about coronavirus, accurate or not, they are sharing it. Because everyone will be talking about COVID-19 until this has passed, check in with them frequently about what is being said.

Give them developmentally appropriate facts:

Once you have a clear idea of what they know, you can tailor the conversation to correct misinformation, reframe what they’ve heard, and fill in the gaps. Instead of having adult-level conversations about COVID-19, explain what is going on in a way they will understand. Children don’t need every detail about the projected trajectories of the virus unless it’s developmentally appropriate. Many pre-teen and teens will need to know all the details to help them understand why social distancing is critical.

 



Talk to your kids about social media and the accuracy of information:

Most kids aren’t too discerning about if the news they hear is from a high-quality source. They are prone to believing what is posted on TikTok or on other sites they visit. It’s important to help them understand that the information shared on social media isn’t always accurate.

Anxiety about COVID-19 is everywhere and children are worried. Here's 6 steps to talk to children about COVID-19 that lower anxiety and help keep them safe

Validate their fears about COVID-19:

Blanket denials or empty reassurance about the COVID-19 outbreak will be confusing for kids and less effective at allaying fears than having a conversation about the facts. If you say, “It can’t happen to you,” most kids know this isn’t true. It’s hard to deny the possibility exists when schools are closing, children can’t see their friends, or even go to a playground. Telling them there isn’t anything to worry about, although momentarily nice to hear, won’t help them feel more in control.

 

Instead, validate them and acknowledge the situation by telling them it’s normal to be frightened when worrisome things like COVID-19 happen. At the same time, remind them that there are experts all over the world, working hard to minimize the spread of this virus and treat people that get sick.

Reduce children’s anxiety about COVID-19 by focusing on the ways they can minimize their risk of infection:

Teach them what they can do to reduce their chance of getting the virus. Empower them and lessen anxiety by focusing on actions they can take to help.

 

  • Proper (and frequent) handwashing,
  • Cough and sneeze containment,
  • No touching their face,
  • Social distancing.

 

This is a good time to review with your children what you and other loved ones are doing to reduce the chance of exposure. Kids want to know how they can avoid getting coronavirus COVID-19 but they also want to ensure the people they love are going to be okay.

Anxiety about COVID-19 is everywhere and children are worried. Here's 6 steps to talk to children about COVID-19 that lower anxiety and help keep them safe

Managing your own anxiety about COVID-19 will decrease your children’s worries

Remember, children take their cues from adults. If parents are openly anxious, have alarmist conversations in front of them, or are obsessively watching the news, kids will panic even more. Parents model coping skills and teach kids how to react to new situations.

 

To reduce your anxiety, limit your intake of the news, and stick to trusted sites like the Center for Disease Control. Minimize information overload because sometimes, too much information gathering becomes problematic. Hearing constant alarm on the news isn’t going to help you or your children manage fears.



Is your child getting overwhelmed by COVID-19?

Be alert for signs your child’s anxiety is increasing and they need a break from hearing about coronavirus. Look for behavior changes such as difficulty sleeping or clinginess that differs from their usual. Obviously, hand washing is essential, but if a child begins to wash excessively or wants to talk about the virus continually, take steps to contain their anxiety.

Here are some ways to lessen the worry:

Try basic stress reduction techniques:

Anxiety about COVID-19 is everywhere and children are worried. Here's 6 steps to talk to children about COVID-19 that lower anxiety and help keep them safe

Spend time having fun:

  • Crank up the music and have a dance party,
  • Watch a funny movie,
  • Look at photo books from their childhood,
  • Play a board game.

 



This is a difficult time for all of us. COVID-19 has collectively forced us to abruptly alter our lives, and we are surrounded by worldwide anxiety. As much we don’t want this to be happening, can you find any silver lining outside the cloud of fear and uncertainty? Maybe you will have more opportunities for quality family time? Although far from a relaxing vacation, could this be a chance to slow down, re-evaluate priorities, and set goals?

 

I hope the above recommendations help to reduce your children’s anxiety about COVID-19 and also contain yours. We are in this together, and if we all do our part and take the proper steps (beyond buying all the toilet paper), we can save lives and come through this with a deeper understanding of what is most important to us.

 

This is a good time to revisit this article:

Feeling stuck in life? Instructions from a psychiatrist on how to live the life you love

 

 

Living with Uncertainty: Managing the Fear of Cancer Recurrence and “Scanxiety”

The truth is, we all live with uncertainty, but for people who have experienced cancer, the awareness is heightened. For some, the relief that comes from being declared “cancer-free” is short-lived and quickly replaced by a fear of recurrence. Among survivors, the fear of cancer recurrence can be so distressing it has a powerful, negative influence on the quality of life; affecting mood, relationships, and decisions for the future. This fear can become a daily catastrophizing worry that dominates thoughts.

 

The Harvard Health Blog states:

By 2024, an estimated 19 million will be living in the United States, a tribute to rapidly evolving options for diagnosis and treatment.

Fear of cancer recurrence

Fear of recurrence is normal and common amongst people treated for cancer. Once past the initial treatment, many survivors of cancer have cyclical increases in this fear, which coincide with anniversaries, upcoming scans, or follow-up appointments. Relief may be experienced after a reassuring appointment, but just like with the initial declaration of a cancer-free status, the fear can begin to build quickly. For those on 6-month follow-up schedules, this leaves little time between appointments to live life worry-free.

 

Enjoying life in survivorship means managing this common and normal fear to prevent the worries about life’s uncertainty from actually taking over.

 

Ni-Cheng Liang, MD is both a physician and a cancer survivor and has had to tackle what she has aptly termed “scanxiety”. She has found certain techniques helpful in managing life’s uncertainty. I am so grateful to her for sharing her story and recommendations:

 

"Scanxiety" and fear of cancer recurrence diminish quality of life. Recommendations for peace despite living with uncertainty caused by fear of recurrence.

Blog by Ni-Cheng Liang, MD:

Scan · xi  · e · ty

noun

A feeling of unease, nervousness, about an upcoming, or immediately past diagnostic study with uncertain results.

 

Too numerous to count scares. Too numerous to count episodes of scanxiety.  This is the price of survivorship. It is expensive, but worth every tear, every butterfly in the stomach, and every droplet of sweat, to remain here on this good earth.

 

This is an excerpt out of my first Caring Bridge blog post back in 2011:

 

I decided to do my first breast exam in 9 months after my incision and drainage from a left breast abscess from neglecting to pump during a busy night of call in the ICU.  Why hadn’t I resumed doing breast exams sooner? Laziness, no difference in survival, knew it was likely to be abnormal anyway had I started doing them sooner due to lactation, but what’s happened has happened, and I can’t do anything to change it. So, I actually found something. Right breast, 12 o’clock, it felt like another clogged duct, but this time, it was firmer. I thought to myself, no problem, I’ll just get an ultrasound.

I had no scanxiety because I was not expecting the worst result.

 

On ultrasound, it was a complex mass which meant biopsy. Luckily, the procedure was done the same afternoon. Perhaps the beginning of scanxiety? I was a little worried, but not that worried. I was hoping that it was necrotic fat, or a remnant of a clogged duct, or a fibroadenoma, anything but cancer.

 

Off I flew to the American Thoracic Society conference in Denver, CO, a day later. I had a poster discussion session on the 15th and was more worried about that than the biopsy results.  I figured no sense in worrying until the result came back in the next few days. I planned to go to the conference, learn and enjoy myself.

The day that changed my life forever

 

May 16, 2011, is the day that my life changed forever. I was having lunch with friends from residency between sessions at the conference when I got a phone call from the radiologist that did my biopsy. I hadn’t expected the results to be back so soon, and  I could tell from her voice that it was bad, “consistent with invasive ductal carcinoma.” I broke down, started crying, “I have breast cancer.”

 

Grateful for the presence of my friends consoling me, I had never been so scared in my life. All I knew was I had breast cancer, didn’t know what type, stage, what the plan was. I got on the next flight back to San Diego. On the way to the airport, I was debating when to tell my husband. I could tell he was scared too but was ready to endure all that came my way, by my side.

 

I enrolled in the ISPY 2 clinical trial, took a year medical leave for treatment, went through 5 months of chemotherapy, 3 surgeries, and I’m here almost 9 years later.  In between acute treatment and now, new pains, new abnormal surveillance scans, all leading to more episodes of scanxiety.  I’ve lost count how many I have had. Scanxiety is part of my life. It returns, catastrophizing, thinking of what-ifs, and the worst-case scenario.  Medical training has groomed me into being an expert catastrophizer.  But, when I turn it towards myself, it’s not always helpful, and often can worsen anxiety.

 

"Scanxiety" and fear of cancer recurrence diminish quality of life. Recommendations for peace despite living with uncertainty caused by fear of recurrence.

Mindset shifts can help manage the fear of recurrence:

Over the years, I’ve learned a few mindset shifts that I’ve found to be helpful:

 

1. Scares are inevitable in survivorship. I try to continue to live my life just as I had originally intended until I receive an objective message to the contrary.

 

2. When I notice myself going through what-ifs and unhelpful catastrophizing, I use the RAIN mindfulness practice, taught by Tara Brach, Ph.D. (see some of Tara’s books at the bottom of this post).

 

  • Recognize that the situation arising is uncomfortable/anxiety-provoking
  • Accept the situation for what it is and allow it to be here because it’s already occurring.
  • Investigate: name body sensations and emotions occurring, notice thoughts about the situation as one sees clouds passing through the sky, or leaves floating on a stream.
  • Not Personal: remind yourself that this situation is unlikely to be an attack on your moral fiber as a human being, it may be a pattern of behavior that you experience in your life, and a similar situation may arise in the future- try not to take it so personally.

 

3. I use the episodes of scanxiety as opportunities to deepen my mindfulness meditation practice. I use them as opportunities to re-focus on the present moment experience, my priorities, and to bring gratitude to all that remains good in my life despite the uncertainty.

Living with uncertainty: The only certainty in life is that it’s uncertain.

 

The only certainty in life is that it’s uncertain. We are unable to change situations where more testing is needed, or the test results, but we can train ourselves to choose healthier responses to uncertainty better.

 

 

Dr. Liang is also a mother to two girls, an award-winning pulmonologist, and a mindfulness teacher. She teaches mindfulness to patients, all levels of medical trainees, healthcare professionals and administrators and is a national speaker.  Check out her website www.ncliangmd.com for free mindfulness recordings, and to learn more about Dr. Liang and her offerings.

 

Additional resources for learning radical acceptance, mindfulness, and living in the here-and-now:

 

Download this free form to help you track and understand your health history! 

Keeping track of the information given during medical visits, including diagnosis, plan of management, recommendations, directions for medication, etc… can be difficult even for people who are not feeling anxious during an appointment. The information is coming so fast!

 

This free form will make it easier to keep track of all the medical information you need to remember. If you fill out the form each visit you can keep a coherent log of your appointments and history. This will make tracking changes and health history much easier to remember and will help ensure you know and understand the important details of your care.

How to stop ruminating: Ruminative thinking doesn’t solve problems!

Do you get a thought stuck in your head and then can’t stop thinking, analyzing, and worrying about it? Are these thoughts negative and focused on possible mistakes you have made? Do you let problems eat away at you? These are examples of ruminating thoughts. Ruminative thinking is not problem-solving that is productive, it is the tendency to repetitively think about situations that are upsetting. Figure out how to stop ruminating by first learning the rumination definition to recognize them when they are occurring.



Who ruminates?

Rumination is more likely to happen in people who have depression, anxiety, or other conditions like eating disorders, psychosis, substance abuse, and trauma.

Rumination definition: What does it mean?

Overthinking and overanalyzing negative experiences happens frequently when people ruminate. These are repetitive, negative thoughts that are often associated with depression and anxiety. Thinking through negative events is normal and can be a helpful part of processing and learning from them. But getting stuck in these thoughts is not helpful and often doesn’t lead to answers.

Rumination is:

  • Often self-critical,
  • Involves self-blame thoughts
  • Focused on perceived past mistakes
  • A mix of stewing and overanalyzing

How are ruminating thoughts different from worrying?

Wondering how to stop ruminating thoughts? Ruminative thinking is not productive problem-solving. Learn the rumination definition to better recognize when it's happening.

Rumination and worry are similar but not the same.

Worries:

Worries focus on future events and often involve catastrophic thinking that projects disastrous or unpleasant future outcomes.



Rumination:

Ruminative thinking is generally focused on the past and what people feel hasn’t worked out well.

Why stop ruminating?

  • People that ruminate can get stuck in depression and set themselves up for future depressions. They may ask themselves “Why am I depressed?” and focus on how bad it feels but not ask “How can I prevent this from happening again”.
  • When stuck in the negative feelings and not the facts of the situation it is hard to see any solutions. Ruminative thinking does not inspire creative problem-solving.
  • Focusing on implied meanings and consequences (Why did this happen? What does this mean for me?) and less on analyzing specifics of what happened and asking targeted questions (How did this happen? What was the context and the sequence of events?) reduces the chance to process the event and move on. Without concrete thinking, it becomes difficult to solve problems and learn from past challenges in order to make changes for the future.

How to stop ruminative thinking:

Wondering how to stop ruminating thoughts? Ruminative thinking is not productive problem-solving. Learn the rumination definition to better recognize when it's happening.

The first step in changing a behavior is to recognize when it is happening. The less we immerse ourselves in non-productive, depressive thoughts the more chance we have to feel better and give room for positive and hopeful thoughts.

 

One way to intervene and stop ruminative thinking is to better identify one’s triggers and develop more productive and effective behaviors to use in place of rumination. Could you substitute kinder and more compassionate thoughts toward yourself instead of criticism?



Take some time to recognize when you are ruminating and then take a hard look at how it serves you. Did you benefit from the ruminating thoughts? My guess is the answer is almost always “No”.

 

Sometimes it is hard to figure this out on your own. It can be quite helpful to bring these questions to therapy. Sort through the ruminations and begin to learn new thinking patterns that incorporate compassion, self-acceptance, and forgiveness a bit more.

 

Change your thoughts and live life fully. Find inspiration to make a change: 

Feeling stuck in life? Instructions from a psychiatrist on how to live the life you love

Achieve Your Dreams! A Series on the Importance of Setting Goals

To good to be true? An effective goal setting process you can sustain even when motivation is lagging. Learn how!

What is Self-Respect?

“Embrace the Suck” How the Power of Positive Thinking Can Turn Your Day Around

 

Adventure Awaits! How to Overcome Fear of Flying Phobia.

Recently, I took an international trip with my family that required a 16-hour plane ride. Stuck in an uncomfortable middle seat for this unpleasantly long flight I had lots of time to think and reflect in order to make the most of this extended period of nothingness. One of the topics I thought about is how life would change if I had a fear of flying phobia and the trips and family adventures I would miss out on. Fear of flying is common and many of my patients talk to me about this very thing. You can learn how to overcome fear of flying phobia. There are many adventures that await you (or business trips). Don’t let the anxiety and fear that accompany this hold you back- get treatment and put the anxiety behind you.



What is a fear of flying phobia?

Fear of flying, or aviophobia, is a type of “specific phobia” involving unreasonable and out-of-proportion levels of intense, persistent, fear of specific objects, situations, activity, or people.

Taking control to manage (and avoid) anxiety

Fear of flying phobia is common. Learn how to overcome fear of flying so you don't let this interfere with your work or family any more. Adventures awaits!

Oftentimes, people with anxiety manage it by doing something that makes them feel in control. Anxiety causes such out-of-control feelings it’s a natural response to reflexively do things to feel back in control. Not all forms of “taking control” actually help us in the long run but they need to be recognized as attempts at self-soothing and anxiety management.

 

These attempts to regain control over anxious feelings may take the form of:

 

  • Obsessively organizing the house,
  • Deciding to drive backroads to avoid a bridge or highway,
  • Choosing to drink alcohol before an event to calm down,
  • Or most commonly, to avoid the anxiety-provoking event entirely.

Flying in an airplane is the ultimate loss of control.

You aren’t flying the plane (well, I hope you aren’t!) and you can’t get off if you want to. If you have a panic attack you will be “trapped” in the airplane for the duration of the flight. It’s no wonder that so many people with anxiety have a fear of flying.



Avoiding the anxious trigger (flying)

Avoidance is usually the coping mechanism that wins with fear of flying. People with a flying phobia will do whatever they can to avoid a flight. I have patients who are willing to drive for 24 hours to make it to an event that they could have flown 3 hours to get to. And 2 days later they have to turn around and drive back. Oftentimes, they insist this doesn’t bother them but I wonder how much that is a defense because the idea of flying is UNTHINKABLE to them.

Is a flying phobia really a big deal?

Having a fear of flying phobia may sound like it wouldn’t cause many difficulties in one’s life since most people don’t need to fly often…. until you hear individuals describe how it has changed their life. I have had patients completely alter their professional trajectory out of fear they would need to travel. This includes declining promotions that they otherwise wanted because the jobs would involve distant business meetings or deciding to change careers entirely to one that will never require airplane travel.

The whole family is affected by this

Fear of flying phobia is common. Learn how to overcome fear of flying so you don't let this interfere with your work or family any more. Adventures awaits!

This phobia interferes with family life when people end up staying home from family trips that require flying. Weddings missed and distant adventures never experienced, a flying phobia can be made into a whole family affair.

 

When people do acquiesce to taking a trip, their anxiety may skyrocket and they often fret and seek reassurance from the time the trip is booked until it happens… sometimes declining to go at the last minute. It can be paralyzing for them. If a trip is booked a year in advance, without treatment a person with a flying phobia may spend the majority of the year with anticipatory anxiety worrying about this upcoming vacation.

Good news! There are excellent treatments available to overcome fear of flying:

Fear of flying phobia is common. Learn how to overcome fear of flying so you don't let this interfere with your work or family any more. Adventures awaits!

Many people seek out medication from their doctor to alleviate the terror they feel about flying. This usually takes the form of as-needed anxiety-relieving medication they can take just before getting on the flight. Although this can reduce the person’s anxiety, and be the reason they agree to fly, there are more effective preventative treatments available.



In the situation of occasional airplane travel, using an as-needed benzodiazepine is possibly reasonable (I say possibly because it depends on the particular person’s history. Benzodiazepines are not appropriate for everyone even if the situation is a reasonable one to use it for). Oftentimes, when a person knows they have a medication that will reduce anxiety, this is enough for them to agree to travel. They may never love flying, but they know they can “white-knuckle” it and get through when they need to.

 

Solely having treatment be an as-needed benzodiazepine isn’t ideal if:

 

  • A person has to travel regularly,
  • They experience high anxiety at the thought of flying,
  • Avoiding flying impacts their life negatively.

 

People can overcome this fear by doing cognitive behavioral therapy (CBT) specifically aimed at addressing their fear of flying.

How to overcome fear of flying: A great treatment option

Created by a pilot (he is also a therapist) who knows everything about airplanes, Soar is a great example of a successful program to address the fear of flying.

 

I love this program because it combines his flying expertise with specially created CBT programs to target fear of flying. He has DVD’s to listen to on your own time, and some packages include 1:1 counseling with him. He even has an emergency program called “Help Me Now” targeted to people flying the next day who need immediate intervention so they can get on a plane.

 

I have had patients terrified of flying use this program who can attest to its benefits. They now fly comfortably without the need for anxiety medication.

 

Watch these educational videos from Captain Bunn about fear of flying. They include pointers about how to get rid of it.

Fear of flying does not need to control you!

Don’t miss out on any other family vacations or work trips that are needed for your career. There are treatments available that can successfully treat flying phobia so you don’t need to avoid and worry any longer.

 

Get the help you need. Talk to your physician and/or check out the Soar program so you can eliminate this fear of flying permanently.



For additional help and information about anxiety read these articles:

Shifting Thoughts and Taking Control: Cognitive Restructuring for Anxiety Management

5 Ways to Stop a Panic Attack

The Best Resources for Anxiety

 

The Controversy Around Use Of Benzodiazepines. What Are Benzodiazepines Used For And Is It Ever Okay? (Yes)

There is controversy around use of benzodiazepines but benzodiazepine medications are necessary and helpful sometimes...just not always. What is a benzodiazepine? What are benzodiazepines used for when they are helpful?

Benzodiazepine medications have gotten a bad rap and there is much controversy in the psychiatric community about their use. Some people feel they should never be used and some feel they are highly useful. Like most areas of life, there is likely a middle ground- sometimes the use of benzodiazepines is essential and quite helpful…sometimes they are harmful and impede the progress of treatment. Let’s look at some situations where a benzodiazepine could be useful or could be potentially harmful. But before we do that, I will review some definitions and basics. What is a benzodiazepine? What are benzodiazepines used for? And then we can break down situations where they may be helpful for treatment or should be avoided.

 

There are effective techniques to get rid of anxious thinking. Download this worksheet so you can start taking control back now!

What is a benzodiazepine?

There are different types of treatments for anxiety and one of the medications used is called a benzodiazepine. Think of the word “benzodiazepine” as the last name for a family and the individual medications are the family members. The individual members of the benzodiazepine family are medications like Xanax/ alprazolam, Ativan/ lorazepam, Klonopin/ clonazepam, Valium/ diazepam, etc…

 

The medications in the family are all similar but they vary in how fast they take effect and how long they last.



What are benzodiazepines used for?

These are called anxiolytic medications which means they work to alleviate anxiety. But benzodiazepines don’t prevent anxiety. They are a bandaid that helps to minimize it when it happens. Similar to taking ibuprofen or acetaminophen for a headache, benzodiazepines are taken when someone is feeling anxious. Read more here: Benzodiazepines: Do They Treat Anxiety?

 

There are other uses for benzodiazepines (for example treating a seizure or alcohol withdrawal) but today we will mainly focus on its uses for anxiety.

 

Benzodiazepines can be helpful: 

1. People with a specific phobia like a fear of flying:

There is controversy around use of benzodiazepines but benzodiazepine medications are necessary and helpful sometimes...just not always. What is a benzodiazepine? What are benzodiazepines used for when they are helpful?

Let’s take the example of someone with a phobia of flying who only has to fly occasionally (if they need to fly more often the treatment would be different).

Is this really a big deal?

Having this phobia may sound like it wouldn’t cause many difficulties in one’s life since most people don’t need to fly often…. until you hear individuals describe how it has changed their life. I have had patients completely alter their professional trajectory out of fear they would need to travel. They have refused promotions because the jobs would involve distant business meetings or decided to change careers entirely to one that will never have that requirement.



This phobia can interfere with family life when people end up staying home from family trips that require flying.

Relief comes from knowing there is a “rescue”

Oftentimes, when a person knows they have a medication that will reduce anxiety before their flight, this is enough for them to stop avoiding travel. They may never love flying, but they know they can get through it when they need to. In this situation, using an as needed benzodiazepine is possibly reasonable (I say possibly because it depends on the particular person’s history. Benzodiazepines are not appropriate for everyone even if the situation is a reasonable one to use it for).

With regular travel, or for someone who wants to eliminate this anxiety forever regardless of how often they travel, there are excellent treatments available:

If a person has to travel regularly, solely having their treatment be an as-needed benzodiazepine isn’t ideal. People can overcome this fear by doing cognitive behavioral therapy (CBT) specifically aimed at addressing their fear of flying. Soar is a great example of a program to address the fear of flying. I love this program because it is created by a pilot who knows everything about airplanes and combines this knowledge to create targeted CBT programs, most of which can be done online. I have had patients terrified of flying use this program who now fly comfortably without the use of any medication.

 

Watch these videos from Captain Bunn about fear of flying and how to get rid of it.

2. Specific time-limited events:

There is controversy around use of benzodiazepines but benzodiazepine medications are necessary and helpful sometimes...just not always. What is a benzodiazepine? What are benzodiazepines used for when they are helpful?

When someone has a predictable and time-limited situation that causes significant anxiety, an as-needed benzodiazepine may be useful.

 

Here are some examples of what I mean:

 

Public speaking: This is an option, however, benzodiazepines aren’t always the best selection for public speaking anxiety. For some people, it works fine but others may feel a bit foggy when they take it. There are other medications (like propranolol) that can be prescribed in this situation and aren’t sedating or cloud thinking.



A particular social event: As long as the social event doesn’t involve drinking alcohol, people who have tremendous anxiety about a situation may be helped by a benzodiazepine before it.

3. Occasional panic attacks:

People that have infrequent, occasional panic attacks may be helped by a benzodiazepine that would be taken when they are starting to have an attack. The medication can interrupt the panic attack shortening its course and lessening its intensity.

 

If panic attacks are a regular occurrence, benzodiazepines aren’t the most effective treatment. They still may be useful, however other preventative medications combined with therapy targetted to address panic attacks would be recommended.

Dangerous or generally not useful:

1. In combination with an opiate:

There is controversy around use of benzodiazepines but benzodiazepine medications are necessary and helpful sometimes...just not always. What is a benzodiazepine? What are benzodiazepines used for when they are helpful?

This is a potentially dangerous and lethal combination. Although there are many people with chronic pain and severe anxiety who have used this combination safely for years this should be avoided if at all possible. For people with addictions, benzodiazepines can enhance a “high” when combined with an opiate and can increase the chance for a lethal overdose.

2. Frequent panic attacks and daily anxiety

When someone has frequent panic attacks or daily anxiety a preventative medication like an antidepressant and/or therapy such as Cognitive Behavioral Therapy is more useful than a benzodiazepine. When the only treatment is a benzodiazepine, people get in a situation where they end up having to chase the anxiety to keep up with it rather than preventing it from the beginning.

 

Unfortunately, not all people tolerate antidepressants (the primary preventative treatment for anxiety) so occasionally, benzodiazepines will still need to be used even when their anxiety is daily.

3. During Cognitive Behavioral Therapy and Dialectical Behavioral Therapy

There is controversy around use of benzodiazepines but benzodiazepine medications are necessary and helpful sometimes...just not always. What is a benzodiazepine? What are benzodiazepines used for when they are helpful?

Certain treatments, like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), need people to experience the situation and the emotions happening in order to practice using skills to get through it. Although this may sound unpleasant, it can be a key in recovery. No longer does someone need to be controlled by the fear of panic or distress if they know they can handle it.



In this type of treatment, taking a benzodiazepine can interfere with learning and practicing coping strategies that will allow a person to overcome panic attacks or episodes of emotional distress on one’s own.

 

4. People who struggle with addiction, particularly to alcohol

Alcohol and benzodiazepines can be lethal in combination. They have synergistic effects and the results aren’t always predictable. There is cross-dependence between both of these substances as they both affect the same receptors in the body.

 

The side effects of benzodiazepines and alcohol are similar to each other so using both at the same time can multiply the body’s response and make the symptoms worse.  Both benzodiazepines and alcohol slow breathing and a major danger of using them together is it increases the chance that the person will stop breathing.

 

Sometimes, a person with an addiction, will not take this medication as prescribed and instead use it as a way to escape or feel high (by taking higher doses) and not as a way to alleviate anxiety. Obviously, in this situation, it is not recommended to prescribe the medication.

 

A side note on addiction potential:

Long term use of benzodiazepine medications can cause physiological dependency and withdrawal. This is not the same as addiction. What this means is that we need to taper benzodiazepines slowly to help avoid physical withdrawal.



There is no physical dependence that happens when these medications are not taken daily.

 

Benzodiazepines: Good or bad?

Like in all parts of life, things generally aren’t all-or-nothing and don’t fall into black and white categories crisply delineating them as good or bad (read more about black and white thinking here). Benzodiazepine medications have a bad rap (sometimes for a very good reason) but can also be extremely helpful for the right type of situation in the appropriate person.

 

Ask your physician if you are wondering if a benzodiazepine would be helpful for you.

 

Learn more about controlling and treating anxiety. Here are my most popular posts:

5 Ways to Stop a Panic Attack

Shifting Thoughts and Taking Control: Cognitive Restructuring for Anxiety Management 

This post has a free worksheet on how to get rid of thoughts related to anxiety so they don’t keep coming! You can also signup to download it here:

 

Catastrophizing Anxiety

The Best Resources for Anxiety

Do what you are afraid of! Stop letting anxiety control you

 

 

***There may be affiliate links in this post. I do not recommend anything I would not use myself or recommend to a family member. These links give a small commission to help cover the cost of running this website but cost you no extra money.***

 

Shifting Thoughts and Taking Control: Cognitive Restructuring for Anxiety Management

Anxiety management and recovery require recognizing anxious catastrophic thinking when it is happening (read here for more details). Once recognized, you can reduce anticipatory anxiety by changing thoughts and interrupting projections. Break down these thoughts and create a framework to analyze them with cognitive restructuring techniques.

First, let’s review some definitions.



Anticipatory anxiety is all the time wasted dreading, worrying, and panicking over a future event (a projection of an imagined outcome) where every imaginable negative outcome is thought of (catastrophizing). Cognitive restructuring techniques are tools to help break down these thoughts and analyze them using a series of questions. These questions help to identify when a cognitive distortion (a thought that isn’t accurate or based in current reality) is driving your anxiety.

Cognitive restructuring techniques: Rethinking anxious catastrophic thinking An important part of anxiety management is cutting down anticipatory anxiety. Manage anxious catastrophic thinking using cognitive restructuring techniques.

Cognitive distortion scenario:

 

You had a friend over for dinner and when they left you told them to text you when they got home. You were worried because it was at night. Later, you realize your friend didn’t text but it is late so you are afraid to call and wake them if they are asleep. But what if they are in trouble? What if they got in an accident and that is why they didn’t call you. What if they have been attacked outside their home and are being killed right now?

Using this example I will give you an idea of how to break a thought down using cognitive restructuring techniques.



1. Are you overestimating the risk?

What is the evidence to support your worries?

Your friend didn’t text you when they got home and they said they would.

 

Is there another way to look at it?

Your friend was exhausted and forgot. They are now asleep.

2. Are you catastrophizing?

What’s the worst that can happen? 

Your friend is killed and you could have intervened if you had called the police.

 

The best?

They are asleep in bed.

 

What is the most realistic outcome?

They are asleep in bed. They are a safe driver and have never been in an accident before. Altho an accident or attack could happen, it never has before and they are cautious. The likelihood that this is why they didn’t call is very low.

3. Is there another way to look at this?

Is it all or none or is there something in between? A shade of grey?

This is similar to the above answers but continues to break the thoughts down and provide alternative explanations with the most realistic outcomes.

4. How would I cope?An important part of anxiety management is cutting down anticipatory anxiety. Manage anxious catastrophic thinking using cognitive restructuring techniques.

Am I underestimating my ability to cope? What resources do I have to get through this? 

 

If you think back to times negative things have happened you will likely remember that it was unpleasant or painful but that you were able to reach out for help when you need it and gather up resources to recover. What difficult situations have you navigated through in your life? Did you learn something about your strength?



Many times, anxious catastrophic thinking isn’t about a life or death but a concern for an unpleasant outcome. For example:

 

  • Not being able to fall asleep and then having a disastrous next day because of it.
  • Losing control of your bowels because you can’t find a bathroom.
  • Failing an exam.
  • Having a panic attack while driving.

 

In all of these situations, it is important to step back and realize that you would be able to cope and your life will continue to go forward. Yes, it would be embarrassing if you had a “bathroom accident” but its a mere blip on the radar in life and doesn’t deserve the level of life-altering panic and avoidance that it gets.

5. Am I accepting anxious thoughts as fact without evidence?

Am I overvaluing anxious thoughts and feelings and accepting them as fact?

It’s important to realize anxiety thoughts for what they are: thoughts that will pass. Just because we are feeling anxious doesn’t mean it is evidence a certain situation will turn out disastrously.



How have your previous catastrophic predictions turned out?

Generally, catastrophic predictions are incorrect given they are not based on real facts. If you search back to other times you have catastrophized the likelihood is that you haven’t been correct with your prediction. Do you ever feel like the catastrophizing has helped you more than it is hurt you?

Putting cognitive restructuring techniques into action:An important part of anxiety management is cutting down anticipatory anxiety. Manage anxious catastrophic thinking using cognitive restructuring techniques.

Use this practice sheet to walk through the questions when you have anticipatory anxiety and catastrophic thinking. If you are prone to catastrophizing, the good news is that you will have plenty of opportunities to practice! (That’s one way to put a positive spin on it, right?)

While learning cognitive restructuring techniques write out the worry and the answers to the questions. As you practice, it will become a more natural and ingrained process.

 

Try these exercises and let me know how it goes. Are there places you get stuck? Have you found a particular technique helpful?

Related articles about management of anxiety:

5 Ways to Stop a Panic Attack

The Best Resources for Anxiety

Do what you are afraid of! Stop letting anxiety control you

Black and White Thinking- Don’t Fall Into the Trap!

 

Catastrophizing Anxiety

We all know what a catastrophe is but what about catastrophizing? Catastrophizing is a common occurrence in people that are feeling anxious. Catastrophizing is caused by anxiety but also serves to fuel anxious symptoms. Because of the cyclical worsening that happens with symptoms of anxiety it is important to interrupt this cycle. People stop living in the moment and spend much of their time worrying about the future.



Feeling anxious? 

An anxious person can turn almost anything into a possible catastrophe.

Headache? Definitely a brain tumor.

Some people with anxiety are over-sensitive to normal bodily sensations. They may catastrophize any physical symptom they feel. Physical symptoms, intermixed with anxiety, are a common driver of panic attacks.

Have a school exam coming up? Likely you will fail and become homeless.

People can catastrophize about finances, friendships, or may jump from one catastrophic thought to the next.



  • “What if I don’t ever get a job?”,
  • “If I make the wrong decision it may cause ______ bad thing to happen!”,
  • “What if the plane crashes?”,
  • “Am I dying?”

Sure, some of these worries might be reasonable at times. But an anxious person will take a very small thought and turn it into a huge worry based on very little evidence.

Worrying about the future with projections:Catastophizing anxiety causes worrying about the future. When feeling anxious people project the future negatively. Catastrophizing is an anxious symptom.

Catastrophizing thoughts are generally not based on current reality but future projections related to worry thoughts. Catastrophizing anxiety thoughts aren’t productive projections and don’t cause you to improve your future. It’s energy wasted and not energy spent on improving life.

 

And projections associated with anxiety are never positive. They don’t uplift you or make you feel hopeful. Instead, they cast a shadow of gloom and doom on life and make you feel out of control.

Recognizing catastrophizing anxiety is the first step to stop it

The first step to stop worrying about the future is to recognize when you are doing it! Some people have been feeling anxious and catastrophizing for so long that it comes naturally to them.

Think about your anxious symptoms

When you are feeling anxious are you worrying about the future? Catastrophizing the consequences without evidence? Take a minute to think about your anxious symptoms and ways that you project into the future. When you are worrying, stop to ask yourself if you are projecting a consequence and using catastrophizing anxiety.



The first goal is to recognize it! Stop and take some time to look at your worry thoughts when you are feeling anxious.

 

For helpful techniques that will help with catastrophizing read this blog: 5 Ways to Stop a Panic Attack

Look for the next post for ways to stop these anxious symptoms!

The next post will talk about how to interrupt the cycle of catastrophizing and projection.

 

Black and White Thinking- Don’t Fall Into the Trap!

Do you get stuck in black and white thinking and it is hard for you to see options other than all or nothing? Does rigid thinking cause you to live in the extremes where it is “my way or the highway”? Black and white thinking in relationships is generally not a benefit that brings harmony. Are you aware of the downsides of dichotomous thinking in your life? Read this post to learn how to stop black and white thinking.



Dichotomous thinking:

Black and white thinking is dichotomous. Dichotomous means something is divided into 2 distinct and opposing parts.

 

Examples of dichotomous thinking:

  • happy-sad
  • good-bad
  • beautiful-ugly
  • success-failure
  • fat-skinny
  • never-always

Rigid thinking:

Rigid thinking can cause stress and conflict. Without flexibility of thought, people are less adaptable to the unpredictability of life in general. They may feel everything needs to be done in a certain way and miss out on alternative ways to view the world and achieve results.

 

Black and white thinking hinders growth and keeps people feeling stuck living in absolutes.

Black and white thinking in relationships:All-or-none thinking or "dichotomous" thinking can contribute to anxiety. Black and white thinking in relationships can cause strain and stress. Learn to catch your rigid thinking and find out how to live in the middle ground in order to find balance. Learn how to stop black and white thinking.

In relationships, people who think in extremes are less likely to compromise or cooperate to meet common interests. This can make someone seem inflexible and judgemental which can definitely stress a relationship.

Life is a series of negotiations:

Life is a series of negotiations that often requires seeing a different person’s point of view and even compromising in order to reach a goal. Being flexible is essential for satisfying balance in relationships where there can be equal give-and-take.

Dichotomous thinking harms mental health and well-being:All-or-none thinking or "dichotomous" thinking can contribute to anxiety. Black and white thinking in relationships can cause strain and stress. Learn to catch your rigid thinking and find out how to live in the middle ground in order to find balance. Learn how to stop black and white thinking.

Black and white thinking increases disappointment, frustration, anger, and anxiety in life. No-one can be all-good or all-bad or do everything perfectly.

 

Life isn’t all-or-nothing and most decisions, events, and relationships fall somewhere in the middle. When something doesn’t go as planned, rigid people forget that the alternative result may turn out for the best.

Anxiety and rigid thinking:

Anxious people get tricked into rigid thinking because it gives a false sense of security that they have control over life’s uncertainties. Dichotomous thinking falsely simplifies options but it isn’t an accurate representation of the complexities of life.

 

Instead of reducing anxiety, thoughts are viewed through a distorted lens that makes people more anxious. If good or bad are the only options available that can put a lot of pressure on a person to be perfect! Using that logic, if I make a mistake then I am not good and therefore I am bad. If I am not a success than I am a failure. Ouch!

 

Looking for other tips on how to tackle anxiety? Read these posts!

Wondering how to stop black and white thinking?

Recognize rigid thinking:All-or-none thinking or "dichotomous" thinking can contribute to anxiety. Black and white thinking in relationships can cause strain and stress. Learn to catch your rigid thinking and find out how to live in the middle ground in order to find balance. Learn how to stop black and white thinking.

If you are wondering how to stop black and white thinking the most important step is to recognize inflexible and rigid thinking. It’s difficult to make any progress without identifying and catching yourself when you are thinking in extremes.

 

Let trusted family or friends know you are working to identify these thinking traps and you may need some help recognizing it.

 

A therapist can be invaluable to help you identify these thinking patterns (called cognitive distortions).

 

If you would like to read more about cognitive distortions this article explains 10 common cognitive distortions.

Stop and challenge the dichotomous thinking:All-or-none thinking or "dichotomous" thinking can contribute to anxiety. Black and white thinking in relationships can cause strain and stress. Learn to catch your rigid thinking and find out how to live in the middle ground in order to find balance. Learn how to stop black and white thinking.

Once you recognize a rigid thought you can stop and challenge the assumptions. Sometimes it is helpful to draw out a continuum and place your thoughts on it. Since rigid thoughts are on one end of the spectrum or the other, try to fill in ideas for what could exist in between the ends. What are other possibilities for the situation? Train yourself to see other options.

 

Remember that everything in life is a negotiation and look for balance in any situation. No-one and no situation is all good or all bad.

 

When people learn to live in the gray zone they will find more happiness. There is a huge relief once rigid expectations are let go of allowing for more openness to a range of life’s possibilities. Disappointments and anger will shift and letting go can happen. Anxiety will be reduced and healing can happen. Give it a try! Start to identify when you may be getting stuck in dichotomous thinking and challenge yourself to begin to see the middle ground. It is there if you look.

 

What are your examples of black and white thinking? Has anything helped you see the middle ground easier?All-or-none thinking or "dichotomous" thinking can contribute to anxiety. Black and white thinking in relationships can cause strain and stress. Learn to catch your rigid thinking and find out how to live in the middle ground in order to find balance. Learn how to stop black and white thinking.

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Looking for additional mental health resources? Visit the Mental Health Bookstore to see a list of doctor-recommended books on many different health topics.

Here are 4 books that will help you conquer anxiety and depression:

 

5 Ways to Stop a Panic Attack

Panic attacks can be terrifying and life-altering if they are not controlled! Often they are so scary that every detail of someone’s first attack becomes etched permanently in their mind.  Are you wondering how to stop a panic attack? Let me tell you what to do during a panic attack so that you can learn how to control panic attacks instead of them controlling you.

 

Panic attacks cause a sudden intense fear when no danger is present or there is no identifiable trigger. This fear triggers your bodies emergency system to be activated causing the physical fight or flight reactions. Your body reacts as if you were under attack and fighting for your life.

Panic attacks can be terrifying and life-altering if they are not controlled! Are you wondering how to stop a panic attack? Learn what to do during a panic attack so and how to control panic attacks instead of panic controlling you.

 

Panic attacks can strike at any time and without warning. Because of this, people begin to fear when and where an attack could happen again. They no longer feel in control of their body and begin to limit what they do because of it. If this is allowed to continue, their world can keep getting smaller until they prefer not to leave the house.



Symptoms of a panic attack generally peak in a few minutes. They are usually brief but can last hours in some people. After they are over people feel exhausted as if they have just climbed a mountain or run a race.

 

For information on panic disorder check out this post by the NIMH. They include a patient description of their experience of panic disorder:

 

“One day, without any warning or reason, a feeling of terrible anxiety came crashing down on me. I felt like I couldn’t get enough air, no matter how hard I breathed. My heart was pounding out of my chest, and I thought I might die. I was sweating and felt dizzy. I felt like I had no control over these feelings and like I was drowning and couldn’t think straight.

“After what seemed like an eternity, my breathing slowed and I eventually let go of the fear and my racing thoughts, but I was totally drained and exhausted. These attacks started to occur every couple of weeks, and I thought I was losing my mind. My friend saw how I was struggling and told me to call my doctor for help.”

Common symptoms of a panic attack:Panic attacks can be terrifying and life-altering if they are not controlled! Are you wondering how to stop a panic attack? Learn what to do during a panic attack so and how to control panic attacks instead of panic controlling you.

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid, pounding heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath or tightness in your throat
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness, lightheadedness or faintness
  • Numbness or tingling sensation
  • Feeling of unreality or detachment

 

Ally is a mental health blogger from Germany who writes about her experiences with anxiety and depression on Allyeveryday. She blogs as a way to spread awareness and break down stigma.

This is how she describes a panic attack: 

Panic feels like losing control. Everything seems like it is happening at once and at the same time, time stands still. My only thought is: “I have to get away!”. Everything is crashing down and I have 1 million thoughts and emotions rushing through my mind. I feel completely overwhelmed. There are no reasons, no explanations… just fear, and anxiety.

 

It feels like you are dying of anxiety- drowning and falling at the same time. I can’t breathe, my heart is racing, I’m shaking, and feel dizzy and sick. At the same time, I feel like I can’t move, can’t think straight, but can’t stop thinking either. I feel like I’m not in control of my brain anymore, and am losing power over my body.  Panic slowly overtakes my mind and I feel in that moment there is nothing I can do but watch myself fall apart. It feels surreal, disconnected from the world, and the only thing that exists is you and your anxiety.

 

Afterwards, everything seems like a bad dream. I realize I got a panic attack over nothing and I, once more, let my anxiety take control. I feel weak and embarrassed for being scared out of my mind and not being able to stop it.

What NOT to do if you think you are about to have a panic attack:

People with anxiety can be oversensitive to normal bodily sensations. When panic starts, it will make it worse if you hyperfocus on things like your heart rate and breathing. Hyperfocusing fuels the panic attack so it continues to grow.

 

Here is an example of hyperfocus to make it easy to see how our thinking can propagate a panic attack:

 

“My heart is going fast. I wonder what’s happening! Am I having a heart attack? I do feel like my chest is getting tight. Am I having a panic attack? What if I pass out? I’m starting to feel a little dizzy! My hands are getting numb and I feel like I can’t breathe! What if I throw up? What if I’m dying?”

Instead of interrupting the anxiety and working to calm oneself, hyperfocus does the exact opposite. The more you focus on how fast your heart is beating the more anxious you will get and the faster it will beat. When anxious, people often tense their body and either hyperventilate or restrict breathing. The breathing changes can then cause the tingling in your limbs which further serve to convince you that you are having a heart attack. This snowball of physical sensation can keep going until you exhaust yourself and the panic passes.

What causes that tingly sensation during a panic attack?

During breathing, you breathe in oxygen (O2) and exhale carbon dioxide (CO2). If you breathe too fast or too slow you end up disrupting the balance between the amount of O2 and CO2 in your body. This leads to many of the physical sensations that happen during a panic attack.

Hyperventilation:

During hyperventilation, the body breathes out too much CO2. This causes changes in your body (blood pH rises causing respiratory alkalosis) which result in the symptoms of dizziness, tingling in your lips, hands and feet, headache, weakness, fainting, and seizures.

Hypoventilation:

Some people restrict their breathing during a panic attack by either holding their breath or by breathing in a short and shallow manner. Hypoventilation can also cause lightheadedness or dizziness. Restricting breathing leads to an increase of CO2 causing blood pH to fall and a respiratory acidosis.

5 Ways to Interrupt a Panic Attack:Panic attacks can be terrifying and life-altering if they are not controlled! Are you wondering how to stop a panic attack? Learn what to do during a panic attack so and how to control panic attacks instead of panic controlling you.

1. Distraction!

If you are sitting on the couch watching tv and you start to feel the beginnings of a panic attack don’t continue to sit there and think about it.

 

Get up and do something else! Don’t remain in the same environment if you can change it.

 

  • Go wash the dishes in another room.
  • Grab the vacuum and vigorously clean.
  • Call a friend and ask them how they are.
  • Leave the house or the office to get some fresh air.
  • Leave your desk and go splash water on your face.
  • Walk quickly around the block (or from room to room) while counting how many steps it takes to get from point A to point B.

2. Breathe properly!

This is very important! If you control hyper- or hypoventilation, you can control the pins and needles sensation. Hyperventilation can cause the sensation of shortness of breath so people breathe deeper and then make the situation worse.

Inhale slowly through your nose by pushing your abdomen out for 5-7 seconds. Hold your breath for a few seconds and then exhale through your mouth slowly. It is important to make sure your abdomen is expanding and not just your chest.Panic attacks can be terrifying and life-altering if they are not controlled! Are you wondering how to stop a panic attack? Learn what to do during a panic attack so and how to control panic attacks instead of panic controlling you.

3. Exercise!

When feeling panic it can be effective to match the intensity of the anxiety with physical exercise.

 

  • Go outside and do some sprints,
  • walk vigorously around the block,
  • do 100 jumping jacks,
  • or walk up and down the stairs until the feeling passes.

 

I find gentle exercise less effective because it is easier to still focus on how you are feeling while you are doing it. Intense exercise can make it difficult to think about anything else and therefore can be a very effective distraction.

 

Exercise can also help your muscles relax. When having anxiety and panic people often tense all their muscles leading to some of the feelings of chest discomfort.

4. Shift your focus:

Pick any item and study it intensely. Give yourself something objective to fixate on instead of focusing on your bodily sensations. Describe every detail of the item. When you finish one item move on to describe other items.

 

Here is an example of studying a plant:Panic attacks can be terrifying and life-altering if they are not controlled! Are you wondering how to stop a panic attack? Learn what to do during a panic attack so and how to control panic attacks instead of panic controlling you.

  • What are the leaves like?
  • Does it have smooth edges?
  • What is the color?
  • Are some new leaves sprouting?
  • What does it feel like when you touch different parts of it?

 

The exercise of shifting your focus can help bring you back to the moment and away from focusing on physical sensations.

5. Progressive muscle relaxation:

 

Progressive muscle relaxation is a great tool for panic because it is active and requires focus to complete. It is an exercise that can relax your mind and body through slowly tensing and then relaxing each muscle group.

 

Start at one end and work your way throughout your entire body.

 

  • Tense your muscle as hard as you can and hold it for 5-10 seconds.
  • Feel the sensation that happens as you are tightening the muscle.
  • Once you relax, feel the muscles relaxing and the tension dissipating.
  • Relax for 20-30 seconds before moving on to the next muscle group.

 

Next time you feel the start of a panic attack use these tools to interrupt it: distraction, breathing properly, exercise, shifting your focus, and progressive muscle relaxation. Don’t let anxiety and fear of a panic attack take control. The time spent fearing panic is never time well-spent. Anxiety and panic attacks are treatable so get help if you need it.

 

Are there other tools that help you? Let me know your thoughts in the comments!

Would you like to read more about anxiety?

Anxiety: The Best Websites, Books, and Apps to Treat it

Do what you are afraid of: Stop letting anxiety control you

Benzodiazepines: Do They Treat Anxiety?

Harley from The Balanced Belles wrote about the stories of 8 anxiety sufferers

For additional resources visit my Mental Health Bookstore

The Best Resources for Anxiety

Want to learn additional ways to deal with anxiety? Don’t spend any more time letting anxiety interfere with your quality of life. Get help if you need it. Here is a list of excellent self-help resources including some of the best anxiety books, websites, and apps available to target anxiety.

 

There are so many different options available!

 

  • Read more about different anxiety disorders and options for treatment.
  • Learn techniques to manage the symptoms of anxiety.
  • Track and graph your moods.
  • Identify your triggers.
  • Set goals.
  • Learn meditation and mindfulness.
  • Reduce negative thinking.
  • Join peer networks with others that struggle with anxiety.


Helpful websites related to anxiety:Address anxiety and learn how to manage symptoms. Explanations and links provided for excellent self-help resources for children and adults, including some of the best anxiety books, websites and apps available.

  • My favorite site is The Anxiety Boss. Dr. Carlo Carandang is a psychiatrist and anxiety expert and maintains this comprehensive resource. He has many articles about anxiety disorders and options for treatment.
  • Anxiety.org has a thorough and well-written overview of different types of anxiety, causes, risk factors, and treatments. I like this article: What is anxiety?
  • The Anxiety Coach is a self-help guide for people with anxiety disorders. They offer information and techniques for the management of anxiety.
  • Fear of Flying SOAR program is meant for people that want to conquer their fear of flying. It includes articles and these videos with tips on how to overcome it. The creator of this program is a pilot who combines his expertise in airplanes with Cognitive Behavioral Therapy and created this very effective program.
  • Driving Fear is a site for people looking to overcome their fear of driving. They have self-help programs and a blog.
  • Social Anxiety Association is a nonprofit organization that promotes understanding and treatment of social anxiety disorder.
  • The Anxiety Social Net is a social network for people struggling with anxiety disorders.
  • Emetophobia Online is a site for information and support for those suffering from the fear of vomiting.Address anxiety and learn how to manage symptoms. Explanations and links provided for excellent self-help resources for children and adults, including some of the best anxiety books, websites and apps available.
  • Simplified Skills maintains a list of natural remedies they recommend to help treat anxiety.
  • Previous blogs I have written related to anxiety: Do what you are afraid of! Stop letting anxiety control you and Benzodiazepines: Do they treat anxiety?

    Ways to deal with anxiety

 

Websites addressing anxiety in children:Address anxiety and learn how to manage symptoms. Explanations and links provided for excellent self-help resources for children and adults, including some of the best anxiety books, websites and apps available.

Recommended apps to help with anxiety:Address anxiety and learn how to manage symptoms. Explanations and links provided for excellent self-help resources for children and adults, including some of the best anxiety books, websites and apps available.

  • Mood Track Diary: Free app. Track and graph your mood patterns and triggers.
  • Pacifica: Free app to reduce stress and anxiety. Mood tracking, goal setting, relaxation techniques, and peer support.
  • Happify: Free app. Overcoming stress and negative thoughts. Skills to train yourself for happiness.
  • Fear of Flying: $125-$595 depending on which package you buy. Includes online resources and support, DVD’s, and individual counseling. It even includes a package for “flying tomorrow or the next day” where you can get urgent help so you don’t need to cancel your flight because of anxiety.
  • Anxiety coach: $4.99 This app is designed to be used over several weeks to months as a tool to gradually face a feared situation and reduce anxiety.


  • Headspace: Free or paid versions. Meditation and mindfulness made simple.
  • Calm: Free app. Reduce anxiety, sleep better, and feel happier. Includes meditation, breathing exercises and relaxation techniques.
  • Breathe2relax: Free app. Stress management tools with practice exercises to help learn stress management skills. i-phone app, android app
  • Insight timer:  Free meditation app. i-phone app, android app
  • Simply Being Too: $1.99 Guided meditation for relaxation. i-phone app, android app

Are you looking for the best books on anxiety?Address anxiety and learn how to manage symptoms. Explanations and links provided for excellent self-help resources for children and adults, including some of the best anxiety books, websites and apps available.

Best anxiety books for adults:


Children’s anxiety books:

 

Are there other resources you have found helpful? Let me know if there is anything I have missed.

For additional resources visit my Mental Health Bookstore.