Exercise – Meditation – Caffeine – Sleep – Therapy
When you have an anxiety disorder, your anxiety can range from a minor nuisance to extremely debilitating on a day-to-day basis. However, developing a well-rounded approach to self-care can help reduce the number of bad days you experience or – at least – decrease the severity of the worst days. Below are five, scientifically-backed ways that can help manage your anxiety. This list is by no means comprehensive, but it should provide a good starting place for anyone wanting to improve his/her self-care.
Everyone knows that exercising helps you attain and maintain good physical health, but did you know that a consistent exercise routine can also help with anxiety1? In particular, aerobic exercise (e.g., running, swimming, walking2) can decrease both state (i.e., how you feel now) and trait (i.e., how you feel on a regular basis) anxiety3. Evidence suggests that developing a consistent routine where one exercises for 20 min or more per session provides the strongest benefits for anxiety.
2. Mindfulness Meditation
In fact, when used in such a way, exercise has been found to be so effective at helping with anxiety that some have suggested that it could serve as a clinical intervention and may even help prevent the development of anxiety disorders4. Thus, including a steady exercise routine as a part of your self-care can help to manage your anxiety over a long period of time. Before starting an exercise routine, consult with a medical professional to ensure that you are healthy enough for exercise and that you choose the exercise type that best fits your lifestyle.
Mindfulness, or the practice of actively and non-judgmentally attending to one’s current experiences, has been en vogue for at least the past 20 years, and you have probably heard any number of claims regarding what mindfulness can do for you. Though perhaps overhyped in popular media, a significant body of research has found that mindfulness based techniques, including meditation, seem to reduce anxiety5, including even cases involving generalized anxiety disorder (GAD) and panic disorder6-8.
What makes mindfulness particularly exciting for the treatment of anxiety is that individuals can implement and maintain these techniques at home without the need for a therapist9-10. If you are interested in learning more about mindfulness and how to use it as a part of your self-care, Anxiety.org has written a number of articles on how mindfulness helps anxiety and how to get started on a meditation routine. In addition, both Android and iOS now have hundreds of free apps that can help introduce you to mindfulness meditation. For an additional guide, Lifehacker has a fantastic overview of mindfulness for beginners.
3. Limiting Caffeine Intake
As an avid coffee drinker, I get quite defensive when anyone suggests I reduce my caffeine intake. However, as an individual with an anxiety disorder, I do need to keep an eye on how much of the drug I consume. Caffeine increases autonomic nervous system activation associated with wakefulness as well as fight-or-flight behaviors11. In other words, caffeine makes you more ready to act – something quite beneficial early on a Monday morning. However, adding caffeine to an anxiety disorder can produce bad results.
Evidence suggests that caffeine can increase anxiety on its own12-13, and anxious individuals seem particularly vulnerable to this effect14. Consequently, if you experience elevated anxiety on a regular basis, then you want to monitor and/or reduce your caffeine intake. I am not advocating completely abstaining from caffeine (I certainly don’t), but good self-care for anxiety includes making sure that you don’t overdo it.
Telling someone who suffers from chronic anxiety to get plenty of sleep is somewhat akin to telling someone with a broken leg to “walk it off.” Anxiety disorders themselves are known to cause poor sleep quality15. Despite this fact, research has uncovered a number of techniques that increase your chances of getting a good night’s sleep, and any good self-care routine should include them. Scientists refer to your habits before sleep as your “sleep hygiene,” and good sleep hygiene includes maintaining a consistent sleep/wake cycle (i.e., going to bed and waking up at consistent times), quenching any thirst before bed, and reducing the amount of environmental noise in the bedroom16.
You also want to decrease the amount of “cognitive activity” in the hours leading up to sleep17. For example, when working hard on a project for work or school, try to stop working at least an hour before going to sleep to let your brain “wind down” before bed. Reducing alcohol and tobacco use before bed can improve sleep quality as well18. In addition, all of the above self-care techniques, limiting caffeine intake19, practicing mindfulness20, and maintaining a good exercise routine21, help improve sleep.
5. Consider Going to Therapy
When people talk about self-care, they typically think only of things that they can do on their own to take care of themselves. However, perhaps one of the best ways to take care of yourself when you experience chronic anxiety is to see a therapist. Over the past 40 years, psychologists have developed a substantial number of truly effective techniques to help treat anxiety, particularly in the realm of cognitive behavioral therapy (CBT).
A remarkable body of research has shown these approaches provide substantial benefits for individuals with anxiety disorders22-23, and this field continues to develop and improve. Beginning therapy can be a daunting task, especially if you have never been to therapy before or you have done therapy in the past with limited success. To help with this process, we recently published an article that describes the process of finding a good therapist, which highlights a number of sources to get you started.
Combined, the above suggestions provide a solid starting point for any self-care routine. For many sufferers, managing anxiety is a lifelong process, but through diligent research, we now have a better understanding of what techniques and approaches individuals can use to improve their experience of anxiety.
1. De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: a population-based study. Preventive medicine, 42(4), 273-279.
2. National Heart, Lung, and Blood Institute. Types of Physical Activity. Retrieved August 30, 2016 from https://www.nhlbi.nih.gov/health/health-topics/topics/phys/types
3. Petruzzello, S. J., Landers, D. M., Hatfield, B. D., Kubitz, K. A., & Salazar, W. (1991). A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports medicine, 11(3), 143-182.
4. Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of neural transmission, 116(6), 777-784.
5. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
6. Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., … & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. The Journal of clinical psychiatry, 74(8), 786-792.
7. Kim, Y. W., Lee, S. H., Choi, T. K., Suh, S. Y., Kim, B., Kim, C. M., … & Song, S. K. (2009). Effectiveness of mindfulness‐based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and anxiety, 26(7), 601-606.
8. Vøllestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. Behaviour research and therapy, 49(4), 281-288.
9. Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General hospital psychiatry, 17(3), 192-200.
10. Edenfield, T. M., & Saeed, S. A. (2012). An update on mindfulness meditation as a self-help treatment for anxiety and depression. Psychol Res Behav Manag, 5, 131-41.
11. Smith, A. (2002). Effects of caffeine on human behavior. Food and chemical toxicology, 40(9), 1243-1255.
12. Veleber, D. M., & Templer, D. I. (1984). Effects of caffeine on anxiety and depression. Journal of Abnormal Psychology, 93(1), 120.
13. Orlikov, A., & Ryzov, I. (1991). Caffeine-induced anxiety and increase of kynurenine concentration in plasma of healthy subjects: a pilot study.Biological psychiatry, 29(4), 391-396.
14. Lee, M. A., Cameron, O. G., & Greden, J. F. (1985). Anxiety and caffeine consumption in people with anxiety disorders. Psychiatry research, 15(3), 211-217.
15. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
16. Brown, F. C., Buboltz Jr, W. C., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral medicine, 28(1), 33-38.
17. Gellis, L. A., & Lichstein, K. L. (2009). Sleep hygiene practices of good and poor sleepers in the United States: an internet-based study. Behavior Therapy, 40(1), 1-9.
18. Jefferson, C. D., Drake, C. L., Scofield, H. M., Myers, E., McClure, T., Roehrs, T., & Roth, T. (2005). Sleep hygiene practices in a population-based sample of insomniacs. Sleep, 28(5), 611-615.
19. Shilo, L., Sabbah, H., Hadari, R., Kovatz, S., Weinberg, U., Dolev, S., … & Shenkman, L. (2002). The effects of coffee consumption on sleep and melatonin secretion. Sleep medicine, 3(3), 271-273.
20. Brand, S., Holsboer-Trachsler, E., Naranjo, J. R., & Schmidt, S. (2012). Influence of mindfulness practice on cortisol and sleep in long-term and short-term meditators. Neuropsychobiology, (3), 109-118.
21. Kubitz, K. A., Landers, D. M., Petruzzello, S. J., & Han, M. (1996). The effects of acute and chronic exercise on sleep. Sports Medicine, 21(4), 277-291.
22. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical psychology review, 26(1), 17-31.
23. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.
Sam Hunley holds a doctorate in cognitive psychology from Emory University. He pursued his Bachelor's degree in psychology from Furman University and a master's from Emory. Sam's research, alongside Dr. Stella Lourenco, focuses on human perception of the space surrounding the body, exploring the impact of anxiety and phobias on this perception. Together, they contribute to Anxiety.org articles. Post-graduation, Sam became a Presidential Management Fellow.