There’s no other way to put it: we live in scary times. Times where we’re inundated with news of what feels like weekly, or even daily, coverage about the next mass shooting. Often, this news involves the senseless, heartbreaking deaths of teachers and school-aged children, taken too soon, from a place that’s supposed to be safe.  

These events are sparking understandable outrage and fear. For both parents, and the children we send off to school every day, the anxiety of a potential school shooting can cause near-paralyzing, constant thoughts of What if? What if the next one is my town, my school, my child? 

First, know this: Your fear is founded. It’s a logical reaction to the horror we’re too regularly experiencing in America. The inexplicable wave of school shootings is changing how we see the very places we’re supposed to trust will help our children grow into adults. The places that are supposed to teach them the ways of the world. Educate them. Prepare them for becoming productive, kind, responsible citizens of society. 

How do we go on after the psychological effects of mass shootings? How can we keep this fear from taking over? Unfortunately, there isn’t one simple answer or solution. What we can do, though, is learn how to take care of ourselves, and our children, in the best ways possible. Though processing each school shooting we hear about feels increasingly impossible, there are healthy ways you can start. The tips we’re providing here can help you cope with the terror so many parents and children are feeling, especially after the latest tragedy.  

“Being able to hear what others are saying not only validates our concerns, but teaches us how to cope with some thoughts and feelings.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP 

7 Tips for Coping with Fear After a School Shooting

There are several things you can do to help manage the anxiety and fear you’re experiencing surrounding school shootings. The most important thing though is knowing when to get help. 

If you’re dealing with anxiety, you might need professional intervention from a licensed therapist. Help is widely available and there’s no shame in asking for it. Try the following coping skills, but don’t be afraid to reach out if you need more.    

Tip #1: Allow yourself to feel

It’s normal to have increased anxiety while processing disturbing, tragic news. Acknowledge and allow yourself to have those feelings. Avoiding what you’re feeling isn’t going to eliminate anxiety. Repressing emotions is a coping skill many of us use to get through difficult times, but it’s not the healthiest solution. 

“Remind yourself that fear is a human emotion and you’re allowed to experience it, but also give yourself the opportunity to reflect on the possibility and the probability of an incident like this happening.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP  

Tip #2: Strengthen your mental health 

When we’re going through something hard, it’s very common to put our mental health at the bottom of our priority list. In difficult times, especially after tragedies like the recent school shootings, do the best you can to prioritize the basics for your mental health. Care and preventative maintenance like sleep, daily movement, eating well, and drinking enough water can all help you strengthen your mental health foundation. 

It’s also important to avoid things that may exacerbate your feelings of fear and anxiety. For example, monitoring your news consumption and social media and how it impacts your anxiety is crucial.

Tip #3: Talk with other parents and friends

When you connect with others, you can find safety and solidarity in how you collectively feel. Finding ways to cope often involves feeling validated in the emotions you’re experiencing. Talking with other people who understand you can do just that. 

“Connect with your family, friends, or community. Sharing how you feel and getting validated can make a huge difference.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP 

Tip #4: Focus on positive talking and thinking

When anxiety spirals and threatens to take over your thought processes, using positive mantras and self-talk can be extremely effective for combating negative thinking. 

Research done on the power of self-talk with athletes found that it can help improve their psychological state. Specifically, positive effects include improved self-confidence and reduced anxiety. 

Ways you can use self-talk and the power of positivity to manage anxiety include:

• Keeping a gratitude journal
• Using positive affirmations 
• Spending time with positive people

Tip #5: Doing something can help

For some people, feelings of vulnerability can be combated by channeling emotions into action. You might find solace by:

• Finding an organization to work with
• Volunteering with an outreach program
• Writing letters to congress and politicians demanding change
• Donating to a community program that helps school shooting survivors 

Tip #6: Ask your school about safety measures

Information can be powerful. When you know the types of things your child’s school is doing (and has done) to prepare for the unimaginable, it might offer a sense of calm. 

Not only can the information be reassuring, but it can also help you prepare to discuss things with your child (like intruder drills) if they come home with questions. 

Tip #7: Know when you need professional help

Any anxiety you might be feeling after hearing news of a school shooting is likely perfectly warranted. It can even be healthy. That said, there’s a difference between good stress and bad stress. There comes a point when anxiety can be detrimental to your overall mental health and well-being. 

“Worrying or feeling afraid is relatively normal, but if you find yourself over-worrying or obsessed with the negative thoughts or feelings, it may be time to look for a professional.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP 

If you feel like your emotions are unmanageable, or your stress is too extreme for you to function, reach out for help. Your doctor or a mental health professional can provide you with self-help tools, therapy, and even, in some cases, medication, so you can learn to deal with extreme anxiety and depression in a healthy manner.

4 Tips for Supporting Your Child’s Mental Health After a School Shooting

Tip #1: Reassure them

They have to go to school, so reminding children that their teachers, principals, and other school officials care about them and their safety is important. 

Let your child know that the adults at their school will do everything in their power to keep them safe. This can be difficult, given the unprecedented prevalence of gun violence in schools today, but try to reinforce the idea that everyone has the same goal: to keep schools as safe as possible. 

Tip #2: Help kids express their feelings 

Kids are smart. They know what’s going on in the world around them. Don’t avoid difficult conversations because you’re uncomfortable. This can be a very scary and traumatizing time for kids and it’s important that you allow them the space to express themselves. 

Some might have actually witnessed a shooting, or a friend or teacher was murdered. Let your children know that it’s ok to feel sad and offer ways they can work through those emotions. Modeling calm and openness as a parent is helpful in supporting your child in processing this grief and fear.

For more information on how to navigate these conversations, learn how to talk to your child about mass shootings in our guide.

Tip #3: Limit their exposure

Especially right after a tragedy, we’re exposed to near-constant coverage of the event, often for days and weeks on end. This exposure can be too much for kids who may already be worried or concerned about their own safety. 

Consider keeping the news off, particularly later in the day and in the evenings before bed. Kids need time to decompress, to let their brain shut off. When violent images and heated discussions play out on TV, on the Internet, or even between adults in your home, it can be overwhelming. 

Try to make a “safe time” where you can play games as a family, color, or watch a favorite program or movie. Even doing chores can help kids regain a sense of normalcy, which will be important as they come to terms with their feelings. 

Tip #4: Know when they need professional help

While it’s perfectly normal (and can even be healthy) to have some fear and anxiety given recent events, there comes a point when a professional might need to intervene. 

“Talking to a therapist can help you mitigate the negative emotions and find ways to feel better sooner. You don’t have to live in fear. Help is available and asking for it is the right thing to do.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP 

If you suspect or notice that your child’s fear is resulting in an inability to function in their daily life, it’s time to get them help. If they have anxiety that’s making it difficult for them to sleep normally, interact with peers and friends, or behave appropriately at school or at home, reach out to their pediatrician to discuss where you can get professional mental health help.

Finding Support

If you’re looking for support as you try to deal with the shock and horror of a recent school shooting, help is available, for both you and your child. 

Support for parents

Parents are superheroes when it comes to protecting their children, but even superheroes need help from time to time. You can find support through:

• Seeking therapy
• Joining a support group 
• Practicing self-care
• Joining or donating to an organization like: 
  • Safe and Sound Schools: A group created by members of the Sandy Hook community that’s now joined by school communities nationwide
• If you’re interested in focusing on legislative change, you can support organizations like:
  • Moms Demand Action: A grassroots organization driving efforts to end gun violence
  • Everytown: A gun safety organization that focuses efforts on legislative change and holding elected officials accountable 

“Joining a support group can be a help if individual therapy isn’t enough or if you prefer to share and learn from others.”

Talkspace therapist Cynthia Catchings, LCSW-S. LCSWC, CFTP 

Support for children

Children need support, reassurance, and hope that they’re safe and protected. You can help them by ensuring they have access to the following: 

• Get them into in-person or online therapy
• Ensure counseling services are readily available at their school
• Keep their routine as stable as possible
• Avoid the news when possible
• Pay attention to their mood, sleeping patterns, and eating habits
• For older children, you might: 
  • Introduce them to an organization like Students Demand Action: A group of young activists who are committed to stopping gun violence
  • Encourage them to promote safety protocols like “Secure Storage Resolutions”: Offers actionable steps children can use to demand school boards take action about safe gun storage

Gun violence in schools is inconceivable, yet somehow, it’s become a terrifying reality. You don’t have any guarantee that it won’t happen in your child’s school, but you do have control over how you manage the anxiety so many are feeling. Learning how you can cope, and helping your child cope, are the best things you can do.  

Sources:

1. Walter N, Nikoleizig L, Alfermann D. Effects of Self-Talk Training on Competitive Anxiety, Self-Efficacy, Volitional Skills, and Performance: An Intervention Study with Junior Sub-Elite Athletes. Sports. 2019;7(6):148. doi:10.3390/sports7060148. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628429/. Accessed May 30, 2022.

2. Get Involved. Safe and Sound Schools. https://www.safeandsoundschools.org/get-involved/. Accessed May 30, 2022. 

3. Moms Demand Action For Gun Sense in America. Moms Demand Action. https://momsdemandaction.org/. Accessed May 30, 2022.

4. Everytown for Gun Safety. Everytown. https://www.everytown.org/. Accessed May 30, 2022.

5. Students Demand Action. Students Demand Action. https://studentsdemandaction.org/. Accessed May 30, 2022.

6. Urge Your School Board to Keep Schools Safe. Students Demand Action. https://studentsdemandaction.org/report/how-to-pass-a-secure-storage-resolution-at-your-school/. Accessed May 30, 2022.

What is Workplace Anxiety?

Workplace anxiety can involve feeling uncomfortable, stressed, nervous, or tense about work. The anxiety might stem from worries about losing your job, about your job performance, or even about relations with your coworkers. According to the American Psychological Association (APA), as many as 40% of American workers suffer from workplace anxiety.

While a little bit of work-related stress and anxiety can actually help you focus and improve work performance, too much can be harmful and affect your quality of life — both at work and outside of the office.

Causes of Anxiety in the Workplace

Many situations can contribute to or lead to work anxiety. These can include conflicts with your boss or coworkers, coworker bullying, uncertainty about job stability, unrealistic deadlines, or even absent or ambiguous instructions that make your job more difficult.

“I took a class in school that opened my eyes to an interesting concept. We take on the roles that we had growing up in our families in the workplace for our own healing. This helped me tremendously because I began to see my role, and instead of blaming, I started healing.”

Talkspace therapist Dr. Karmen Smith LCSW DD

Many people believe that all anxiety is the same, but the truth is, there are many forms of anxiety. In fact, there are a few different types of anxiety that you may be dealing with. Knowing the differences can help as you try to address the issue and learn better, healthier thought and behavior patterns. 

Generalized anxiety

Generalized anxiety disorder is an overall nervous feeling, or a feeling like something is going to go wrong, even if you don’t know what, exactly, is going to happen.

Performance anxiety

Work performance anxiety is more specific. This type of anxiety can be felt when you’re worried about not being able to do your job well enough. For example, you might have anxious thoughts about your boss or client not liking the report you spent all week preparing.

Imposter syndrome

Imposter syndrome refers to feeling like you’re a fraud or having an irrational fear that you’re not good enough for your job position. This type of work anxiety is especially prevalent in high-achieving people who might have difficulty accepting their success. Imposter syndrome can, in part, be caused by low self-esteem or subtle bullying by coworkers that undermine someone’s confidence in their work.

Feeling a sense of urgency

Feeling like you have too many tasks to complete in too little time is another type of work anxiety. This can come from your boss making unreasonable and unattainable demands on your time. It can also be the result of pressure you put on yourself, too. 

Social anxiety (social phobia)

Social anxiety disorder, also known as social phobia, is an anxiety condition marked by intense self-consciousness and overwhelming anxiety in daily social situations. This can be anything from being afraid to speak in both formal and informal situations, to experiencing anxiety symptoms by just being around other people. Perhaps you experience social anxiety with co-workers in the office or when meeting new clients.

Tips for Dealing with Anxiety at Work

There is some good news, however. You don’t just have to accept workplace anxiety. Below are a few tips on how to deal with anxiety symptoms at work so you can be as productive and content in your job as possible, and achieve a better work-life balance. 

“See your role in the situation, analyze your expectations — are you taking on the role you had/have in your family? Are you ready to see it differently and make changes? All of these are good questions to ask, and they allow you to go inward.”

Talkspace therapist Dr. Karmen Smith LCSW DD 

Talk to a trusted coworker

Sometimes just being able to discuss a work situation with someone else can reduce anxiety. However, make sure that if you talk with a coworker, it’s someone you can trust. You don’t want your words to be turned against you. That said, if you have someone you feel you can confide in, coworkers can be great sounding boards. They understand the context and environment you’re struggling in but may have a slightly different (or even detached) viewpoint of the situation. This might allow them to offer you some insight on how to handle things and reduce anxiety.

Talk to your manager

Assuming your manager is not the source of your anxiety, you might want to discuss your stressful situation with them. If someone is bullying you, being inappropriate, or undermining your work, your boss might be able to help. If it’s your boss who’s giving you anxiety about going to work, you might want to discuss the situation with someone in your human resources (HR) department.

Use a task manager to plan and prepare

If the source of your anxiety is having too many tasks each day and feeling overwhelmed or unorganized, task manager software might be able to help. This tech solution manages your daily or weekly to-do list and helps you avoid putting too many tasks on each day’s list. You’ll be more successful at completing your list, and you will reduce the risk of inadvertently dropping items that are continuously being pushed to the next day. Using a task manager is a huge time saver and can help you improve your productivity dramatically.

Be realistic with deadlines

Sometimes it can be easy to tell your boss or your client that you’ll have a project completed by a specific date until you get in the middle of the project and realize you’ve drastically underestimated the time the project will take to complete.

Feeling like you don’t have enough time to finish a project (and be proud of a job well-done) can create a lot of anxiety about going to work. 

Avoid this by putting a bit more thought into how much time a project will take, and then adding a cushion to your timeframe before you commit to a deadline. Don’t be afraid to be honest and push back if your boss or client tries to get you to agree to complete a task in a time that’s simply not realistic.

Take a mental health day

Taking a periodic mental health day can be a great way to reduce anxiety, sharpen your focus, and increase your productivity. Use your day away from the office to do something enjoyable for yourself, not to catch up on housework or chores (or, it should go without saying, work). You also may be eligible to take a stress leave from work for more than one day under the Family Medical Leave Act.

Seek a therapist

A therapist can be a resource for you if you need to discuss your workplace stress and anxiety. This is especially true if you don’t have a confidant in a co-worker, friend, or family member who you feel like you can talk to. Yes, therapists can help give you perspective, but beyond that, their worth can be much more instrumental in your health and wellbeing. 

A skilled therapist can determine if your anxiety triggers are normal, or if your anxiety is so extreme that it might be worth exploring serious change…like finding a new job. Don’t worry, though; most often, anxiety is manageable, especially if you have the tools and coping skills to reduce or overcome it. 

Anxiety at work is common, but it can be a destructive dilemma. You don’t have to live with it, though. Get rid of the dread when you have to go to work by admitting that you feel anxious. Then,  address the cause and learn how to eliminate the parts of your work life that are increasing your anxiety. You can do this, and help is there if you need it with Talkspace.

Sources:

1. Agnvall E. Stress and Disease – Conditions that May Be Caused by Chronic Stress. AARP. https://www.aarp.org/health/healthy-living/info-2014/stress-and-disease.html. Published 2014. Accessed April 30, 2022.

 2. Radvansky G, Krawietz S, Tamplin A. Walking through Doorways Causes Forgetting: Further Explorations. Quarterly Journal of Experimental Psychology. 2011;64(8):1632-1645. doi:10.1080/17470218.2011.571267. https://www.tandfonline.com/doi/abs/10.1080/17470218.2011.571267. Accessed April 30, 2022.

3. Cheng B, McCarthy J. Understanding the dark and bright sides of anxiety: A theory of workplace anxiety. Journal of Applied Psychology. 2018;103(5):537-560. doi:10.1037/apl0000266. https://doi.apa.org/doiLanding?doi=10.1037%2Fapl0000266. Accessed April 30, 2022.

Symptoms of Stress and Anxiety

Stress and anxiety both have a wide range of psychological, physiological, and physical symptoms. Some of them — like rapid breathing, upset stomach, constipation, diarrhea, rapid heartbeat, and an inability to relax — overlap and can be present in both conditions.  

It’s important to understand that both stress and anxiety are natural human responses that have a purpose. They warn us about danger or try to keep us safe. A major difference, however, is that stress is typically a short-term response to a recognized threat. Anxiety is more enduring, and it can sometimes be difficult to discern what’s causing it.

Stress and anxiety only become problematic when they’re chronic or excessively intense. In reality, they can be beneficial to our health and well-being when experienced in small doses over short periods.

Let’s examine some of the symptoms of stress vs anxiety separately.

Symptoms of stress

Some of the most common symptoms of stress include:

• Nausea
• Dizziness
• Dry mouth
• Headache
• Sweaty palms
• Chest pain (angina)
• Rapid breathing

Stress can also often cause you to feel overwhelmed, moody, or irritable.

Symptoms of anxiety

Some of the most common symptoms of anxiety include:

• Tense muscles
• Being easily startled
• Numbness or tingling in the hands and feet
• Consistent feelings of dread or impending doom

Anxiety can cause you to feel restless and jittery. It may also make falling or staying asleep difficult.

Causes Of Stress vs. Anxiety

The causes of anxiety and stress are known as “triggers.” Anxiety can be caused by a combination of environmental factors, genetics, and chemical imbalances that are unique to each individual. Excessively entertaining negative thoughts can also exacerbate generalized anxiety. Comparatively, stress is triggered by outside factors.

Stress triggers 

Stress symptoms can be triggered by external life events such as:

• Dealing with major pressures like work deadlines and professional presentations
• Significant life changes like getting married, buying a new property, a death
• Feeling out of control about the outcome of important situations
• Being at odds with somebody you love
• Common everyday worries

It’s important to understand that there doesn’t need to be a single powerful stressor that’s causing you to feel stressed. Stress can result from various small triggers over time.

Anxiety triggers

Anxiety in small doses is healthy and keeps us alert and aware of potential threats around us. It changes our senses and prepares us for survival. For instance, maybe you feel anxious while walking down a dark city street. That feeling is healthy. It prepares you to fight or flee. It’s your survival instinct at work.

However, when anxiety is chronic and excessive, it can lead to various mental health conditions and anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, and post-traumatic stress disorder (PTSD), to name a few.  

Some of the most common triggers for anxiety can include:

• Conflict with people at work, family members, or romantic partners
• Chronic insomnia or other sleep disturbances
• A serious health diagnosis
• Public speaking  
• Long-term financial problems
• Heavy caffeine use

Learning how to anticipate and recognize your triggers can help you to determine the best coping strategies for dealing with your stress and anxiety — but how do you know which one you’re experiencing at any given time?

How to Know If You’re Dealing with Stress or Anxiety

Knowing the difference between stress and anxiety is easier once you understand more about each condition. Anxiety and stress are both parts of the body’s natural fight or flight response system, which is controlled by the brain’s limbic system. When we feel threatened, our bodies release stress hormones. Those hormones cause our heart rate to increase, which results in increased blood circulation to the limbs and organs.

The stress response prepares you to either fight or run away from a threat. Your breathing becomes quicker and more shallow. Your blood pressure rises. At the same time, your senses become sharper as the body releases special nutrients into the circulatory system so that the entire body is charged with energy. This stress process happens almost instantaneously, and its effects are powerful. 

Anxiety, however, is the body’s response to the stress process. It’s typically marked by feelings of unease, dread, or distress, like something harmful might happen at any moment. Because each person has different stressors, naturally, there are different types of anxiety, like social anxiety disorder, separation anxiety disorder, generalized anxiety disorder, etc.

These responses might kick in when you’re faced with an emotional or physical threat, even if that threat is just imaginary. While the process is necessary for our survival and health, if it happens too often or too intensely, it can cause problems in our daily life.

One of the main ways to tell anxiety from stress is duration. Stress typically self-resolves within a short time. Anxiety can last longer, and its cause is often difficult to discern. If you’re experiencing repetitive symptoms and can’t tell whether they’re stress or anxiety-related, you might want to consider seeking help from a mental health professional.

“Anxiety can be triggered by stress, of course, but it can also resonate internally on its own, without a trigger, due to a perceived or imagined fear. Stress is often linked to a known source such as work, a relationship, or even a challenging situation. Working with clients to identify and manage both can truly empower a growth mindset rather than feeling stalled by dysregulation.”

Talkspace therapist Elizabeth Keohan, LCSW-C, LICSW, LCSW

When Should You Find Help?

Sometimes, anxiety and stress happen simultaneously, and it can feel very overwhelming. If you’re constantly feeling stressed out or anxious, to the point where it’s affecting your daily life, you might want to get professional support from a psychologist, psychiatrist, or other mental health professional. Fortunately, you can find some that are willing to conduct online therapy. So you can still get medical advice when you are unable to go in person.

Learning to recognize and anticipate your triggers is an effective strategy you can practice at home. When you learn to spot your triggers as they occur, you can take immediate action to avoid the onset of stress and anxiety symptoms and figure out how to respond during a stressful situation. You can also figure out strategies for effective anxiety or stress management. For instance, you could do deep breathing exercises, meditate, or take a nice relaxing Epsom salt bath.

“It can be so helpful to reach out to a trusted support system or a therapist when stress and anxiety start to hamper your daily activities. Increased physical symptoms such as digestive issues, migraines, or headaches and poor sleep can be a sign that you’re not yourself and an indicator that stress and anxiety are getting in the way.”

Talkspace therapist Elizabeth Keohan, LCSW-C, LICSW, LCSW

You should speak to a doctor or therapist about exploring therapy for anxiety if you feel out of control and unable to handle routine life events. Consider seeking professional help if you:

• Had a significant change in eating, sleeping, or personal hygiene habits
• Have been thinking about harming yourself or other people
• Have been using alcohol and drugs to numb your feelings
• Are unable to complete your daily work and life tasks
• Always feel in a low mood or depressed
• Are having irrational fears

Remember that chronic stress and anxiety are both very treatable and manageable. Educate yourself about basic, effective coping mechanisms (and other medical advice) and use them daily. With just a few minutes of practice a day, you can retrain your mind and learn to anticipate stress and anxiety triggers before they take hold of your emotions.

Sources:

1. Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA. Anxiety and Depression Association of America, ADAA. https://adaa.org/. Accessed February 11, 2022.

2. Anxiety. https://www.apa.org. https://www.apa.org/topics/anxiety. Accessed February 11, 2022.

3. Tips to Manage Anxiety and Stress | Anxiety and Depression Association of America, ADAA. Adaa.org. https://adaa.org/tips. Published 2021. Accessed February 11, 2022.

4. Anxiety: Stop Negative Thoughts, University of Michigan Health, https://www.uofmhealth.org/health-library/uf9897, Accessed February 23, 2022.

What is the Difference Between Fear and Anxiety?

There’s a distinct, key difference between fear and anxiety. Fear results from a clear and present danger, while anxiety results from the anticipation of an unspecified threat. Each of these emotions is marked by unique expressions of mental and bodily effects.

“Fear and anxiety can feel like the same thing as the symptoms are quite similar. While it’s difficult to tease it out at the moment, gaining insight if one is experiencing fear over anxiety is important. Anxiety often stems from an unclear threat, while fear is based around a real and clear threat. It’s not to say that fear and anxiety don’t work together, but that they tap into different triggers.”

Talkspace therapist Minkyung Chung, MS, LMHC

Signs and Symptoms of Fear

As emotions go, fear causes some of the most noticeable changes in the brain and body. That’s because we’re forced to pay attention to our fear. Anxiety, on the other hand, is not imperative for survival. That’s why we sometimes don’t feel symptoms of anxiety quite as strongly or instantly as we might experience fear.

There are some common physiological, psychological, and physical symptoms of fear.

Physiological symptoms of fear:

• Quick, shallow breathing
• Shortness of breath
• Hot flashes or chills
• Rapid heartbeat
• Upset stomach
• Goosebumps
• Tight chest
• Dry mouth
• Trembling
• Sweating
• Nausea

Psychological symptoms of fear:

• Feeling detached from your body
• Inability to focus and concentrate
• Feeling a sense of stress
• Lacking emotional control
• A pending sense of doom

Physical symptoms of fear:

• Flight response (running for safety)
• Freezing up (inability to move)
• Displaying violence
• Clenching fists

What is Anxiety?

Anxiety is a sense of vague apprehension. It can be difficult to know how to diagnose anxiety disorders. It makes you feel unpleasant, negative thoughts and you often can’t understand why. What causes anxiety is imprecise threats that may or may not have any foundation. It’s a general sense of dis-ease, like how you might feel when walking down a dark, quiet city street in the middle of the night.

Signs and Symptoms of Anxiety

Anxiety is believed to have evolved in humans as a mechanism for protecting us against threats that may not even exist. Overwhelming anxiety gives us warnings that something dangerous might be about to happen.

For instance, you might get anxious because you believe that you could be attacked by a bear while walking in the woods. However, there may be no bears for miles around you. Anxiety isn’t completely useless though, because there actually could be a bear nearby. Ultimately, anxiety can serve to help keep you alert but causes harm when it goes too far.

Physiological symptoms of anxiety:

• Trembling or shaking
• Sweating
• Tightness in the chest area
• Upset stomach and nausea
• Quick, shallow breathing
• Chills or hot flashes
• Rapid heart rate
• Muscle pain
• Headaches
• Dizziness

Psychological symptoms of anxiety:

• Inability to focus on conversations, tasks, or thoughts
• Racing, negative thoughts
• Sense of impending doom
• Feeling overwhelmed
• Constant worrying
• Catastrophizing
• Restlessness
• Irritability
• Fatigue

Physical symptoms of anxiety:

• Inability to complete mundane tasks
• Difficulty sitting still and staying calm
• Drug and alcohol use
• Being startled easily
• Social withdrawal

How to Know if You Are Experiencing Fear vs Anxiety

Fear and anxiety both cause similar co-occurring physiological, psychological, and physical symptoms. Though the symptoms can overlap, it’s not uncommon if you experience an independent, unique experience, either.

Sometimes, it can be challenging to tell the difference between fear and anxiety, especially when you’re actively having symptoms. Still, if you’re experiencing fear or anxiety (or both), it’s not likely that you’ll even be questioning the differences at that time.

The differences in symptom expression between fear and anxiety are centered on several factors, including:

• Your emotional & mental capacity
• Your available resources to help you cope
• What event triggered your response 

In short, the difference between fear and anxiety are: 

Fear starts very suddenly as a fight-or-flight response to a well-defined threat. 

Anxiety onsets in response to an unspecified, possibly non-existent threat.

“Working through and lowering levels of fear and anxiety are very similar. It’s about teasing out the stimuli that manifested those emotions. Understanding the stimuli reaction helps to define the next steps of working through those emotions.”

Talkspace therapist Minkyung Chung, MS, LMHC

When to Seek Help

Chronic anxiety and fear have both been linked to mental health conditions, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, and specific phobias like agoraphobia or arachnophobia.

The National Alliance on Mental Health (NAMI) reports that an estimated 20% of adults in the United States experience symptoms of anxiety conditions each year. Women are more likely to be affected than men.  

If you’re experiencing repetitive, worsening symptoms like the ones we’ve discussed here, and they’re beginning to interfere with your functioning and daily life, it might be time to learn about how to treat anxiety or fear, as well as go in for a screening. You can reach out to a therapist or contact a doctor to start the process. Your doctor will review your medical history and try to discern a possible cause for your symptoms.

“The two are so similar it’s hard to figure out what a person is struggling with at that moment. A mental health professional can help with learning the differences and the coping skills necessary to be successful in managing both fear and anxiety.”

Talkspace therapist Minkyung Chung, MS, LMHC

If a diagnosis is made, you’ll likely be referred to different types of therapy for anxiety and fear such as online therapy. Then, you can begin treatment and learn new coping skills to better control the chronic fear or anxiety you’ve been experiencing. You don’t have to let fear or anxiety take over your life. Get the skills and coping tools you need to overcome your fear and anxiety, and you’ll begin on the path to a healthy, rewarding life. 

Sources:

1. Tovote P, Fadok J, Lüthi A. Neuronal circuits for fear and anxiety. Nature Reviews Neuroscience. 2015;16(6):317-331. doi:10.1038/nrn3945. https://www.nature.com/articles/nrn3945. Accessed February 5, 2022.

2. Jacobs Hendel, LCSW H. Anxiety And Fear: What’s The Difference? | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/Blogs/NAMI-Blog/May-2021/Anxiety-And-Fear-What-s-The-Difference. Published 2021. Accessed February 5, 2022.

Why Do I Wake Up With Anxiety?

Waking up with anxiety can put a real strain on your day. Right from the jump, you’re stuck feeling that heavy weight of stress and dread. Some common symptoms of morning anxiety are:

• Feeling like your day is doomed right from the beginning
• Feeling fatigued, even though you just woke up
• Feeling like you just can’t get out of bed
• Difficulty focusing and concentrating
• Rapid, shallow breathing
• Rapid heartbeat
• Perspiring

So what causes anxiety in the morning?

The natural response

The most common theory about waking up with anxiety has to do with a stress hormone called cortisol. As a defense mechanism designed to protect us, our brain and body will naturally react to stress by raising our cortisol level. Although we no longer face the types of threats our ancestors once did, stress results in our bodies and brains reacting as if we’re under attack.

Thus, when we’re stressed, we release more stress hormones, including adrenaline and cortisol. Adrenaline causes the heart rate to increase, boosts blood pressure, and spikes energy supply. Cortisol is the primary stress hormone in the body. It acts to release more glucose into the blood and enhances the brain’s usage of those sugars to enhance alertness and prepare us to defend ourselves.

Research has shown that cortisol levels already surge in the morning for the first 30 – 45 minutes after waking. This is known as Cortisol Awakening Response (CAR) and may increase morning anxiety.

Stress

The common demands of life, like taking care of your family, accomplishing a huge workload, paying the bills, and preparing for the future, are all stressors. The limbic system of your brain perceives stressors as threats, and that can make you feel anxious from the moment you wake up each morning.

Substance abuse

If you’re using or abusing drugs and/or alcohol, waking up with anxiety can be common. While substance abuse may not have direct links to anxiety, it is known to increase anxiety symptoms. 

Relationship struggles

Some studies show that the energy in a relationship may affect how well you sleep at night and how rested and calm you wake up in the morning. 

Physical health problems

If you’re dealing with a chronic health condition, it’s natural to be stressed. Anxiety is common for those who have heart disease, diabetes, cancer, asthma, hypertension, and other serious health-related issues. Waking up with anxiety in the middle of the night or in the morning can be common when you have a serious medical condition. 

Financial stress

Worrying about money is a normal stress for many adults. Especially if you’re financially insecure, waking up with anxiety about how or when you’ll be able to pay rent, buy groceries, or cover bills is not unreasonable. 

Mental health conditions

Like our physical health, mental health conditions can weigh heavily on our psyches. Living with bipolar disorder, depression, or another mental health disorder can result in heightened anxiety or anxious thoughts at all times of the day, even in the mornings.

“If you find yourself waking up feeling anxious, ask yourself what happened the night before? What were you thinking about before you went to bed? These questions can help you identify the cause of your anxiety.”

Talkspace therapist Bisma Anwar, LMHC

Fortunately, there are various techniques you can employ, beginning right now, that are known to alleviate morning anxiety symptoms. You can practice these daily upon waking and decrease the frequency and intensity of morning stress.

6 Calming Techniques to Avoid Waking Up with Anxiety

Wondering how to stop waking up with anxiety? You’re not alone. Let’s review some techniques that have been found to help many people wake up more confidently, calm, and energetic, ready to face their day. 

Though you might not be able to totally prevent the feeling of anxiety or panic you experience when you first wake up, you can help lessen the physical symptoms and severity with natural remedies for anxiety. Try using any or all of these methods right away. 

“There are many ways to help calm your anxiety. You can do a guided meditation, do yoga or a workout, engage in a deep breathing exercise, have a healthy breakfast, listen to relaxing music, take a walk, or write a journal.”

Talkspace therapist Bisma Anwar, LMHC

Change your diet

The foods and beverages we choose to consume have an effect on our mood and functioning. Neurotransmitters, hormones, and other biological chemicals are all synthesized in our bodies based on the nutrients (or lack thereof) we get through our diet.

Studies show certain foods are associated with anti-anxiety effects. These include: 

• Brazil nuts
• Eggs
• Pumpkin seeds
• Chamomile
• Yogurt
• Turmeric
• Dark chocolate
• Fatty fish like mackerel and salmon

Consider adding more of these foods in your daily diet to help your anxiety levels.

Also, you might want to watch your intake of caffeine and other stimulating substances. If you’re already prone to anxiety, caffeine might exacerbate those symptoms. A glass of warm lemon water or decaf tea with honey in it may not be as exciting as that strong cup of coffee, but it can definitely be more calming.

Meditation & deep breathing (pranayama)

Mindfulness meditation offers many benefits to improve emotional and mental health. You can do it anywhere, without any equipment or memberships. Most communities have group meditation courses and support available. There are several different meditation styles, each having benefits for generalized anxiety disorder. Even just five minutes of meditation or deep breathing exercises for anxiety daily can have measurable benefits.

Leave the television off & opt for music

Repetitive exposure to negative stories like what we see and hear in the mainstream media these days has been linked to increased anxiety. If you don’t like the silence in the morning, try putting on some calming music to create a more relaxing environment. Remember, “calming” doesn’t have to be the same for everyone. You might prefer classical music, jazz, acoustic…try whatever is soothing to you.

Exercise

There are several various ways that daily exercise helps to alleviate a high anxiety level, including:

• Diverting your attention from what’s making you anxious
• Activating executive functions in the brain
• Decreasing muscle tension
• Altering brain chemistry

Regular exercise builds up resources in the body that help increase resilience to erratic emotions. Exercise actually changes your brain chemistry by increasing the availability of neurochemicals that work against anxiety, including gamma-aminobutyric acid (GABA), serotonin, various endocannabinoids, and brain-derived neurotrophic factor (BDNF).

Journaling

Taking a few minutes each morning or at night just before bed to jot down your anxious feelings or thoughts can help to calm your mind and focus your thoughts. If you’re journaling in the morning, try tracking your dreams from the night before.

Solidifying your relationship with yourself is an excellent way to decrease nighttime anxiety. Doing so can help you stay in touch with your goals and aspirations and spot negative emotions creeping up on you as they occur.

Create a morning routine

Develop a realistic routine for your mornings, and then stick to it. Having a schedule helps you stay focused on your goals and avoid distracting thoughts and actions. It can also let you feel more steady, which can reduce anxious feelings that might stem from a feeling of being out of control. Additionally, knowing you have a routine to wake up to in the morning might help you stop waking up with anxiety in the middle of the night.

Learning How to Manage Anxiety Day-to-Day

If you’re waking up with anxiety every morning, cognitive behavioral therapy (CBT), exposure therapy, and other types of therapy for anxiety and techniques can help. Working with a therapist, you’ll learn new coping skills for how to treat anxiety that can work to decrease your morning stress.

You might also consider taking prescription medication for anxiety like benzodiazepines, anti-anxiety drugs, beta-blockers, or antidepressants, but note that these are often associated with adverse side effects and do little to solve the core problem causing your anxiety. If you and your doctor do decide to try medication for generalized anxiety disorder, it likely will be a short term solution that’s coupled with effective, proactive strategies like those we’ve discussed here today. 

Focusing on holistic approaches like mindfulness meditation, taking a relaxing bath, setting and being committed to goals, and showing gratitude are all simple, effective ways to combat waking up with anxiety every morning. 

Each of them can help to reduce morning anxiety symptoms so you can have calmer, happier days. If you’re ready to start your journey and take steps to learn how to stop waking up with anxiety, Talkspace can help. Our approach to online therapy makes the process as easy as possible. Get started by connecting with a therapist for a possible anxiety diagnosis.

Sources:

1. Powell D, Schlotz W. Daily Life Stress and the Cortisol Awakening Response: Testing the Anticipation Hypothesis. PLoS One. 2012;7(12):e52067. doi:10.1371/journal.pone.0052067. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527370/. Accessed February 13, 2022.

2. Hasler B, Troxel W. Couples’ Nighttime Sleep Efficiency and Concordance: Evidence for Bidirectional Associations With Daytime Relationship Functioning. Psychosom Med. 2010;72(8):794-801. doi:10.1097/psy.0b013e3181ecd08a. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950886/. Accessed February 13, 2022.

3. Liu C, Liu Y. Media Exposure and Anxiety during COVID-19: The Mediation Effect of Media Vicarious Traumatization. Int J Environ Res Public Health. 2020;17(13):4720. doi:10.3390/ijerph17134720. https://www.mdpi.com/1660-4601/17/13/4720. Accessed February 13, 2022.

4. Audiffren M, André N. The exercise–cognition relationship: A virtuous circle. J Sport Health Sci. 2019;8(4):339-347. doi:10.1016/j.jshs.2019.03.001. https://www.sciencedirect.com/science/article/pii/S2095254619300298. Accessed February 13, 2022.

5. Brellenthin A, Crombie K, Hillard C, Koltyn K. Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels. Medicine & Science in Sports & Exercise. 2017;49(8):1688-1696. doi:10.1249/mss.0000000000001276. https://www.ncbi.nlm.nih.gov/pubmed/28319590. Accessed February 13, 2022.

1. Limit Social Media

Social media can be a great way to keep in contact with family and friends. It can all but eliminate the long-distance barrier relationships once suffered from. Like everything else in life, though, too much of anything can have a negative impact. 

If you’re like most people out there, you probably have a morning routine that includes checking your social accounts within seconds of your eyes opening. While this might be a habit that’s difficult to break, be careful about what you’re allowing yourself to be inundated with on social media. 

Misinformation, negativity, and abusive discourse have unfortunately become the norm across virtually every major social platform. Overexposure can result in major anxiety and stress, even about specific topics like war. If you’re finding that your social media usage is negatively impacting you, consider limiting how much time you spend scrolling each day. Look for ways to reduce your social media intake.

TIPS:

• Commit to a time period (IE: 30 minutes a day, or 15 minutes per session)
• Set a definitive number of click-throughs you allow yourself (IE: 5 articles, or 3 sites)
• Limit the sites you connect with
• Delete apps or platforms you find most stressful
• Mute or unfollow profiles that add to your anxiety about war

2. Be Mindful About Over Consumption of News

We all want to be informed, but with the 24-hour news cycle, it can be easy to get lost in bad news, especially about the war. Smartphones alert you via notifications and pop-ups about each recent traumatic event. You have 10+ news channels pushing out constant programming, literally any time of the day or night. Newsletter emails are delivered on the hour, around the clock. “Breaking” news is available any time you want to find it. 

“Find ways that work for you to stay informed about the war and current events that don’t also trigger your anxiety symptoms so much and make you feel overwhelmed (ie: perhaps turn off your news notifications, and then instead, check the news when it feels right for you).”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

Be mindful of how much you allow yourself to become sucked into the news each day. Setting limits on how much you’re exposed to can be helpful, particularly if you have anxiety about war-related information.

TIPS: 

• Give yourself a time limit on how much news you’re getting each day 
• Pick programs you trust and record them 
• Mute alerts during your workday so you’re not receiving constant interruptions
• Delete apps that give you anxiety or increase your fear
• Take a break from any news sites that you find distressing

“If, however, you’re living with someone who wants to have the news on all the time, and you know that increases your anxiety, consider communicating your needs. Find a solution that helps you both to stay informed while also allowing you to stay as mentally well as you can at this time.”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

3. Fact Check

Digital access makes finding information simple. Fortunately, it also allows you to fact-check sources and information. While this can be a slippery slope, and it can be easy to go down that proverbial rabbit hole, a quick fact check on alarming or concerning information can be a great way to keep your anxiety in check. 

Be aware of clickbait (shocking or catchy headlines that are used to entice you to click on an article). Take the time to ensure quotes are in context, facts aren’t being embellished, and headlines aren’t intentionally misleading. You’ll find this is a useful skill even when it’s not a time of war. 

TIPS:

• Check and verify credentials
• Assess bias
• Check dates
• Read “About Us” sections
• Analyze URLS — .edu and .org domains are typically valid, but if there’s a “lo” or a “.co” at the end, you should be leery
• Trust your gut — if something sounds sensational or unbelievable, it might be worth doing a little digging
• Use authoritative and trustworthy fact checking sites like:
  • Snopes.com
  • FactCheck.org
  • PolitiFact
  • WaPo Fact Checker
• Use a browser extension for alerts and notifications on suspicions sites and organizations:
  • Chrome Know News
  • Chrome Fake News Detector
• Look for manipulated videos — Washington Post has a great video on how to spot altered video content

4. Practice Self Care

Self-care is essential and beneficial all the time, but it’s even more critical if you’re experiencing recent war anxiety. You can learn how to calm your mind and relieve major stress about the things you have no control over by using some very easy-to-follow techniques that encourage peace and structure in your life. 

Deep breathing and relaxation exercises can help decrease anxiety symptoms. Deep belly breathing activates our parasympathetic nervous system response, helping to bring our bodies and minds out of that anxiety ‘fight or flight’ response and into a more relaxed ‘rest and digest’ response. It signals to your body and mind that you are safe. To practice this exercise, try taking three deep breaths, making your exhales a little longer than your inhales. Even if it only helps turn the ‘volume’ of your anxiety down from a 10 to a 9, taking small actions like this can support you in doing the next right thing, so that your anxiety is not the decision-maker, but rather, you are.

There’s a reason flight attendants instruct parents to put on their own oxygen mask first in the event of an in-flight emergency. Think of self-care like your oxygen — if you don’t take care of yourself, you won’t have the time, energy, resources, or ability to take care of anyone who needs you.

TIPS:

• Learn how to meditate for anxiety
• Exercise
• Listen to calming music or sounds
• Diffuse essential oils
• Get outdoors
• Be mindful of your sleep schedule
• Eat well 
• Stay hydrated

“Getting back to the basics is important when managing anxiety symptoms. Think about how you’re sleeping, if you’re drinking enough water, if you’re moving your body every day (if you’re able-bodied and can do so), eating well, etc. Sleep issues can often manifest as depression or anxiety symptoms. Making sure you can get a strong foundation for your mental health by taking care of your basic needs as best you can is a good line of prevention for mental health conditions. Regarding eating well, consider your caffeine intake. Experiment to see how your anxiety symptoms are with that cup of coffee, and see how your anxiety symptoms feel if you switch to caffeine-free or decaf for a while (you might notice a decrease in anxiety symptoms, but everyone is different).”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

5. Learn Your Triggers

Knowing what triggers your anxiety is step one in learning to manage it. If you know that you get riled up when looking at Twitter, avoid it. If a certain person’s posts on Meta ( formerly known as Facebook) stresses you out, mute or unfollow them. If a specific news program is constantly keeping you up worried about the war, think about taking a break or canceling the DVR recording for a bit. 

Learning your triggers is a powerful way to take control of your life and your anxiety or depression. This is true during isolated times of stress (like a war) as well as when struggling with the stressors from normal, everyday life. 

TIPS:

• Take inventory of things that lead to severe anxiety about the war (and avoid them)
• Notice if a specific activity is triggering you — like scrolling on social media or watching a certain program
• Find things that give you a sense of control 
• Mute or delete apps that are triggering your war anxiety
• Avoid conversations or spending time with people who add to your anxiety

6. Lean on Loved Ones

Having a support system can be incredibly important if you’re finding it difficult to know how to deal with anxiety about war. Surround yourself with people who understand you, support you, and want the best for you. Anxiety can result in feelings of isolation, and spending time with people who love and care about you can be helpful.

Remember that you don’t need to only surround yourself with people who are like-minded. That said, realizing who you’re comfortable with might make it easier for you to share your feelings. Getting into combative conversations with people probably isn’t going to be the best for coping with war anxiety.

TIPS:

• Surround yourself with people you can trust
• Don’t be afraid to open up and share your anxiety
• Be honest if you want conversations to remain confidential
• Don’t feel the need to label your feelings

“If you’re a parent or guardian and caring for children or loved ones who are also feeling anxious, find age-appropriate ways of talking with them and supporting them through this. Then you’re not only coping with your war anxiety, but your entire home and community is also getting healthy ways to cope with this anxiety as well.”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

7. Focus on the Positives

The power of positive thinking has been proven in scientific research and studies. Particularly if you already struggle with anxiety, or if you’ve been previously diagnosed with an anxiety disorder, reminding yourself of the good things in life can be a powerful way to combat war anxiety. 

Simple acts that focus on the positives can help you manage anxiety about war stress that’s interfering with your daily functioning. One great way to manage anxiety can be to give back or find volunteer opportunities to donate your time and resources to. 

“If you’re feeling helpless, but think doing something to help support victims of war might help your anxiety symptoms, look into ways that you can help that feel right for you. No effort is too small. See if doing something for others helps mitigate your anxiety in any way.”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

Rosenblatt offers the following ideas: 

• Make a monetary donation to an organization doing great work
• Organize a food and clothing drive for your community that you can share with organizations delivering food and basic needs
• Join a solidarity march or movement in your community
• Talk with your kids about offering age-appropriate support to victims (for example, with younger children, you can ask if they want to draw pictures or write letters to people in war-torn communities)

Giving back can make you feel good in times of hopelessness, but there are also several other ways to re-focus your mind on the positives.

TIPS:

• Physically list the people you care about and are grateful for 
• Keep a gratitude journal
• Take the time to get outdoors and go for a walk 
• Set a time each day to recognize, enjoy, and appreciate the little things you might normally take for granted
• Volunteer

8. Come to Terms with Uncertainty

The unfortunate reality is there’s a lot of uncertainty in our world right now. Coming to terms with that, and accepting it, might help you get through your days. 

Of course you want to know what tomorrow holds — we all do. That feeling can be wildly amplified if you’re worried for the people who are directly affected by war and concerned about what the ultimate, final outcome might be. However, the simple truth is this: you’re not in control of any of these things. Allowing yourself to accept this idea can be game-changing. 

TIPS:

• Make your health a priority
• Take a break from news and negativity
• Acknowledge and accept your emotions, but don’t let them take hold of your mental state

9. Consider Therapy

Therapy can be an invaluable tool when you’re dealing with feelings of anxiety, worry, and fear. If you find yourself feeling more anxious than usually because of war anxiety, feel free to ask your therapist for more weekly sessions or more support if that feels helpful. 

Let your therapist know how you’re feeling, and ask them for coping skills and ideas to help prevent and manage your anxiety symptoms. In therapy, you learn that you don’t have to believe everything you think, especially anxiety thoughts that can be the worst-case scenario type or automatic negative thoughts. 

Learning skills to identify these thoughts and ways to cope with them can be key to managing war anxiety. If you’re prescribed medications for anxiety, make sure you have enough and you’re taking them as directed.

TIPS:

• Take the time to find a therapist you’re comfortable with
• Be willing to put in the work — therapy isn’t always easy, but it is rewarding when you’re committed
• Be patient — therapy doesn’t fix things overnight

“Research in Proceedings of the National Academy of Sciences (PNAS) shows that if you’re feeling anxious, you can try an emotion regulation technique called ‘cognitive distancing’ to start feeling better. Cognitive distancing works by creating some separation between yourself and your feelings. One way to do this is when you’re feeling anxious, talk to yourself in the third person instead of first person. For example, instead of asking yourself “Why did I do that?” ask yourself “Why did <your name> do that?” Self talk matters for managing anxiety symptoms, and therapy by messaging seems to help with that.”

Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC

Finding Support

If you feel that your war anxiety is increasing or becoming something you can’t manage on your own, reach out for help with your mental health. You can talk to your doctor or find an online therapist with Talkspace to help you find ways to deal with your anxiety. It’s normal to experience anxiety about war, but you don’t have to go through it alone.

The Difference Between Anxiety in Men vs. Women

Though it’s very common in both genders, anxiety can be different for men than women. It’s not fully understood why, but research has shown that there are some specific differences. 

For example, women experience a higher diagnosis rate for almost all types of anxiety disorders. The exception here is social anxiety disorder (SAD), which occurs at roughly the same rate for both women and men. Women who are diagnosed with one anxiety disorder are also more likely than men to at some point be diagnosed with another mental health condition.

Another difference is between how men and women tend to deal with their anxiety. Overwhelmingly, men are more prone to turning to substance abuse, whereas women more often turn to agoraphobic avoidance.

“Men are often socialized to portray strength at all times. This can make it difficult for men to seek support in treating anxiety.”

Talkspace therapist Liz Kelly, LICSW

Signs & Symptoms of Anxiety in Men

Many people equate anxiety to having feelings of nervousness, a racing heart, or sweating, but anxiety can be much more than anxious feelings. Male anxiety symptoms can go far beyond feelings of worry or fear. There are both physical and emotional symptoms to be aware of. 

Physical anxiety symptoms in men:

• Excessive sweating
• Headaches
• A racing heart
• Muscle tension
• Outbursts of anger
• Feeling restless
• Gastrointestinal issues
• Agitation
• Feeling dizzy or having vertigo
• Insomnia
• Shortness of breath
• Experiencing a choking sensation
• Panic attack

Emotional anxiety symptoms in men: 

• Feelings of dread
• Frequently worrying about things going wrong
• Avoidance
• Difficulty concentrating
• Catastrophic thinking
• Feeling overly vigilant about the potential for danger
• Irritability
• Anger 
• Edginess
• Fear of losing control
• Absentmindedness

“Men and women often experience anxiety in different ways. Anxiety in men may look like anger and irritability, muscle tension and physical symptoms, difficulty sleeping, and relying heavily on alcohol and other mood-altering substances to cope.”

Talkspace therapist Liz Kelly, LICSW

Causes of Anxiety in Men

Anxiety can be caused by a number of things, including work stress, family dynamics, traumatic events, and more. It also can stem from ongoing medical conditions like diabetes, heart disease, or even a natural decline in hormone levels. Low testosterone has been known to increase anxiety levels and is also a contributor to increased levels of the stress hormone cortisol, which is related to anxiety.

Types of Anxiety Men Experience

There are 5 major types of anxiety disorders, all of which men can experience.

• Generalized anxiety disorder (GAD): General anxiety disorder is characterized or marked by excessively intense worry, anxiety, and stress about everyday common events. There’s no obvious or reasonable cause for the worry, but men with GAD are always anticipating the next major disaster in life. They can’t stop worrying about basic things like money, their health, family, relationships, and work.
• Social anxiety disorder (SAD): Social anxiety disorder results in men experiencing anxiety, fear, and avoidance that’s so intense it interferes with daily life and relationships. Men with SAD often avoid any type of social situation so they can try to thwart the fear and panic they typically experience any time they’re in social settings.
• Panic disorder: Panic disorder is marked by repeated episodes that are unexpected and feel like they come out of the blue. These occasions are filled with overwhelming fear and generally have physical symptoms including heart palpitations, chest pain, dizziness, shortness of breath, or abdominal pain.
• Post traumatic stress disorder (PTSD): PTSD is a condition that can result after an extremely traumatic event in one’s life. The psychiatric disorder can occur after men experience things like a very severe accident, a natural disaster, war or combat, an extremely violent and unexpected death, or other traumatic event.
• Obsessive compulsive disorder (OCD): Obsessive compulsive disorder causes unwanted recurring thoughts, sensations (obsessions), and ideas that are so overwhelming and powerful they often drive men to repeatedly act (compulsions) in an attempt to stop their thoughts.

Anxiety Treatment for Men

When left untreated, signs of anxiety in men can be extremely painful and debilitating. There is good news, though. Anxiety is treatable. Treatment can come in the form of therapy, medication, lifestyle changes, or a combination of all of these.

“If you are having a tough time, know that anxiety is very treatable. Talking with a mental health professional can help. They can help provide insight into how the anxiety is manifesting and give you skills to learn to cope with successfully.”

Talkspace therapist Liz Kelly, LICSW

Therapy

Some types of therapy work better in treating anxiety in men than others. The specific type of anxiety disorder a man is diagnosed with can determine which therapy technique might work best. In general, talk therapy (also known as psychotherapy), cognitive behavioral therapy, and exposure therapy are all effective in treating male anxiety symptoms.

Medication

Medication can be used successfully for many men who have anxiety. Before anything is prescribed, however, it’s very common for a doctor to test a man’s testosterone levels to see if testosterone replacement therapy (TRT) might be a good option for treatment. If testosterone levels are within a normal range, there are three main types of medication used to treat anxiety in men.

• Antidepressants
• Benzodiazepines
• Buspirone

Like with many mental health conditions, medication can take a while to get right. Sometimes a combination of medications will work best. Other times, medication combined with therapy might be able to get the most optimal results.

Lifestyle changes

Lifestyle changes like diet, sleep habits, and exercise can all be very helpful in reducing severe symptoms of anxiety in men. Meditation, breathing exercises, physical exercise, yoga, acupuncture, and a healthy diet can all potentially improve many aspects of mental health, including anxiety.

Anxiety can be overwhelming to deal with but with the right support in your life, you can learn how to deal with anxiety effectively. Whether this means seeing a therapist or talking to a doctor about medication, there is help out there to improve the symptoms and signs of anxiety in men.

If you or someone you know might be experiencing anxiety, take our anxiety test to learn more. From there, we can help get you connected with a licensed therapist for diagnosis and treatment.

Sources:

1. NIMH » Any Anxiety Disorder. Nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder. Accessed November 4, 2021.

2. Blumberg SJ, Clarke TC, Blackwell DL. Racial and ethnic disparities in men’s use of mental health treatments. NCHS data brief, no 206. Hyattsville, MD: National Center for Health Statistics. 2015. https://www.cdc.gov/nchs/data/databriefs/db206.pdf. Accessed November 4, 2021.

3. Facts & Statistics | Anxiety and Depression Association of America, ADAA. Adaa.org. https://adaa.org/understanding-anxiety/facts-statistics. Published 2020. Accessed November 4, 2021.

4. NIMH » Generalized Anxiety Disorder. Nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/generalized-anxiety-disorder/ Accessed November 4, 2021.

5. McLean C, Asnaani A, Litz B, Hofmann S. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027-1035. doi:10.1016/j.jpsychires.2011.03.006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/. Accessed November 4, 2021.

6. What are the five major types of anxiety disorders?. HHS.gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html. Accessed November 4, 2021.

Types of Medications Used to Treat Anxiety

There are some well-known anti-anxiety meds that may be worth looking into if you’re considering medical treatment or if therapy alone isn’t working to reduce your anxiety. 

Several types of medication for anxiety have been found effective including:

• Antidepressants
• Benzodiazepines (sometimes called simply “benzos”)
• Buspirone
• Hydroxyzine
• Beta-blockers

Antidepressants

Antidepressants are often the first line of treatment for those with anxiety disorders. There are two subgroups of antidepressant medication that seem to be most effective in treating anxiety. 

Selective serotonin reuptake inhibitors (SSRIs)

These are the most commonly prescribed antidepressants for anxiety. They work by helping your brain make more serotonin — a neurotransmitter that aids in regulating and enhancing mood. 

Some SSRIs that are commonly used to treat anxiety include:

• Zoloft
• Prozac
• Celexa
• Lexapro

Possible side effects of SSRIs to treat anxiety:

• Agitation
• Feeling shaky or anxious
• Indigestion
• Diarrhea or constipation
• Blurred vision
• Loss of appetite
• Weight loss
• Dizziness

Serotonin-norepinephrine reuptake inhibitors (SNRIs) 

These inhibit reabsorption of certain brain chemicals that can increase or induce anxiety. While SSRIs work only on serotonin, SNRIs can combat low levels of serotonin as well as norepinephrine, both of which impact mood. 

Some SNRIs that are commonly used to treat anxiety include:

• Effexor
• Cymbalta
• Pristiq

Possible side effects of SNRIs to treat anxiety:

• Dry mouth
• Nausea
• Headache
• Dizziness
• Excessive sweating

Bupropion

There are a few other antidepressants that can help with anxiety symptoms in addition to SSRIs and SNRIs. They include:

• Aplenzin (bupropion)
• Wellbutrin (bupropion)  
• Zyban (bupropion)

Possible side effects of bupropion to treat anxiety:

• Weight loss
• Headache
• Dry mouth
• Nausea
• Insomnia
• Dizziness
• Rapid heart rate
• Constipation
• Sore throat

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants are used in the treatment of anxiety or depression because they work to balance serotonin and norepinephrine — neurotransmitters in your brain. Too much of these chemicals can result in anxiety. TCAs are older drugs that aren’t as common and may have more side effects than some newer drug options do.

• Amitid (amitriptyline)
• Amitril
• Anafranil (clomipramine)
• Aventyl/Pamelor (nortriptyline)
• Elavil/Endep (amitriptyline)
• Tofranil (imipramine)

Possible side effects of tricyclic antidepressants to treat anxiety:

• Slightly blurred vision
• Dry mouth
• Constipation
• Dizziness
• Drowsiness
• Weight gain
• Difficulty urinating
• Excessive sweating (particularly at night)

Monoamine oxidase inhibitors (MAOIs)

MAOIs are yet another type of antidepressant that can be used as an off-label treatment for anxiety. While off-label treatment means the use of a treatment that is approved for a condition other than yours, this is a legal and common way that many conditions are treated. MAOIs are typically prescribed to treat social phobias or panic disorder. MAOIs increase how many transmitters are working to regulate your mood. 

Some MAOIs that are used to treat anxiety (again, as an off-label treatment) include:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Possible side effects of MAOIs to treat anxiety:

• Nausea
• Dry mouth
• Diarrhea or constipation
• Drowsiness
• Headache
• Insomnia
• Dizziness
• Lightheadedness 

Buspirone (BuSpar)

Buspirone is often prescribed in addition to an antidepressant. It can be used when treating general anxiety disorder. While it’s not totally understood why or how buspirone works, it’s thought to affect some of the chemicals in the brain that help regulate mood.

Possible side effects of buspirone to treat anxiety:

• Nausea
• Dizziness
• Headache
• Drowsiness
• Nervousness
• Lightheadedness
• Being tired
• Blurred vision

Hydroxyzine

Hydroxyzine is an antihistamine that’s been approved to treat anxiety. It works by reducing some of the activity in the central nervous system, so it acts as a sedative that can treat tension and anxiety. However, it’s also associated with drowsiness and is used for insomnia, so it may not work for everyone.

There are several brand names for hydroxyzine:

• ANX
• Atarax
• Hyzine
• Rezine
• Vistaril
• Vistaril IM
• Vistaject-50

Possible side effects of hydroxyzine to treat anxiety:

• Drowsiness
• Dizziness
• Fatigue
• Blurred vision
• Urinary retention
• Dry mouth
• Confusion
• Headache
• Irritability  

Benzodiazepines

Benzodiazepines are fast acting and known to reduce anxiety by increasing neurotransmitter activity that has a relaxed, sedative effect. They’re commonly prescribed for people who have generalized anxiety disorder, social anxiety disorder, or panic disorder. 

The caveat to benzodiazepines is people can easily build up a tolerance to them and they’re addictive. They’re typically not prescribed for a long time period. These are prescribed in conjunction with other medications and rarely used as a sole agent.

Some prescribed benzodiazepines to treat anxiety are:

• Ativan (lorazepam) 
• Klonopin (clonazepam) 
• Librium (chlordiazepoxide)
• Xanax/Niravam (alprazolam)
• Valium (diazepam)

Possible side effects of benzodiazepines to treat anxiety:

• Confusion
• Drowsiness
• Lightheadedness
• Dizziness or unsteadiness
• Slurred speech
• Memory problems
• Muscle weakness

Beta-blockers

While beta-blockers are a commonly known treatment for heart conditions, they’re also an off-label option for anxiety. Beta-blockers can work for short-term anxiety, like social phobias, stage or speech fright, etc. They’re known to potentially help reduce physical symptoms in certain anxiety disorders — for example, the rapid heart rate or sweating that can be associated with social anxiety disorder. 

Since they block the effects of adrenaline (epinephrine) on beta receptors, beta-blockers are considered a beta-adrenoceptor antagonist. Epinephrine is the hormone that plays a significant role in our fight or flight response which is associated with anxiety. 

The most commonly prescribed beta-blocker that’s used as an anti-anxiety medication is:

• Inderal (propranolol)

Possible side effects of beta-blockers to treat anxiety:

• Dizziness
• Feeling tired
• Lightheadedness
• Difficulty sleeping
• Nightmares
• Cold fingers/toes
• Feeling sick

Medications Commonly Prescribed for Anxiety

The following anxiety medication list shares some (but not all) of the most prescribed medications for anxiety available. 

Talk to your psychiatrist or healthcare professional about the possible risks and benefits associated with the above anxiety medications before starting treatment.

How to Get Anxiety Medication

If you’re thinking about anti-anxiety meds, you should talk to your doctor about getting a prescription. Together, you can come up with the most effective course of treatment to help you manage your anxiety. 

Treatment will likely include more than just medication though. Over the counter anxiety medication might also be an option. Talk therapy (psychotherapy) is another effective treatment technique that’s often used, either on its own or in conjunction with anxiety medication.  

In order to get anxiety medication, the following steps should be taken:

1. Get an anxiety diagnosis
   To be diagnosed, you’ll need a psychological evaluation. 
2. Begin therapy or treatment
   Therapy can be a key element in managing your anxiety. 
3. Consider your medication options
   Review the pros and cons of each type with a professional.
4. Talk to a prescriber
   Your psychiatrist can prescribe your medication for anxiety. 

Should You Treat Anxiety with Medication? 

Any time you decide to treat a mental health condition with medication — including anxiety — you want to be confident that you understand all your options. Taking the time to discuss your treatment plan with a psychiatrist, doctor, or other healthcare provider is well worth it. You’ll be able to learn more about your options, including what alternatives there are to medication, as well as any potential benefits and drawbacks certain medications might have. 

Be sure to have a candid conversation about what medication can mean for you should you decide to take it. 

Questions to ask your doctor:

• Should I consider anxiety medication?
  Ask your doctor to help you weigh the benefits and drawbacks of any medication for anxiety that you may be considering. 
• What are the possible side effects of this medication?
  Knowing the potential side effects can help you make the best decision. You can be confident in your understanding of which medication you might find the most beneficial.
• What other treatments should I be considering for my anxiety?
  Medication isn’t your only option for treating intense anxiety. You can choose to combine anti-anxiety meds with other holistic, self-help techniques as well as therapy.
• Should I consider treatment in conjunction with anti anxiety medication?
  Any time you make the decision to begin medication for a health condition, you want to be sure you understand what else you might need to do. For example, should you consider talk therapy in addition to medication? Your doctor can help you make that decision.
• Are there any holistic or self-help techniques I can try?
  There are a number of holistic and self-help techniques you can implement to help you manage intense anxiety. Meditation, journal writing, exercise, a healthy diet, and a consistent, regular sleep habit can all be important in controlling anxiety.
• Should I consider therapy in addition to medication?
  Certain forms of talk therapy — like types of cognitive behavioral therapy  (CBT) — are known to be productive and effective in dealing with anxiety. 
• Are there any other conditions going on that could be contributing to my anxiety?
  Anxiety is related to multiple other mental and physical conditions. If not dealt with, it can either lead to or worsen existing conditions like depression, substance abuse, insomnia, digestive problems, and other physical health issues like headaches, bowel problems, or migraines. 

If you’re ready to seek anxiety treatment through medication, get connected with a prescriber. 

Sources: 

1. National Comorbidity Survey. Hcp.med.harvard.edu. https://www.hcp.med.harvard.edu/ncs/index.php. Published 2021. Accessed October 11, 2021.
2. Borza L. Cognitive-behavioral therapy for generalized anxiety. Dialogues Clin Neurosci. 2017;19(2):203-208. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573564/
3. Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA. Anxiety and Depression Association of America, ADAA. https://adaa.org. Accessed October 11, 2021.
4. Mental Health Medications | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Hydroxyzine-(Vistaril-Atarax)#:~:text=Hydroxyzine%20is%20an%20antihistamine.,%2C%20skin%20rash%2C%20and%20allergies. Published 2021. Accessed October 11, 2021.
5. Entringer, PharmD. S. Hydroxyzine. Drugs.com. https://www.drugs.com/hydroxyzine.html. Published 2020. Accessed October 11, 2021.

What is Anxiety Chest Pain and Why Is It So Common? 

Is your chest tightness anxiety, or is it something more? Research shows that anxiety is a contributing factor for about 30% to 40% of people who experience low-risk chest pain and go to the ER.

Even just the thought of chest pain can make us, well, anxious. Feeling anxiety in chest regions, however, is a fairly common symptom of anxiety. It’s the association of chest pain with heart related conditions or, in the worst cases, a heart attack, that makes any type of chest pain seem frightening.      

Knowing the difference between anxiety-driven chest pain, and when it could be something more, is important. To do that, you need to understand how anxiety chest pain usually feels.

What Does Anxiety Chest Pain Feel Like?

One of the hardest parts about anxiety is that it often doesn’t present the same way in any two people. What type and how severe your anxiety symptoms are can range from day to day. 

Even the same physical symptom of chest pain from anxiety can differ from person to person. For most, the pain is sudden, harsh, and sharp but others may experience anxiety chest pain gradually. 

Chest tightness anxiety symptoms can be described as any of the following:

• A persistent ache in the chest
• A shooting or sharp pain
• A burning, dull ache, or numbness in the chest area
• An abnormal muscle twitch or spasm
• Chest tightness or tension
• Stabbing pressure in the chest

“For those with anxiety chest pain, people describe it as though there is a heavy weight on their chest, making them feel as though they are suffocating — which can be absolutely terrifying.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

Causes of Anxiety Chest Pain

Understanding what can cause chest pain that’s related to anxiety can help you manage it. 

Stress Response

When we become anxious, our body has a natural physical reaction. Sweating, shortness of breath or difficulty breathing, your body tensing up, a racing heartbeat, and more can all be the result of a physiological change due to your brain setting off a stress response.

Sometimes there are emotional or psychological responses, too. You may find that you’re suddenly very aggressive or hostile, or you’re easily upset when you’re anxious. These responses are commonly known as fight-or-flight responses. They’re a way for your head and body to take over in dangerous situations. However, when you experience fight-or-flight reactions often, it can take your body a lot longer to recover. The result can be extreme muscle tension you may feel in your chest. 

Combine this tightness with the potential for an increased heart rate (another symptom of anxiety), and you may suddenly begin wondering if what you’re feeling is really just anxiety in your chest or if it’s something much more. 

“There are so many causes of anxiety chest pain, but the more major ones include either traumatic experiences for the first time or regularly triggering past traumatic experiences. Typically, our perception has led us to believe that we need to fight or flight for longer periods of time. It wears on our emotional capacity and eventually leads to physical symptoms.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

Cardiovascular System Mechanism

Chest pain that results from anxiety can be from cardiac system mechanisms, or they may not be related at all. In some cases, it may even be a combination of the two. If you’re experiencing anxiety chest pain that’s not cardiac related, your pain may be due to:

• Esophageal dysmotility — Due to irregular contractions in your esophagus.
• Hyperventilating — Due to rapid breathing that causes lower carbon dioxide levels in your blood, which can cause tingling in your extremities and lightheadedness.

How Does Anxiety Chest Pain Differ From a Heart Attack?

Though they may seem very similar in how they feel, they are different. You might be able to calm yourself down a bit by knowing how anxiety chest pain and heart attack chest pain differ.

Anxiety chest pain symptoms 

Anxiety chest pain often starts suddenly with a stabbing pain in the chest area that might begin even if you’re sitting quietly. It may also come on after you’re already feeling other symptoms of anxiety. It usually starts and fades fast — often within just about 10 minutes or so.

Other symptoms can include: 

• Feeling faint
• Trembling
• Feeling out of control
• Heart palpitations 
• Feeling dizzy
• Having shortness of breath
• Body temperature changes
• Feeling numb
• Sweating

Heart attack symptoms 

Heart attack symptoms, by contrast, typically come on during periods of activity. Many describe feelings of pain that:

• Start in the chest and travel to other body parts (like the shoulder, jaw, or arms)
• Begin slowly and increase gradually
• Feel like heavy pressure or a squeezing sensation

“While anxiety chest pain and a heart attack have more in common than they don’t, a heart attack differs from anxiety chest pain in that many people report a squeezing in their chest (around their heart) and/or a fullness that seems to be different from the suffocating feeling that anxiety chest pain offers. Heartburn and/or belching also seem to be unique to heart attacks.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

How to Treat Anxiety Chest Pain

Fortunately, if you have pain in your chest from anxiety, there are a number of treatment options you can try. First and foremost, in-person or online therapy can be extremely helpful in learning how to manage your anxiety and alleviate your symptoms. 

A therapist can use cognitive behavioral therapy techniques to help you restructure the thought processes that may be leading to your anxiety and contributing to your chest pain. Many people find this route of treatment preferable if they’re hoping to avoid medication. 

However, you should know that anxiety medication is another effective form of treatment for many people. However, therapy and medication aren’t the only two ways you can handle chest tightness anxiety. 

You can also try: 

• Using deep breathing techniques to slow your heart rate and keep your anxiety from worsening
• Finding a safe place that you feel comfortable in to help you reduce your anxiety
• Focusing on positive or peaceful things or images to reduce how severe your anxiety attack might become.
• Journaling regularly to help manage your stress and allow yourself to let go of some of the anxiety you may be feeling.
• Working out — yoga, biking, swimming, walking, and dancing are all ways to manage and eliminate some anxiety
• Meditating to calm your mind and practice staying in the moment  
• Getting on (and sticking to) a good sleep pattern. 
• Eating healthy and avoiding high-processed foods or foods high in refined sugar 
• Reducing or completely avoiding caffeine and alcohol
• Quitting smoking and/or using drugs

Anxiety disorder symptoms can be challenging enough, even without chest pain. Additionally, t can become so much worse when you have the fear that chest pain often brings on. To eliminate the possibility that something more is going on, you should see a doctor or healthcare provider to be evaluated any time you have chest tightness anxiety, heart palpitations, or any other type of chest pain. This can rule out any other conditions if you’re still unsure. 

While it’s a common symptom for anxiety to sometimes cause chest pain, you can’t just assume that what you’re experiencing is non-cardiac chest pain. Having a proper diagnosis by a doctor or licensed therapist may even help you manage your anxiety and understand where your chest pain symptom is coming from.

If you need help managing your anxiety, reach out to Talkspace today. Our licensed therapists are specialized in anxiety in teens and adults so you can get the treatment you need.

Sources:

1. Musey Jr, MD, MS P, Patel, MD, MPH R, Fry, MS C, Jimenez, MS G, Koene, BA R, Kline, MD J. Anxiety Associated With Increased Risk for Emergency Department Recidivism in Patients With Low-Risk Chest Pain. Am J Cardiol. 2018;122(7):1133-1141. doi:10.1016/j.amjcard.2018.06.044. Accessed September 14th, 2021. https://scholarworks.iupui.edu/bitstream/handle/1805/17233/Musey_2018_anxiety.pdf;jsessionid=7B2CAA206B608AA638AD651F1618FF3F?sequence=1

2. DeVon H, Mirzaei S, Zègre‐Hemsey J. Typical and Atypical Symptoms of Acute Coronary Syndrome: Time to Retire the Terms?. J Am Heart Assoc. 2020;9(7). doi:10.1161/jaha.119.015539. Accessed September 14th, 2021. https://www.ahajournals.org/doi/10.1161/JAHA.119.015539