ANXIETY is something that everyone experiences from time to time, but for some people it can become pervasive and excessive. This is a condition which doctors are having to deal with more and more, and has also been a feature during periods of lockdown. Anxiety in adults and young adults is characterised by persistent, excessive worry.

If the problem just started and ended with a worry, it might not be such a big deal. However, people with what is termed generalised anxiety disorder (GAD) get bogged down as one worry leads to another and another.

1) What causes anxiety?

Some people tend to be more prone to anxiety, often due to their upbringing or genetics, but there are also other factors at work that can contribute to the anxiety cycle. Some of these include:

Avoidance: Anxiety can persist and even get worse because of the ways people respond to their worries. Individuals with untreated anxiety problems tend to respond to their fears by trying to suppress the worry, seek reassurance that nothing bad will happen, or avoid situations that might trigger the fear. These strategies can backfire and reinforce anxiety, thus creating a cycle.

Distorted or biased thinking: Some worries might persist because of biased thinking. This could involve an overestimation of the likelihood of a bad outcome, or an exaggeration of how bad the outcome will be.

Negative thinking: Some worries are strengthened by negative thoughts about oneself, such as the belief that one would be unable to cope with uncertainty or an undesirable outcome.

Selective memory and attention: Worries can also persist because of how information is processed. A person with GAD may selectively tune into information that supports the worry and ignore evidence that refutes it. Memory can also be selective.

In some cases, people with anxiety problems have difficulty recalling data that is inconsistent with a particular worry.

2) Benefits of overcoming anxiety

Anxiety can have a number of distressing effects on your health and wellbeing. Some of these may include the avoidance of triggering situations, fatigue, fear, irritability, insomnia, intrusive or unwanted thoughts, nausea, panic attacks, poor concentration and restlessness.

Intrusive, anxious thoughts can create distress and make it difficult to cope.

Take, for example, this worry: ‘My boyfriend is going to break up with me’. This is an intrusive thought that is actually quite normal for a person to have. It might come up out of the blue or in response to a specific situation.

However, an overly anxious person would appraise this thought as very meaningful, review all the reasons why this thought might be true, try to reduce the anxiety in the short term, (effectively strengthening it in the long term), and become very stressed by it.

Then the belief becomes even more significant and is experienced more frequently and more intensely than in someone without an anxiety problem. To overcome anxiety, this vicious cycle needs to be broken.

3) How to overcome anxiety

There are different ways that you may be able to overcome anxiety in order to enjoy better emotional wellness. Some strategies you might try include:

Acceptance: One way to overcome anxiety is to learn to accept that not every intrusive thought is signalling a legitimate reason to worry. Simply put, not every thought is true. Instead of trying to wrestle with beliefs, acceptance-based techniques involve identifying the thought, labelling it (“worry” or “judgment,” for example), and being mindful of the moment that gives rise to the belief as well as the moment when it begins to recede from awareness.

Questioning: Another strategy that can effectively break the link between biases in thinking and information processing is cognitive restructuring. This technique is a cornerstone of a treatment approach called cognitive behavioural therapy (CBT). Cognitive restructuring offers a way to critically evaluate potentially distorted thoughts, like “He’s definitely going to break up with me” or “I cannot go on without him,” by asking a series of questions about the belief that can encourage a more balanced view of the relevant facts.

Exposure: This is a tool that can help you overcome anxiety by eliminating reliance on ineffective anxiety reduction strategies. The basic concept of exposure is to lean into anxiety by confronting, rather than avoiding, anxiety-provoking situations, to learn by experience either that nothing terrible will happen, or that bad outcomes are manageable – and might even have an upside.

When facing a fear, it is critical to refrain from any safety behaviours that might ‘undo’ learning; this is sometimes referred to as response prevention. Exposure exercises, for the example above, would include intentionally disagreeing with a boyfriend or imagining what it would be like to get into a major argument. Repetition helps with exposure, so it would be important to disagree with some regularity or to imagine the major argument again and again – until it all becomes more boring than anxiety-provoking.

The response prevention component would be to do these things and not ask whether or not your boyfriend is mad, so as to learn to live with uncertainty. While the cycle of anxiety is often vicious, breaking even one link can go a long way to diminishing worry and the anxiety to which it leads.

4) Treatment

Anxiety can lead to a number of other disorders in addition to GAD, including phobias, panic disorder and social anxiety disorder.

It is important to recognise that you are not alone – anxiety disorders are one of the most common mental health conditions.

According to an international study an estimated 19% of adults experienced some type of anxiety disorder during the past year, and more than 30% of adults will have an anxiety disorder at some point in their lives.

If anxiety is causing distress and disruptions in your normal functioning, it is important to get help. Treatments for anxiety typically rely on psychotherapy, medications, or a combination of the two. Talk to your doctor about your symptoms in order to determine what approach to treatment might work best for you.

Other coping strategies you can try to help ease anxiety include practicing relaxation techniques such as mindfulness, meditation, deep breathing, and progressive muscle relaxation. One study, for example, found that people who practiced a technique known as mindfulness meditation experienced significant reductions in stress and anxiety.