Guided Practice

It’s normal and even useful to experience some anxiety in your life. The symptoms of anxiety – including shallow breathing, rapid pulse, sweating, and difficulty focusing – can be a signal that something is causing you to feel some uncertainty. Anxiety is part of our innate “fight or flight” response to stress. It serves to motivate you to make changes to stay safe or otherwise take care of yourself and your life. However, if you experience generalized anxiety (out-of-control worrying) that has become part of your daily life, it becomes difficult to function and fulfill your responsibilities. While in everyone’s life there are times we experience worry that we can’t get away from (for instance, if you or a person you care about is facing a scary medical situation), if your anxiety has no true cause and is not based on any actual threat, you may have an anxiety disorder.

Anxiety disorders have become quite common – by some estimates, as many as 18% of American adults have an anxiety disorder at any given time. This type of anxiety is destructive to your life and well-being. It can interfere with your relationships, intrude on your career, and be destructive to your health.

Characteristics of an anxiety disorder include excessive, uncontrollable, and often irrational worrying about everyday matters in a disproportionate way. Though different people experience different types of symptoms, the most common forms of anxiety disorders are:

  • Phobias (irrational, disproportionate fear of certain settings, objects, or situations – ranging from spiders to elevators to leaving home)
  • Social Anxiety (discomfort interacting with people you don’t know or functioning in unfamiliar settings or situations)
  • Obsessive-Compulsive Behavior (intrusive, unpleasant thoughts that you seek to control with certain rituals – for example, excessive hand washing due to a fear of getting sick)
  • Post-traumatic Stress Disorder (following a trauma, symptoms such as flashbacks, avoidance, or numbness)

Stop Anxiety in Its Tracks

When you find yourself feeling anxious, I suggest you try a meditative technique that is designed to bring you back to the present moment – to the reality that you are, right now, in a safe and secure place. You can do this by reminding yourself to come back to the present. Next time you experience anxious thoughts about something unrelated to what you are actually doing, stop yourself – literally say, in your brain or out loud, “stop.”

Ask yourself this question: “Am I leaving the current moment?” (Of course the answer is “yes,” but the question is a prompt that will help you push the anxiety away and return to the present.) Now look around at your surroundings – whether you are in your car, your office, outdoors, or at home. Even if you’ve been in this same location thousands of times before, make a point to look carefully at what’s around you and describe it to yourself (again, out loud or in your mind – your choice).

Then describe what you are doing (“paying bills” or “driving home from work,” for example). Remind yourself why you are doing this. This part of the exercise anchors you in the life you are living.

Now take a moment to focus on your feelings – both physical sensations (sitting on a hard wooden chair in a cool room, breathing) and emotions (drained, sad, anxious). Feel all of it, for a moment or two … and then, breathing deeply, consciously relax your muscles. Each time you exhale, repeat a mantra that validates your self-worth. Two that I like are “I am more than this” and “I am a whole human being.”

After you have done this a few times, you may find that you are developing the ability to notice, tolerate, and then move past your anxious feelings.

Instructions: On the DSM‑5 Level 1 cross-cutting questionnaire that you just completed, you indicated that during the past 2 weeks you (the individual receiving care) have been bothered by “no interest or pleasure in doing things” and/or “feeling down, depressed, or hopeless” at a mild or greater level of severity. The questions below ask about these feelings in more detail and especially how often you (the individual receiving care)have been bothered by a list of symptoms during the past 7 days. Please respond to each item by marking (? or x) one box per row.

In the past SEVEN (7) DAYS.…

Not at all One or
two days
More than
half the days
every day
Painkillers (like Vicodin).
Stimulants (like Ritalin, Adderall).
Sedatives or tranquilizers (like sleeping pills or Valium).
Or drugs like:
Cocaine or crack.
Club drugs (like ecstasy).
Hallucinogens (like LSD).
Inhalants or solvents (like glue).
Methamphetamine (like speed).