A physician shares her anxiety management tips

I started working with a new coaching client the other day. I’d already been following the twists and turns of her life saga for about a year, via excited emails she’d been sending me ever since reading my book Live a Life You Love.

“As you know, I’ve made all kinds of wonderful changes in my life,” she told me over the phone, “I left a job I couldn’t stand, sold my house and bought a new one in a great new community where I have lots of friends, and I finally have the time and money to pursue my big dream. All this is great, but there’s something I’m really worried about: I’ve been feeling unbelievably anxious – what do you think is wrong with me? Does this mean I’ve made a terrible mistake?”

I hear this concern often – in fact, one of the clients whose life and attitude changes I’m proudest of almost had a full-blown panic attack right before our first session.

Most of us associate anxiety with danger or unwelcome events and circumstances. If there’s an unfriendly person you know who you don’t like spending time with, you’ll feel anxious before seeing them. If you’re like me, you might experience high anxiety when a plane goes through bad turbulence and feels like it might crash at any moment.

Yet here’s the thing: any time you’re out of your comfort zone, you’re going to feel anxious. Just because you feel anxious does not mean something bad is going to happen. In fact, for me most of the time anxiety means something really great is going on and that I’m moving through new territory in the direction of my dreams.

Years ago, I set the goal of becoming a professional speaker, the kind who would get flown around to different fabulous locations to speak to a variety of interesting groups. In 2003, as a result of a monthly nutrition column I wrote for the national medical community, I was invited to speak at a huge women’s wellness event on the other side of the country. This was my big dream showing up in full regalia, but there was one minor problem: I’d never given a speech before.

For three months I grew steadily more terrified as the days ticked closer. First I was anxious that I wouldn’t know what to say, and then right before the big event I started to worry that no one would show up. Was this anxiety an intuition that something terrible was going to happen, my fight or flight system warning me with primal authority that I needed to turn around and run?

Absolutely not. I delivered my speech with confidence and I got such a great testimonial from the client that brought me in (he commented that my event was so packed that people listened from outside the closed doors) that it’s still on my website to this day!

If you’re implementing positive, fresh change in your life, odds are high you’re going to be anxious. And this phenomenon may never go away completely. I’m very comfortable speaking now, but then some new challenge comes along and I feel those familiar flutters.

Here are some key tips to manage those jitters:

1. Write down what you’re anxious about. What are you most afraid of? What are all the terrible things that could happen? What’s the worst case? Write them all down. Now look at them, and ask yourself what the probability is that any of this would happen? Would it really be the end of the world?

Chances are none of these bad things will come about, and if you’ve written this in a journal with the day’s date, you’ll look back months or years later and smile thinking how everything turned out just fine. Maybe the results were downright amazing. This is a great reference to have for future anxieties.

Finally, when I’ve made this kind of list I hand it over to God to take care of, and then move on and do whatever I have to do next.

2. Breathe. When we’re scared or stressed we breathe shallowly. If you feel nervous take a bunch of long deep breaths – 4 counts breathing in, 6 counts to hold it, 8 to breathe out. You’ll feel much calmer and also have more mental clarity that will help you with problem-solving and planning.

3. Do yoga or stretching. I have audios of yoga routines on my computer that I can do whether on the road or at home. If I’m particularly stressed or anxious I’ll do the one that’s geared to produce evening relaxation, lots of calm gentle stretches and poses. The combination of breathing and stretching calm the nervous system and help you relax. It also gets you out of your worried monkey mind and into your body, which can be a great relief.

4. Exercise regularly. Do some form of exercise every day. Walks are really great for calming an anxious mind and blowing off steam. If I’m feeling really wired, I’ll turn it into a run and sometimes even talk or shout out loud about my worries or frustrations as I pound my feet across the ground. (luckily, I have a place I can go where there usually aren’t too many people around to witness this spectacle) Don’t exercise too close to bedtime, though, as this can make it hard to sleep if you’re already tense.

5. Seek out positive memories. A great tool is to go back in your mind to times when you felt seriously anxious about a new element of your life. How did things turn out? Chances are everything was just fine, and it’s really useful to remind yourself of this.

6. Hire a coach or counselor to help you through. When you’re worried about steps you’re taking forward and the related anxiety, it’s helpful to have an expert sounding board. It’s one of my greatest joys to tell clients that their worries are totally normal and that I have had similar experiences – I love hearing and feeling their relief pouring down the phone line.

7. Avoid stimulants. When some people are nervous they drink more coffee, or smoke more cigarettes, or drink more cola or energy drinks – and then wonder why their tremors are off the Richter scale. If you’re feeling edgy you need to limit stimulants, and also should eat well and regularly to avoid blood sugar crashes that can make you feel shaky.

All this said, if your anxiety is so bad that it’s affecting your ability to function, it’s a good idea to see a professional who can evaluate your situation.

But, if you’ve just made a big change in your life that you’ve dreamed of for years, and are worried about the nerves you’re feeling, don’t. Applaud yourself instead – it takes courage to step out of your comfort zone and create real forward change. And once you’ve successfully pulled it off once, it just gets easier and easier.

Susan Biali is a physician and author of Live a Life You Love: 7 Steps to a Healthier, Happier, More Passionate You. She blogs at her self-titled site, Dr. Susan Biali, MD.

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