Anticipatory Anxiety: Signs, Symptoms, & Treatment

Anticipatory anxiety is heightened anxiety and apprehension in anticipation of something bad that could happen in the future. People with anticipatory anxiety may mentally rehearse bad outcomes even when they are highly unlikely to occur. While it’s not its own mental health condition, anticipatory anxiety may happen for those with other conditions like generalized anxiety disorder (GAD).

How to Deal With Anticipatory Anxiety

While it isn’t possible to completely prevent anticipatory anxiety, here are 10 ways to calm your anxiety:^{2, 6, 7, 8}

1. Wait for More Information

Wait until you have more information before you start thinking and planning for the future situation you are worried about. This will help you ensure that your thinking process leads to productive planning rather than unproductive worrying.

2. Resist Letting Your Anxiety Predict the Future

When fight or flight is activated, the prefrontal cortex (part of the brain that thinks, plans, and makes good decisions) is impaired. Resist the urge to worry and predict the future with limited information, as this just offers more unknowns to worry about.

3. Follow Your Normal Routine

When there is a false alarm triggering anticipatory anxiety, work on following your normal routine as much as possible. This signals your brain that you are safe and ok, which will help to rewire your fight or flight system to respond more neutrally in the future.

4. Turn Anxious Thoughts Into “Even If” Thoughts

“Even if” thoughts are much more helpful because they help you focus on your response to a possible bad outcome, which is within your control. These thoughts can help you feel more prepared for a possible bad outcome, more in control and less anxious.

5. Don’t Respond to False Alarms

The more you act as if false alarms (i.e. irrational fears that trigger fight or flight) are real, the more the false alarm is reinforced. Resist the urge to change or cancel plans. Instead, work on reacting in calm and reasonable ways, even if you are still anxious.

6. Don’t Sit & Worry

Worrying is never productive and will only make you feel more anxious. Worrying, rehearsing and ruminating while you are anxious does not provide any outlet for the nervous energy that is generated by the fight or flight response.

7. Move Your Body

Getting up and being physically active is proven to be helpful in reducing both stress and anxiety. Physical activity also provides an outlet for the nervous energy generated by the fight or flight response, and helps restore your body and brain chemistry to normal.

8. Accept the Anxiety & Move Forward With It

You are probably going to have anxiety whether you like and accept it or not. Instead of focusing so much attention on stopping your anxiety, think about where and how your time and energy would be better spent. Refocus yourself on these activities instead of letting anxiety drive and change your behavior.

9. Journal About Your Anxiety

Journaling allows you to write how and what you’re feeling regarding the stressors in your life without any judgment. You can pour your emotions onto a blank page and unload your fear, anxiety or depression from your mind and heart. Journaling allows you to keep a record of your emotions, both positive and negative, over time as well as allowing you to reflect and find opportunities for emotional growth.

10. Don’t Focus on “What If” Thoughts

“What if” thoughts are at the center of anticipatory anxiety but tend to focus on the aspects of the future that are unknown and beyond your control. Focusing on these what if thoughts tends to make anxiety worse and fears more irrational.

11. Try Mindfulness Meditation

Mindfulness skills and formal meditation also have powerful anxiety and stress-relieving capabilities, and these skills are often integrated into therapy. Mindfulness and meditation can help you learn to pull your attention away from unhelpful thoughts and to be more present in a way that allows you to honor the negative emotions and channel towards more positive emotions.

12. Practice Yoga

There are many benefits of yoga for mental health, and it allows you to express emotions through your body. There are a lot of benefits to moving your body and exercising, however yoga takes that one step further as the goal tends to be finding balance. When finding balance and an emotional equilibrium is at the center of your mind, it becomes that much easier to process stressful emotions to get to a balanced state. There are many guided yoga meditations and yoga assist classes that can help restore this missing balance and help you acknowledge the full range of your emotional state.

13. Work With Your Anxiety

While it may seem counterintuitive, trying to stop, control or get rid of anxiety often backfires. Struggling to stop or control anxiety can lead you to become more frustrated, stressed out, and exhausted, and usually does not get rid of it, making it an ineffective use of your time, effort and energy.

14. Take Nature Walks

There is a lot of research which suggests that spending time in nature helps to reduce feelings of anxiety, depression, stress, and other mental health issues. Nature has a way of improving the mood. There is a strong connection between the time spent in nature and overall mental state.

15. Talk to a Therapist

Another great way to deal with this type of anxiety is to speak with a therapist. They are equipped to help you understand and normalize the wide range of emotions you feel and can help you learn strategies of coping with these emotions. You can find a therapist by searching an online therapist directory or reviewing the in-network providers with your insurance. Looking through profiles online and narrowing down a few to contact for initial talks is a good first step. Many therapists offer a free phone consultation and that can give someone an opportunity to evaluate if that may be the right fit for anxiety therapy.

When to Get Professional Help for Anticipatory Anxiety

People who experience more chronic, excessive, and intense anticipatory anxiety that interferes with their quality of life or ability to function should seek professional treatment.

Some of the signs that may indicate a need to seek treatment include:

• Constantly feeling worried, nervous, or on-edge
• Being unable to focus or get things done because of anxiety
• Having your performance impaired because of anxiety
• Being unable to sleep or eat normally because of anxiety
• Canceling plans or avoiding situations because of anticipatory anxiety
• Other significant impairments in routine or functioning related to anxiety

Therapy for Anxiety

Anxiety is a highly treatable condition, and anticipatory anxiety can be treated using the same types of therapy and medication that have been found to be effective in helping people manage symptoms and improve their functioning.

Some of the more commonly used treatments for anxiety disorders include:²

• Cognitive Behavioral Therapy (CBT): Teaches skills to interrupt anxious thoughts that feed the anxiety, as well as helpful responses to the triggers
• Acceptance and Commitment Therapy (ACT): ACT for anxiety Encourages people to be willing to experience and accept their emotions, and make choices based on personal values
• Exposure therapy: A type of CBT that teaches relaxation skills and encourages people to gradually face their fears
• Mindfulness: Can be practiced numerous ways, including guided imagery, progressive muscle relaxation, and even yoga-based therapies

Medication for Anxiety

In some cases, medication for anxiety may be prescribed, either for daily use or as-needed. If you’re interested in medication, talk to your primary care physician, who may prescribe it or give you a referral for a psychiatrist.

Preventing Anticipatory Anxiety

There are some situations where anticipatory anxiety is normal and even helpful, so sometimes the goal should not be to prevent or stop the anxiety, but instead to learn how to respond more effectively to it. For example, having anxiety before a major life transition like moving away, having a baby, or taking an important exam is completely normal. Sitting and worrying about something is almost never productive, but channeling it to thoroughly plan, prepare, and be proactive ahead of a major event can help ensure a positive outcome.

When anxiety occurs in anticipation of something that is insignificant, unlikely to happen, or impossible to predict or control, it tends to be less helpful and productive. Because stress and anxiety are very similar, many of the same methods of reducing stress also help with reducing anxiety. These include things like being physically active, engaging in active problem solving, and increasing time for relaxation and self-care. These strategies may not completely prevent or stop the anxiety but can prevent it from escalating.

Because anticipatory anxiety is driven by worried thoughts about the future, the best method of preventing and short-circuiting anticipatory anxiety is to stop worrying. While this sounds easier than it is, reducing worrying can be accomplished with the use of distraction techniques, CBT exercises, and even mindfulness skills, which are reviewed in more detail below.

For Further Reading

• Anxiety & Depression Association of America
• American Psychiatric Association
• American Psychological Association
• NAMI

Anticipatory Anxiety Infographics