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Fixating on negative outcomes isn't doing your mental health any favors.

By Samantha Lande
March 15, 2021
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The pandemic has put a spotlight on mental health. In an incredibly stressful year, more people are struggling—but on a positive note, more are seeking professional help. One issue that mental health professionals have noticed come up more often in the past year is anticipatory anxiety.

Anxiety disorders are the most common mental disorders in the United States, with 18.1 percent of the population diagnosed with one. This year, of course, has piled on the stress. According to a study by the American Psychological Association (APA) called 2020 Stress in America, nearly one in five adults (19 percent) say their mental health is worse than it was at this time last year.

"We all have a genetic disposition for any sort of disorder," says explains Javier Barranco, a clinician at Berman Psychotherapy in Atlanta. "Some have a higher disposition than others," which means they have a higher threshold and can take on more stress before experiencing symptoms. 

What Is Anticipatory Anxiety? What It Means and How to Help: pencil with bite marks
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What makes anticipatory anxiety different?

Anticipatory anxiety isn’t technically its own diagnosis, but rather a symptom of generalized anxiety disorder or panic disorder. Anticipatory anxiety refers to worry about specific future events, the fear over what bad things could happen. “It’s the anticipation of what could possibly happen,” says Veronda Bellamy, a mental health counselor in Charlotte, N.C. “It can come by way of trauma, bad experiences, or anything that's going to shock your system. With the ‘possibility,’ people tend to go negative.” It can be the first (and sometimes only) symptom, but isn't a diagnosis within itself. 

Say you’re not connecting with a friend for some reason. Instead of reaching out and confronting them, you create a negative narrative in your head that they’re angry with you and the friendship may be over. In reality, and from your friend’s perspective, you two just need to have an honest conversation to clear the air. Or maybe your doctor sends you to get a routine test to check something out, and you immediately start planning out your potentially terrible diagnosis and course of treatment.

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Even when these outcomes aren’t true, someone experiencing anticipatory anxiety will get their minds so focused on the future story they’ve created that they start to believe it. “Our brain doesn’t understand tense. It just hears ‘this is happening’ over and over again,” Barranco explains.

When that anxiety builds up, our natural reaction is to go into fight-or-flight mode, which starts to produce those anxiety-related physical reactions—upset stomach, sweaty palms, rapid pulse, and panicked breathing.

With excess social media use, a 24/7 news cycle, and an immense sense of gloom this year, it’s not surprising that mental health professionals have seen a rise in this fear-of-the-future type of anxiety.

“When you think about the big picture of this past year—the election, pandemic, people out of work, remote learning—it’s been so heavy for so many people, and it makes sense [for them to fixate on] the negative,” Bellamy says.

It’s normal to be nervous or have momentary anxiety before something like a big presentation, but it’s the constant future worries that defines anticipatory anxiety. The further in the future you go, the more severe the anxiety becomes. Barranco uses the analogy of a tricycle. “That front wheel (our thoughts) is going to dictate where the back two wheels (our behaviors and emotions) go,” he says. “This catastrophic thinking starts to guide our behaviors and emotions.” That’s when we get into a cycle that’s not easy to break.

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How to Stop the Cycle of Anticipatory Anxiety

The good news is that there are many ways to deal with anticipatory anxiety, and it’s not always a lifelong symptom of anxiety. 

Work with a therapist. First and foremost, if anxious thoughts are starting to interfere with your daily life, you should definitely see a mental health professional. They have specific techniques, such as cognitive behavioral therapy techniques, that can help train your brain to recognize unhelpful negative thought loops and replace them with more rational, positive ones. You’ll start to examine, unpack, and ultimately disprove your future-oriented worries until they’re no longer your default way of thinking and reacting.  

Meanwhile, there are many coping strategies you can try at home to relieve some stress and lessen anxious anticipation. 

Move your body. Exercise for at least 15 minutes a day, whatever that means to you. Bellamy loves outdoor walks for her clients for the Vitamin D and the ability to find a few moments of peace for yourself outside. What's more, not getting enough regular physical activity can have as detrimental an effect on your mental health as it can on physical health.

Journal. “This allows you to see better the connection between emotions and thoughts,” Barranco says. Journaling can be extremely therapeutic and calming exercise.

Breathe deep. Deep breathing is another natural and effective calming technique. Intentional deep breathing, also called belly breathing or diaphragmatic, increases your oxygen intake and helps activate the parasympathetic nervous system, which signals to your body that it’s safe and OK to relax. Breathe in gently and deeply for four seconds, hold it for three seconds, and breath out evenly for four seconds. Do this cycle 10 times.

Practice mindfulness. Mindfulness is not about having zero thoughts while you meditate. Instead, mindfulness teaches you to “step back” mentally and observe any thoughts, feelings, or sensations that arise, whatever they may be, without judgment. “It’s important to be able to identify thoughts and emotions as they come up,” says Barranco, which is the first step in eventually being mentally aware enough to replace them with healthy thoughts. 

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