Try these 4 strategies to help manage anxiety

SEP 24, 2018
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An estimated 40 million American adults suffer from anxiety disorders, the most common psychiatric illnesses. Although anxiety disorders generally can be treated, only about 1 in 3 sufferers receives treatment.1


And often those patients wait 8 or 9 years to seek professional help because they may not recognize when their stress has gone out of bounds, says Maria Koshy, MD, who works in the Psychiatry Department at Kaiser Permanente South Sacramento, CA. Years after they first experience increased anxiety, they’re more likely to be functioning poorly, and they may have developed unhealthy ways to cope.


But don’t we all worry, at least a little? When does that worry become a disorder? Dr. Koshy answers these questions and more.


When does one’s worry become an anxiety disorder?
Anxiety has an evolutionary purpose that was crucial to our survival as human beings. In prehistoric times, when our caveman ancestors were confronted with a life-threatening situation, it was the fight-or-flight response that saved their lives. These days we don’t usually encounter wandering bears or hungry tigers, but we do have other stressors, such as deadlines, illnesses, relationship turmoil and so on, that produce a fight-or-flight response.


When you have an anxiety disorder, a diagnosis can depend on the negative impact in one’s daily life and how long the symptoms last. Generalized anxiety disorder, for example, is a persistent level of heightened anxiety for at least 6 months. Symptoms include having trouble falling asleep or waking up, an excessive amount of time worrying about the future, suffering from tension headaches, feeling edgy or restless for no apparent reason, being irritable, and having trouble concentrating on tasks.


Studies show women are twice as likely to have an anxiety disorder. Why is that?
Many studies have shown this surprising statistic.2 Factors that could contribute to this higher level of anxiety include biological differences, namely changing levels of estrogen and progesterone, especially during pregnancy, postpartum, and menopause. There could also be a psychological piece, in which men are potentially less likely to report their anxiety because it may be socially less acceptable. Women are also statistically more likely to be victims of trauma, which may lead to an increased lifetime prevalence of anxiety. Lastly, there could be a social aspect to it because women’s roles have expanded. They’re juggling home life and career, and attempting to be successful at both, which may leave them more prone to psychological distress.


What advice can you give someone suffering from anxiety?

  • Exercise, first of all. You can’t underestimate the power of exercise in helping to reduce stress and altering brain chemistry to help us cope better. We recommend 150 minutes of aerobic activity a week (for example, 30 minutes, 5 days a week), but try to fit in exercise at least 3 times a week.
  • Healthy eating is also important. People prone to anxiety should limit their intake of caffeinated drinks because they can make you feel edgier.
  • Good sleep can also help. That means being consistent with waking up and going to sleep times and only using the bed for sleep. If you can’t go to sleep, then don’t stay in the bed, tossing and turning, because that can lead to a fear of the bed. Also, it’s important to limit daytime napping as this can interfere with nighttime sleeping. Expose yourself to natural light during the day, and then keep your bedroom quiet and dark.
  • Finally, learn about mindfulness exercises, which can help ground you in the moment and help to ease some anxiety that comes with worrying about the future — often the hallmark of anxiety disorders.

When might a physician prescribe medication?
For mild and moderate anxiety, therapy is recommended as a first step. Cognitive behavioral therapy, which teaches patients how to change their thinking and fears, has the best data for treating various anxiety disorders. For moderate to severe anxiety that leads to depression and suicidal thoughts, medications are important for recovery. Often a combination of medications and therapy work well together. Medications can help ease symptoms and therapy can address coping skills, as well as thinking and behavioral patterns that lead to increased anxiety.


Find more resources about how to help manage anxiety on


Interview by Elizabeth Schainbaum.


1“Facts & Statistics,” Anxiety and Depression Association of America, accessed September 21, 2018,

2See note 1.

TOPICSanxietyMental Health and WellnessStress ManagementWomen's Health