During my first year of college, I realized something was wrong with me. But it was something that I had always lived with. I suppose I finally decided that the little beast I carried around since childhood had grown large enough that others could notice. And when other people noticed there was something “off” about me, I got nervous. I used my two recent breakups as an excuse for my gloomy behavior, but on the inside, I knew the truth. So I went to the doctor. It was a routine check-up. I was freshly 18 and didn’t need my mother to go to the back room with me, but I asked her anyway.

I’m sure my mother already knew about my anxiety. My father struggles with it, too, but we’re not the kind of family to openly talk about our struggles. Perhaps that’s part of my problem. But I couldn’t muster the courage to form the words. “Mom. Dad. I want to get on anxiety medicine. I’m feeling lonely, purposeless, and suicidal.” More than anything, I was terrified of the conversation. Of justifying the very real feelings that were consuming me. So when my then-pediatrician handed me the routine “mental health checklist,” I answered honestly (note: I usually lied). And the results were troubling.

Generalized Anxiety Disorder (GAD) is defined as “excessive, exaggerated anxiety and worry about everyday life events for no obvious reason. People with symptoms of generalized anxiety disorder tend to always expect disaster and can’t stop worrying about health, money, family, work, or school” (WebMD). My doctor suspected I was one of the thousands of teenaged victims of the disorder, which was further confirmed by subsequent tests telling me that I ranked among the “severe” cases. Rather than suffering from one particular kind of anxiety, such as social or health anxiety, I ranked noticeably in every category. I always noticed my social anxiety, but never realized how much trouble anxiety caused me in all realms of life. After some tears and an honest conversation or two, I began taking Lexapro.

The next semester was the best of my undergraduate career. My classes weren’t exceptionally difficult, I wasn’t working, and I prioritized friendships. I had never prioritized my friendships before. But then things got bad again. Really bad. Two more heartbreaks under my belt, Covid-19 cutting me off from my friends, and deciding I didn’t “need” my Lexapro, I suffered from life-threatening anxiety. I couldn’t focus in class, every day was defined by tears, I called my boyfriend constantly for reassurance, and I never had more than an hour of peace.

Sounds pretty dire, right? But it’s not all doom and gloom! It’s been about a year since I began therapy for my anxiety and started taking my medicine again. I’ve learned hundreds of new techniques for self-care, living with gratitude, and managing my anxiety. Not every technique has worked for me, but many have. So I’ve decided to compile a GAD Help Guide for all the lucky folks out there with the disorder. I can’t list every technique (or I’d put my therapist out of business), but I will include all of my favorite techniques as well as popular techniques that I have tried even if they weren’t the most effective for my lifestyle.

Medication

Taking medication for your mental health disorder is a valid treatment option. Unfortunately, I was terrified of medication due to various misinformation. When I was religious, medication was viewed as a cop-out for not being “faithful” enough in God. Some peers thoughts that medication was a slippery slope into lifelong dependence and substance-abuse issues. And I had personal fears as well, such as suffering from minor side effects. All of this misinformation led me to stop taking my medication, which completely ruined two years of progress I made dealing with my anxiety. It was only when I read a personal narrative about a woman who realized she needed her medication to function normally and wasn’t ashamed of it, I knew I had to return to Lexapro.

This section is not an endorsement of drugs and I am not an expert. Just know that it’s not shameful to seek treatment for a chemical imbalance.

Therapy

Cognitive-Behavioral Therapy (CBT) helps patients “learn to recognize and change thought patterns and behaviors that lead to anxious feelings.” This kind of therapy can be achieved by joining a support group, seeking out educational materials, or seeking a traditional therapist. I was lucky enough to find a local therapist to help me tackle my anxiety. I thought I would spend each session lying down on a couch and crying about my feelings. While I did cry a lot, CBT took a lot more dedication than spewing all of my thoughts once a week.

My therapist gave me weekly homework. In session, we discussed all of my anxious thoughts I and theorized about how I could combat them. I learned to take time to pursue my hobbies even when I was stressed about class, work, and relationships. CBT not only gave me the confidence to believe in myself and own my feelings, it was a safe space to practice practical exercises to manage my disorder.

Worry Time

Worry entails thinking about negative things that will happen in the future. Everybody worries, but when it becomes excessive enough to distract you from daily life, then it’s a problem. Worry Time is the practice of scheduling your worry to a certain time each day. Throughout the day, worriers are encouraged to stop their worried thoughts in their tracks. Instead of worrying about things in the moment, they should write down their worried thought and say to themselves “I will think about this at Worry Time.” For instance, I tried to limit my worrying to 2 p.m. for 5 minutes. During my Worry Time, I would pull out my notebook and let myself worry incessantly for the allotted time. However, I found that I really didn’t feel like worrying when 2 p.m. came around. Most of the items on my list either weren’t a problem to me anymore or I was forced to worry about “unsolvable” problems. So what happens when we have anxiety that can’t be addressed with problem-solving at Worry Time?

Mindfulness

Mindful.org defines mindfulness as “the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.” Because technology entices us into constant busy-ness, humans are increasingly less mindful of the present moment. Therefore, the purpose of directing your attention to the present moment and “directly experiencing via your senses” is to restructure your brain — literally! The brain is a muscle, and the more we practice living in the present moment, the more we will LIVE in the present moment without overwhelming worry. At least, it should be easier to manage worry.

One of the most popular methods to practice mindfulness is meditation. The New York Times published a piece by author David Gelles, a reporter and author of “Mindful Work: How Meditation Is Changing Business From the Inside Out.” He has over 20 years of experience researching and practicing mindfulness meditation; thus, I believe is a great source for learning how to get started.

Here are the basics:

1. DIY: The foundation of any meditation session is you. All you need is a comfortable space to sit and close your eyes. So, at the most basic level, anyone can sit down and clear their minds if they try hard enough. But most of us realize very quickly that not thinking feels impossible. So try visualizing meditation this way: Focus on your breathing. It’s natural — and expected — for your mind to wander, so don’t punish yourself for getting distracted. Instead, practice grace with yourself and gently guide your thoughts back to your breathing. Where do you feel yourself breathing? Your stomach, your chest, your nose? Do you feel pain in your back or in the crick of your neck? What are the smells of the room? Can you feel your clothes pressing on your skin? Try focusing on physical sensations.
2. Guided Meditations: Jumping straight into meditating all on your own is terrifying, especially for us anxious folks. “How will I know if I’m doing it right? Should I feel so distracted? I suck at this!” Guided meditations are helpful tools to kickstart your meditation journey. Many guided meditations are available for free by experts in the field, and they’re simple enough that anyone can make them. So if you get good enough, consider making one of your own that caters to your interests.
3. Time, Place, Consistency: Try your best to meditate at the same time and place every day for the same amount of time. This advice is particularly aimed toward beginners because the habit hasn’t formed yet. But that doesn’t mean your time and location can’t change. Our lives are hectic, so make sure you make mindfulness work for YOU, not the other way around.

Gratitude

Gratitude means being thankful, returning kindness, and showing appreciation for other people, things, and life events. Gratitude is one of the most powerful tools any anxious person can have in their toolbelt. It sounds simple, and that’s the beauty of it. Gratitude IS simple! Harvard Health sings the praises of gratitude, writing, “In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.” Overall, practicing gratitude helps people realize that happiness doesn’t only exist outside themselves, it can exist because of themselves, too.

Here are a few ways to practice gratitude:

1. Keep a Gratitude Journal: Gratitude journals can be simple post-it note lists, stored in Google Calendar, scribbled in planners, and housed in actual bound journals. The point of the gratitude journal is not it’s form, but the practice of writing down what you’re thankul for. Some people wake up and write down 3-5 things they are grateful for every morning, while others make a list for the week to focus on. Whichever method you choose, the gratitude journal is the simplest way to practice gratitude.
2. Simple Acts of Kindness: Practicing kindness and gratitude aren’t the same, but they heavily overlap. Try making it a habit to do a few random acts of kindness every week. That could mean doing an extra chore around the house, helping a stranger you’d usually ignore, or even paying for someone groceries. No matter how big or small, being kind has big payoffs in reducing anxiety and increasing happiness.
3. Write a Gratitude Letter: Similar to keeping a gratitude journal, try writing a letter to someone that you’re particularly thankful for. This could be a family member, a partner, a friend, even your pet! You don’t have to give the person the letter (though that it highly encouraged) but pinpointing the reaons why you’re happy someone exists in your life helps you become more self-aware and appreciative.

Breathing

Breathing techniques are helpful for practicing mindfulness meditation. Even better, they’re super helpful in everyday life, too! Like guided meditations, countless experts and YouTube mental health gurus have produced their own guided breathing practices. By getting your breathing under control, you can slow your heart rate and possibly prevent a dire anxiety attack. Breathing can help you calm down in the heat of an argument, in the face of a terrifying presentation, or before an important interview. Here’s one of my favorite breathing techniques:

1. Sit in a chair with your feet flat on the floor.
2. Close your eyes (optional).
3. Breathe in through your nose for 4 seconds, couting to yourself (1-2-3-4).
4. Hold your breath for 4 seconds.
5. Breathe out through your mouth for 4 seconds.
6. Hold your breath for 4 seconds.
7. Repeat as many times as needed.

Pendulation

Pendulation is by far my favorite quick-and-easy technique for battling anxiety in the moment. While mindfulness and are effective for long-term purposes, pendulation has saved me from many potential anxiety attacks and impulsive displays of emotion. The purpose of this technique is to calm down your anxiety by using physical responsdes. By locating the parts of your body that are physically anxious and the parts that are physically calm, your brain can better understand that you are not actually in danger and will calm down the entire body.

The Pendulation Technique was developed by Peter Levine from his research concerning Somatic Experiencing (SE). Here is an excerpt describing the practice:

“SE is a therapeutic approach that is informed by our biology and our inborn ability to heal from trauma.  I originally learned this technique from Pam Stockton, who specializes in SE.  Like the hand-over-the heart technique, this technique is about noticing a feeling in your body and noticing how that feeling changes.  

Here are the steps:

1. When you are feeling distress, start by noticing how you feel physically, somatically.  Where do you feel the distress?  What does it feel like?  Take a moment and let yourself fully experience this.  Special Note:  If you feel that you might become overwhelmed by focusing on the distress directly, focus on just a little piece at the edge instead.  
2. Now scan your body and find a place that feels neutral or calm.  Maybe there is a place that is free from the emotional pain or maybe there is a place where the feeling is just less intense.  What does it feel like?  Stay with that feeling for a moment, really giving yourself time to experience it.  Special Note:  If it is difficult to find a place in your body that feels less pain, check your pinky toe.
3. Now continue this process, shifting your attention between these two areas of your body, or “pendulating.”  Move slowly.  Stay with the pain, allow yourself to really experience it.  Then, shift your attention back to the part of your body where you don’t feel the pain.  Then shift back to the pain.  Then shift back to the area without pain.  As you continue to pendulate, notice how the distress changes.”

I typically practice pendulation like so:

1. Identify where in my body that my anxiety feels the strongest. Typically, I feel anxiety in my chest or the pit of my stomach.
2. Allow myself to think actively about what I’m anxious about and to feel the uncomfortable feeling. This may take about 20-30 seconds.
3. After 20-30 seconds, I will identify a part of my body where I am completely anxiety free. This location is usually my fingers or my feet.
4. Focus on the lack of anxiety in that spot and refrain from worrying.
5. Pendulate between the anxious place and the peaceful place as many times as necessary. Your body should naturally calm itself down after practicing pendulation.

Concluding Thoughts

While this help guide might be helpful for many people, I fully recognize that I will be the primary user. I wanted to compile all of the techniques that have helped me battle anxiety into one place as a reference point for whenever I just can’t think straight!