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How to Manage Anxiety

Article Content
Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical OfficerRead Bio
Written ByJill Kirby

Anxiety is a universal struggle. It can strike without warning and be hard to control. While a natural part of life, when anxiety becomes unmanageable, it can lead to major problems. This article will explore managing anxiety.

What is anxiety?

Anxiety is a feeling of fear, dread, and uneasiness, sometimes accompanied by feeling tense, apprehensive, and worried1. The term anxious comes from the Latin word "anxius" which means "to anxiety."2

Anxiety can be caused by stress, which can be a result of too much work, too many responsibilities, or not enough time to relax. Stress can also be caused by changes in your environment, like a new job, a move, or the death of a loved one.

Anxiety is a normal response to stress and can be beneficial in some situations. It can help you to be alert and aware of potential dangers. However, when anxiety becomes severe, it can interfere with daily life and may even lead to panic attacks.

There are several different types of anxiety disorders, including:

Generalized anxiety disorder: Persistent and excessive worry about a number of things, like your health, work, family, or finances.3

Social anxiety disorder: Fear of social situations, like meeting new people, public speaking, or going on dates.4

Phobias: These are fears of specific objects or situations, like heights (Acrophobia), spiders (Arachnophobia), or flying (Aerophobia).5

Panic disorder: This is characterized by unexpected and repeated episodes of intense fear, accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. Panic disorder can lead to a panic attack, which can make a person feel like they’re having a heart attack; they might have trouble breathing, and their heart will race.6

Anxiety can also manifest itself in a variety of physical symptoms, including:

  • Feeling tense or jumpy

  • Rapid heart rate or palpitations

  • Sweating

  • Difficulty breathing

  • Feeling faint, like you might pass out

  • Nausea

  • Dizziness or lightheadedness

  • Trembling or shaking

Perimenopause and anxiety

Perimenopause is the phase leading up to when a woman ceases menstruating, and it can last anywhere from a few months to several years. At this stage, hormone production slows, and the hormone fluctuations create various symptoms.

While anxiety is common for both men and women at all ages, as women move into their menopause transition, anxiety is a common symptom - even for a woman who hasn’t suffered from anxiety previously. Some women also find that they are more sensitive to stress during this time. There is evidence to suggest that the decreasing hormones in perimenopause are what creates anxiety.

Fortunately, there are many approaches to relieving anxiety, whether brought on by perimenopause or otherwise. Read on to learn about management techniques and determine which are the best for you.

Identify triggers

Anxiety can be very unpredictable, and it can be difficult to know what might trigger an attack. However, there are some common triggers to be aware of:

  • Stressful situations

  • Negative thoughts or memories

  • Physical symptoms like pain or fatigue

  • Sensory triggers like loud noises or bright lights

  • Social situations

  • Certain foods or drinks

If you're aware of your personal triggers, you can take steps to avoid them or prepare for them ahead of time. For example, if you know that stress is a trigger for you, you might try to schedule regular breaks during your workday, or practice relaxation techniques like yoga or meditation. If you know that bright lights make you anxious, you might bring sunglasses with you to crowded places, or avoid watching television or using the computer late at night. If you're sensitive to caffeine, you might avoid drinking coffee or tea in the hours before bedtime.

Being aware of your triggers is an important part of managing your anxiety. With time and practice, you'll learn how to deal with them when they arise.


One of the best ways to manage anxiety is to get enough sleep. Your body and mind are better equipped to handle stress and tension when you're well-rested. During sleep, your brain processes and stores information from the day, which helps you stay alert and focused during the following day.

Anxiety symptoms may worsen with a consistent sleep deficit. Symptoms of fatigue can often be mistaken for symptoms of anxiety, so it's important to make sure that you're getting an adequate amount of rest each night.

To encourage better sleep, try winding down for 30 minutes before bedtime by reading or taking a hot bath; avoid caffeine and alcohol before bed; keep a regular sleep schedule; and create a relaxing bedroom environment with dim lighting and calming music.


It might seem simple, but breathing exercises can go a long way toward alleviating anxiety. The following are six popular breath patterns:

  1. The calming breath: This type of breath is designed to calm the body and mind. Sit up straight, with your shoulders relaxed and hands resting in your lap. Close your eyes and focus on your breath. Inhale slowly and deeply through your nose, hold for a count of three, then exhale slowly through your mouth. Be sure to relax your shoulder muscles and the muscles in your face and jaw. Repeat for five to ten minutes.7

  2. The box breath: This type of breath is designed to energize your body and mind. Sit up straight, with your shoulders relaxed and your hands resting in your lap. Close your eyes and focus on your breath. Inhale slowly and deeply through your nose for four counts, hold your breath for four counts, and exhale slowly through your mouth for four counts. Repeat for five to ten minutes.8

  3. The four-seven-eight breath: This type of breath is designed to promote relaxation and help you fall asleep. Sit up straight, with your shoulders relaxed and your hands resting in your lap. Close your eyes and focus on your breath. Inhale slowly and deeply through your nose, counting to four as you do so. Hold your breath for a count of seven, then exhale slowly through your mouth for eight. Repeat for five to ten minutes.9

  4. The alternate nostril breath: This type of breath is designed to improve your concentration and focus. Sit up straight, with your shoulders relaxed and your hands resting in your lap. Close your eyes and focus on your breath. Using your right hand, block off your right nostril with your thumb, and inhale slowly and deeply through your left nostril. Then, switch to block your left nostril with your ring finger, and exhale slowly through your right nostril. Keep your right nostril clear and inhale, starting over. Repeat for five to ten minutes, switching nostrils on each breath. 10

  5. The lion's breath: This type of breath is designed to release tension and fatigue. Sit up straight, with your shoulders relaxed and your hands resting in your lap. Close your eyes and focus on your breath. Inhale slowly and deeply through your nose, then exhale slowly through your mouth while making a "ha" sound. Repeat for five to ten minutes.

  6. The abdominal breath: This type of breath is designed to help you relax, by focusing on the movement of your stomach. Sit up straight, with your shoulders relaxed and your hands resting on your stomach. Close your eyes and focus on your breath. Inhale slowly and deeply through your nose, allowing your stomach to expand as you do so. Then, exhale slowly through your mouth, pushing all the air out of your stomach. Repeat for five to ten minutes.

These are just a few of many breathing exercises that can help manage anxiety. Experiment with different ones to see what works for you. Try different techniques at different times of day or in different situations to see how they affect you. Remember, there is no one "right" way; the key is simply to be mindful of your breath and focus on relaxing your body and mind.


There is mounting evidence that meditation can be effective for anxiety management and improving mental health. Meditation is a practice that involves focusing on your breath and quieting your mind. It can be a great way to relax your mind and body and has been shown to help reduce anxiety symptoms.

Practice yoga

There is growing evidence that yoga can be an effective tool for managing anxiety.12 Yoga combines stretching and breathing exercises with meditation and can be a great way to relax your mind and body.

One study found that yoga was as effective as medication in reducing anxiety symptoms and that it also had the added benefit of improving overall mental health.13 Another study showed that yoga helped participants cope better with stress and anxiety.14

If you're interested in trying yoga to help manage your anxiety, be sure to find a class or instructor that is right for you. Some classes are geared specifically towards people with anxiety, while others are more general. You may also want to try doing some basic yoga poses at home to get started. Whatever you do, remember to be patient and take things slowly. With time and practice, yoga can be a powerful tool for managing your symptoms.


Exercise is one of the best things you can do for your mental health, and it's especially beneficial for people who suffer from anxiety. Regular exercise and physical activity eliminate tension from the body and relieve stress.

Exercising also releases endorphins, which are hormones that have a mood-boosting effect. 15 Endorphins can also lower blood pressure, improve stress response, and even act as a natural pain reliever.

Physical activity helps to improve overall physical health. When you're in good physical shape, your body is better equipped to handle stress and tension. Exercising has also been shown to boost self-confidence and self-esteem, which can be helpful for people with anxiety disorders.

Exercise doesn't have to be anything strenuous – even a brisk walk or light jog can make a big difference. Be sure to find something that you enjoy, so you'll be more likely to stick with it!

Eat healthy

Eating a healthy diet can ward off many health issues, anxiety included. A nutritious diet that incorporates vegetables, fruits, and whole grains can help lower anxiety. A study in 2011 showed that omega-3s, which are found in fatty fish like salmon, cod, and lake trout, may help reduce anxiety 16. If you prefer to eat vegetarian or plant-based, omega-3s can also be found in foods like walnuts, chia seeds, edamame, and more.

Be sure not to skip any meals and keep healthy, energy-boosting snacks on hand like bananas, peanut butter, and yogurt.

Avoid alcohol

Alcohol consumption can make anxiety worse. Alcohol is a central nervous system depressant, and it can slow down the workings of the brain. Drinking alcohol affects the levels of neurotransmitters in the brain, like serotonin. As the alcohol wears off, anxiety can be the result. This can lead to increased anxiety and panic attacks. Alcohol also disrupts sleep, which can further exacerbate anxiety symptoms.


Distraction can be a helpful tool for managing anxiety. When you're feeling overwhelmed or anxious, doing something fun and distracting can help to take your mind off things.
You can watch a movie, read a book, play a game, or go for a walk. If you're stuck at home, there are also plenty of things you can do to keep busy. You can cook a meal, do some chores, or take a nap.

The important thing is to find something that you enjoy that will keep you occupied. When you're focused on something else, it's less likely that you'll dwell on your anxiety symptoms. This can be a helpful way to manage them in the short term.


Therapy is a valuable tool for managing anxiety. It can provide you with support, guidance, and strategies to help you deal with your symptoms and even get to the root cause of mental health challenges.

There are many different types of therapy, and the best one for you will depend on your individual needs. Some therapies are specifically designed for people with anxiety, while others are geared toward other concerns.

It's important to find a therapist that you feel comfortable with. Trust is essential in any patient-therapist relationship, and you should feel safe discussing your thoughts and feelings. If you're not sure where to start, ask your doctor or health care provider for a referral. Or, you can search online for therapists in your area.


For some people, medication may be necessary. There are many different types of medication that can be effective, and the best one for you will depend on your individual needs.

Some common medications used to treat anxiety include:

  • Selective serotonin reuptake inhibitors (SSRIs)

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)

  • Benzodiazepines

Before starting any medication, it's important to talk with your healthcare provider about the potential risks and benefits. Medication can be an effective way to manage anxiety, but it's not right for everyone.

If you decide to take medication, be sure to follow your healthcare provider's instructions and take the medication as prescribed. Don't stop taking your medication without talking to your doctor first.

Hormone Replacement Therapy

For those women whose anxiety is related to hormone fluctuations in perimenopause and menopause, hormone replacement therapy (HRT) is a great option. HRT is effective, because it corrects the hormone imbalances that are often associated with anxiety and other symptoms.

HRT isn’t right for everyone, so it’s important to talk with your healthcare provider about the potential risks and benefits. If you have been experiencing problems with anxiety, and you’re interested in HRT, the team at Winona can help. Our providers can assess if you are a good candidate, and together you and your doctor can create a treatment plan that works for you.

For some women, HRT is not an option, particularly those who have had blood clotting disorders, strokes, heart attacks, and certain types of cancer. In that case, your Winona doctor will recommend alternative treatments.

Wrap up

There are many different ways to manage anxiety, including lifestyle changes, mindfulness practices, and medications. It's important to find what options give you results and are sustainable. There is no one-size-fits-all solution, so it may take some time to find the right method or combination of methods.

If you're struggling with anxiety, don't hesitate to ask for help. Talk to your healthcare provider about your options, and find the treatment plan that's right for you.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

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