By Marla W. Deibler, Psy.D. Executive Director, Licensed Clinical Psychologist The Center for Emotional Health of Greater Philadelphia, LLC
Everyone experiences anxiety. Anxiety is our body’s reaction to what we perceive as threatening. Anxiety can be a healthy and adaptive response to stress. But anxiety occurs on a continuum, ranging from normal, healthy concern on one end to worry, anxiety and panic toward the other end.
Normal caution and concern can help motivate you, estimate risks and get things done. Worry, anxiety and panic are more akin to apprehension or fear. They can dominate your thoughts and make things harder for you. They don’t help you solve problems. They create more problems.
Where do you fall on the anxiety scale? Test your level of anxiety and discover ways to manage your daily stress.
Directions: Over the last two weeks, how often have you been bothered by the following problems? Read each of the seven statements. For each item, assign a score of:
- “0” if you have not experienced this symptom at all
- “1” if you have experienced this symptom for several days
- “2” if you have experienced this symptom for more than half the days
- “3” if you have experienced this symptoms nearly every day
Scoring: Once you have answered each item, add all answers for a total score.
Understanding Your Score
Total Score of 0 to 4
Scores between 0 and 4 fall in the minimal/non-significant range. These individuals are likely to experience some anxiety from time to time, but do not find anxiety to be problematic in their daily lives.
Total Score of 5 to 9
Scores between 5 and 9 fall within the mild range. These individuals may worry and/or experience mild physical symptoms of anxiety. Intrusive thoughts may be begin to become bothersome or distracting, causing stress.
Strategies to Take Action
Change Your Thoughts: Be aware of your unhelpful thoughts and modify unrealistic thinking. We all have moments wherein we unintentionally increase or maintain our own worry by thinking unhelpful thoughts. These thoughts are often unrealistic, inaccurate, or, to some extent, unreasonable. Identify those thoughts. Think about them and how the affect your feelings and behavior. If they are not helpful, change them to more helpful, adaptive thoughts. For example, beware of “what if” thinking, thoughts that are all-or-nothing in nature, or catastrophizing.
Practice Self-Care: Attend to your own feelings and healthy lifestyle practices: Good nutrition, sleep, and exercise are important to well-being, resilience, and healthy stress management.
Stay Connected: Social support is vital to managing stress. Maintain connections to family and friends. Talking with others can do a world of good.
Take a Break: Whether it be a simple change of pace or scenery, enjoying a hobby, or switching “to-do” tasks, breaking from concerted effort can be refreshing.
Take Action: Engage in an activity you enjoy; take a walk; listen to music; read a book. Or, engage in problem-solving (In what ways might you address the stressors that are causing these feelings?).
Total Score of 10 to 14
Note: A score of 10 or above warrants further assessment and may be indicative of an anxiety disorder.
Scores between 10 and 14 fall within the moderate range. These individuals may experience increased worry or preoccupation in addition to greater emotional and behavioral responses. Chronic levels of moderate anxiety may also result in symptoms of chronic stress such as headaches, stomach upset, and tense muscles in the neck, back, and shoulders.
Strategies to Take Action
Take a Deep Breath: Deep diaphragmatic breathing triggers our relaxation response (switching from our fight-or-flight response of the sympathetic nervous system, to the relaxed, balanced response of our parasympathetic nervous system). Try slowly inhaling to a count of 4, filling your belly first and then your chest, gently holding your breath to a count of 4, and slowly exhaling to a count of 4 and repeat several times.
Practice Mindfulness and Acceptance: It is “normal” to experience some degree of anxiety when stressors are unfamiliar, unpredictable, and/or imminent. Anxiety, in itself, feels bad, but is not inherently harmful and does pass. Think of it like a wave of the ocean; allow it to come in, experience it, and ride it out.
Challenge Your Thoughts: Ask yourself about your anxiety. “Is this worry realistic?” “Is this really likely to happen?” “If the worst possible outcome happens, what would be so bad about that?” “Could I handle that?” “What might I do?” “If something bad happens, what might that mean about me?” “Is this really true or does it just seem that way?” “What might I do to prepare for whatever may happen?”
Practice Positive Coping Statements: For example: “Anxiety is just a feeling, like any other feeling." “This feels bad, but I can use some strategies to control it.” Positive thoughts about your ability to manage stress can be helpful in maintaining motivation and persistence in making healthy stress management strategies.
Total Score of 15 or more
Scores of 15 or more fall within the severe range. When severe levels of anxiety persist, most or all areas of one’s life may be impacted. It can become difficult to work, relationships with others can become strained, the ability to do everyday tasks becomes difficult, and caring for oneself, one’s home, and one’s family can be a challenge. Some individuals may experience panic attacks, which are short periods of overwhelming, very intense anxiety wherein they feel a sense of impending doom that something horrible is going to happen from which they need to find safety.
Strategies to Take Action
Slow Your Breathing: Practice relaxation. Diaphragmatic breathing or other relaxation-inducing practice (e.g., guided imagery exercises, tai chi, yoga) can reduce stress by helping to encourage the relaxation response.
Develop skills to control your physical experience of anxiety/panic:
- Progressive muscle relaxation, for example, is a kind of guided relaxation exercise that leads you to tense and release different muscle groups of your body, teaching you to notice and learn the difference between tension and relaxation so that you may have greater awareness and control over these bodily experiences.
- Biofeedback training, for example, involves heightening awareness of and gaining greater control of your physiological processes through feedback from the ongoing processes themselves. Some of this feedback may include instruments that measure and provide feedback regarding heart rate variability (HRV), brainwaves (EEG), skin temperature/conductance, and/or muscle tension. There are some great smartphone apps available at low cost to assist in building these skills.
Face Your Fears: Avoidance of that which causes anxiety can unintentionally maintain the anxiety. Challenge yourself to face your fears and learn that the feared situation is not nearly as frightening or dangerous as it seems. Aim for mastery experiences, experiences after which you can say, “I did it!”
Seek Professional Help: Sometimes anxiety can be difficult to manage without professional help. A clinical psychologist who provides cognitive behavioral therapy can assist individuals in learning to face their fears and better manage their anxious thoughts and feelings.