10 Evidence-Based Techniques to Manage Anxiety Naturally

Anxiety is manageable. You can apply these research-supported strategies to reduce feelings of anxiety and help you experience more calmness and control.

Note: Severe Anxiety

Please seek professional help if you have one or more of the following:

• Panic attacks (sudden intense fear)
• Anxiety that is interfering with your daily life
• Uncontrollable worry (not limited to specific feared situations)
• Physical symptoms: (chest discomfort, trouble breathing)
• Thoughts about self-harm
• Anxiety lasting for weeks without improvement (despite trying to implement coping skills, practicing distraction methods, or other techniques)

The techniques recommended here supplement professional treatment for severe anxiety or anxiety disorders but do not replace professional treatment.

Normal Anxiety vs. Anxiety Disorder

Normal Anxiety (context and specific circumstances):

• Trigger to worry (i.e., a specific concern or event)
• In proportion to the situation
• Temporary
• Not affecting day-to-day activities or life

Anxiety Disorder (out of context):

• Persistent worry (not limited to specific feared situations)
• Out of proportion to the anxiety event
• Difficult to control
• Interferes with daily life/activities/hobbies and responsibilities

Physical symptoms of anxiety: (physiological symptoms)

• Heart racing; fast heartbeat
• Sweating (excessive sweating)
• Trembling (shakiness)
• Having trouble breathing (or feeling an inadequate amount of air)
• Muscle tension
• Fatigue (increased tiredness)
• Difficulty sleeping or insomnia

10 Natural Anxiety Management Techniques

1. Deep Breathing Exercises

Engages the parasympathetic nervous system to mitigate the body's stress response, thereby decreasing anxiety.

There are some different techniques for accomplishing this:

4-7-8 Breathing Technique:

• Exhale all your breath through your mouth
• Close your mouth and inhale together through your nose for 4 counts
• Hold your breath for 7 counts
• Exhale through your mouth for 8 counts
• Repeat this process 3-4 times

Box Breathing:

• Inhale for 4 counts
• Hold for 4 counts
• Exhale for 4 counts
• Hold empty for 4 counts
• Repeat this 4-5 times

When to use? You can use either technique to help slow down your anxiety and worry during the moment of anxiety spike or you may use any of these techniques preventatively 2-3x daily.

The Scientific Explanation! Both techniques slow your heart rate and lowers your blood pressure and calms down your nervous system.

2. Progressive Muscle Relaxation

Aims to release the physical tension commonly experienced with anxiety.

How to do it:

• Start by finding a quiet space for you to lie or sit comfortably
• Begin to create tension in your foot for 5 seconds
• Release the tension and notice the feeling of relaxation
• Then move up your body:
  • Calves
  • Thighs
  • Abdomen
  • Chest
  • Arms
  • Shoulders
  • Face

The entire process lasts approximately 10-15 minutes and is very helpful in identifying where you store areas of tension.

Best time? Personally, I like to use it before bed and during times of stress.

3. Regular Physical Exercise

Physical activity is as effective a treatment as medication for mild to moderate anxiety.

Here's how exercise helps:

• Release endorphins (natural mood enhancers)
• Reduces stress hormones (cortisol)
• Helps regulate sleep cycle and duration
• Focuses your attention from your anxiety and worry
• Build your confidence

Steps to Consider: A well balanced work out program recommends 30 minutes of moderate activity each day. Activities include walking, jogging, cycling, swimming, yoga (85-90% movement/10% breathing), etc. As long as you do an activity you enjoy - just start small! Even 10 minutes to start will be beneficial!

4. Mindfulness Meditation

Develops the habit of keeping your thoughts in the present rather than worrying about the future.

Simple mindfulness practice:

• Find a comfortable seated position
• Focus on your breath
• Notice when your thoughts drift
• Gently bring your focus back to your breath
• Start with 5 minutes and increase from there

Body Scan Meditation:

• Find a comfortable setting lying down
• Bring your attention to a single body part
• Notice body sensations, no judgment
• Slowly scan the body from toes to head
• 10 to 20 minutes

Recommended Apps:

• Headspace (beginner)
• Calm (wide range of techniques)
• Insight Timer (has free options)

Research shows: as little as 8 weeks of daily practice will lead to a significant decrease in anxiety

5. Limit Caffeine and Alcohol

Both can make anxiety worse.

Caffeine:

• Increases heart rate and feeling jittery
• Disrupts sleep
• Mimics anxiety symptoms
• Can start panic attacks

What to do: Limit caffeine to 200mg daily (2 cups of coffee) and try to cut it off after 2 pm.

Alcohol:

• It masks anxiety temporarily
• It actually makes anxiety worse when you are less intoxicated
• Disrupts quality of sleep
• May lead to dependence

What to do: Limit or stop drinking if you struggle with anxiety.

What to drink:

• Herbal teas (chamomile, peppermint)
• Decaf coffee
• Water with lemon
• Green tea (less caffeine and has L-theanine)

6. Challenge Anxious Thoughts

Anxiety distorts our thinking. It is important to learn how to challenge anxiety thoughts.

Some common thought patterns related to anxiety:

• Catastrophizing ("this will be a disaster")
• All-or-nothing ("I always screw that up")
• Mind reading ("They think I'm dumb")
• Fortune telling ("I know I will fail")

Steps for a challenge:

• Identify an anxious thought
• Ask yourself: "What is the evidence?"
• Think of other potential explanations
• What would I tell a friend?
• What is actually probable to happen?

Example:

• Anxious thought: "I am going to embarrass myself at this presentation."
• Challenge: "I am prepared to do this, I have done this before successfully. Even if I mess up, that is just part of being human and that is okay."
• Realistic thought: "I may be nervous, but I can manage it."

7. Create a Consistent Sleep Routine

Poor sleep contributes to anxiety and anxiety contributes to poor sleep. You need to break this cycle.

Sleep hygiene for anxiety:

• Go to sleep and rise at the same time each day
• Limit screen time 1 hour before bedtime
• Keep bedroom cool and dark (18-20°C)
• Avoid caffeine after 2 PM
• Avoid drinking too many fluids before bed
• Jot down worries on a notepad to clear the brain

If you have trouble falling asleep:

• If you lie in bed awake for longer than 20 minutes, get out of bed and do something calming and return to bed once you feel tired
• Avoid looking at your watch

Target: 7-9 hours of sleep each night.

8. Practice Grounding Techniques

Brings you back to present moment during anxiety spike.

5-4-3-2-1 Technique:

• Name 5 things you see
• 4 things you touch
• 3 things you hear
• 2 things you smell
• 1 thing you taste

Other grounding methods:

• Keep ice cube in hand
• Splash cold water on face
• Identify physical sensations
• Describe surroundings in detail
• Touch a few different textures

Use technique when: Start to feel overwhelmed, during a panic attack, or during a dissociative state

9. Start Social Pipeline

The sad truth of anxiety is isolation worsens it. Connecting with supportive people helps lessen anxiety.

Things to do:

• Plan regular talks with supportive people
• Find clubs/groups of interest
• Find a volunteer activity or program (this helps perspective and finding purpose)
• Share your feelings with supportive friends
• Join a support group if you're comfortable at that point

Again, quality is better than quantity, and even having one good friend is great.

If the socialization is increasing anxiety, start small. Text someone before you call them. Go have coffee with friends before going to a party or other social obligation.

10. Worry Scheduling

Worry scheduling offers an ironic benefit of decreasing overall anxiety.

How does it work?

• Schedule 15-30 minutes a day
• At the same time of day, and in the same place each day
• Fear all worries aloud when scheduled
• Problem-solve what you can during that time, and choose to accept what is out of your control or any worries that arise after your scheduled worry time
• If you have worries outside of the scheduled worry time, tell yourself, "I will think about this during my worry time."

Why does it help? It confines worries to a 15-30 minute time period, as opposed to worrying and ruminating all day long.

Stress-Reducing Lifestyle Habits

Nutrition:

• Eat 3 meals within the same time frame each day (skipping meals will increase anxiety)
• Cut back on processed food and sugars
• Make sure to include omega-3 fatty acids in meals
• Be sure to drink enough fluids (preferably water)
• Consider taking a magnesium supplement (300mg-400mg/day)

Daily Structure:

• Wake up and go to sleep at the same time each day
• Eat meals at the same times each day
• Schedule your daily activities
• Balance activities with adequate rest

Time in Nature:

• Spend 20 minutes a day outside
• Reduces cortisol levels
• Improves mood
• Provides perspective

Limiting News/Social Media:

• Consistently checking negative news can increase anxiety
• Social media can improve mental health, but can also increase anxiety if you compare yourself to others
• Communicate your positive experiences through social media and set specific times to check your accounts
• Unfollow accounts that do not improve your mental health

Natural Supplements with Evidence

Check with your doctor before taking any supplements.

May reduce anxiety:

• Magnesium (300-400mg daily)
• Omega-3 fatty acids (1000-2000mg EPA+DHA)
• L-theanine (200mg, found in green tea)
• Chamomile tea or supplement
• Lavender aroma or supplement

Limited or mixed support:

• Valerian root
• Passionflower
• Ashwagandha
• CBD oil

Not recommended:

• Kava (potential liver toxicity)
• High-dose supplements without following a doctor's direction

When Natural Approaches Are Not Enough

Therapy is very effective for anxiety. You may try:

Cognitive Behavioral Therapy (CBT):

• The most evidence to support as effective for anxiety management
• Practical skills learned
• Most people go to 12-20 session, follow-up or booster sessions may occur later
• Can maintain gains over time

Other effective therapies include:

• Acceptance and Commitment Therapy, ACT
• Exposure therapy (for phobias, OCD)
• Mindfulness-Based Stress Reduction, MBSR

Medication:

• may be appropriate for moderate to severe anxiety
• will be used in combination with therapy
• usually by prescription (e.g., SSRIs, SNRIs, etc.)
• need to have a medical doctor like a psychiatrist or your primary care physician provide medical evaluation for medication

Developing Your Anxiety Management Plan

Daily practices (choose 3-4):

• Morning: Engage in mild exercise or take a walk for 30 minutes
• Midday: Practice mindfulness meditation for 10 minutes
• Evening: Try progressive muscle relaxation for 15 minutes
• Ongoing: Continue to challenge anxious thoughts as they come up

Weekly:

• Touch base with a friend or family member
• Engage with something that you love to do
• Journal about your practices and any changes you notice

As Needed:

• Initiate your "deep breathing" practice during spikes of anxiety
• Use grounding techniques to help ease anxiety in the moment
• Write in your journal

Realistic Timeline of Your Progress

Week 1-2: We may feel like any of the techniques we want to use feel awkward, or may not even see results
Week 3-4: We will start to notice slight changes
Week 6-8: We may be using techniques a little more naturally
After 12 weeks: You may have a significant reduction in the symptoms of anxiety you have had previously

Important: These are skills. They take practice and patience.

Key Point

Managing Anxiety naturally looks like the following (all of these points are important):

1. You practice daily (not just when you're feeling anxious)
2. You practice multiple methods (and what helps will vary)
3. You practice with patience (after the first 6-12 weeks, you may notice differences)
4. You progress professional help when needed (not a sign of weakness)
5. You practice self-compassion (kindness)

I encourage you to start with 1-2 techniques. You will practice that method daily. As you become more comfortable with these techniques, you can add more methods. Consider journaling to track what strategies help.

Anxiety is treatable. These techniques work for many people. If your experience does not improve, therapy and medications are valid approaches too. Remember to practice self-kindness! Mental health is just as important as your physical health.

You don't have to do this alone! There is help!