Struggling with
Anxiety Symptoms?

by Dave Carbonell, PhD

You can train yourself to handle anxiety symptoms with powerful techniques that bring chronic anxiety disorders to an end. This article will look at each of the different types of symptoms, suggest adaptive ways of responding to each, and then show you some methods for handling all of them in moments of high anxiety or panic.

The key to handling anxiety symptoms is to train yourself to:

1. recognize them for what they are, and

2. respond in ways that actually calm, rather than aggravate, your body and your mood.

What are anxiety symptoms?

An emotion like fear, or high anxiety, is usually pretty obvious. You don't need me to tell you when you're afraid.

What you might not notice are the other anxiety symptoms that build your emotions of fear and chronic anxiety. You might not even think of them as anxiety symptoms.

The important symptoms to notice are:

Thoughts: what you think

Physical sensations: what you feel

Behaviors: what you do

The first step in responding to a moment of high anxiety is to recognize and identify these symptoms. You might get so caught up in the feeling of fear that you don't notice its different parts. If so, you can work on becoming more aware of these symptoms.

Or, you might be aware of them, but want to ignore them, in the hope that what you don't notice won't bother you. If this is the case, you have been tricked into using distraction. You may have even been encouraged to do this by a well meaning therapist or friend, or perhaps you read it in a book. It's unfortunate, but you have probably been misled. Avoiding or distracting from your chronic anxiety symptoms will usually lead you to more, not less, trouble.

Let's take a closer look at each of these symptom types. After that, I'll have some suggestions about how to structure your response to anxiety.


People often don’t realize that thoughts can be anxiety symptoms. We so admire our intellect that we tend to think of our thoughts as always representing some powerful, truthful expression of reality. However, our brains are just as capable of producing a bunch of noisy nonsense as they are of solving a complex equation, or writing a beautiful sonata.

Our brains are organs devoted to solving problems, just like our stomachs are organs devoted to digesting food. When we direct them to solve a problem, like adding up numbers or reading a paragraph, brains generally do a good job. But there is no "off switch" to the brain. It is always looking for problems, just as our stomachs are always waiting for food. When our brains lack problems to solve, they often make some up.

Two very important words

One of the ways brains make up problems is the creative use of the two most frequently used words in the vocabulary of an anxiety sufferer. Do you know what those words are? They're the words "What if?". One of the principal sources of chronic anxiety among people with anxiety disorders is these anticipatory thoughts.

Another way that thoughts become anxiety symptoms is when we take a casual connection between two events and mistakenly think these two events will always go together. If I'm the father of a new born child, seeing a sunrise as I leave the hospital, I’m likely to associate the dawn of a new day with the beginning of my son's life, and feel good each time I see a sunrise. If a friend just died at that hospital, I’ll associate the sunrise with the loss of my friend, and feel sad when I see another sunrise. On the other hand, if a person has a panic attack while seeing a sunrise, this person will probably start to view sunrises with great suspicion, as if they were warnings of a panic attack.

Actually, the only thing the sunrise tells us for sure is that there wasn't a supernova explosion the night before.

No Need to Argue...with Yourself

A third way that thoughts become anxiety symptoms is when people fight their worries with thought stopping techniques or get into a battle to "correct" their thoughts. It's not always necessary to correct your anxious thoughts, and it won't usually be all that helpful. In fact, the effort to correct your thoughts often becomes the problem.

You can learn how to work with your unreasonable and unrealistic thoughts, not against them, and this will be very useful to you. One powerful way to work with your thoughts is the use of worry appointments.

We all experience noisy nonsense in our heads - you don't need to become the exception!

Responding to Anxious Thoughts

First, recognize that you just experienced a thought. You didn't get a telegram from God, you had a thought. You'll have countless thoughts in your lifetime, some true, some important, and some just noisy nonsense.

Second, if it seems like an important or threatening thought, bring some more attention to it. Write it down, on a file card you carry for this purpose. Fill out one of the observational journals that are available on this site. Look for any evidence that might cast some light on what this thought means.

For instance, have you had this thought before? What happened then? How do you usually want to respond when you have this thought? If, say, you're having a thought about having a heart attack, what does this motivate you to do? If you notice an urge to get in your car and drive home, where you can be alone, what does this suggest to you? Is this what someone having a heart attack would really want to do, be alone? Or does it suggest that you're feeling, not just anxious, but also feeling self conscious about that?

Third, make your move. Respond to the thought only after you've taken some time to observe and reflect on it. When people have a lot of trouble with chronic worry, they tend to rush into action, reflexively, without any reasonable review of the evidence, as if that thought were a blowtorch that someone had just applied to their feet. Instead, follow this rule: don't just do something, stand there.

Train yourself to respond NOT, in this way:

1. Notice you have a thought

2. Observe and review the thought

3. Then take whatever action you deem beneficial


There are so many different ways that people experience physical anxiety, and so many ways people describe the symptoms, that an all inclusive list is impossible.

For instance, it's a common anxiety attack symptom to feel some kind of tingling or numbness in your extremities, such as toes, fingers, and scalp. But all kinds of variation are possible in terms of where you feel it and exactly what you feel, not to mention the words you choose to describe it. Among the terms I've heard patients use for this symptom are: tinglies, spiders, head zingers, wax drippings, head expanding, and many more.

So don't be fooled by the thought that one or another of your anxiety symptoms is something unique. Anxiety disorders occur to millions and millions of people around the globe - some 45 million in the U.S. alone - and yet so many of those people think that they're "the only one". You have nothing to patent. No symptoms or diseases will be named after you!

No list is all inclusive, but here are the common anxiety symptoms as they are often described.

*Variations in heart activity: faster, slower, skipping, louder

*Feeling light headed and/or dizzy

*Labored and impaired breathing

*Pain and/or heaviness in the chest

*Numbness and/or tingling in the toes, fingers, and scalp



*Feeling weak

*Urge to run

*Bodily trembling

*Voice cracking or trembling

*Various pains: back pain, headache

*Stomach upset

*Urge to urinate or have a bowel movement

*Feeling "hyper"

*Feelings of head expansion or contraction

*Visual disturbances

*Feelings of unreality, as if you're no longer inside your body

It's not "All in Your Head"

One of the problems people have with physical symptoms of anxiety is that they tend to expect that anxiety symptoms should just be thoughts and emotions, not physical sensations. They often believe that if they have a physical symptom, it means they have a physical problem. Nothing could be further from the truth! Your mind and your body are linked together in so many ways that it doesn't really make much sense to think of them as separate structures.

If you watch someone eat a lemon, you'll probably find yourself salivating; if you read a scary book you might find your heart racing; if I asked you not to yawn while you read this, you'd probably find yourself yawning, or struggling to suppress a yawn; if you see an attractive member of the opposite sex across the room, your body will respond even if that person is completely unavailable to you; and so on.

Don't be confused by that old saw "it's all in your head". Anxiety symptoms will be experienced throughout your body as well.

Another problem people have with physical sensations is that they seem so extreme, so unreasonably powerful and out of proportion to the situation. Well, yes, they are. The fact that you notice them is a strong clue to what's happening. If a mad dog suddenly charged you from behind a hedge, you'd have many of the same sensations, but you wouldn't be bothered by them. You'd be too busy protecting yourself to notice. The symptoms aren't a sign of danger. They're a sign that the fire alarm has rung in the absence of a fire.

Responding to Physical Sensations

How can you best respond to these kind of symptoms? First, have them evaluated by your physician, once, if you have not already done so. If the results indicate that you don’t have any physical disorder causing them, that’s usually an indication that they are anxiety symptoms. If there is something clearly ambiguous about the results which indicates the need for a second opinion, then get one. But be wary of embarking on a long search for a physical explanation in the absence of any suchevidence. It's easy to waste a lot of time and money, hoping to find a physical problem that isn't there.

Be aware that if your physician finds no physical cause for your symptoms, he or she will likely offer you some form of medication for anxiety. Physicians don't do this because this is the best method. They do this because they generally don't have much training in mental health, and rely on the tools they know best, medications. See the article, First Steps for information about treatment options.

The best response to physical symptoms starts with the observation that you are experiencing one; a willingness to experience and observe it without treating it like an emergency situation; and then, perhaps, specific physical responses. Most of the physical anxiety attack symptoms - labored breathing, feeling lightheaded, chest pain, tingling, even heart racing - are due to short and shallow breathing. A switch to Belly Breathing would be an excellent response. Noting which muscles are tight and which joints are locked, and then releasing them, is another.

Again, train yourself to respond NOT:

1. Notice you have a sensation

2. Observe and review the sensation

3. Then take whatever action you deem beneficial


It might surprise you to think that behaviors - what you do - could be anxiety symptoms. But it very often happens that people get so scared, and fooled, by the symptoms of thoughts and physical sensations that they respond with characteristic, reflexive behaviors. They hope these behaviors will help but, as is typically the case with anxiety disorders, they get fooled into "putting out fires with gasoline", and the result of these behaviors is that the anxiety gets more severe and more chronic over time.

Examples of these behaviors include:

*Avoiding situations and activities you associate with anxiety

*Fleeing a place if you become anxious

*Gripping armrests, chair, steering wheel, etc.

*Holding your breath


*Staying near "support people"

*Carrying "safety objects" like water bottles and cellular phones

*Reassuring yourself by looking at your bottle of pills

*Calling friends to distract yourself when anxious

*Ritualistic behaviors - wearing safe clothes, eating comfort foods, counting, checking

*Biting fingernails, picking skin, pulling hair

*Trying to distract yourself so as to not think of anxiety provoking topics

*Avoiding activities you fear may induce anxiety, i.e., watching television news

*Self medicating with alcoholic beverages and/or street drugs

*Avoiding eye contact

*Tensing certain muscles, for example, standing as if rooted to the ground

*Changes in one’s usual pattern: talking more than usual for quiet people, or being more quiet than usual for talkative people

If you come to realize that you've been "putting out fires with gasoline", this tells you why your problem has been getting worse rather than better. Maybe you don't know what to do instead. But the first step is always the same. Put down the buckets! Stop throwing that gasoline!

And, respond NOT:

1. Notice you've been throwing gas on the fire, and "put down the buckets"

2. Observe and review the situation

3. Then take whatever alternative action you deem beneficial

Putting it All Together

As you get better with responding NOT to the different kinds of anxiety symptoms, you will probably find it useful to have a broader plan of action for responding to panic attacks and other moments of high anxiety.

Before you do that, become very aware of how chronic anxiety functions as a Trick. Learn how the Anxiety Trick works, and become aware of how it functions in your life, so you can get better at seeing through it.

From there, you can begin working with the AWARE steps as an ongoing guide to responding to moments of peak anxiety symptoms.

For a good, inexpensive guide to overcoming panic attacks and phobias, consider my Panic Attacks Workbook.

Want more resources? Here's another good article on the topic.

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© 2010-2024 David Carbonell, PhD.  Anxiety Coach® is a registered mark.
P.O. Box 256539, Chicago, IL 60625

Last updated on June 25, 2024