Learning About the Anxiety Cycle and How to Break it

Anxiety is a common experience for teens and young adults, with a little over 30% of teens meeting criteria for an anxiety disorder according to the National Institute of Mental Health [1]. This article will help you identify the signs of anxiety and how to recognize and break from the anxiety cycle.

What is Anxiety?

Everyone worries! In fact, worrying can lead to helpful problem-solving strategies. However, there are important differences between helpful worrying and unhelpful anxiety. 

Helpful worrying leads someone to think through a specific and concrete problem. After the person comes up with a solution or the problem is resolved, worry fades away. 

Anxiety, on the other hand, leads someone to think about many potential problems that may or may not actually happen. Anxiety is the fear of the unknown, or fear that something bad is going to happen. The person might come up with potential solutions, but the anxiety persists. Additionally, anxiety is characterized by catastrophizing, or always thinking about the worst case scenarios. While helpful worrying is temporary and focused, unhelpful anxiety is longer lasting and more generalized. 

Signs and symptoms of anxiety include frequently feeling stressed, nervous, or irritable, having difficulty concentrating or paying attention, feeling ”on edge”, experiencing increased fatigue and having difficulty sleeping, and noticing either increased or decreased appetite. Additionally, teenagers and adults may experience physical symptoms while anxious which may include a racing heart, faster paced or shallow breathing, nausea, lightheadedness, dizziness, or shaking.

As anxiety and depression can occur together and have some overlapping symptoms, it’s important to know differences between the disorders. The key difference is the overall mood - anxiety leads to feelings of nervousness and stress, while depression leads to feelings of sadness and hopelessness. 

The Anxiety Cycle

Unhelpful anxiety often follows a pattern. Learning about this pattern allows you to recognize your anxiety earlier, and in turn start coping quicker. The image below depicts the anxiety cycle. Let’s look at examples of how the cycle happens with two common types of anxiety, performance anxiety and morning anxiety.

Performance Anxiety in Teens

1. A stressful event triggers worry thoughts. 
   a. Let’s say you’ve got an upcoming test the next day. You might begin to notice thoughts like, “I’m not prepared”, “I’m going to fail”, or “I can’t do this”.
2. The event plus worry thoughts lead to anxiety. 
   a. Your thoughts begin to race and you might begin to experience physical sensations like a racing heart or difficulty breathing. Your anxiety, including your thoughts and bodily sensations, is uncomfortable and distressing.
3. You attempt to feel better through avoidance and safety behaviors.
   a. Because anxiety is so uncomfortable, you want to get rid of it right away. The first way you might try to do this is through avoidance, ignoring the stressful situation altogether. In this example, you might skip school the next day to avoid taking the test.
   b. The second way you might do this is through safety behaviors. These behaviors are things you do to try to help yourself feel better in the moment. They range from distracting yourself on your phone, to talking to a friend, to using substances. 
4. You initially feel better.
   a. After avoiding or using safety behaviors, you immediately feel a sense of relief because you’ve found a way to decrease your anxiety in the moment.
5. Your anxiety increases long-term.
   a. While anxiety decreases quickly in the short-term, it actually increases in the long-term. Why does this happen? First, when you use your safety behaviors or avoid what makes you anxious, you start becoming dependent on those behaviors as the only ways you know to decrease your anxiety. 
   b. Second, you prevent your brain from learning new information, like the possibility you would have passed the test or that it wouldn’t have been as bad as you thought or that your anxiety would have gone down on its own and you could have handled it. 
   c. Lastly, if you can’t avoid or use safety behaviors in similar situations in the future, your brain interprets the situation as a catastrophe and increases your anxiety, making future tests even harder to take.

Morning Anxiety in Teens

1. A stressful event triggers worry thoughts.
   a. You wake up and begin to notice thoughts like “I’ve got so much to do today”, “This is overwhelming”, or “I don’t want to get up”.
2. The event plus worry thoughts lead to anxiety. 
   a. Just like with performance anxiety, your thoughts begin to race and you might begin to experience physical sensations like a racing heart or difficulty breathing. Your anxiety, including your thoughts and bodily sensations, is uncomfortable and distressing.
3. You attempt to feel better through avoidance and safety behaviors.
   a. Because anxiety is so uncomfortable, you want to get rid of it right away. The first way you might try to do this is through avoidance, ignoring the stressful situation altogether. In this example, you might go back to sleep to avoid facing your stressors.
   b. The second way you might do this is through safety behaviors. These behaviors are things you do to try to help yourself feel better in the moment. They range from distracting yourself on your phone, to talking to a friend, to using substances. 
4. You initially feel better.
   a. After avoiding or using safety behaviors, you immediately feel a sense of relief because you’ve found a way to decrease your anxiety in the moment.
5. Your anxiety increases long-term.
   a. Just like in the previous example, while anxiety decreases quickly in the short-term, it actually increases in the long-term. Why does this happen? First, when you use your safety behaviors or avoid what makes you anxious, you start becoming dependent on those behaviors as the only ways you know to decrease your anxiety. 
   b. Second, you prevent your brain from learning new information, like the possibility you could get everything done you needed to do or that the day wouldn’t have been as bad as you thought or that your anxiety would have gone down on its own and you could have handled it. 
   c. Lastly, if you can’t avoid or use safety behaviors in similar situations in the future, your brain interprets the situation as a catastrophe and increases your anxiety, making it even harder to get up going forward.

How to Break the Cycle

While the anxiety cycle can be intense, and over time become habitual, there are ways to break the cycle. The first step to breaking the cycle is learning about it and being able to recognize it. A good place to start is by noticing the times you feel like avoiding situations - that’s likely a good indicator that you’re in the midst of an anxiety cycle. 

The second step is to learn how to gradually approach the things you’ve been anxious about. When you feel like avoiding or using a safety behavior, think of small ways you can approach instead. Taking the performance anxiety example, this might mean pulling out your study guide and setting a timer to study for 15 minutes. With the morning anxiety example, this might mean sitting up in bed and putting your feet on the floor. 

After you begin approaching, the third step is to get comfortable being uncomfortable. Work on allowing yourself to experience a short-term, temporary increase in anxiety, and pair that with more adaptive coping skills. Skills that can help include deep breathing, learning to challenge negative thoughts, and recognizing what is and what is out of your control. By slowly approaching the situations that make you anxious, you’ll become more confident in your ability to manage your anxiety and break the anxiety cycle.

Parents: How You Can Help

It can be really tough to watch your teenager struggle with anxiety. Here are some things you can do to help your teen break their anxiety cycle. You can start by helping them identify signs and symptoms of their anxiety. What do you notice happens when they’re anxious? You can also sit with them while they’re anxious, to let them know they’re not alone and you’re there to support them. When your teen is feeling overwhelmed, it can be hard for them to remember what to do to help themselves feel better. That’s where you come in! You can help remind them of their skills and how to use them. 

Treatment Options: Therapy and Medication

If you’re struggling to manage anxiety on your own, it’s really important to get mental health support. The most effective treatments for anxiety disorders include therapy and medication. 

Cognitive behavioral therapy, or CBT, focuses on the relationship between your thoughts, emotions, and behaviors. While doing CBT, you will learn relaxation techniques, ways to challenge your catastrophic thinking, coping skills to use when you’re experiencing anxiety, and how to approach situations you are afraid of or are avoiding. Research has shown CBT is effective in treating anxiety symptoms. 

Selective Serotonin Reuptake Inhibitors, or SSRIs, are a type of antidepressant medication frequently prescribed for anxiety disorders. SSRIs work by increasing the brain chemical serotonin. They are typically the first kind of medication prescribed for individuals with anxiety disorders. Common SSRIs prescribed for anxiety include Prozac (fluoxetine) and Lexapro (escitalopram). SSRIs may come with side effects, including flu-like symptoms, gastrointestinal (GI) distress, and an increase in suicidal thoughts. It’s important to talk to your parent and doctor if you experience any side effects.

If you’re struggling with anxiety, know that you are not alone and there is help available for you. 

The fastest way to determine if you may have an anxiety disorder and find relief, is to connect to a licensed professional who specializes in evidence-based care, like the clinicians at Joon Care. If you’d like to explore therapy options and see how Joon Care can support you, you can get matched with a therapist or email us at hello@joon.com.