Anxiety, Worry, and Fear


Even when we succeed in creating a life perspective that is as realistic and optimistic as possible, we’ll still have to admit, life on planet earth is downright frightening.  And further, in our western world, life tends to be very fast-paced and high stress.  It is no wonder that anxiety disorders have now surpassed the depressive disorders, to become the number one mental health problem in the U.S.!


Despite all this, we find that we can still do so very much to counter and address the causal forces of worry, anxiety, and fear.  Research and personal experience reveals that treatment in its various forms, when competently offered and sincerely followed, resolves up to 80% of all anxiety problems encountered.  Moreover, people with genuine “intrinsic” faith in a higher power, along with healthy supportive friendships, do even better overall at overcoming their anxieties.


Here are the top 6 anxiety-related disorders most often addressed by mental health counselors, listed in the order of their frequency.


  1. Phobias (20 million adults, US)—This involves a severe dread (to a paralyzing or crippling degree) of certain animals or insects, heights, elevators, airplanes, doctors or dentists, thunder or lightning, blood, illness, or germs

  2. Social Anxiety (16 million)—A strong fear of embarrassment or humiliation in common social situations, usually because of the supposed prospect of being watched, evaluated, scrutinized, or judged by others.

  3. Post Traumatic Stress Disorder, or PTSD (9 million)—Persistent, disabling psychological symptoms following a traumatic event (such as combat, natural disaster, car crashes, rape, assault or other violent crimes against you, someone in proximity to you, or someone you care about).

  4. Generalized Anxiety Disorder, or GAD (8 million)—An ongoing, relentless anxiety and worry about certain life circumstances (relationships, finances, health, work or school performance), out of proportion to the likelihood of anything terrible happening, with little control over the intense worry.

  5. Obsessive-Compulsive Disorder (6 million)—Unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), and/or behaviors that make them feel driven to do something (compulsions).  Often the person carries out the compulsive behaviors to get rid of the obsessive thoughts, but this only provides temporary relief.  Not performing the obsessive rituals can cause great anxiety.  Therefore people with OCD generally: 

    • Have repeated thoughts or images about many different things, such as:  fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy (all are obsessions).

    • Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again (all are compulsions).

  6. Panic Disorder, with or without agoraphobia (3 million)—Sudden episodes of intense fear or apprehension that occur “out of the blue,” without any apparent cause, lasting from a few minutes to a few hours.  This may or may not include agoraphobia, which involves the fear of being away from home, and being in situations where a panic attack might occur but no help or escape would be available.


We now understand there are several causal factors within every individual person—Genetic, bio-chemical, early developmental, distorted thinking, and unhealthy spiritual beliefs—that can, by themselves or in combination, be powerful enough to lead to an anxiety disorder.


Here is a brief summary of what our first line of defense, or counter-measures, for each of the causal factors of anxiety mentioned in the paragraph above.  Although there are also more specific treatment strategies available for each anxiety disorder, these are general counter-measures, for:


  1. Genetic and bio-chemical causes: Genetic intervention and engineering are only in their infancy, so perhaps in the future, such approaches could help relieve or alleviate the anxiety disorders.  In the mean time, medication that addresses the brain’s bio-chemical imbalance is sometimes the treatment of choice.  Nutrition, vitamins, and herbs can also help.

  2. Early childhood experiences (i.e., neglect, physical/sexual/emotional abuse, chronic or traumatic stress, unrealistic expectations, anxiety/fear modeled by a close family member): The primary approach for this causal factor is counseling, which often includes “airing out” what happened, but then understanding it from a new and godly perspective, in an atmosphere of a safe therapeutic relationship.

  3. Distorted thinking patterns: This aspect is usually addressed using some type of “cognitive” corrective approach.  That is, distorted, untrue thoughts are discovered and systematically challenged and transformed, with a counselor’s guidance.  Cognitive restructuring along with optimistic alternative perspectives are considered and eventually embraced, in place of the distorted thoughts and beliefs.



The Management of Anxiety
Adapted from top-notch workshops approved of by the
American Psychological Association


Education:  Relaxation is counter to anxiety.  It’s not something you do; it is a natural response that you allow to happen.  Relaxation is what is left, when you stop creating tension.


Do you breathe?  Do you think?  Ok, then you are already practicing the two most powerful tools for staying calm!  It’s the way that you use these tools, that contributes to either increasing anxiety or diminishing it!  For example, the greater depth and slower speed of our inhalations and exhalations affects the amount of tension in our bodies, the clarity of our thinking, which in turn affects the way we are feeling.  That’s right, the way we breathe and the thoughts that we entertain, do impact our feelings—for good or ill.


Anxiety management is meant to be a way of life, part of every day (as is brushing your teeth).  This lowers current stress and anxiety, and it helps decrease the severity of subsequent bouts.


It is best to keep a daily log of your anxiety patterns—recording the day, time, activities, and intensity that you feel.  Observing your patterns helps you to better understand the source of your anxiety.


Breathing:  More times than we know, we shorten our breath and even hold it, at various times throughout the day, whenever we encounter stress or alarm!  Breathing (slow and deep) counters stress as it calms the body, quiets the mind, relaxes muscles, improves clarity, strengthens immunity, and reduces anxiety.


The 7-7 Exercise – Sit or lie down comfortably.  Close your mouth in inhale deeply through your nose, filling/expanding your lungs.  Hold this breath to the count of 7.  Then exhale slowly and completely out your mouth.  Repeat this cycle for a total of 7 inhalations/exhalations.  Do this morning and afternoon, and whenever you feel anxious.  


Bonus #1:  While you breathe in through the nose, think “peace” (or whatever will bring you peace, such as a pleasant image or a favorite quote or Scripture).  As you exhale out your mouth, intentionally breathe out all “tension.”  Breathe in calm.  Breathe out tension.  


Bonus #2Visualizing – Picture yourself in a very relaxing place; perhaps by the seashore, in a meadow of soft grass and flowers, in a deep forest, looking out from a mountain top.  Breathe in and out as you fully enjoy the scene—feel the air, listen to the wind … soak it in.


Muscle Relaxation:  Sit or lie down with eyes closed.  Use breathing for a couple of minutes.  We will start at the top of the body (although some prefer to start at the feet).  Begin with your head, and notice if you feel any tension in your scalp, face, chin, or jaw.  Briefly but firmly tighten those muscles, and then completely release them.  As you release each one, imagine all of the tension leaving your head and flowing out of you.  Next, move your attention to your neck.  Look for any tension in your neck (especially the back) and your throat area.  Where you feel tension, firmly tighten that area, then completely release and relax it, allowing the tension to freely flow out.  Continue this approach, slowly and methodically for each area—your shoulders and upper back, chest and lungs, upper arms, lower back, lower arms and hands, then abdomen.  Let all the tension of your upper torso flow out of you.  Next focus on your upper legs (front and back), your lower legs muscles, then your feet and toes.  Continue to let all tension and energy flow out until you are at complete rest.  Then just sit or lie quietly and enjoy the peace.  This can be accompanied by peaceful music.  Ahhh! …


Renewing the Mind:  Along with every anxiety, worry, and fear, we are inevitably thinking negative “what-ifs and maybe’s.”  These thoughts only reinforce our angst.  The anxious thoughts have to be noticed, exposed, and renounced.  In their place, we introduce and welcome the truths that are more balanced, optimistic, and hopeful.  This venture is both more extensive and specific than I can offer you here.  But renewing the mind throughout the day is vital to our mental health and emotional calm.  The resources we cite below will help you more specifically with this strategy.




Further Resources:

The Anxiety and Phobia Workbook [Paperback], Edmund J. Bourne PhD (Author) 

The Anti-Anxiety Workbook: Proven Strategies to Overcome Worry, Fear, Panic, Obsessions.  By Martin M. Antony and Peter J. Norton
The Cognitive Behavioral Workbook for Anxiety: A Step-by-Step Program [Paperback].  By William J. Knaus EdD (Author), Jon Carlson PsyD EdD (Foreword)
The Anxiety Cure [Paperback; well-done faith-based perspective], Dr. Archibald D. Hart

CBT with Children, Adolescents and Families
A great workbook on anxiety to help children






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© 2015 by Jack Merenda, Psy.D., Inc.