15 Ways to Manage Stress

Margarita Tartakovsky, M.S., argues that a handful of straightforward habits can bring down anxiety and keep everyday stress in check. People living with generalized anxiety disorder (GAD) often carry a steady, outsized worry about ordinary parts of life: money, relationships, work, their own health. With social anxiety, the fear centers on being judged or humiliated in front of others. Almost everyone feels nervous now and then. What sets a diagnosis apart is how hard it becomes to turn the feeling down or make it come less often.

"Anxiety is a normal, predictable part of life," said Tom Corboy, MFT, founder and executive director of the OCD Center of Los Angeles and co-author of the forthcoming book The Mindfulness Workbook for OCD. Below are fifteen things you can try.

1. Breathe deeply. Slow breathing from the diaphragm flips the body out of the sympathetic nervous system's fight-or-flight mode and into the calmer, more balanced parasympathetic response, explains Marla Deibler, PsyD, a clinical psychologist and executive director of The Center for Emotional Health of Greater Philadelphia. Her suggestion, repeated a few times: breathe in slowly for a count of four, beginning low in your belly and letting the air rise into your chest, hold gently for four, then let it out over four counts.

2. Move your body. Exercise is one of the better tools against anxiety. Cardiovascular work in particular bumps up the release of endorphins, and that tends to quiet the anxious response.

3. Sleep enough. People have known for a very long time that sleep sits at the base of how we function. Running on fewer than seven or eight hours can set anxiety off on its own. A full night gives your body and brain a chance to reset. To get there, wind down first: a mug of decaf tea, a warm bath, some quiet music.

4. Question the thought. Deibler points out that all of us, without meaning to, feed our own worry with unhelpful thinking. Those thoughts are frequently unrealistic, off the mark, or just not reasonable. Ask yourself whether a given thought is rational or not. If it isn't, push back on it and rework it.

5. Use affirmations. Repeating positive statements about yourself can lift your self-esteem and shift you toward feeling in command of your life rather than at the mercy of it.

6. Lean on people. A dependable circle matters. Friends and family give you someone to talk things through with, or simply to sit beside you when the pressure or the anxiety runs high.

7. Cut the caffeine. Caffeine itself can switch on the flight-or-flight reaction, so dialing it back often takes the edge off anxious feelings.

8. Skip drugs and alcohol. Corboy and his colleagues have worked with many clients whose first panic attack hit while they were using something like marijuana, ecstasy, or LSD. As Tartakovsky puts it, panic attacks are rough enough when you're clear-headed; being high and unable to come down until the drug wears off makes them far worse. Substances can trigger an anxiety response of their own.

9. Make time for fun. Spend it on what you like, with people whose company you enjoy. Keeping up a social life or a hobby pulls your attention off the thoughts that stoke anxiety.

10. Step away. Short breaks let you reboot. Five minutes clear of your responsibilities works as a small mental vacation, enough to steady yourself before things tip into panic.

11. Problem-solve. Look at what's actually driving the stress in your life, then start naming possible ways to deal with it.

12. Read up on anxiety. Plenty of good books teach real coping skills. For social anxiety, Corboy recommends Dying of Embarrassment; for body dysmorphic disorder, The BDD Workbook; for OCD, The Imp of the Mind and The OCD Workbook. Deibler points adults with OCD to Stop Obsessing (and kids to Up and Down the Worry Hill). For panic attacks she suggests Don't Panic: Taking Control of Anxiety Attacks. As a broad introduction to cognitive-behavioral therapy for anxiety, Corboy names The Anxiety and Phobia Workbook, along with Get Out of Your Mind and Into Your Life and The Wisdom of No Escape. More recommendations are on his website.

13. Try relaxation practices. Meditation and yoga both work well here.

14. See a therapist. A professional can walk you through cognitive behavioral therapy (CBT), which brings down the anxious feelings while building up your ability to cope.

15. Accept the anxiety. "If you really want to effectively manage your anxiety, the key is to accept it," Corboy says. That can sound backwards. But the anxiety by itself isn't the real trouble. The trouble is our struggle to control and get rid of it. "Not accepting these unwanted inner experiences is the actual source of so much of our self-induced suffering." Acceptance isn't surrender to a life of misery, he adds. It means recognizing and fully allowing anxiety and other uncomfortable states that are bound to show up and are, in the end, temporary.