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What is anticipatory anxiety disorder? My story

Anxiety can be crippling.

I know because I’ve fought serious anxiety for years. It should sound comforting to say “you’re not alone,” but actually it’s scary to find out just how not alone you are.

In fact, serious anxiety impacts over 40 million Americans – almost one-fifth of the country.

Even many people who look outwardly “fine” are actually struggling more than you could imagine with anxiety and panic disorders.

One of the most frustrating forms of anxiety that I want to talk about today is anticipatory anxiety disorder.

Anticipatory anxiety disorder is when you get locked up in fear thinking about a future event or scenario.

To put it bluntly: it’s fear of the future.

If you’re wondering how to overcome anticipatory anxiety you have come to the right place.

Even though it’s not defined as an official anxiety disorder, anticipatory anxiety is a major drag. It can interrupt even the simplest things in life like going on a date or visiting a new place.

In this guide, I’m going to explain more about what anticipatory anxiety is and how to overcome anticipatory anxiety. Read on.

What is anticipatory anxiety?

anticipatory anxiety

Anticipatory anxiety is when you are anxious about something that will or might happen in the future.

Like I said above, it basically boils down to fear of the future.

The future is unknown, and that alone can be kind of terrifying. Believe me, I know.

Anticipatory anxiety about a big test, a first date, worry about the health of a loved one: it can all become too much and start to negatively impact your day-to-day life.

Being worried about the future or a little stressed is one thing: when it starts leading to ongoing anxiety attacks as part of a panic disorder or produces severe anxiety for weeks and months before the feared event then it becomes a serious problem that has to be dealt with.

If you’re wondering how to overcome anticipatory anxiety it’s important to understand how it is triggered.

As counselor Sheryl Ankrom explains, anticipatory anxiety can become a deep fear of fear.

“This is because the anticipation, or the way you visualize a future event, is focused on having a panic attack in certain situations.”

Anticipatory anxiety happens when you begin to fear and anticipate the worst possible outcome to an upcoming situation, whether it’s going to the grocery store or taking an airplane flight. 

If you answer yes to these questions then you are suffering from anticipatory anxiety:

  • Are you experiencing feelings of tension and anxiety in the build up to an event?
  • Do you have images or negative predictions about what may happen at this event?
  • Do you sometimes avoid events or situations because of the increased anxiety they provoke?

What causes anticipatory anxiety?

anticipatory anxiety

Anticipatory anxiety and learning how to overcome anticipatory anxiety is a matter of locating its roots.

In most cases, anticipatory anxiety is built up by your mindset.

Often a traumatic experience – or several awful experiences – can put you in a state of fear and tension.

You begin to see potential new danger around every corner.

Sometimes literally.

You absolutely dread the chance that a negative or dangerous situation will happen to you again.

And therefore you begin to take steps on a conscious and unconscious level to protect yourself.

Counterintuitively, the first thing your mind begins to do to protect itself is flood you with fear and thoughts about the potential risks of everything you do.

When you start to think of the world as a threat and feel yourself in danger, the tension and fear builds up, eventually reaching a fully anxious state:

“Anticipatory anxiety is closely associated with the way you think. With panic disorder, your thoughts are generally focused on worrying about having a panic attack in a situation that will result in embarrassment, extreme discomfort, a heart attack, or even worse.”

If you suffer from anticipatory anxiety then fear starting with “what if” is your daily reality.

You picture horrible scenes:

Collapsing in public, shaking uncontrollably, making weird noises, everyone looking at you in fear or confusion like you are going crazy.

Sometimes you just picture failure on an epic scale.

What if:

  • I fail my test and eventually end up homeless?
  • I choke during the job interview and never get hired again?
  • the plane I’m in suddenly blows up or falls from the sky?
  • my dad gets sick from an incurable disease?
  • I get robbed or raped walking home from the store?

The world can obviously be a dangerous place. And I’m not here to tell you that worrying is always stupid or useless.

But if anticipatory anxiety is stopping you from doing daily tasks or moving forward in life then it’s a problem you’ll have to face.

As Lisa Fritscher writes:

“Anticipatory anxiety can be extremely life-limiting as you search for ways to avoid the experiences. It can put stress on your personal relationships because you’re distracted and appear self-absorbed.

You may also find it compromises your ability to function competently at work if you are consistently distracted.”

What are the symptoms of anticipatory anxiety?

anticipatory anxiety

Emotional, mental, and physical symptoms often pop up when you are having an onset of anticipatory anxiety.

Sometimes they can be hard to identify and you can even confuse them for real physical health problems.

These are common signs of anticipatory anxiety:

  • chest pain
  • hyperventilation
  • muscle spasms
  • heart palpitations
  • dissociation and feelings of unreality
  • shakiness and over-sweating
  • difficulty concentrating
  • overthinking about the future
  • extreme feelings of fear
  • dizziness
  • upset stomach
  • numbness or tingling
  • cold chills or hot flashes

Obviously, when you are having these symptoms and feeling overwhelmed by thoughts of the future you’re not usually going to be in the best mood.

This means you will often feel:

  • Angry
  • Hopeless
  • Confused
  • “Out of control”
  • Misunderstood
  • Alone
  • Irritable

And even ashamed or guilty…

The guilt can come from a fixation on “what is wrong with me” and “why am I so messed up?”

This then feeds into the negative feedback cycle, worsening symptoms and increasing feelings of hopelessness and frustration.

The key as to how to overcome anticipatory anxiety is to know that this situation you are stuck in psychologically can and will get better. You will not always feel this way.

But while you are struggling with anticipatory anxiety it can be hard to see any light at the end of the tunnel.

The problem can become so bad that decisions literally become impossible.

You’ll do almost anything except make a firm decision in order to avoid future events that your mind tells you could threaten your safety.

It’s a vicious cycle…

Understanding the domino effect of anticipatory anxiety

anticipatory anxiety

It’s natural to feel fear in certain situations.

It’s also natural to feel fear in anticipation of upcoming situations that might be potentially embarrassing, risky, or unpredictable.

What’s not healthy is when fear goes from a normal emotional state you occasionally have to a loop. 

It not only goes around and around in circles in anticipation: the fear actually stacks on the previous fear and eventually becomes a completely unmanageable tangle of pure panic.

It’s a domino effect.

A past trauma or awful situation triggered anxiety and you eventually had a major panic attack once or maybe twice.

I have had them a lot and I know it is far, far worse than most people realize who have not had an actual panic attack.

I am not by any means underestimating the impact that this had on you or how disturbing it was.

The problem is that when you begin to fear having another panic attack you become locked in a fear of fear that creates a domino effect of anticipatory anxiety.

The symptoms then build on themselves in a downward spiral of thoughts, emotions and physical issues that can reach the point of triggering a full crisis and reinforcing your initial fears.

“See? I told you it was a bad idea to walk in a huge open mall far away from anywhere to get away from the open space.”

Phobias, such as agorophobia described above, all come from anticipatory anxiety.

Few know it, but phobias are actually a result of anticipatory anxiety.

If there is a phobia you have: whether it’s open spaces, closed spaces, social situations, water or heights, you will begin to feel anticipatory anxiety even thinking about these things.

The awful truth is that sometimes thinking about how bad something might be ends up being far worse than how bad it actually is.

As therapist Ken Fields puts it, the future is a blank slate, but:

“We guess, fabricate, and imagine, and yet we don’t know how it’s actually going to turn out — which in itself can bring about anxiety. Nevertheless, because we fabricate outcomes (usually negative ones) for events that haven’t happened yet, we tend to become anxious.”

Life is unpredictable and often surprising, and this alone can trigger serious levels of anticipatory anxiety.

This is the needle you have to thread:

Life is unpredictable and it can be genuinely terrifying.

But it’s also perfectly fine a lot of the time.

The key to learning how to overcome anticipatory anxiety is to allow life to be what it is without living in fear of the future.

Here are some ways to help do that.

How to overcome anticipatory anxiety

For highly sensitive people and those who struggle with anxiety disorders and panic, it isn’t always possible to permanently “cure” anticipatory anxiety.

As someone who is susceptible to anxiety and panic, you have to work harder and more consistently to keep it from controlling your life than a person who’s less sensitive or hasn’t had serious anxiety.

That’s just a fact.

But the good news is that there are tried-and-true ways to overcome anticipatory anxiety and make it take a back seat so you can get on with living your life.

By following these steps you can greatly improve your mental and emotional health and lead to real recovery from anticipatory anxiety.

1. Improve your sleep

anticipatory anxiety

What do you spend about half your life doing but not even remember doing?

It’s not a trick question: it’s sleep. 

Sleep has a major impact on our physical health.

And it also influences our mental and emotional health way more than some people realize.

Making sure you’re getting enough sleep and at a healthy time of day to still be productive can be a crucial step to alleviating anticipatory anxiety.

When you don’t sleep your brain starts having negative activity in the amygdala and insular cortex.

The amygdala and insular cortex are crucial for dealing with emotions and anxiety-inducing thoughts, and when they get fried from lack of sleep you’re already on a downward path.

The problem – of course – is that often the exact reason you can’t sleep is that you’re really anxious. 

This obviously creates a bit of a dilemma: you need sleep to help feel less anxious, but you feel too anxious to sleep.

Solutions? There are a few suggestions that can help.

  • Set a sleep schedule so you get up at the same time each morning, making you more tired at night.
  • Exercise on a regular basis, even if it’s just 20 minutes of walking or running per day
  • Don’t drink caffeine like coffee or Coke prior to six hours before sleeping
  • Also avoid large meals, drinking, smoking, and medications that can cause wakefulness
  • Do relaxing activities like meditation, listening to chilled out music, or reading an easygoing book before bed
  • Don’t nap more than an hour during the day, and no later than the afternoon
  • Avoid sleeping in late in the morning as this can make you less tired at nighttime

Making sure you are getting enough sleep can make a big difference to your overall wellbeing and also start to majorly decrease the amount of anxiety you’re experiencing.

2. Try relaxation techniques

anticipatory anxiety

Another very effective way for how to overcome anticipatory anxiety is to try out meditation and relaxation techniques.

I know it sounds like a cliche, but some of these things can really help.

In particular, I’ve found the shaman Rudá Iandê’s guided breathwork meditation to be extremely good at making me feel connected to myself and my surroundings and lessening anxiety.

By connecting me to the power of my breath, Rudá’s meditation helped me find an anchor within myself.

This, in turn, led me to feel much less anxious about the world outside and its threats and to trust my own reactions and existence so I don’t feel as vulnerable and endangered by the chance of having an anxiety meltdown when I’m doing something in public.

Yoga and meditation – as well as pilates – have also been very helpful for me when it comes to relaxation techniques for how to overcome anticipatory anxiety.

Mindfulness meditation and writing in a journal have also been really beneficial for me.

Another great relaxation technique I discovered for how to overcome anticipatory anxiety is Progressive Muscle Relaxation (PMR).

What PMR does is it uses simple but powerful relaxation techniques over your whole body so that the crazy physical symptoms like heart palpitations, dizziness and chest pain no longer trigger your full fight-or-flight response and panic.

It’s been a game-changer – along with Rudá’s meditation – and I think it can be for you, too.

3. Flip the script on negativity

anticipatory anxiety

I know it gets tiring to be told to “think positive.”

When you feel like shit the last thing you want to be told is that you’re making it even worse.

But the truth is that negative thinking is shooting yourself in the foot.

At the very least, when you think of how awful an upcoming situation might be realize that your thoughts and anxiety about it isn’t you. Nor is it necessarily accurate.

Flip the script.

You don’t need to become a Cheery Cathy overnight, but just for fun try thinking of something coming up that you’re freaked out about and then imagine one positive thing that could happen.

Just humor me and try it.

Imagine you win some money, or meet a new person you find very attractive, or end up feeling super relaxed and hearing the funniest joke you’ve heard in five years.

You wouldn’t want to miss that, would you?

As Srini Pillay, M.D. says: “Simply interrupt the anticipatory fear with a random positive thought. If you can’t think of a thought in time, keep some positive images near you, so that you can look at then, or keep some positive music near you.”

Boom.

4. Take a reality check

anticipatory anxiety

Anticipatory anxiety is the worst.

After all: how can you really convince yourself that the plane won’t crash, the boat won’t sink, you won’t suddenly have a heart attack in public or your parents won’t get in a car accident?

All of these are possible.

You could catch a rare disease tomorrow that paralyzes you or makes you drool and be unable to eat normally the rest of your life.

But:

You most likely will not. 

Even though the anxiety is coursing through your veins, and you feel like you’re going to burst or collapse just stop for one second and think of your situation like a scientist:

Don’t try to push the anxiety down.

Don’t beat yourself up.

But think, really, just for a second: how likely is it that this awful outcome will really happen if I go boating tomorrow on the lake for a couple hours or fly to Mexico next month?

Realistic thinking doesn’t mean “thinking positive” necessarily: it just means being a bit more objective. As Anxiety Canada explains:

“Realistic thinking means looking at all aspects of a situation (the positive, the negative, and the neutral) before making conclusions. In other words, realistic thinking means looking at yourself, others, and the world in a balanced and fair way.”

Don’t try to push the fear down or beat yourself up over it.

But just take a look at it with curiosity and be objective.

Then the next time you’re right about nothing bad happening in a situation you feared sit down on a comfortable chair and think about it for a minute.

5. Don’t focus on the source of your anticipatory anxiety

anticipatory anxiety

Many therapists and anxiety experts tell patients to find the source of their anxiety and work on overcoming it.

This is terrible, harmful advice.

The truth is, if you want to find out how to overcome anticipatory anxiety you have to stop focusing on what caused your anticipatory anxiety.

Doing so is causing a feedback loop of intensifying anxiety and backing you into a psychological corner.

As a world-renowned therapist, author, and former anxiety sufferer Charles Linden of the Linden Method explains, your focus on trying to find out what’s wrong with you and to think about how awful the cause of your anxiety was is a big reason your anxiety isn’t going away. 

It’s counterintuitive because when we have a problem we obviously want to solve it.

But as Linden teaches in his program, which has helped hundreds of thousands of severely anxious individuals to recover, it is only by redirecting your energy and focus onto things you can do, structure, and everything that’s right in your life, that you can begin to recover.

As Linden says:

“If you have had treatments and they haven’t worked it’s because the people treating you do not practice science based recovery instruction. Even though it seems like they do.”

6. Get out your schedule and start writing

anticipatory anxiety

Scheduling and having a routine is one of the keys when it comes to how to overcome anticipatory anxiety.

So get out your schedule and start writing.

Too much lack of structure and open-endedness is part of what increases anticipatory anxiety.

It’s true that the future is an unknown, but when you divide it up into time (even marking down “free time” or “recreation” at specific times) then you help your mind grasp the future.

Instead of waking up each day and “seeing what happens” once you fulfill your basic obligations, consider doing something different.

Set a regular routine:

  • When you wake up
  • When you cook
  • When you go out
  • When you exercise
  • When you socialize
  • When you work

Then stick to it as much as possible.

You can even set aside a specific “worry time” when you can be stressed and anxious if you want. That way you don’t have to worry about the pressure of feeling like you can never be anxious.

You’ll notice your anticipatory anxiety start to calm down a little.

7. Stop overthinking

anticipatory anxiety

Overthinking is one of the main sources of anxiety.

Regardless of the traumas in the past and the severity of the anxiety you may have suffered – or be currently suffering – the more you focus on it and think of how bad it is the worse it is going to get. 

I’m not saying to snap out of it or “be happy.”

You’re miserable, anxious, and feel absolutely terrible. I get that.

But you have one last shred of power left: the power to do anything possible not to be focused on that anxiety or thinking about it and the things that lead to it.

Take that shred of power and grasp it.

Overthinking and feeding the anticipatory anxiety is a dark path to go down that will only lead to a worsening of your situation.

It’s OK to be upset, angry, worried …

But let the thoughts and the “story” go.

And don’t believe your thoughts telling you that you’re broken, weak, or worthless.

You will get better and see the other side of this struggle. And it’s crucial that you truly believe that and hold that belief deep inside yourself.

8. Find your passion and pursue it

Everyone has different passions and interests.

For me, it’s history, geopolitics, theology, weightlifting, and playing piano and guitar.

For you, it could be cooking, drawing, and designing computer programs.

Or building houses, fixing cars, and planting trees.

I can’t speak on your behalf.

But I do know we were each given different gifts and talents.

And in many cases, we can use them to do good things for those around us including our family, loved ones, and community.

By finding your passion and pursuing it you can begin to put yourself back in the driver’s seat and let anticipatory anxiety fade away.

That feeling of not being in control won’t irk you so much, because you will be back in control – at least of your own goals and direction.

The best way to follow your passion is to enter the flow state, but there’s a right way and a wrong way.

The truth is that “getting into flow” is terrible advice. If you truly want to enter the flow state the right way you need to find your intuitive expertise and then focus on it.

Going with the flow isn’t so much about “letting go” or anything goes: it’s about holding on to the important things and letting the rest go.

9. Rediscover a zest for the finer things in life

anticipatory anxiety

Now and then it’s a great thing to give yourself a little bit of a reward and enjoy the finer things in life.

That may not mean shrimp cocktails and a day spent getting a deluxe massage – although it may – but it could be as simple as having a delicious lunch overlooking a beautiful landscape or buying an extremely comfortable pair of pants that makes getting dressed and strolling down the street a genuinely pleasurable activity.

Maybe you want to sit in a comfy chair after a day of exercise and mastering how to overcome anticipatory anxiety with a nice glass of whiskey and your favorite movie playing.

Looking after yourself and having a bit of a reward for your accomplishments now and then is a good thing.

Enjoy it.

You deserve it.

Chances are you’re doing a lot better than you give yourself credit for, and even if anticipatory anxiety is still giving you headaches rest assured that you’re on the right path forward.

Should you seek professional help for anticipatory anxiety?

anticipatory anxiety
counselling-psychologist

If anticipatory anxiety is starting to get in the way of your daily life and even your longer-term plans, relationships, and commitments then it can be a good idea to see a counselor.

Professional help can sometimes make a difference, as can medication. Several therapies I recommend are:

  • The Linden Method – as I mentioned above the Linden Method is a very effective and groundbreaking approach to anxiety that focuses on healing and recovery by promoting structure, goals, and positive self-image. By showing you how to actively get out of the negative feedback loop of anxiety symptoms you become much more empowered and stop having anxiety symptoms and thoughts that characterize anticipatory anxiety.
  • Panic-focused Psychodynamic Psychotherapy –  Anticipatory anxiety often causes panic attacks and severe anxiety. One of the best approaches is panic-focused psychodynamic psychotherapy. It tackles anxiety and panic disorder head-on by locating defense mechanisms and unconscious patterns that trigger our anxiety. As such it can be far more effective than Cognitive Behavioral Therapy and other approaches which end up just leaving you more focused on your anxiety and feeling worse about it.

Flying with anticipatory anxiety

anticipatory anxiety

One of the most common causes of anticipatory anxiety is about air travel.

I know that in my case it’s because I fear having a panic attack while I’m on a flight that I can’t get off of. I fear I will “die” or “go crazy” or feel like I am anyway, while on a long flight.

It’s caused me a lot of trouble and inconvenience avoiding long flights, and the more I focus on it the worse it gets.

Other people have flight anxiety because they hear awful things in the news or

Some even deliberately avoid flying because of this anxiety.

The Virtual Reality Medical Institution defines anticipatory anxiety from flying as:

“A specific flying phobia that is characterized by marked distress prior to the actual flight. The person may begin to feel anxious months before a trip, as they anticipate the actual flight and “things” which may happen take the form of distressing thoughts.”

The thing that’s even trickier about flying anticipatory anxiety is that it doesn’t only happen when you’re on an airplane.

It happens when you think about flying.

When you see planes on TV

When you buy a ticket

When you drive near the airport …

You name it.

The best solution is to remember that statistically flying is very safe, turbulence is generally harmless and there is always melatonin or a sleeping pill to give you a little break until you reach your destination.

How to overcome anticipatory anxiety panic attacks

Anticipatory anxiety

Anticipatory anxiety often leads to a cycle of panic attacks and the development of the panic disorder.

The fear builds up and then you meltdown.

Even one time is then enough to convince your conscious and unconscious mind that your fears were right and the cycle of panic disorder begins.

The best way for how to overcome anticipatory anxiety and panic attacks is to stop trying to overcome them and busy yourself doing other things.

If and when it does hit, trying using anchoring technique developed by psychologist Charles Schaeffer. As he explains: “one way to counter that out-of-body feeling is to reconnect with your body and anchor yourself in the tangible world.”

Schaeffer advises focuses on your breathing and touching tactile surfaces like floors or tables.

When you have a panic attack your limbic (survival system) is essentially hijacking your body and mind. That’s why you can’t “think” your way out of a panic attack.

In fact what you have to do is actively work your way out of the panic attack by focusing 100% of your attention on another necessary task, whether that be finding a location you are driving to, checking a work responsibility, or helping someone next to you who needs something.

Refocusing on an urgent necessity is one of the few things that will have the power to “override” and redirect your attention away from feeling you are dying and on to a different issue.

Closing thoughts on anticipatory anxiety

Anxiety is common, but it varies in severity. I know that in my experience I’ve been very deeply affected. I even had years where I could barely leave home even to drive to the store.

I would stay up all night sometimes with anticipatory anxiety and refrain from even walking around the block because of the fear that I would have a panic attack if I tried.

It sounds ridiculous, but if you’ve had severe anxiety and anticipatory anxiety it can really get this extreme.

I hope that this guide on how to overcome anticipatory anxiety has been helpful and given you some practical steps for recovery and refocusing your efforts on a brighter future of empowerment, cooperation, and confidence.

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