"The Three 'Ex's of Anxiety" by Director of Counseling Jennifer Hamilton, LEP
There has been increased media focus over the past several years on anxiety; teen anxiety, in particular. Anxiety is a normal reaction to stress that most people experience from time to time, and it can actually be beneficial in some situations. It can mobilize us to act, motivate us, and even protect us from entering dangerous situations. For some people, however, anxiety can become excessive and can affect day-to-day living, causing fear, avoidance, or paralysis.
According to the National Institutes of Mental Health, anxiety disorders are the most prevalent mental health diagnosis, with 25% of teens aged 13-18 diagnosed at some point during their teen years. Anxiety is highly treatable, but tragically many people who are struggling do not seek treatment (up to 80% of teens do not seek support) and left untreated, it can have a profound effect on one’s ability to enjoy life.
Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality style, life events, and learned habits. Yet no matter the underlying causes, the way we think and talk about anxiety can have a profound effect on how it is managed and experienced. There is a physiological reason that anxiety feels the way it does, and it can be helpful to explain this to teens so that each time they feel their heart racing, their stomach drop, or any of the other myriad anxiety symptoms, they understand that these sensations are not necessarily a signal that something horrible is happening to them.
When we begin to worry, our prefrontal cortex imagines all of the terrible scenarios that could potentially unfold. The brain perceives these worries as a legitimate threat and the amygdala (a very primitive part of the brain) jumps into action, effectively shutting off our higher-order thinking processes and putting us in “fight or flight” mode. The adrenal glands release norepinephrine, which is responsible for many of the unpleasant feelings that we associate with anxiety. These chemicals cause our hearts to race, our digestion to shut down, our blood pressure to increase and our pupils to dilate. All of these things happen for an evolutionary reason: These reactions allow the blood to pump harder and to be diverted to our large muscles so that we can flee potential danger. It doesn’t matter to our brains that we are not being chased by a saber-toothed tiger… even a math test or an awkward social situation can be enough to signal this response in our bodies, and as anyone who has ever experienced this knows, this host of physiological sensations can be quite aversive. Very often, we try to avoid anything that might cause us to have these feelings.
The conventional wisdom around how to best treat anxiety has shifted and expanded over the past several years. Many people used to believe that the best way to deal with anxiety was to try to avoid the very thing that causes it. While this makes perfect sense at face value, the problem is that if we adjust our experiences in order to avoid anxiety-producing situations, we inadvertently send the message that the thing that is making us anxious truly is noxious, thus increasing the worry! You really can’t get rid of anxiety; human beings are designed to worry! The key to treating anxiety is in shifting the way we think about it, and arming ourselves with the tools to cope with worries.
The book Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children, by psychologist Lynn Lyons, forever changed the way I think about (and treat) anxiety. A strategy that she suggests, “The Three ‘Ex’s of Anxiety,” are extremely helpful in arming and empowering students with the skills to cope with their worries.
Expect: Instead of viewing anxiety as a sign that something is wrong, think ahead about what anxiety feels like to you, and when it is most likely to happen. If, for example, you tend to feel anxious in social situations, you can think to yourself, “I always start to sweat and get an upset stomach when I go to parties…” Then, when those feelings come up, you can recognize they’re normal for you under these circumstances, and not a signal that you need to avoid the situation.
Externalize: Seeing the worry as something separate from yourself lets you examine it and make a different choice about how to proceed. For example, when anxious feelings arise, you can tell yourself “Here comes Anxiety, right on cue—I was expecting you. You always show up when I’m in social situations.” It sounds corny, but it truly is effective! Over time, this approach helps people tolerate doing things that are difficult for them and the anxiety begins to lessen.
Experiment: Purposely choose to try something different. For example, if at a party your anxiety is telling you to avoid people, you could instead do the opposite and plant yourself right in the kitchen where large groups of people are gathered.
In essence, you acknowledge the fear, expect it, talk back to it, and do it anyway. Using these strategies trains our brains to become more flexible. We can actually change our neural pathways by adopting these different ways of thinking and behaving. Learning to cope with anxious feelings decreases anxiety over time.
As always, I love hearing from you and invite you to get in touch with me at if you’d like to discuss anxiety, or anything else.