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Fact Sheet

Anxiety

This education sheet contains things you can do that might help in coping with and managing anxiety.

What is anxiety?

Anxiety is a very common mental health experience. Anxiety can be caused by being in stressful situations and by thinking about stressful things. Feeling anxious or worried sometimes is normal and can help keep you motivated, focused and safe from danger when it happens in small and manageable amounts.

When you feel anxious, it is because your survival instinct kicks in and your brain sends a message to your nervous system (your body) that you need to protect yourself. Your nervous system releases adrenaline and other stress hormones that prepare your body to fight, flight (run away) or freeze. This causes changes in the body such as tense muscles, fast breathing and other symptoms.

The word “anxiety” describes both the temporary feeling of being worried and, when symptoms are felt strongly and repeatedly, “anxiety” can refer to disorders that a health professional (doctor, nurse) may diagnose, listed below.

  • Generalized anxiety disorder: experiencing anxiety symptoms frequently
  • Social anxiety: fear of looking silly or being rejected in social situations
  • Phobia: fear of specific things or situations
  • Panic disorder: experiencing repeated panic attacks
  • Panic attack: sudden intense onset of anxiety symptoms within minutes
  • Post Traumatic stress disorder: frequent memories of traumatic experiences

A health professional can talk to you about diagnosing anxiety disorders and about treatment options including medication and/or counselling.

There are many valid reasons to feel anxious in life. However, even living in a world that gives you some valid reasons to be anxious, you also deserve to feel some calmness.

What does anxiety look like?

Anxiety looks and feels different for everyone. Anxiety can affect your thinking. For example, you may have more thoughts related to fear, dread or a lack of control. Anxiety can also affect your behaviour. For example, if talking in front of people makes you very anxious (thought), you may decide to drop a class that contains a lot of presentations (behaviour).

Anxiety may feel like being:

  • nervous
  • panicked
  • worried
  • suffocated
  • tense
  • exhausted
  • confused
  • fearful

Anxiety also affects the body. It can cause physical reactions like:

  • fast heartbeat
  • quick or shallow breathing
  • sweating or feeling cold
  • trembling or shaking
  • having trouble sleeping
  • chest pain or tightness
  • tension
  • feeling jumpy
  • dizziness
  • numbness
  • nausea

Some of these things can be caused by other health concerns such as low iron or vitamin deficiencies. If you have these symptoms, it may be a good idea to get your blood work checked by talking to your doctor.Anxiety also affects the body. It can cause physical reactions like:

What can I do about my anxiety?

Your emotions, physical body, thoughts and behaviours are all linked. What happens in one area usually impacts what is happening in another area. For example, if you are feeling overwhelmed by your school workload (emotion) you may become tense and jittery (physical state); you may think an anxious thought like “I am going to fail my class” (thought); and you may stay up all night studying (behaviour). This could create a cycle that causes more anxious emotions, thoughts, physical states and behaviours.

Overall Mind and Body State

However, you can also use these links to decrease the overall impact of anxiety. For example, when you are feeling overwhelmed (emotion), you can practice deep breathing to lower your heart rate (physical state), which could allow you to think more clearly.

When it feels possible, you can practice managing and coping with your behaviours, emotions, thoughts and physical states in your body to encourage more calmness. The more you practice, the easier it becomes to cope and manage. Remember that you are not defined by your anxiety, or your thoughts, feelings, behaviours, or physical states.

Here are some things you can do to cope with anxiety.

Physical State

Breathing techniques

Anxiety might make your breathing get faster, shallower, or even stop at times. This causes your body to activate the fight, flight or freeze response, which then increases anxiety symptoms.

When you breathe slowly and deeply, you create a more balanced level of oxygen in your blood which can decrease the symptoms of anxiety. It is good to notice whether your breathing changes when you are anxious.

Try to practice the following breathing techniques in a comfortable, quiet place on a regular basis for at least five minutes. This way, when you are in other situations and places, you can use these breathing techniques more easily. Some people find that trying to control their breathing actually increases the symptoms of their anxiety. If this is the case for you, then try another anxiety-calming technique.

See list at the end of the this booklet for apps and online resources for breathing techniques.

For each of these breathing techniques, repeat 5-10 times, or until you feel more relaxed. Make sure to exhale fully.

Deep belly breaths
  • When breathing fully into your lungs, it pushes your diaphragm down and your stomach out. When you breathe out, your diaphragm pulls back up and your stomach pulls inward.
  • You can visualize this process by imagining your breathing as a balloon – when you breathe in, the balloon inflates, and when you breathe out, imagine it deflating.

  • Place your hands on your stomach. Take deep breaths so that your hands can feel your stomach move inwards and outwards as you breathe in and out. This can be done sitting up or lying down.
  • You can remind yourself to relax while you breathe. When you inhale, say the word “re-” in your head, and when you exhale, say the word “lax”.
  • You can also visualize a calm, relaxing place while you breathe.
4 – 7 – 8 breath
  • Inhale for 4 counts (count 1-2-3-4 in your head while inhaling).
  • Hold your breath for 7 counts.
  • Exhale for 8 counts.
Lengthening your breath
  • Inhale for 1 count and exhale for 1 count
  • Inhale for 2 counts, exhale for 2 counts
  • Keep going anywhere up to a count of 10.
Alternate nostril breathing
  • Use your thumb and another finger (on the same hand) to alternately block one nostril at a time.
  • Cover your right nostril and inhale using the left nostril only
  • Switch nostrils. Cover the left nostril while you exhale through the right nostril.
  • Keep the hand placement and inhale through the right nostril
  • Switch nostrils, and exhale through the left nostril
Progressive Muscle Relaxation

Feeling anxious can cause you to tense your muscles. Relaxing your muscles helps to decrease anxiety symptoms and calms your body. Practicing tensing and relaxing your body in a safe environment can help you become more aware of when your muscles start to get tense. When you practice how to relax in a safe environment, it becomes easier to relax when you are in a stressful situation.

None of these movements should feel painful in any way. You can do as much or as little of this exercise as makes sense for you, skipping areas of the body as needed.

Find a comfortable, quiet place to lie down. It might also help to take a few deep, slow breaths.

Lower body
  • Curl your toes downward in a squeezing motion. Count to 5 in your head while continuing to squeeze (count 1-2-3-4-5 while squeezing your toes).
  • Relax your feet and toes and take 3-5 full breaths, noticing how it feels in your feet to be relaxed.
  • Flex your feet towards you, so you feel the heel pushing away and the calf stretching. At the same time, squeeze all the muscles in the thighs so you feel them tighten. Count to 5 in your head while continuing to squeeze.
  • Release the tension and relax through your feet and legs, take 3-5 breaths and notice how it feels to be relaxed in your lower body.
Hands and arms
  • Squeeze your hands into fists. Count to 5.
  • Relax your hands and take 3-5 full breaths. Notice how it feels to be relaxed in your hands.
  • Squeeze your hands into fists and also squeeze through the forearms and upper arms. Count to 5.
  • Relax through the hands and arms, and take 3-5 full breaths. Notice how it feels to be relaxed in your arms.
Upper body
  • Squeeze in and engage your stomach like you are an immovable mountain. Count to 5.
  • Relax your stomach and take 3-5 full breaths, noticing how it feels to be relaxed in your stomach.
  • Expand your chest by taking a full breath in and hold for 5 counts..
  • Breathe out and relax your chest. Take 3-5 full breaths. Notice how it feels to be relaxed.
  • Shrug your shoulders up to your ears and squeeze. Count to 5.
  • Let your shoulders relax and drop down away from your ears. Take 3-5 full breaths. Notice how it feels to be relaxed.
Head and face
  • Scrunch all the muscles in your face towards your nose. Squeeze your eyes shut, draw your eyebrows down, squeeze your mouth shut. Count to 5.
  • Relax all the muscles in the face. Remember to relax your eyebrows, and create a little space between your upper and lower teeth to relax the mouth and jaw. Take 3-5 full breaths. Notice how it feels to be relaxed in the face.

Thoughts

Anxiety can affect how you think and the kinds of thoughts you have. Feeling anxious might cause you to have thoughts that are unhelpful and unrealistic. It is good to notice whether this happens to you.

Journaling

Sometimes anxious thoughts can come from having too many thoughts in your mind that need time and space to be considered. Journaling can be a helpful exercise for sorting these thoughts out and giving them space.

10-minute stream of consciousness

  • This can be done by writing or speaking and recording it on a phone or other device. Set a timer for 10 minutes. Write down or record yourself saying everything that comes to mind in a “stream of consciousness” style, where the goal is to not edit and to not stop writing or speaking at all, even if it doesn’t make sense. Stop after 10 minutes. Some people like to review what they wrote or said, while others do not. Some people choose to keep this record of their thoughts, while others may tear it up or discard it. Do what makes you feel best.

Scheduling “worry time”

  • Set aside a short time every day when you give yourself permission to be anxious without trying to stop it. Write down or record your thoughts during this time. Make to-do lists if you like. Take no more than 15 minutes for this activity. You may find that you can spend less amount of your day worrying when you know that you have scheduled time to consider those thoughts later.

Talking

  • Counselling and talk therapy are great ways to sort out your thoughts and get help with anxiety. A health professional can refer you to counselling resources, and counselling resources are also listed at the end of this booklet.
  • You can also try talking with a supportive friend, family member, mentor, teacher, doctor, parent, or other trusted person in your life. It can feel intimidating to talk about anxiety with others. The following script can help guide your conversation on how to talk about anxiety:
    • “Hey (person’s name), “I have been feeling really stressed/overwhelmed/nervous/(any other emotion) about (topic)/I don’t know why. Do you think we could take 10 minutes now or another time for you to listen to me as I talk about this?”
    • Wait for them to let you know whether it is ok for them right now so that the conversation feels comfortable and safer for both of you.
    • Asking them to just listen to you can be a good way for you to get your thoughts and feelings out without interruption and without the other person feeling pressure to fix it or offer advice. However keep in mind that the other person may do these things anyway.
    • As you learn what helps you with your anxiety, in addition to asking to talk about your experiences, you can also ask trusted people in your life to offer physical or emotional support in specific ways. For example, you might ask for a friend to hold your hand, to make you a cup of tea, to go for a walk with you, to distract you, or to remind you of how amazing you are.

Affirmations

Balancing out anxious thoughts with calming, positive and affirming thoughts can help reduce the impact of frequent anxious thoughts. Your affirming thoughts should feel meaningful, realistic and true to you. Spending time writing your affirmations and repeating them to yourself can help bring calming, positive thoughts more frequently into your mind.

At Planned Parenthood Toronto, a group of youth created a deck of affirmations for the Filling in the Blanks: Queering Sex Ed Project. Check out www.teenhealthsource.com/blog/resource-affirmations-deck to download your own copy. You can pick up a printed affirmations deck from PPT if you live in Toronto.

Examples of affirmations:

  • I am enough
  • I am strong
  • I am capable
  • Let go
  • I am in the right place
  • I trust my intuition
  • I feel my power
  • I give myself time and space
  • My feelings are valid
  • I am kind to myself
  • I am gentle with myself

Meditate with your affirmations

  • Pick a quiet, comfortable place to sit or lie down and practice a few slow, deep breaths.
  • Once you are settled, repeat your affirmation in your head to the pace of your breath. For example, for the affirmation “I give myself time and space”, as you inhale, say to yourself: “I give myself”, as you exhale: “time and space”.
  • Practice this for anywhere from 5 to 15 minutes.

Behaviour

Eating and Sleeping Regularly

To better cope with the symptoms of anxiety, consider whether it might help to make some changes to  make sure you are eating and sleeping regularly.

  • For youth 14-17 years old, try to get 8-10 hours of sleep per night.
  • For youth 18 years and older, try to get 7-9 hours of sleep per night.
  • You can use the “Lengthening your breath” breathing technique to help you fall asleep.
  • Eat plenty of colourful vegetables and fruits, foods with protein, healthy fats, whole grains and stay hydrated with lots of water. Visit food-guide.canada.ca for more resources.

Caffeine

Anxiety symptoms may be caused by consuming too much caffeine in things like coffee and chocolate. You may be able to reduce anxiety symptoms by reducing caffeine intake.

Physical Exercise

It may be helpful to engage in physical exercise to reduce anxiety symptoms. You can do things like go for a walk, practice yoga, go for a swim at a community centre, or any other activity that feels good. Notice if these activities help you with anxiety.

Spend Time in Nature

It can be helpful to spend time in nature to decrease anxiety symptoms. This can include spending time in greenhouses, in plant stores, in public parks, at the waterfront and more. Some free or low-cost options to spend time in natural, green spaces in the GTA are listed at the end of this booklet.

Avoidance and Procrastination

Sometimes feeling anxious might cause you to procrastinate, where you avoid tasks that are necessary and important. Avoiding a task might feel good in the short-term, but could lead to increased anxiety later on. Notice if this happens to you. The following techniques can be used to help.

  • When you are trying to accomplish a task, it is important to just get started. Start by working on a task for 2-5 minutes. You can break up big tasks into smaller steps until the task feels like it is small enough to finish.
  • Think about what activities you do when you are avoiding a task (eg. going online, watching Netflix) and try to limit those distractions during the time you are working on your task. You can use an app like the Stay Focused phone app: innoxapps.com/stay-focused.
  • Pomodoro Technique: Work on a task for 25 minutes, and then take a 5 minute break. After you do four cycles, take a longer break of 15-20 minutes.
  • Use website blockers when needed

Note on techniques

These are just a few techniques that you can try out on your own. Just because one technique works for you, doesn’t mean that all of them will. Take what works for you, and leave the rest.

You may need more support than what can be presented in this resource. If so, you can contact Planned Parenthood Toronto if you live in the GTA to make an appointment for mental health support, including free short- and long-term counselling (call to set up a consultation and to access resources). You can also visit our online list of mental health resources (ppt.on.ca/mental-health/), or speak to your healthcare provider, parent, teacher, or school support staff.

Here are a few more resources you can use to manage your anxiety:

General anxiety support:

Breathing and Meditation support:

Green spaces in the GTA:

  • Allen Gardens
  • Lake Ontario Waterfront
  • Toronto Botanical Gardens
  • Rouge Park
  • Don Valley Park and Trails

Remember, every small step you take is amazing. It is about progress, not perfection. The process of managing anxiety is life long for many, and it gets easier with time, practice and effort. Keep doing the best you can.

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