Tips for Managing Anxiety While in Public

Everyone experiences occasional anxiety. You might feel shyness or discomfort when faced with a challenging situation like public speaking or making an important decision. But if you’re regularly overwhelmed with anxiety, you may be struggling with an anxiety disorder.

Anxiety disorders are characterized by persistent feelings of anxiety and are often accompanied by uncomfortable physical symptoms. Excessive anxiety can interfere with daily life, including job performance, academics, and relationships.

As one of the most common mental disorders, anxiety disorders affect over 40 million U.S. adults. Generalized anxiety disorder (GAD) affects 3.1% of the U.S. population, while panic disorder affects six million adults. Social anxiety disorders and specific phobias are also relatively common, affecting 6.8% and 8.7% of adults in the U.S., respectively. Anxiety disorders are twice as common among women compared to men, according to the Anxiety and Depression Association of America.

Although anxiety disorders are highly treatable with a combination of medication and long-term psychological treatment, only 36.9% of those suffering seek professional help. 

What do you need to know about anxiety disorders, and how can you effectively manage them?

Types of Anxiety Disorders

Mental health specialists use “anxiety disorder” as an umbrella term to describe different mental disorders. Some common anxiety disorders include:

• Generalized anxiety disorder (GAD): People with GAD experience anxious thoughts and excessive anxiety feelings for no reason. Physical symptoms, such as muscle tension and fatigue, are common.
• Panic disorder: People with panic disorder experience intense fear without warning. Sometimes, a panic attack can feel like a heart attack.
• Obsessive-compulsive disorder (OCD): OCD is characterized by intrusive thoughts that lead to obsessions and rituals, such as hand washing. OCD sufferers feel like they must perform their rituals to prevent something terrible from happening.
• Separation anxiety disorder: People struggling with separation anxiety (usually children or adolescents) experience intense fear at the thought of being apart from their caregiver.
• Social anxiety disorder (social phobia): The symptoms of social anxiety disorder involve overwhelming anxiety surrounding social situations and social interactions due to a fear of rejection, embarrassment, and humiliation. According to the American Psychiatric Association, the fear of social situations and social anxiety can lead to social isolation, extreme shyness, and the disruption of everyday activities. Many people with social anxiety disorder have difficulty meeting new people, building friendships, and maintaining a healthy social life.
• Specific phobias: Phobias are characterized by an intense fear of a particular object or situation where no actual threat is present. For example, agoraphobia involves an excessive fear of specific situations in which no escape is possible, leading to social isolation and the disruption of daily activities.
• Posttraumatic stress disorder (PTSD): Some people experience anxiety after exposure to traumatic life experiences. The symptoms of PTSD include nightmares, flashbacks, suicidal thoughts, and avoidance, or apprehension toward situations that remind the sufferer of the traumatic event.

According to the National Institute of Mental Health (NIMH), anxiety disorders often co-occur with other mental health disorders, including substance use disorders, eating disorders, and mood disorders, such as major depression and bipolar disorder. Multiple research studies have linked the co-occurrence of these mental health disorders with greater symptom severity and higher disability levels.

Symptoms of Anxiety

All anxiety disorders share similar symptoms, including:

• Panic, dread, and discomfort
• Sleeping problems, such as restlessness, insomnia, and fatigue
• Shortness of breath
• Dizziness
• Muscle tension
• Digestive issues, such as nausea

Panic attacks are episodes of extreme fear and begin without warning. Some people have occasional panic attacks, while others experience frequent attacks.

Panic attacks affect everyone differently, but the physical symptoms of anxiety usually peak within a short period. Under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), panic attacks are characterized by a sudden onset of the following symptoms:

• Sense of impending doom
• Fear of losing control or dying
• Rapid heartbeat
• Trembling or shaking
• Shortness of breath or difficulty breathing
• Chills or hot flashes
• Nausea
• Chest pain
• Headache
• Dizziness, lightheadedness, or faintness
• Numbness or tingling sensation
• Feelings of detachment from real life

Many people with panic disorder experience an intense fear that they’ll experience another attack. Sufferers may fear panic attacks so much that they avoid particular situations where they may occur.

Managing Anxiety in Public

Anxiety symptoms can be challenging to manage, and experiencing a panic attack is even more difficult when you’re in public.

Practice deep breathing exercises.

When anxiety symptoms arise, your breathing is usually the first change that occurs in your body. Shortness of breath and hyperventilation are some of the most common physical symptoms of a panic or anxiety attack—but experiencing shortness of breath in public can make you feel even more anxious and can increase your feelings of anxiety.

Practicing deep breathing and relaxation exercises can help you slow your breath and ease intense anxiety while in public. Deep breathing can also help prevent other symptoms from worsening, such as chest pain, rapid heart rate, nausea, and heart palpitations.

Using deep breathing exercises during a panic attack requires you to practice regularly, even when you’re not experiencing anxiety. For example, it can help to start your day off with a few minutes of deep breathing or practice exercises in front of others.

Bring someone you trust.

When faced with situations that trigger intense anxiety, it can help bring a trusted friend or close family member for emotional support. With social support, you can feel more secure and relaxed in social situations.

Before going out in public, prepare your friend or family member by explaining your anxiety symptoms and fears. Come up with an action plan that includes recognizing your acute anxiety, utilizing coping strategies, and finding the best way to leave a particular situation if necessary.

Take it slow and set realistic goals.

People with panic disorder, social anxiety disorder, agoraphobia, and other phobias should slow down when entering feared situations. To effectively manage your anxiety, set realistic goals for how long you want to expose yourself to a feared situation.

Systematic desensitization can help people with anxiety disorders gradually overcome feared situations. Systemic desensitization helps people with anxiety unlearn fears and overcome circumstances that trigger anxiety reactions, such as public speaking. Systematic desensitization helps people overcome anxiety associated with managing excessive fear in public through visualization and other anxiety management techniques.

Seek professional help for your anxiety.

The symptoms of anxiety disorders can hinder you from reaching your true potential and interfere with daily functioning, preventing you from living the life you want to live.

For example, if you have agoraphobia, you may develop extreme avoidance behaviors, causing you to avoid particular situations. You might avoid public transportation, crowds, or going into public for an extended period. You might steer clear of everyday situations in more severe cases due to excessive worry, causing you to become homebound.

If significant anxiety prevents you from feeling comfortable in everyday social situations, it’s essential to seek professional help from a licensed mental health professional. The sooner you begin your treatment plan, the quicker you’ll be able to manage the symptoms of anxiety.

Treatment Options for Anxiety Disorders

If you’re experiencing chronic anxiety, exploring potential treatment options can help you improve your quality of life and feel more comfortable in public.

• Therapy: Psychotherapy, or talk therapy, can help people with anxiety disorders feel more comfortable in everyday situations. To be effective, psychotherapy treatment should be directed at a person’s specific anxieties and tailored to their particular mental health needs. For information on finding a mental health specialist to manage your anxiety, see the tips below.
• Check-ups: Because medical conditions such as heart disease and high blood pressure have similar symptoms to anxiety disorder, it’s important to schedule regular appointments with your primary care provider to examine your medical history and rule out any related conditions. If you’re struggling with high anxiety levels, your healthcare provider can provide a referral to a psychiatrist or psychologist.
• Medications: Anti-anxiety medications and anticonvulsants, such as clonazepam and benzodiazepine, are often used to manage anxiety symptoms. Selective serotonin reuptake inhibitors (SSRI) antidepressants, also used to treat major depression, can also help treat anxiety disorders by boosting serotonin production in the brain. Additionally, beta-blockers lower blood pressure by blocking adrenaline. If you’re interested in incorporating meds into your treatment plan, talk to your psychiatrist about potential side effects and different types of medication.
• Support groups: Support groups encourage anxious people to share their problems and achievements with others, strengthen social skills, and make new friends and social connections. Talking with a close friend or family member can also provide social support, but it’s essential to keep in mind that this is not necessarily a sufficient alternative to mental healthcare from a mental health specialist. Support groups and group therapy can be especially helpful in the treatment of social anxiety disorder and substance abuse problems.
• Lifestyle changes: Making healthy lifestyle changes, like incorporating relaxation techniques, getting enough sleep, and avoiding substances, can help reduce anxiety symptoms. Reducing your intake of stimulants like caffeine can also help with anxiety.

Finding the Right Therapist

Because your therapeutic relationship can significantly influence your treatment plan’s success, it’s crucial to take the time to find a good fit. Placing your mental health in the hands of the right mental health counselor, psychologist, social worker, or psychotherapist can ultimately help you make a positive change and improve your quality of life.

Some common types of therapy used to treat anxiety disorders include:

• Psychodynamic Psychotherapy: Psychodynamic therapy focuses on exploring and understanding the past so that people are better able to understand and find solutions in the present. This type of therapy has been shown to be effective in helping people to address anxiety.
  
• Cognitive-behavioral therapy (CBT): CBT, a type of psychotherapy, teaches people with anxiety disorders how to identify and change negative thoughts and behaviors that trigger anxious feelings. CBT is an effective treatment in a wide variety of mental health conditions, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), schizophrenia, and major depressive disorder.
• Acceptance and commitment therapy (ACT): ACT for anxiety disorders focuses on managing the fear response and learning new skills to cope with negative thoughts. By learning to accept feelings of anxiety, anxious people can take small steps toward psychological flexibility.
• Exposure therapy: Exposure therapy, a form of CBT, uses exposure exercises to gradually expose people to a feared object or situation, according to the National Alliance on Mental Illness. Exposure exercises can include exposure to situations like public speaking or objects such as spiders or butterflies. Exposure therapy helps people learn to control their fear response around their triggers.

Whether you’re considering online therapy for the first time or interested in continuing your treatment, reach out to a therapist through the Therapy Group of NYC. We know how challenging it can be to cope with anxiety, especially given the uncertainty and fear surrounding the ongoing COVID-19 pandemic. One of the qualified mental health providers at the Therapy Group of NYC will help you explore treatment options, learn coping skills, and find the strength to help you manage your anxiety symptoms.