Anxiety & Panic Disorders Health Center

Anxiety is having too much fear and worry. Some people have what's called generalized anxiety disorder. They feel worried and stressed about many things. Often they worry about even small things. Some people also may have panic attacks. A panic attack is a sudden feeling of extreme anxiety.

People who have social anxiety disorder worry that they will do or say the wrong thing and embarrass themselves around others.

Anxiety can cause physical symptoms like a fast heartbeat and sweaty hands. It can make you limit your activities and can make it hard to enjoy your life.

Positive thinking can help you prevent or control anxiety.

Key points

• Negative thoughts can increase your worry or fear.
• Cognitive-behavioral therapy, or CBT, is a type of therapy that can help you replace negative thoughts with positive ones.
• Changing your thinking will take some time. You need to practice healthy thinking every day. After a while, positive thinking will come naturally to you.
• Positive thinking may not be enough to help some people who have worry and anxiety. Call your doctor or therapist if you think you need more help.

Positive Thinking: Stopping Unwanted Thoughts.

Positive thinking, or healthy thinking, is a way to help you stay well by changing how you think. It’s based on research that shows that you can change how you think. And how you think affects how you feel.

Cognitive-behavioral therapy, also called CBT, is a type of therapy that is often used to help people think in a healthy way. CBT can help you learn to replace negative thoughts with positive ones. These negative thoughts are sometimes called irrational or automatic thoughts.

Working on your own or with a counselor, you can practice these three steps:

• Stop. When you notice a negative thought, stop it in its tracks and write it down.
• Ask. Look at that thought and ask yourself whether it is helpful or unhelpful right now.
• Choose. Choose a new, helpful thought to replace a negative one.

The goal is to have positive thoughts come naturally. It may take some time to change the way you think. So you will need to practice positive thinking every day.

Changing your thinking can help you prevent or cope with anxiety.¹ It can help you stop the worry by replacing negative thoughts with helpful ones. It's also helpful in controlling panic attacks.

Positive thoughts can help stop the "fight or flight" feelings that you have with anxiety. In a fight-or-flight response, your body senses danger and the need to fight or run away. Your body releases hormones like adrenaline, which makes your heart beat fast and your blood pressure rise. Positive thoughts can calm you and stop this response.

For example, maybe you are about to have a job review. It's normal to be a little nervous. But you have trouble sleeping and have a fast heartbeat and sweaty hands. You think constantly about the review. You've been telling yourself that your boss is going to say bad things about your performance-even though you haven't been getting bad comments from her.

Or perhaps you have a doctor's appointment coming up. And you're worried that he may find something wrong.

If you have anxiety, you may worry a lot about many things. You are sure that something bad is going to happen, even though you have no proof that something bad will happen.

The more you talk in a negative way to yourself, the harder it is to keep a positive outlook. The negative thinking makes you feel bad. And that can make you feel more anxious, which leads to more bad thoughts about yourself. It's a cycle that's hard to break.

But with practice, you can retrain your brain. After all, you weren't born telling yourself negative things. You learned how to do it. So there’s no reason you can't teach your brain to unlearn it and replace negative thinking with more helpful thoughts.

Positive thinking also is good for your health in other ways. If you feel bad about yourself, you could get depressed. Positive thinking also can help you handle stress better. Too much stress can raise your blood pressure and make your heart work harder, which can increase your risk for a heart attack. Stress also can weaken your immune system, which can make you more open to infection and disease.

Stop your thoughts

The first step is to stop your negative thoughts or "self-talk." Self-talk is what you think and believe about yourself and your experiences. It's like a running commentary in your head. Your self-talk may be positive and helpful. Or it may be negative and not helpful.

Ask about your thoughts

The next step is to ask yourself whether your thoughts are helpful or unhelpful. Look at what you're saying to yourself. Does the evidence support your negative thought? Some of your self-talk may be true. Or it may be partly true, but exaggerated.

One of the best ways to see if you are worrying too much is to look at the odds. What are the odds, or chances, that the bad thing you are worried about will happen? If you have a job review that has one small criticism among many compliments, what are the odds that you really are in danger of losing your job? The odds are probably low.

There are several kinds of irrational thoughts. Here are a few types to look for:

• Focusing on the negative: This is sometimes called filtering. You filter out the good and focus only on the bad. Example: "I get so nervous speaking in public. I just know that people are thinking about how bad I am at speaking." Reality: Probably no one is more focused on your performance than you. It may help to look for some evidence that good things happened after one of your presentations. Did people applaud afterward? Did anyone tell you that you did a good job?
• Should: People sometimes have set ideas about how they "should" act. If you hear yourself saying that you or other people "should," "ought to," or "have to" do something, then you might be setting yourself up to feel bad. Example: "I have to be in control all the time or I can't cope with things." Reality: There's nothing wrong with wanting to have some control over the things that you can control. But you may cause yourself anxiety by worrying about things that you can't control.
• Overgeneralizing: This is taking one example and saying it's true for everything. Look for words such as "never" and "always." Example: "I'll never feel normal. I worry about everything all the time." Reality: You may worry about many things. But everything? Is it possible you are exaggerating? Although you may worry about many things, you also may find that you feel strong and calm about other things.
• All-or-nothing thinking: This is also called black-or-white thinking. Example: "If I don't get a perfect job review, then I'll lose my job." Reality: Most performance reviews include some constructive criticism-something you can work on to improve. If you get five positive comments and one constructive suggestion, that is a good review. It doesn't mean that you're in danger of losing your job.
• Catastrophic thinking: This is assuming that the worst will happen. This type of irrational thinking often includes "what if" questions. Example: "I've been having headaches lately. I'm so worried. What if it's a brain tumor?" Reality: If you have lots of headaches, you should see a doctor. But the odds are that it's something more common and far less serious. You might need glasses. You could have a sinus infection. Maybe you're getting tension headaches from stress.

Choose your thoughts

The next step is to choose a positive, helpful thought to replace the unhelpful one.

Keeping a journal of your thoughts is one of the best ways to practice stopping, asking, and choosing your thoughts. It makes you aware of your self-talk. Write down any negative or unhelpful thoughts you had during the day. If you think you might not remember them at the end of your day, keep a notepad with you so that you can write down any thoughts as they happen. Then write down helpful messages to correct the negative thoughts.

If you do this every day, positive or helpful thoughts will soon come naturally to you.

But there may be some truth in some of your negative thoughts. You may have some things you want to work on. If you didn't perform as well as you would like on something, write that down. You can work on a plan to correct or improve that area.

If you want, you also could write down what kind of irrational thought you had. Journal entries might look something like this:

Now that you have read this information, you are ready to practice positive thinking to help you prevent and control anxiety.