What is Anticipatory Anxiety and Why Does it Happen?

Before unwrapping anticipatory anxiety, one may benefit from determining the differences between disordered anxiety, anxiety as an emotion, and forms of anxiety. Anxiety is a general term used to describe distressing emotional responses to external and internal cues. All people capable of experiencing emotions experience anxiety. The average person would become anxious before speaking to a crowd, attending an interview, or going on a first date. If anxiety arises in scenarios in which most people would not experience it or begins to disrupt life, then it may be an anxiety disorder. Lastly, specific types of anxiety can be described and defined by the circumstances they arise in. Anticipatory anxiety occurs when a future event is a trigger for a rise in anxiety and distress levels. The severity of anxiety responses for anticipatory anxiety can vary greatly.

Situational Versus Chronic

Situational anxiety is common and occurs in acute time periods. The anxiety issue will typically resolve itself when the triggering event has been resolved. For example, an individual may become anxious during the week of performance reviews. In situational anxiety, the end of the review would end the anxiety. Chronic anxiety is an ongoing experience in which symptoms aren't resolved for a long period of time. Chronic anxiety may differ in the intensity of anxiety but still qualify as chronic. Meaning, a person may have a few days where symptoms are mild or nonexistent and then spike to moderate or severe. Regardless, this person is still experiencing chronic anxiety with days of relief intermixed.

Signs and Symptoms

Anticipatory anxiety's hallmark symptom is increased rumination on a future event. Racings thoughts and excessive worry are common with anticipatory anxiety as well. Bodily symptoms can be present too such as a racing heart, slowed shallow breathing, and body tension. The experience may induce a panic attack or just an array of symptoms typically associated with anxiety. Emotional symptoms may be present with anticipatory anxiety as well. Emotional responses can range from feeling nervous, overwhelmed, fearful, panicked, or other distressing emotions.

Is there a link between cognitive distortions and anticipatory anxiety?

Theoretical orientations between therapists vary based on their preferred approach to care. However, all therapists can agree that anxiety and distorted thoughts (cognitions) are linked and affect each other. Different areas of our brain respond to stress and anxiety simultaneously. This is the beauty of our human systems working in sync to keep us alive. The neocortex (where we think in language and reason, the limbic system (our emotional center), and our brain stem (what causes our physical responses to stress) work in tandem. Meaning, you can't use one without the other.

Your brain believes the stories you tell it. Some people can see this illustrated through stories that cause anxiety. For example, if you have ever been in a car and played a scenario about a family member dying, you may have teared up and become emotional. This is because the brain can't decipher between what s real or not unless your conscious intentionally do it. This is what therapy often focuses on to correct anxiety as it arises or addresses the root issue.

Phasic fear versus anticipatory anxiety

Phasic fear is a brief emotional response to external stimuli. This response if usually intense and short-lived as (as long as the triggering factor is removed quickly). Whereas anticipatory anxiety is a stress response to a future event. The event can be in the near or far future and stress can occur for as long as a person remains focused on it. These two phenomena are different in nature as phasic fear is a brief response and anticipatory can become chronic. Stress responses in our body and brain present themselves similarly - so thoughts may race and a fight or flight response may occur- but the event that initiates it and the longevity make the differences.

Tips for Management

Many approaches exist to address anxiety symptoms. The first thing someone should recognize is that coping resources can absolutely provide relief however expectations should be managed first for the best outcome. Too many people will indicate their anxiety is an 8/10 and after using some coping techniques and skills, will report it decreased to 3/10 for example. They will come back and share the skill was ineffective because it did not alleviate all symptoms. However, if we can shift our mindsets to realizing that we do not need something to work perfectly for it to support us, we open up a lot more opportunities. Focusing on reducing the severity and mastering using some skills will create a foundation for healing.

Now, this is covered, we can explore coping skills to use at home. The first is moving your body. I can't prescribe exercise as I am not technically a personal trainer or movement expert. However, based on the research I have reviewed and knowledge of human behavior and stress responses, getting even 15-30 minutes of movement can make a big impact. This can be through anything you enjoy- dancing, walking, yoga, etc. The movement supports your body to regulate itself, which is what is lacking when anxiety is high.

The second coping skill suggestion is box breathing. You can look up additional video suggestions to walk you through this but you will essentially focus on your breath with this exercise. You will breathe in through your nose for four counts, out through your mouth four counts, in through your nose for four counts, and again out through your mouth four counts. The 4x4x4x4 nature of this is where it gets the name box breathing. This approach uses human biology to connect the brain to an awareness of safety. Breathwork is really powerful and overlooked. While it is simple, it does not mean it comes easy.

When should someone see a professional?

Every single person is so unique! I have an article written all about deciding on when it may be great to see a therapist. This is the link https://www.brighterdaysrecoverycounseling.com/ohiocounseling/do-i-need-a-therapist-or-psychologist

Self Help Recommendations

Some recommendations for further coping with anticipatory anxiety or other distressing emotions are the books Joyful by Ingrid Fittel Lee, The Body Keeps the Score by Bessel van der Kolk, and Trauma Made Simple by Jamie Marich. Some podcasts I recommend are Brene Brown's Unlocking Us, Trailercast, and The Adult Chair by Michelle Chalfant. Lastly, while it may seem silly I believe that Inside Out (Pixar film) is one of the best illustrations for understanding the importance of all emotions!