Living with anxiety is “exhausting.” That’s the word I hear most often from those who suffer from this disorder. And it’s no coincidence. Being constantly on high alert, both physically and mentally, waiting for anything to trigger that feeling of tightness in your chest, the sensation that you can’t breathe, or the lump in your throat that prevents you from swallowing, creates a systematic strain that eventually takes its toll.
Anxiety is like a silent enemy, slowly eroding your mental health, always lurking, ready to strike at the most inopportune moments. The good news is that there are psychological strategies to manage this apprehension in daily life and prevent anxiety from dictating our decisions and behaviors.
What does it really mean to live with anxiety?
A diagnosis of anxiety disorder is often both a relief and a challenge. On the one hand, it finally provides an explanation for those confusing feelings you’ve been experiencing. But on the other hand, you also wonder: What now?
State of hypervigilance: When you can never let your guard down
Living with anxiety is living in constant alert mode. It’s as if your brain doesn’t know how to turn off the alarm, even when there’s no fire. How does that translate into daily life? It means being constantly aware of everything: your body, other people, your surroundings, what could go wrong…
In fact, although we tend to think that pessimism is more characteristic of depression, it actually also accompanies anxiety. An anxious person makes mountains out of molehills, imagines catastrophes, and always expects the worst.
It’s not that you’re exaggerating or a hypochondriac; it’s that your nervous system is hyper-trained to detect threats, even the most improbable ones. The problem is that this constant vigilance is exhausting. You never fully rest, never fully relax, never truly switch off. Even in moments of tranquility, a part of you is “scanning,” as if something bad is about to happen.
Over time, this hypervigilance not only becomes exhausting, but it also erodes your sense of inner security. You find it hard to trust that everything will be alright, because you’re constantly looking for signs that tell you otherwise.
Everything costs double or triple (and nobody sees it)
One of the most invisible aspects of anxiety is the extra effort it takes to live. Things that are automatic or incredibly simple for others, like leaving the house, concentrating, making a call, socializing, or dealing with deadlines, demand an enormous amount of energy from you.
It’s not a lack of motivation or laziness; it’s that part of your mind is occupied managing internal discomfort: calming catastrophic thoughts, controlling physical sensations, anticipating problems, managing worries… When the brain is in threat mode, it constantly consumes resources, leaving less energy for the rest.
That’s why you tire more easily, burn out faster, and need more time to recover. Sometimes, even small tasks can feel like climbing Mount Everest. And the hardest part is that it’s not noticeable from the outside. No one sees the internal effort, so many people with anxiety feel misunderstood and guilty for not being able to keep up with others, when in reality they’re working two or three times as hard just to stay afloat.
Living by avoiding… and paying the price
Many people with anxiety learn, almost without realizing it, to live by avoiding things. You probably avoid situations that trigger discomfort, uncomfortable conversations, specific places, physical sensations, or even intense emotions. In the short term, avoiding these things provides relief. But in the long term, it shrinks your life.
Each attempt to avoid the situation reinforces the internal message that you can’t handle it. And that message takes hold. The world shrinks, options dwindle, and anxiety gains ground. Not because you’re weak, but because your nervous system has learned that escape is the only way to feel safe.
The problem is that tranquility based on avoidance is fragile. It only takes the situation (or something similar) to reappear for the fear to return with even greater force. That’s why you’re likely to feel that anxiety is more in control than you’d like, even if you make a tremendous effort to manage it.
What can you expect from anxiety?
The first – and perhaps most important – thing we psychologists do is help people adjust their expectations. Anxiety isn’t a disorder that can be “erased,” nor is it a system error that needs to be eliminated. It’s a basic emotion, necessary for survival and designed to alert us to danger.
The problem isn’t feeling anxious, but rather when it appears too intensely or frequently, or at times when there’s no real threat. Therefore, the goal isn’t to eliminate anxiety, but to learn to manage it and respond to it differently.
When you start working on anxiety, it’s not usually the case that it stops suddenly, but rather that you notice it gradually losing its power over you. It still appears, but it no longer controls you. It no longer decides what you do, where you go, or what you avoid. You learn to recognize it earlier, to understand what triggers it, and to avoid panicking when it arises. And that might not sound as spectacular or hopeful as you thought, but it can profoundly change your quality of life.
Psychological treatments for anxiety are effective. More than half of people go into remission, although an even greater number report significant clinical improvement after treatment, according to a meta-analysis published in Clinical Psychology Review.
Anxiety therapy isn’t about “convincing” you that nothing is wrong; it focuses on breaking the cycle of fear. It tries to understand how anxiety is maintained and teaches you to reduce avoidance, learn to tolerate uncomfortable sensations without running away, and change your relationship with your thoughts.
Gradually, the body learns that it’s not in constant danger and lowers its alarm level. Over time, what usually changes isn’t just the anxiety, but also how you see yourself. You regain confidence, autonomy, and a sense of control.
And the medication?
Many people believe that anxiety symptoms can only be treated with medication, but this isn’t always necessary or mandatory . In many cases, psychotherapy and behavioral strategies are enough to see profound and lasting improvements.
However, there are cases where anxiety medication can be helpful in relieving severe symptoms, especially at the beginning of treatment or in combination with therapy. This decision should be made in consultation with a psychiatrist, weighing the benefits and side effects.
In particular, I do not recommend drug therapy as the only way to combat anxiety for a very simple reason: it may relieve the symptoms, but it will not explain its origin or teach you how to manage the situations that generate that anxiety.
Learning to live with anxiety involves gradually incorporating small tools that, when combined, make a big difference. Sometimes it starts with understanding what’s happening to you, other times with learning to breathe better, rest more, move around, set boundaries, change certain mental habits, or stop avoiding what scares you.
There is no single formula that works for everyone, although these 10 strategies to treat anxiety can be a good starting point to begin taking action, step by step, without putting too much pressure on yourself.
Source:
Springer, K. S. et. al. (2018) Remission in CBT for adult anxiety disorders: A meta-analysis. clinical Psychology Review; 61: 1-8.
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