Can one learn not to panic? How?

Can one learn not to panic? How?

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It's always impressive to listen to the professionalism of a commercial pilot communicating in a crisis situation, apparently remaining calm and in control in terrifying circumstances, with terrible responsibility. I imagine this occurs because (a) the industry does not promote those who panic to this position and (b) pilots practice a great deal in simulators, learning to cope with crisis calmly.

Am I imagining correctly, here?

To what extent can practice (b) overcome a deficiency in (a) a natural tendency to calmness?

Does practice at staying cool in one field (say, making decisions during play of a fast computer game) transfer to staying cool generally (say, being accosted by an aggressive stranger on the street)?

I read What characterises people who stay calm in crisis situations? and that does relate (a) to calmness in a crisis but I don't think it says anything about (b).

I believe that there is a fundamental flaw in your scenario in that, pilots are not promoted to being a pilot from being something else. Pilots take intensive training courses that may include simulation training and do include many hours of practice in an actual aeroplane, under supervision of a trained instructor.

To more generally answer your question:

Can one learn not to panic?

Yes, using behavioural training techniques we can train ourselves, or be trained by others, to respond to situations or stimuli in a different way than is our instinctive reaction.

With the situation you noted about pilots, a trained pilot will have all of the knowledge of how to deal with a situation that they may encounter and will have practiced this knowledge in an applied setting (an actual plane) many times, making the training become the pilots first response to a dangerous situation (Exposure Therapy, and Repetitive Learning are some ways of doing this).

A novel situation can also be trained for. In your scenario, I would suspect that their training would include an emergency checklist type of activity that would then be repeated over and over so that it is ingrained in their memory and behaviours and will also become the pilots first response to a novel dangerous situation.

How to learn not to panic is really all about training your brain to behave in a different way then its instincts tell it to, this may or may not mean that you totally remove the instinctive fear response.

Simple Steps to Help You Cope With Anxiety

Rachel Goldman, PhD FTOS is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in weight management and eating behaviors.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Anxiety involves feelings of worry, fear, and apprehension. Anxiety is typically experienced on cognitive, emotional, and physical levels.   For instance, when feeling anxious a person may have negative or disturbing thoughts.

On an emotional level, one may feel scared or out-of-control. It is also common to experience severe anxiety through somatic sensations, such as sweating, trembling, or shortness of breath.  

These symptoms are common for people who have been diagnosed with an anxiety disorder. People with panic disorder are typically familiar with the struggle of managing feelings of anxiety.   It can feel as if the anxiety is taking over or completely out of one’s control.

Does anxiety have an overwhelming pull in your life? Fortunately, there are some simple steps you can take to manage your anxiety. Listed below are 4 tips to help you cope with your feelings of anxiety.

Simple Steps to Help You Cope With Anxiety

Rachel Goldman, PhD FTOS is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in weight management and eating behaviors.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Anxiety involves feelings of worry, fear, and apprehension. Anxiety is typically experienced on cognitive, emotional, and physical levels.   For instance, when feeling anxious a person may have negative or disturbing thoughts.

On an emotional level, one may feel scared or out-of-control. It is also common to experience severe anxiety through somatic sensations, such as sweating, trembling, or shortness of breath.  

These symptoms are common for people who have been diagnosed with an anxiety disorder. People with panic disorder are typically familiar with the struggle of managing feelings of anxiety.   It can feel as if the anxiety is taking over or completely out of one’s control.

Does anxiety have an overwhelming pull in your life? Fortunately, there are some simple steps you can take to manage your anxiety. Listed below are 4 tips to help you cope with your feelings of anxiety.

Types of Anxiety And Differences

One thing that is clear is that anxiety disorders can present themselves in many different ways. Panic disorder is different from generalized anxiety disorder, which is different from social anxiety disorder and so on.

So even though these disorders are all referred to as "anxiety," they are different disorders each with their own set of symptoms (sometimes the symptoms overlap). This brings up an interesting question: can you have more than one anxiety disorder? The answer is yes. Here are some of the anxiety disorders that can be diagnosed, according to the American Psychiatric Association’s manual of disorders (the DSM V):

  • Selective Mutism
  • Specific Phobia
  • Social Anxiety Disorder
  • Separation Anxiety Disorder
  • Panic Disorder
  • Generalized Anxiety Disorder

Coping With Anxiety: 10 Strategies

Although anxiety is a natural emotion, it does not have to become so overwhelming that it creates major interference in your life. Learning to identify when feelings of anxiety begin to emerge, and ways to cope with them can help prevent complications later. Coping with anxiety can be as simple as a change in routine or habits. Let&rsquos look at some coping strategies for dealing with anxiety.

#1: It&rsquos Important To Practice Self-Care

Self-care is simply the practice of actively taking measures to improve or preserve one&rsquos health. Although the concept of self-care is theoretically simple, many people overlook its importance. Self-care is not selfish. Taking care of yourself, both physically and emotionally, can help improve overall health and decrease anxiety.


Self-care measures include recognizing when life seems more difficult that it&rsquos okay to slow down, getting enough sleep, and having a healthy diet and exercise routine. Practicing self-care means that you want to get to know you better. What makes you happy? What hobbies do you enjoy, or would you be interested in trying? Anything you can do to give yourself time to decompress when situations feel stressful is part of self-care and can help relieve the symptoms of anxiety.

Taking the time to slow down can help make you more productive, which can reduce anxiety. Slowing down may mean taking some time each day to have a cup of coffee and read a book or write in a journal, do some yoga or meditate. For some, simply saying &ldquono&rdquo to extra commitments that don&rsquot benefit, you can be helpful.

#2: Meditation

Spend at least 5 minutes each day to stop and meditate. If you&rsquove never meditated before, there are some great apps to help get you started. The Mindfulness App, Headspace, and Calm are some great resources for tips and tricks to learning the art of meditation.

#3: Take A Bath

Baths are a great way to reduce stress and anxiety. You can create a relaxing detox bath by mixing 1 cup of Epsom salt, ½ cup of baking soda, ½ cup of sea salt, and your favorite essential oil. Light a candle and let the bath do its work!

#4: Get Creative

Whether you like to write, paint, or cook, anything you can do that gets your creativity flowing will help reduce anxiety. Focusing your mind and energy on things you enjoy doing helps give a positive release for some of the weight that anxiety can cause emotionally.

#5: Get Moving

Exercise releases endorphins also referred to as the &ldquohappy hormones&rdquo of the body. A walk in the park or around the neighborhood, a leisurely bike ride or a workout are all ways to get your body moving and to relieve anxiety. Not to mention, there are great physical health benefits, such as reducing the risk of stress-related illnesses like high blood pressure and heart disease.

#6: Get Enough Sleep

Lack of adequate sleep can affect both physical and mental well-being. Make it a priority to set aside at least 8 hours for sleep each night. Be intentional about your sleep routine. If you need to set the alarm on your phone to remind you that it&rsquos time to wrap up the activities of the day, do it. When it&rsquos time for bed, turn off any electronic devices such as your phone or television as these can stimulate your brain and make falling asleep more difficult. Make sure your thermostat is set to a comfortable setting and that your room is quiet and calm


#7: Practice Deep Breathing

Deep breathing exercises, when done correctly, help to regulate breathing, which helps reduce heart rate. Reduced heart rate can help calm anxiety. Breathe in for a count of 4 then breathe out for a count of 4. Do this for 5 minutes. You may be pleasantly surprised at how much more at ease you feel after just a few minutes of deep breathing.

#8: Learn To Control Your Thoughts. Don&rsquot Let Them Control You

Negative thoughts can increase feelings of anxiety. In fact, if they are not controlled, they can cause a situation to become worse and can leave feelings of distorted reality. One way to control your thoughts is to ask yourself: 1.) &ldquoIs this true?&rdquo and 2.) &ldquoWill thinking about this make me feel better or worse?&rdquo Anything that does not improve your thought pattern and relieve stress is something you should avoid focusing on as much as possible.

#9: Make Sure You Have A Support System

Dealing with anxiety can feel overwhelming at times. Having a friend or family member that you can talk to about your feelings is a good way to sort through emotions and try to gain perspective. One thing you should consider when deciding who your support system/support person is going to be is whether that person/people can offer you nonjudgmental support. Anxiety is difficult on its own. You need to rely on supportive people who will let you talk about your emotions and offer some positive reinforcement without passing judgement or being overly opinionated, which could lead to increased anxiety.

#10: Knowing When To Ask for Help

Even the strongest people experience times when help is beneficial. If anxiety has become an all-too-often occurrence for you, or if you feel unable to manage the symptoms of anxiety alone, seeking the help of a counselor or therapist could be helpful. Mental health counselors are professionals who are trained to assist with problems, such as anxiety. They can listen to your concerns and suggest options to help resolve the issues and help minimize the symptoms related to anxiety with a plan that is tailored specifically for you.

Whether you choose to see a local counselor, join a support group, or engage in online counseling, it&rsquos important to address any anxiety and try to resolve the issues. If you have a counseling center or therapist in mind, call for a consultation. If you don&rsquot know of someone locally, your primary care provider can offer resources to get you connected with someone to help.

Also, if you prefer, online counseling options are available from several sources. Online counseling, such as that provided by BetterHelp allows individuals to connect with licensed, professional counselors, from the comfort and privacy of your own home.

You Can Reduce Anxiety Symptoms

While experiencing anxiety from time to time is normal, you don&rsquot have to be controlled by the overwhelming presence of anxiety every day. Consider these steps for coping with anxiety and enjoy your best, anxiety-free life!

Frequently Asked Questions (FAQs)

What are some coping strategies for anxiety?

Coping techniques may vary from person to person. However, according to the Anxiety and Depression Association of America, these are good methods of dealing with anxiety medically reviewed and typically effective:

  • Eating balanced meals
  • Limiting alcohol and caffeine
  • Mediation, mindfulness, and relation techniques
  • Exercise daily
  • Deep breathing and counting to 10
  • Learn what triggers your anxiety
  • Know that you are in control of your thoughts
  • Stop anxious thoughts by practicing positive self-talk
  • Find a treatment center and talk to a medical professional about how you are feeling and ask for advice on how to cope with anxiety

What are the 5 types of coping strategies?

The five types of medically reviewed strategies for coping with stress and anxiety are:

Appraisal-focused coping strategies for anxiety

These types of coping methods occur when an individual changes the way they think by actively denying how they are feeling or distancing themselves from the problems that they are facing. They may also change their anxious thoughts by changing their values and goals.

Adaptive behavioral coping strategies for anxiety

People will focus on trying to deal with what is causing the problem. This type of coping focuses on taking control and changing or removing the source of their stress and anxiety.

Emotion-focused coping strategies for anxiety

These methods to cope with anxiety include:

  • Releasing emotions that have built up over time
  • Mediation
  • Mindfulness practices
  • Exercising
  • Distracting yourself
  • Trying relaxing techniques when you&rsquore anxious
  • Seeking support from others
  • Finding a therapist

Reactive and proactive coping strategies for anxiety

These strategies include the anticipation of long term or future stressors so you can prepare for them.

Social coping strategies for anxiety

Individuals will embed themselves in a social environment such as hanging out with friends or family or looking to find a treatment center.

Humor is used by individuals as a quick coping method that can provide some time for finding a long term coping mechanism. By having a humorous mindset, people can reduce their overall anxiety greatly.

What helps severe anxiety?

If you are experiencing severe anxiety that is disrupting your everyday routines and causing you a great deal of distress, the best thing for you to do is to speak with a mental health professional, find a therapist, and find a treatment center to get medical advice on how to properly cope. Your therapist will most likely prescribe you types of therapy such as behavioral therapy or cognitive behavioral therapy to help you deal with your anxiety long term.

What are effective coping strategies?

Medically reviewed coping strategies for long term coping/quick coping of anxiety, panic attack, addiction ADHD, bipolar disorder, and stress are:

  • Seeking support, medical advice, visiting a treatment center, find a therapist
  • Problem solving to try and locate the source of your anxiety
  • Relaxation to help with physical symptoms of anxiety, self-care
  • Exercising
  • Adjusting expectations and preparing for a stress associated event
  • Venting once you find a therapist

When experiencing anxiety self care can be one of the best things you can practice. Even if it feels silly, taking a bubble bath might calm you down a little or even just spending time walking your dog. Self care isn&rsquot medically reviewed, but it can still be helpful.

How can I deal with anxiety naturally?

According to Healthline media, some medically reviewed natural ways to deal with anxiety and a panic attack are:

  • Staying active as much as possible
  • Refraining from alcohol and drugs
  • Stopping your smoking habit
  • Stopping your consumption of caffeine
  • Getting enough sleep and rest each night
  • Meditating
  • Eating a healthy and balanced diet
  • Practicing deep breathing and mindfulness
  • Engaging with aromatherapy for anxiety self-care
  • Drinking chamomile tea

What helps panic attacks fast?

According to Healthline media, if you are experiencing a panic attack you should try the following quick coping methods:

  • Use deep breathing techniques
  • Recognize that you are having a panic attack instead of having heart palpitations or a heart attack
  • Close your eyes to block out extra stimuli
  • Practice mindfulness
  • Focus on an object and give that object your full attention
  • Use muscle relaxation techniques
  • Visualize your happy place
  • Try doing a light exercise to boost endorphins in your body
  • Use lavender oil to soothe your stress
  • Try and repeat an internal mantra to calm your racing thoughts

What are 3 coping strategies?

When dealing with anxiety medically reviewed strategies are:

  • Calming coping strategies such as taking a moment to yourself, deep breathing, relaxation techniques
  • Emotion-focused coping strategies such as journaling your emotions, meditation, and visualization
  • Solution-focused coping strategies such as problem-solving strategies, conflict resolution, time management

What are emotional coping skills?

According to Healthline media, medically reviewed, emotional coping skills for long-term coping include:

  • Meditation
  • Journaling
  • Positive thinking
  • Reframing situations (types of therapy for this include behavioral therapy)
  • Talking it out with others
  • Try to find a therapist (a mental health professional can refer you to one)

What are unhealthy coping skills?

Unhealthy long term coping skills include:

  • Projecting thoughts, angers, and feelings onto others to distract what is actually going on
  • Dissociating to escape from overwhelming emotions associated with any traumatic memories we may have
  • Self-medicating which can lead to addiction or other mental health issues such as low self-esteem and other addictive behaviors. When dealing with addiction ADHD or other mental disorders can make coping difficult.
  • Denial or repression of thoughts and feelings to protect yourself from what may come such as a medical advice diagnosis

What are 3 positive coping strategies to deal with stress?

Positive psychology methods that help people focus on long term positive aspects of their lives to deal with stress include:

  • Listening to music
  • Exercise
  • Reading
  • Meditation
  • Yoga
  • Going to church or practicing spirituality (if applicable)
  • Getting a massage

When approaching anxiety self care can make a big difference. Although not medically reviewed, they are still effective.

What are 4 strategies for managing stress?

If you are trying to manage stress, try the 4 A&rsquos of stress management:

  • Avoid: take control of your surroundings, avoid people and situations that cause stress, learn how to say no to others
  • Alter: communicate your feelings openly to others, ask others to change their behaviors in a respectful way, practice better time management
  • Accept: talking to someone (find a therapist), practice positive psychology methods such as positive self-talk, learn from your mistakes
  • Adapt: look at the big picture of things instead of worrying about the details, adjust your standards for long term benefit, and reframe your thoughts

What do you do when coping skills don't work?

If your coping mechanism is not working, try the following:

  • Visit a treatment center and speak with a mental health specialist
  • Find a new coping mechanism to try
  • Try giving your old coping mechanisms a second chance
  • Stay connected to people and reach out for help

How do you develop coping skills?

Developing coping skills that are healthy is key to overcoming anxiety, stress, and any other types of mental health disorder. Therefore, to develop coping skills you should:

  • Take time to breathe throughout your day
  • Analyze your feelings and put things into perspective by looking at the big picture
  • Develop habits that are healthy and positive such as exercising, positive self-talk, eating healthy, mediation

What are 3 signs of stress?

According to Healthline media, three signs of stress include:

How do you teach coping skills?

Teaching kids from a young age to develop positive coping skills will help them deal with stress, anxiety, and more mental health disorders when they are older should they develop them. Therefore, from a young age you should:

What Going Crazy Feels In Different Anxiety Disorders

There are many different forms of anxiety, and each anxiety disorder can cause its own experience or feeling of "going crazy". Anxiety often causes a feeling of losing control, and for many, that lack of control contributes to the sensation of going crazy. While this can occur in any type of anxiety, it is far more common in some than others. For example:

Panic Disorder

Many people feel as though they are going crazy when they suffer from panic disorder, and in many different ways. Some people's panic attacks are so severe that it feels like their brain genuinely isn't working - as though it's causing them to feel things that their own mind is telling them it shouldn't.

During a panic attack, the mind can shoot so rapidly and in a way that appears to have no flow. In some cases, their mind and thoughts are so overwhelming that they can't be followed, and the person has trouble thinking. Others describe it as "feeling their brain" as though they're on the outside of their own cognitions, and some simply experience so many physical sensations as a result of their mind that they feel they're going crazy as a result.

That feeling of going crazy is a very real and very common symptom of panic disorder, and why it doesn't affect everyone, it has been known to cause significant distress.

Obsessive Compulsive Disorder (OCD)

Those with OCD may also feel as though they're going crazy, although in a very different way. Many recognize that their obsessions and compulsions are "irrational" at their heart, but no matter how hard they try they can't shake them. This makes them feel like their mind is controlling them in a way that their thoughts aren't. Things start to nag at them and they pick up ticks that may also contribute to this feeling of losing control.

Post-Traumatic Stress Disorder (PTSD)

Many of those with severe PTSD have symptoms that make them feel like they're going crazy. Some with PTSD have vivid flashbacks, some have paranoia, and some even suffer from auditory and visual hallucinations.

While these absolutely fall under the heading of psychosis, they're still a hallmark of an anxiety disorder. In most cases, a psychologist treats the anxiety directly. You're not going crazy if you suffer from PTSD. It's simply a reaction to the anxiety you experienced as a result of your trauma, and what happens when your entire body is on high alert.

Dealing With The "Going Crazy" Feeling From Anxiety

Only a trained psychologist can diagnose your mental health, and anyone that feels anything that resembles psychosis deserves a trained professional diagnosis.

But anxiety causes a lot of different emotions, and the feeling of going crazy is one of them. Many of those suffering from intense anxiety have this feeling of going crazy that comes from the extremely high emotions, a rush of adrenaline and stress, and the overwhelming feeling of losing control. It's a natural response to severe anxiety.

The question is how to control it. Unlike regular daily anxiety and stress, the feeling going crazy comes from losing control. Once you feel you've lost that control, you may simply need to wait it out. Often during anxiety attacks, your sense of self will come back to you, and you can start addressing the issues that are causing you to feel like you're losing control. There are some solutions you can try now, including:

  • Learn More About Anxiety Symptoms - For many with anxiety, the feeling of going crazy comes from not understanding what's going on, and how something like anxiety can be causing these incredibly powerful feelings. You need to research what is causing your symptoms so that you better understand them, that way you no longer feel like you're losing control. For example, many of the physical symptoms of panic attacks come from hyperventilation. The more you understand hyperventilation, the more you'll be able to control the way you feel when you start to hyperventilate. Knowledge has a great deal of power on how much anxiety overwhelms you.
  • Reality Reminder - When that feeling of going crazy is over, take some time to remind yourself that you're still grounded in reality. Call a friend, see a movie, watch your favorite show on TV - do things that you couldn't do if you were really breaking from reality. Many people choose to sit there and think about the anxiety they just experience, but getting back into what life is like is a better tool for gaining control over the way you feel.
  • Supplements and Anxiety Drugs - Generally, anxiety medications are not recommended, and even herbal supplements have their setbacks. But if your anxiety is so profound that you feel as though the world is crashing down around you, it may be time to consider these options. Talk to you doctor about some safe, low dose treatments, or research herbal supplements like kava and passionflower to see if they're right for you.
  • Therapy and Support Groups - Seeking some type of long term treatment method can also be useful if you can afford it, and doing so right away may help you ease you into the idea of treating your anxiety. Support groups are also a good place to start. Find others that have dealt with severe anxiety (online or offline) and you'll be able to remind yourself that others experience the same thing as you do - and overcome it.
  • Exercise - Exercise is an important tool for combatting anxiety. It has a bit less of an effect on feelings of psychosis, but it can reduce anxiety severity which should decrease any feelings as though you're going crazy.

Those that feel like they might be suffering from psychosis are often experiencing very severe anxiety that needs a very real, very effective treatment. Remind yourself that you're not going crazy, and start committing to a way to treat anxiety that works.


You’re not going crazy. Losing touch with reality is not something people typically know is occurring. But anxiety can be severe, and cause symptoms – depending on the type of anxiety – that can make it feel like one is losing control. There are techniques that can keep you from feeling like you’re going crazy, but ultimately a long-term anxiety reduction strategy is critical.

Here are several studies that suggest positive thinking can treat anxiety.

1. Online Therapy for Anxiety

It has long been established that the amygdala is an important area for fear conditioning.

The amygdala is a small cluster of nuclei situated in the temporal lobe. It receives a stimulus that causes it to pass on electrical output to other regions of the brain that prompt typical fear reactions. These can be increased heart rate, additional sweating, dizziness etc.

The first study found that 9-weeks of online therapy led to a distinct change in the shape of participant’s amygdalae.

The study consisted of online cognitive behavioural therapy devised for people that all experienced social anxiety disorder.

Mr. Kristoffer NT Månsson, an author of the study, said:

The greater the improvement we saw in the patients, the smaller the size of their amygdalae. The study also suggests that the reduction in volume drives the reduction in brain activity.

2. Optimistic Thinking Benefits the Anxious Brain

Another region of the brain that is important to anxiety and negative reasoning is the orbitofrontal cortex (OFC).

A second study also showed a change in this part of the brain.

The study showed that just by thinking positive thoughts instead of negative ones, a person could actually increase the size of their OFC’s.

The lead researcher – Professor Florin Dolcos said:

If you can train people’s responses, the theory is that over longer periods, their ability to control their responses on a moment-by-moment basis will eventually be embedded in their brain structure.

3. Brain Training can Reduce Anxiety

In a third study, researchers found that by concentrating on a simple task, unnecessary fearful emotions could be avoided.

In this way, the brain could be trained to disregard anxiety-inducing triggers.

The study involved participants identifying which arrows on a screen were pointing left or right.

During the task, they also had to ignore all the other arrows on the screen.

When the brains scans were taken, they showed that those participants who studied the most difficult tasks actually performed better when dealing with their negative emotions.

Finally, if you need any more evidence to prove that positive thinking can treat anxiety, one further study showed a possible correlation between dementia and depression and anxiety.

4. Connection Between Dementia and Anxiety

This new research presented a high probability that stress and anxiety use the same neurological paths in the brain as depression and dementia.

The study strongly suggests that by relieving stress and anxiety in our lives, we can be at a decreased risk of dementia and depression in later life.

Scientists say there is a broad overlap between the neural pathways of the two conditions.

Dr. Linda Mah, the lead author of the study, said:

Pathological anxiety and chronic stress are associated with structural degeneration and impaired functioning of the hippocampus and the prefrontal cortex (PFC), which may account for the increased risk of developing neuropsychiatric disorders, including depression and dementia.

So, since positive thinking could actually treat anxiety, perhaps there is some truth in the saying ‘Mind over matter’!

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Science will increasingly be researching the brain’s ability to cure itself of all disorders and diseases. I believe that a new paradigm of physics and biology is due, one that uses inner, non-physical experience as opposed to exterior, physical research to prove theories.
This is vital information that has been forgotten. Our future could be very different than the direction we are currently headed if we learn to use our innate faculties of renewal foe the benefit of ourselves and our world!

How to Deal With Anxiety

Dealing with anxiety is not easy. One of the benefits of professional help is that it gives you someone to keep you accountable, and provides you with validation that what you've done thus far has been working.

It is possible to deal with anxiety on your own. But in order to do so, you have to be able to commit to lifestyle changes, avoid some of the most common anxiety fueling behaviors, and be ready to hold yourself accountable for your changes.

How Anxiety Affects Speech

Different forms of anxiety seem to affect speech in different ways. You should absolutely make sure that you're addressing your anxiety specifically.

Anxiety causes both physical and mental issues that can affect speech. These include:

  • Shaky Voice Perhaps the most well-known speech issue is simply a shaky voice. When you're talking, it feels like your voice box is shaking along with the rest of your body (and it is). That can make it sound like it is cracking or vibrating, both of which are a sign to others that you're nervous.
  • Quiet Voice Those with anxiety - especially social phobia - often find that they also have a hard time speaking up in public. This type of quietness is very common, and while not technically a speech pattern, it can make your entire voice and the way you speak sound different to others. Although many will think of this in terms of volume, talking down at your feet will also exacerbate the effect.
  • Dry Throat/Loss of Voice Some people find that anxiety seems to dry out their throat, or cause them to feel as though they're losing their voice.. One possible reason is that anxiety can make acid reflux symptoms worse, and those with acid reflux do have a tendency to wake up with sore throat and a loss of voice. Anxiety also increases the activity of your nervous system when your fight or flight response is activated your mouth will naturally produce less saliva as a natural side effect.
  • Trouble Putting Thoughts to Words Not all of the speech pattern symptoms of anxiety are physical either. Some of them are mental. Anxiety can make it much harder to for you to think about the words you're going to say, which can cause you to step over yourself, forget words, replace words with incorrect words, and more. Speaking generally has to be natural to be clear, and when you overthink it's not uncommon to find the opposite effect.
  • Stuttering Similarly, anxiety can create stuttering. Stuttering itself is a separate disorder that can be made worse by anxiety. But beyond that, those that are overthinking their own sentences and word choices often find they end up stuttering a considerable amount, which in turn can create this feeling of embarrassment.

These are only a few of the issues that anxiety has with speech and speech patterns. There are even those that are bilingual that find that when they have anxiety they mix up the languages. Anxiety can do some unusual things to the way you talk to others, and that means that your speech patterns are occasionally very different than you expect them to be.


Individuals with panic disorder regularly suffer intense episodes of anxiety, known as panic attacks (see below). They worry a lot about having more attacks, or about what the attacks imply or might cause, or have made changes to their behaviors because of the attacks.

Panic Attacks

These intense anxiety attacks include 4 or more of the following symptoms:

  • shortness of breath
  • increased heart beats
  • trembling, shaking
  • dizziness
  • chest pain
  • sweating
  • chills or hot flashes
  • feelings of unreality or being detached from oneself
  • numbing or tingling sensations
  • nausea
  • choking sensations
  • fear of dying
  • fear of insanity or of losing control

Panic attacks begin suddenly and usually peak quickly, within 10 minutes or less of starting. Multiple attacks of different intensities may occur over several hours, which might feel as if one panic attack is rolling into the next, like waves. At first, panic attacks usually seem to come ‘out of the blue,’ but over time a person may come to expect them in certain situations. If a person begins to avoid these situations due to fear of a panic attack, they may also have agoraphobia (see below).

Some people suffer panic attacks on a daily or weekly basis. The outward symptoms of a panic attack frequently result in social difficulties, such as embarrassment, stigma, or social isolation. However, people who have had these attacks for a long time are often able to restrain outward signs of even very intense panic attacks. Sometimes people will suffer milder attacks with only 3 or less of the above symptoms, which are known as Limited Symptom Attacks (see below).

Onset & Course

Panic disorder is a serious mental health problem, but it can be successfully treated. An estimated 2-3% of Americans have panic disorder at some point in their lives. It is observable before 14 years of age, but the prevalence is low in this age category. The rates gradually increase throughout puberty and peak during adulthood. This timeframe is particularly common if someone has been subjected to a traumatic experience. Women are twice as likely as men to develop panic disorder.

The frequency and severity of panic attacks vary widely between individuals. Panic disorder can continue for months or years, depending on how and when treatment is pursued. If left untreated, symptoms may become so severe that a person has significant problems with their friends, family, or job. Some people may experience several months or years of frequent symptoms, then many symptom-free years. In others, symptoms persist at the same level indefinitely. There is some evidence that many people, particularly those whose symptoms begin at an early age, may naturally experience a partial or even complete reduction in symptoms after middle age.


Risk factors can be temperamental (i.e. neuroticism and anxiety sensitivity), environmental (i.e. childhood abuse and smoking), or genetic and physiological. The exact causes of panic disorder are not known, but like many other anxiety disorders, panic disorder runs in families, meaning that inheritance may play a strong role in determining who becomes affected by it. In fact, panic disorder is often found in combination with other hereditary disorders such as bipolar disorder and alcoholism. However, many people without a family history of panic disorder develop it. Malfunctioning in brain areas such as the amygdala and adrenaline glands may cause an overproduction of certain chemicals which produce the physical symptoms.

Other biological factors, stressful life events, and exaggerated thinking about common bodily reactions are also believed to play a role in the onset of panic disorder. Often the first attacks are triggered by physical illnesses, major stressors, or certain medications. People who take on too many responsibilities may develop a tendency to suffer panic attacks. Individuals with post-traumatic stress disorder (PTSD) also show a much higher rate of panic disorder than other people. Some evidence suggests that hypoglycemia, hyperthyroidism, mitral valve prolapse, labyrinthitis, and pheochromocytoma may trigger or worsen panic disorder.


Agoraphobia is a disorder in which a person becomes anxious in and therefore begins to avoid situations from which escape might be difficult or help might be unavailable in the event of a panic attack. In the recent shift from the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR) to the Fifth Edition of the DSM (DSM-5), agoraphobia was transitioned from only being diagnosed in individuals with panic disorder to being a standalone diagnosis. To be diagnosed with agoraphobia, the individual must exhibit explicitly observable fear or anxiety about two or more of the following situations:

  • Using public transportation
  • Being in open spaces
  • Being in enclosed spaces
  • Standing in line or behind a crowd
  • Being outside of the home alone

This anxiety is often increased by a fear of embarrassment, as the person fears suffering a panic attack and showing distress in public. About one of every three people with panic disorder develops agoraphobia.

Agoraphobics may experience panic attacks in the situations where they feel trapped, insecure, out of control, or too far from their comfort zone. In very severe cases, an agoraphobic may confine themselves to their home. These people may live for years without leaving their homes, while happily seeing visitors in and working from their personal safety zones.

Limited Symptom Attacks

Many people with panic disorder have a mixture of panic attacks and limited symptom attacks. A limited symptom attack (LSA) is a lower-scale, less comprehensive onset of panic symptoms, when a person feels 3 or less of the panic symptoms listed above. For example, a sudden episode of trembling or nausea accompanied by a fear of dying would be considered an LSA. Not everyone who experiences an LSA has a mental illness. People often experience limited symptom attacks while recovering from or being treated for panic disorder. Like a panic attack, an LSA usually peaks in 10 minutes however, an attack might last only 1 to 5 minutes, or could be part of a panic episode of varying intensity that lasts several hours.

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Stress related to health conditions/issues

When you are facing a tough health condition or concern, stress tends to skyrocket. That’s because in addition to the illness itself, there are many other issues to worry about while you are going through a trying time. Here’s a brief rundown of the stress you might expect to feel when you get bad news from the doctor.

Pain, fear, and uncertainty. What is going to happen to you? What will the outcome be? What kind of procedures will you have to endure? How long will this last? Depending upon the condition you are dealing with, the answers to these questions can be frightening. The stress you feel during a medical crisis can be compounded by getting negative or troubling answers to your concerns.

The money issues. Serious health conditions or sudden illness come along with many problems, and at the heart of that might be finances. You might face a loss of income while you are in the hospital or recuperating. If the situation is bad enough, you might have to give up your job. In the meantime, you are paying for your treatments, and dealing with the insurance company. Many individuals might have great insurance, but that doesn’t negate the costs of copays, deductibles, and out of pocket limits – all of which can make a huge dent in your savings.

Worrying about your loved ones. They are worried about you, certainly. But you don’t want to be a burden, and so you are worried about making life as easy for them as possible while you go through this trying time. By attempting to take care of them, rather than letting them take care of you, the stress you feel is likely going to increase dramatically.

Caregiving. Speaking of loved ones, what if you are the caregiver for someone who is seriously ill? You have a great deal of stress on your plate, too. You want to keep them comfortable, say all the right things, and do everything in the right way, but those responsibilities can be overwhelming. Reaching out for help might make you feel as though you are burdening others that can prompt you to dig deep for more patience and strength, and do it all yourself. You might not even recognize that you need help, too.

5 Health Conditions/Issues Stress Busting Tips

When stress becomes overwhelming, it’s time to calm down. These tips can help you deal with health conditions or medical issues without blowing your top.

Knowledge is power, and it can help you cope. The more you know about your condition and treatments, the more in-control you will feel.

Enlist help.

When you are faced with a debilitating medical condition, you cannot handle it alone. Recognize that you need help, and don’t hesitate to reach out for it.

Have a good cry.

Trying to stay strong in the face of a serious medical condition might help at first, but over time the lack of “falling apart” can take a toll. You deserve the time to grieve the situation you are in allow yourself to cry, scream, rant, and otherwise take out the stress before it makes you even sicker.

If your medical condition will be a temporary one, consider it a wake-up call, and start planning the rest of your life accordingly. If you are facing a terminal illness, make plans for the time you have left.

Find a spiritual advisor.

Even if you are not a religious or spiritual person, finding someone who can talk to you about “what comes after” might be a helpful step to put your illness in perspective.

Get help for health-related stress

Every hospital or healthcare facility has a social worker on staff, or is able to reach out to one within a short period of time. The social worker can help you find resources such as support groups or financial assistance.

Those who are taking care of a loved one can turn to respite care, a service often provided by members of the local community. This allows caregivers to take time away from the responsibility and reduce their stress level.

Contacting the billing and financial department can result in payment plans, the potential for lowered payments and other financial assistance.

Talking to those who are going through the same issues can help alleviate stress. Support groups are available for almost everything, and not just for patients – they are good for children, caregivers, parents and more.

Those who work in the health care field can direct you to community resources that can help with everything from getting the right medical equipment to introducing you to new physicians.

Health-Related Stress Resources


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