Have you ever had a doctor’s appointment, or maybe a school assignment that you were dreading a week or more before it happened? You know the feeling, a pit in your stomach, bodily tension, increased heart rate, racing thoughts, only to get there and realize it wasn’t as bad as you had imagined it would be? That’s anticipatory anxiety.

What is Anticipatory Anxiety?

Anticipatory anxiety is the feeling of dread and/or fear that is experienced before a future event. It is the normal human response to stress but becomes a problem when it affects a person’s daily functioning. It can proceed large events such as giving a big presentation, or it can precede everyday life events such as going to work or talking to others. While some worry or nervousness is normal before an event, anticipatory anxiety, seems to focus on worry relating to negative outcomes of the event, and the anxiety experienced can be debilitating. The mind catastrophizes the event, in other words, you “make a mountain out of a mole hill”, and you do this days, weeks, or even months in advance.

What are the symptoms?

While Anticipatory Anxiety itself is not a formal diagnosis, it can be part of the criteria for other anxiety disorders such as social anxiety, generalized anxiety disorder, or a specific phobia disorder. Anticipatory anxiety may look and feel like other anxiety disorders; however, the difference is in specifically feeling worried and fearful about the future. Symptoms may include:

• Dread
• Worry/Nervousness
• Tension
• Restlessness
• Irritability
• Catastrophizing (anticipating the worst outcome)
• Increased heart rate
• Shallow breathing or difficulty breathing
• Gastrointestinal issues (ie. Upset stomach, diarrhea, heart burn)

What can you do about Anticipatory Anxiety?

Good self-care is an important component of managing anticipatory anxiety. Anticipatory anxiety can create disturbances in daily living such as problems sleeping, which can in turn increase symptoms of anxiety. The following are coping skills that may help manage symptoms:

• Practice grounding & mindfulness techniques—Grounding & mindfulness techniques help you stay connected to yourself in the present moment by becoming aware of what is going on within and around you.
• Practice relaxation techniques—Progressive muscle relaxation, and focused deep breathing, for example, are great tools to relieve bodily tension, promote the relaxation response and improve sleep.  
• Exercise Regularly—There have been many studies conducted that show a strong correlation between exercise and decreased anxiety as well as improved mood.
• Prioritize a good night’s sleep—Some studies have shown that those who get more deep sleep, experienced less anxiety symptoms the following day.
• Eat a balance diet—Try avoiding caffeine and sugar, both of which can affect anxiety. Instead try foods rich in magnesium as well as zinc which have been linked to lower levels of anxiety.
• Utilize thought stopping & cognitive reframing—Interrupting negative thinking patterns with a “stop” command and replacing it with a positive or more adaptive statement is not only a helpful reminder but also a distraction from the anxiety producing thought.
• Visualize—When we are experiencing anticipatory anxiety, we are often focusing on the worst possible outcome. Through the use of visualization, you can practice seeing yourself be successful in various stages of the event, so that when you actually get to the real event you feel more prepared.
• Identify what you can control—Anxiety can feel like you are not in control of your situation, and anticipatory anxiety specifically is the fear of a future event. Therefore, it may be helpful to identify what is in your control in the feared event. For example, if you are worried about having to give a presentation, you can take charge by practicing what you plan to say or do during the presentation.

Anticipatory anxiety can feel overwhelming and you don’t need to go through it alone. If you need help navigating your response to anxiety, reach out to Graceful Balance to see how we might work together.