Updated: Nov 10
Fear gets a lot of press as being the bad guy keeping you stuck in job you hate because you can't take a leap into the unknown. Anxiety, however, is like a scared mouse hiding in your shadow. We don't talk about her as much. Maybe it's because most of us in high-stress jobs with achiever-type personalities are so used to anxiety being a part of our lives, we assume it's just who we are. Or, we don't recognize it at all, calling it by other names like "stress."
I had no idea I had anxiety until my mid-30s. We'd been seeing our marriage therapist for over a year when she casually mentioned, "Hope's anxiety." Prone to daydreaming, this comment snapped me out of my trance. I'd never heard the word "anxiety" associated with me. "Wait. Me, anxious?!" I asked, confused and defensive. The therapist and my husband looked at each other with bemused smiles as if I'd asked if I had brown hair. "Yes. You. Hope. Anxious."
As I thought about it later that day, I realized it was true. I was the textbook picture of anxiety. Worry 24/7, preoccupation with my to-do's and all the possible things that can go wrong, type A, intense, high strung, restless. I reread my journal from 8th grade and could see it spelled out in my own handwriting. Even my 11-year-old daughter noticed it as I read my journal entries with page after page of stressful ruminations over my grades, all of which were above 95.
Some of us may wear our anxiety like a badge of honor. Sort of like being a go-getter, super achiever. But here's what I see in my clients. Anxiety affects the brain by literally rewiring how the brain works and reacts. Anxiety can be the determinant of what you do and don't do with your life. It can, in short, run the show, writing the script of how your life will play out.
Anxiety isn't a "bad" emotion, it's simply a clue about what what's going on in your head. It serves as a filter through which thoughts and emotions are formed. However, if left unchecked, anxiety will lead to a life based on fear and worry-led decisions.
As a dermatology PA, I see anxiety show up in skin issues. Psoriasis flares, lupus flares, eczema flares, acne flares. I think of these cases as skin dis-eases. The dis-ease (i.e. anxiety and stress) eventually manifests in the body as diseases or other medical issues.
On the other hand, with my life coaching clients, I see anxiety show up as a feeling of fear-based stuckness, keeping them trapped for years in an unfulfilling job. I also talk to clients who manifest their anxiety with a victim mindset. They use words like can't, and are quick to point out all the reasons they aren't able to move forward. Lastly, many anxious clients have a history of leapfrogging from job to job in search of the perfect fit.
Let's pause and talk about why anxiety is even a thing. Why does it exist? It's simple, actually. Anxiety happens because we don't feel safe.
Think about early humans. Why was it important their brains be hypervigilant about safety? Safety meant staying alive and ensuring the human race would continue. Brains adapted to put safety first. If a cave person's brain noticed something new in the environment, like a set of large animal footprints, or broken branches, their bodies got a dose of stress hormones delivered, letting them know to be alert. Their brains were making sure they didn't get eaten by a prehistoric crocodile or saber tooth tiger.
Even though we're no longer in mortal danger, an anxious brain can interpret things like a busy work schedule, a spouses' harsh tone or a screaming toddler as unsafe. This shows up as anxiety and a surge of stress hormones.
For example, as I explained to a constipated patient who was super anxious, "your body won't let you stop and poop if it thinks you're supposed to be running from a predator." She also disclosed her body wasn't letting her fall asleep at night. Again, her body didn't feel safe.
Likewise, anxiety can halt weight loss. The lizard brain (the part of our brain that developed to ensure survival) thinks it needs to hold onto fat reserves in case you truly are in danger and can't eat for a prolonged period. There's no way it'll allow you to get skinny regardless of your exercise and diet.
What about reproduction? If your body thinks you're not safe and that you might get killed, is it going to allow you to slow down and make a baby? Hell no. Now is not the time to get it on with your cave man and make a baby. If you're not safe now, you sure won't be safe if you're pregnant or nursing. I was baffled when it took over a year to get pregnant with a second child, but in hindsight, that was the most stressful period of my 20-year career in medicine.
Anxiety also affects creativity in a big way. If you're burned out and anxious, now is not the time to remodel the cave, or start a new side hustle. Why does creativity matter with job burnout? Finding productive solutions to burnout requires problem solving and creativity, but this can feel impossible if you have anxiety. If you want to switch career fields, anxiety isn't going to allow you to dream and scheme. Remember, change=danger according to your lizard brain.
By now I hope it's clear how anxiety can stop you in your tracks. Here you are, burned out and thinking your mission is to figure out a way to quit your job, but your brain is convinced you're in danger. It doesn't want change because change isn't safe, so you find yourself hitting dead ends with every attempt to find a new job or change your current situation. Not only that, but your brain isn't letting you problem solve creatively. Clients in this state will stare at me blankly when I ask what ideas they have about job or career changes. They literally can't see a way out. It's tunnel vision. All they can see and hear is "RUN!!!"
11 Tricks for Managing Your Anxiety (whether you're burned out or not)
Establish safety. The first step is convincing your brain there's no danger. Talk to yourself. Talk to your anxiety: I know you're freaking out, but you're safe. What do you need to feel safe? Recall times in the past you've been anxious and remind yourself you were okay, you didn't die. Arthur Brooks, author of Strength to Strength says he has his ivy league students keep a disaster journal. When they have something disastrous happen and their lizard brains are freaking out, they pull out their disaster journal and record all the details. He has them skip a few lines and go back 1 month and 6 months later to record how they feel about the disaster. As you might guess, the disasters don't usually feel as awful months later. By seeing this in writing, we reassure our brains that we're safe, even when bad things happen. 99% of the time we're not facing a life or death situation.
Focus on your body. Your physical self needs to feel safe in order to counteract anxiety. This isn't the time to do high intensity workouts which would reinforce to your brain that things aren't safe because adrenaline is pumping through your veins. Ask yourself what you need to feel physically safe. It might be comfy clothes, a familiar and welcoming smell from a candle, stroking your sweet pet's head, or time to sit home and veg instead of being Miss Social Butterfly. When my daughter feels anxious, she wraps herself burrito-style in her big soft pink blanket and curls up with the cat on her bed with the lights out.
Microdose creativity. No, I'm not talking LSD, I'm talking tiny creative endeavors. Creativity accesses the right side of the brain, and while it can feel impossible to launch yourself into a new hobby while you're anxious or burned out, dipping your toe into the right brain for even a few minutes a day will create a sense of safety and curiosity. For example, colored pens and a doodle pad, a piece of silly putty, trying a new recipe, or creating a Pinterest board all use the right side of the brain which will spark feelings of creativity and well-being.
Sleep 7-8 hours minimum. Hard to fall asleep with anxiety, I know. Yes, it will require work and sacrifice. You might have to keep your phone in another room, cut out screen time after 7pm, or take melatonin for a short period. Getting 7-8 hours of sleep every single night means your body has time to rest and repair itself from all the damaging stress hormones you pumped out during the workday. Our bodies go into fight or flight mode when we're dealing with a stressful job situation, hangry whining kids, and spousal arguments. Sleep, however, does the opposite. It puts your body into parasympathetic nervous system mode. Inadequate sleep means you're putting yourself at risk for mental and physical health problems.
Nourish your body with healthy foods and minimize numbing agents. Let's be honest, most of us can name the unhealthy food or drink habit we turn to when we're anxious. It's our body's way of self-soothing. Drink that wine or eat those donuts because you deserve it, you poor little stressed lamb. And yet, we all know it's a lie that they'll help us feel better. Whatever your numbing agent of choice, make it a rule you have to leave the house to have it and you can't consume it alone. When my anxiety is running the show, it wants sugar, lots of sugar. If I had it at home, I'd end up passed out from the glucose surge. But, if I have to drive to the local bakery, it involves a car ride, choosing which sweet I want, interacting with the cashier, and sitting down to eat it at a table inside the bakery. This many steps lessens the likelihood I'll buy bakery sweets very often.
Kindly ask anxiety to step outside. Whether you choose to journal online on a password protected site, brain dump in a notebook or talk to a therapist, getting the stressful, worrisome thoughts out of your head is vital. Anxiety, once outside the brain, doesn't look or feel as scary, and as a result, it has less power.
Learn body awareness. Notice your body at least once a day. If you've been anxious for years, you may not even realize how it affects your body. Do a mental body scan by bringing all your attention to your breath. Nice, slow, deep breaths will send signals of safety to your brain. Then, start at your feet and simply notice your soles with all your awareness. Move slowly up your body, noticing each body part without judgement or opinions. If you get side tracked, keep returning to your breath. Even as I was typing this, I became aware of my lips pressed tightly together and the tightness in my jaw. Two deep rounds of breath calmed down those areas, relaxing my brain.
Work on rewiring your brain by changing the story you tell yourself, i.e., your thoughts. If you tell yourself you can't find a better job, you'll look for evidence all around you to support this belief. Naming why this thought is BS will help, but actually giving yourself a new script works better. Try practicing a new way of talking to yourself with statements like: "I am capable. I am moving towards a better future. I can and I will" It'll feel fake at first, but after a month you'll start believing it.
Watch your anxiety as you would an interesting zoo animal. Describe it in great detail. What's it doing? What's it thinking? Is it a certain shape, color? Answer as if you're a small child with a wild imagination who's endlessly curious. What's your anxiety doing now? What's fascinating about it? If this creature could talk, what would it want you to know? This exercise sounds silly but it's powerful because it forces the anxiety to step outside of you, putting you back in the driver's seat.
Speak your anxious thoughts out loud using this noticing tool based on ACT therapy. It's so simple it feels dumb, but humor me. Find an anxious thought like "I'm not good enough" and say out loud 3 times, "I'm having the thought that I'm not good enough". Then, say the same phrase again three times, but add in "I notice I'm having the thought that I'm not good enough." After using this tool, my clients usually comment on how, by adding the words I notice, they no longer feel as dis-empowered and upset by the original thought. The simple act of noticing helps them question whether the thought is true.
Ask yourself this big-picture question: One year from now, how do you want your life to look different? Without taking time to worry about how you'll accomplish the changes, , just blurt out what you'd like to see different 365 days from now. If this new life were guaranteed to become your reality, what would you need to change to make it happen? What would you have to believe about yourself in order for it to come true?