Simple Steps To
Overcome Anxiety
& Worrying
By Dr. Sarah Allen
Simple Steps Stop Anxiety & Worrying
TABLE OF CONTENTS
INTRODUCTION............................................................................................................4
STEP 1 – BREATHE..……………....................................................................................5
Fight or Flight Response …..5
Relaxation Response…..6
How to Do Paced Breathing…..7
How to Cope With Racing Thoughts …..8
STEP 2 – REDUCE EVERY DAY STRESS.................................................................11
Effects of Stress …..11
When People Make You Angry .….12
When You Are Upset By Arguments .….13
STEP 3 – GET MORE SLEEP……………………………………………………...................14
Why Sleep is Important …..14
Ways To Relax ……..15
STEP 4 – HOW COGNITIVE THERAPY HELPS DECREASE WORRYING.......16
When Your Worry Is Not Solvable …..18
When Your Worry Is Solvable …..19
Stop Worrying By Questioning Your Thoughts …..20
ABOUT THE AUTHOR ...............................................................................................24
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Simple Steps Stop Anxiety & Worrying
Thank you for downloading my booklet. If you have got this far you are probably
worrying about something. Have you always been a worrier or are you anxious
about a specific thing? Either way, it is time to start doing something about it and
change the way you are feeling. I am here to help.
When you feel overwhelmed, stressed and worried, life’s challenges, big or small, are a lot harder to
manage. When clients first come in to see me, the main concerns that come up again and again are:
1. What should I do when I get really anxious about something?
2. How can I feel less stressed in my everyday life?
3. What lifestyle changes can help improve how I feel?
4. How can I stop my mind from going over and over something that has happened in the past?
5. How can I stop worrying about everything: my children, partner, friends, work, my “to do” list….
In this booklet I have highlighted areas of your life where you can make small changes, which added
together result in big changes in your mood. You won’t be able to do all these things I suggest in the
report at once, but adding one or two small changes a day to your routine can really help to reduce
worry and make life more enjoyable.
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Simple Steps Stop Anxiety & Worrying
Step 1 – Just Breathe
In small doses, stress can actually be useful as it helps you to stay focused, alert and increases energy.
But when stress becomes chronic, it can damage your health, your mood, your relationships, and
your overall quality of life. Stress is sneaky! It can easily creep up on you so that being frazzled and
overwhelmed starts to feel normal. You may not even recognize how much it is affecting you so it is
really important to recognize the signs and symptoms of stress and then take steps to stop feeling so
overwhelmed.
The Fight or Flight Response:
When we worry or become anxious, our sympathetic nervous system is triggered. You have probably
heard of the Fight or Flight response. This is where adrenaline floods though our body to gear us up
to either run away or fight the object causing us to be scared. No one feels all of the physical effects
shown below, but we tend to experience the same few ones such as:
• An increase in heart rate
• Your breathing speeds up, you may feel
breathless, a choking feeling or heaviness in
your chest
• Muscles feel tense, achy or shaky
• You feel hot and maybe sweaty
• You become lightheaded
• Your vision may become blurred
• Butterflies or cramps in your stomach or an
urge to go to the toilet
• Your thoughts race so you can’t think straight
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Originally our bodies were flooded with adrenaline to enable us to fight or run away when faced with
danger. We don’t usually have to physically fight people anymore or run from danger (not many
bears around here!) so we now find that this physical response is activated in situations where it isn’t
appropriate like in traffic jams or during a stressful day at work. The physical sensations it generates
leaves us agitated, anxious or angry because we are not physically releasing it.
The Relaxation Response:
The physical responses to adrenaline do eventually go down by themselves but experiencing this
anxiousness and agitated state feels unpleasant so the way to counteract these feelings quickly is to
engage our parasympathetic nervous system by deep breathing.
Basically, deep breathing and adrenaline can’t co-exist in the same body.
Deep breathing triggers the stimulation of the Vagus nerve—a
nerve running from the base of the brain to the abdomen, that
emits a useful neurotransmitter (acetylcholine) that dampens our
nervous system, lowering heart rate, relaxes muscles and most
importantly, stops your thoughts from racing so you can think
straight. In effect, the relaxation response is the anti-fight or
flight response!
So How Do We Get This Relaxation Response?
The relaxation response is activated by doing paced breathing which involves taking smooth, slow,
and regular breaths. Sitting upright is usually better than lying down or slouching, because it can
increase the capacity of your lungs to fill with air. It is best to ‘take the weight’ off your shoulders by
supporting your arms on the side-arms of a chair, or on your lap. Print out the next page and keep it
handy.
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How To Do Paced Breathing:
1. Take a slow breath in through the nose, breathing into your lower belly so you feel it
inflate like a balloon (for the count of 4)
2. Hold your breath for 1 or 2 seconds
3. Exhale slowly through the mouth so that you are pushing out the air in the “balloon”
and you feel your belly suck in (for the count of 5)
4. Make sure the exhale breath is one or two counts longer that the inhale breath as
this activates a greater relaxation response.
5. Wait a few seconds before taking another breath
About 6-8 breathing cycles per minute is often helpful to decrease anxiety, but find
your own comfortable breathing rhythm.
A lot of my clients have reported that they find this
Practice, Practice, Practice:
techniques works even better if you increase the number
You do not need to be
of breaths each time:
feeling anxious to practice
First breath – inhale for the count of 4, exhale for the paced breathing – in fact, at
count of 5 first you should practice
while feeling relatively calm.
Second breath – inhale for the count of 5, exhale for
You’ll gradually master this
the count of 6
skill and feel the benefits!
Third breath – inhale for the count of 6, exhale for the
count of 7
Start from the count of 4 again and repeat the cycle.
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Simple Steps Stop Anxiety & Worrying
Use this technique next time you feel really anxious about something. It is even effective if you are
experiencing a panic attack.
Summary:
1. We experience a trigger thought e.g. – “Something bad is
going to happen”, “I’m not going to be able to cope”.
2. We then have a body reaction due to the fight or flight
response.
3. Do paced breathing to activate the relaxation response.
4. Say to yourself – “I can cope with these feelings, I’ve got
through it before. This will pass”.
The purpose of calm breathing is not to avoid anxiety at all costs, but just to take
the edge off or help you “ride out” the feelings so that when you feel calmer you
can use the strategies we talk about later to challenge the thoughts and things
you do or don’t do that are unhelpful to you.
How to Cope With Racing Thoughts
Do your thoughts race? Is it always or occasionally? Thoughts can start off triggered by a specific
situation or worry and then become a string of confused and racing ideas. This can be overwhelming,
confusing and distressing and racing thoughts can hinder your ability to concentrate and accomplish
daily tasks. They can also affect your memory and quality of sleep.
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Paced breathing can help when your thoughts are racing and another useful technique I teach my
clients to utilize when they feel anxious is called Grounding which basically means bring your focus to
what is happening to you physically, either in your body or in your surroundings, instead of being
trapped by the thoughts in your head that are causing you to feel anxious.
Grounding helps you stay in the present moment instead of worrying about things that may happen
in the future or events that have already happened, but you still find yourself going over and over
them in your mind.
On my blog I have an article that details 7 different grounding techniques including the one below
that is called the 5-4-3-2-1 technique that gets you to use all your five senses to help you to get back
to the present.
It starts with you sitting comfortably, now close your eyes and taking a couple of deep breathes. In
through your nose (count to 3), out through your mouth (to the count of 3).
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Now open your eyes and look around you. Name out loud:
5 – things you can see (you can look within the room and out of the window)
4 – things you can feel (the silkiness of your skin, the texture of the material on your chair, what
does your hair feel like? What is in front of you that you can touch? A table perhaps?)
3 – things you can hear (traffic noise or birds outside, when you are quiet and actually listening
things in your room constantly make a noise but typically we don’t hear them).
2 – things you can smell (hopefully nothing awful!)
1 – thing you can taste (it might be a good idea to keep a piece of chocolate handy in case you are
doing this grounding exercise! You can always leave your chair for this one and when you taste
whatever it is that you have chosen, take a small bite and let it swill around your mouth for a
couple of seconds, really savoring the flavor).
Take a deep breath to end.
If you would like to read the 6 other grounding techniques, they are in this blog post 7 Grounding
Techniques For Calming Down Quickly
Progressive muscle relaxation (PMR) is another very helpful technique in calming your mind and
relaxing your body. PMR involves tensing specific muscle groups and then relaxing them to create
awareness of tension and relaxation. It is termed progressive because it proceeds through all major
muscle groups, relaxing them one at a time, and eventually leads to total muscle relaxation. A relaxed
body results in a calm mind. If you come to my office to see me I can give you a CD that has a 20
minute progressive muscle relaxation as well as a short 7 minute relaxation exercise and a 10 minute
beach visualization.
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Simple Steps Stop Anxiety & Worrying
Step 2 – Reduce Everyday Stress
Sometimes life is more stressful than at other times, usually when you have to juggle many things at
once. I like to think of it as we have a bucket of stressors. Throw this stress in and we are fine, throw
in a couple of more stressors and we are just about okay, but it is that last thing that comes along
that makes your ‘stress bucket’ over full and everything gets totally overwhelming. We need to look
at all the things you have in your ‘stress bucket’ and see what we can get rid of so the things we can’t
change are more manageable.
The table below shows the many negative effects stress can have on your mind and body.
Effects of Stress
Brain Effects Mood Effects
• Memory problems • Moodiness
• Inability to concentrate • Irritability or short fuse
• Poor judgment • Agitation, inability to relax
• Seeing the negative rather than positive • Feeling overwhelmed
• Constant worrying • Depression or general
• Anxious or racing thoughts unhappiness
• Sense of loneliness and isolation
Physical Effects Behavioral Effects
• Aches and pains • Changes in eating habit (more or less)
• Frequent illnesses • Changes in sleep habits (too much or too
• Diarrhea or constipation little)
• Nausea, dizziness • Isolating yourself from others
• Chest pain, racing heartbeat • Procrastinating or neglecting responsibilities
• Loss of sex drive • Nervous habits (e.g. nail biting, pacing)
• Using alcohol, cigarettes or drugs to relax
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Simple Steps Stop Anxiety & Worrying
You may feel like the stress in your life is out of your control, and it’s true, sometimes you can’t
control situations or the way other people act. But you can take charge: take charge of your thoughts,
your emotions, your schedule, your environment, and the way you deal with your problems.
Doing nothing will only make problems
worse!
We humans are social animals and we usually like to be with other people. Unfortunately, other
people can often be the source of our stress. Here are a couple of situations that often come up.
What to Do When People Are Making You Angry
When people stress us out, we often feel frustrated and angry.
As we talked about before, when you are stressed adrenaline
runs through your body and one effect of that is that your
thoughts race. This make thinking clearly difficult and that is
when you are more likely to lash out and say things you don’t
mean.
Doing a quick breathing exercise clears your thoughts and lets you take a time out so you can come
back to the situation and deal with it calmly. This usually means you will get a better response from
the other person and a better outcome overall.
Prevent losing your cool by breathing and squeezing the tips your thumb and middle finger
together. Now breathe out slowly and relax your tense hands.
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I don’t mean that you should always push down your anger and ignore what is bothering you.
Driving your feelings underground only forces them to pop up again, bigger and uglier, at
inappropriate times and places and usually towards someone that doesn’t deserve it. Better to use
the above technique to calm down and then tackle the issue with good communication skills which
brings me to me next tip.
What to Do When You Are Upset By Arguments with Other People
Disagreements can be dealt with more quickly by using
good communication skills such as stating your needs
or distress directly (not expecting the other person to
mind-read) and avoiding "you always" or "you never"
(these statements always make the other person
defensive and more likely to continue arguing).
Use “I” language instead, i.e. "I feel _____ when you _____. "; "I would really appreciate it if you
could _____. "; "I need some help in _________”. It also helps to stick to the present disagreement
and not bring in past hurts. These communication tips aren’t just for our partner. They work well with
our children, friends and acquaintances too.
As you can see, reducing stress in your life is really important in improving your overall mood. Stress
is also the number one cause of insomnia so we will spend quite a lot of time talking about that in my
next section.
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Simple Steps Stop Anxiety & Worrying
Step 3. Get More Sleep!
There is a huge connection between our physical health and our mental health and sleep is a very
important component of both.
Getting more sleep sounds easy in theory, but so many people find it hard to achieve. The average
amount of sleep needed by adults for their body and mind to be fully rested is around seven to eight
hours a night. This of course can vary but you know you aren’t getting enough when your mood is
negatively affected.
Lack of sleep can stop you thinking clearly, wrecks productivity and can alter your mood significantly.
According to the National Sleep Foundation (NSF) the “walking tired” anger more easily, have
problematic relationships and are less likely than those who sleep well to exercise, eat healthfully,
have sex and engage in fun leisure activities; all
because they are too tired.
What with work, errands and seeing to your family’s
needs, you have so much to do that you can only get
them done by staying up late. Maybe going to bed in
the wee hours is the only way to get some “me
time”.
Staying up late is probably not working for you though and improving your sleep is one of the best
ways to improve the quality of your life. We need to work on being either more organized or less
perfectionist about getting things done, knowing it’s okay to ask and expect help, and knowing it is
totally necessary to have “me time”. But not at the expense of sleep!
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In the meantime, we need to work on setting up a good
Here Are Some Ways To Relax
night-time routine. Our every day “to do list” is much less
daunting when we are refreshed!
❖ Have a warm bath (not hot) as this will
The National Sleep Foundation states “It’s not uncommon help your body reach a temperature
for people who don’t get enough sleep to be depressed or that's ideal for rest.
for people who are depressed to not sleep well enough.” ❖ Writing “to do” lists for the next day
This is very ‘chicken and the egg’. Who knows which comes can organize your thoughts and clear
first, but what we do know is that over time, impaired your mind of any worrying thoughts
that pop in to your head (more about
memory, mood and other functions become a chronic way
that later…)
of life. In the long term, this can affect your job or
relationships. ❖ Relaxation exercises, such as light yoga
stretches, help to relax the
So how can we improve sleep? Firstly, keep regular muscles. Don't exercise vigorously
though, as it will have the opposite
sleeping hours. A bedtime ritual teaches the brain to effect.
become familiar with sleep times and wake times and
programs the brain and internal body clock to get used to a ❖ Relaxation CDs can help as they use a
hypnotic voice to guide you through
set routine. Most adults need between six and nine hours
muscle relaxation and soothing music
of sleep every night. By working out what time you need to and sound effects to relax your brain.
wake up, you can work backwards and set a regular
❖ Watching TV or any computer or phone
bedtime schedule.
screen keeps the brain engaged and
active so it is harder to fall asleep. It is
Secondly, you can’t expect to “go, go, go”, then be better to read a book or listen to the
radio as that relaxes the mind by
able to fall straight to sleep. Winding down is a critical distracting it from the present worries.
stage in preparing for bed
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Perhaps the most important thing to remember in getting enough sleep is that your needs are
important and putting your need for sleep above the
demands of others is the kindest thing you can do for yourself
and those who are important to you.
Insomnia can often be caused by lying awake worrying which
brings me to the next step I think it is important to work on in
order to improve your mood.
Step 4 – How Cognitive Therapy Helps To Decrease Worrying
So why do we worry about things? Worries bother us. We can’t sleep or concentrate because we
have pessimistic thoughts going round and around in our head, but in a way, worries make sense as
they pull us in to a false sense of feeling in control. We’re doing something, even if it is just worrying.
You continue to worry because our mind thinks:
• Maybe I'll find a solution.
• I don't want to overlook anything.
• If I keep thinking a little longer, maybe I'll figure it
out.
• I don't want to be surprised. If I consider all the
possible outcomes, I’ll be more in control when
something bad happens.
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We can have a hard time giving up on our
worries because, in a sense, our worries have
been working for us.
So now I’ve pointed that out, let’s just stop worrying then! Unfortunately, telling yourself to stop
worrying doesn’t work for long. You can distract yourself or suppress the thoughts, but they keep
popping back up.
Instead I would like you to distinguish between whether your worry is solvable or not.
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Here are some good questions to ask yourself when you are worrying about something.
▪ Is the problem something you’re currently facing? Is it an imaginary what-if or
maybe it is something that is in the past and has already happened?
▪ If the problem is an imaginary what-if, how likely is it to happen? Is your concern
realistic?
▪ If it is something you are currently facing, can you do something about the
problem or prepare for it, or is it out of your control?
Learning To Accept Difficult Feelings When Worry Is Not Solvable
If the problem is in the past then you have to decide whether to say something to the person
involved or do nothing and accept what happened. If the worry isn’t something you can solve, you
have to do nothing and practice acceptance. That doesn’t mean it doesn’t feel bad though. In such
cases, it’s important to tune into your emotions. Your brain is so busy going over and over pretend
conversations with the person that caused the hurt that it gives a temporary sense of control that
something is being done. But it’s not really allowing you to get over it and it doesn’t allow you time to
feel.
The only way out of this is by embracing your feelings. Sometimes we just can’t control events and
we have to embrace uncertainty. Sometimes we are hurt and angry but there is nothing that can be
done,but feel our emotions. You are in control. You are deciding to feel your feelings so you can
eventually let it go.
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What to Do When the Worry Is Solvable
If the worry is solvable, we can use Active Worrying. This is where worrying serves a purpose. For
example we worry about a deadline at work and that motivates us to get the project done. It is really
important to differentiate between a worry that can be solved and one that we can’t do anything
about.
Active worrying involves brainstorming
ideas about all the possible solutions you
can think of (try not to get hung up on
finding a perfect solution though) and
then make a plan that focuses on things
you have the power to change.
Once you have a plan of action and start doing something about the problem, you’ll feel much less
worried. This technique is also very useful when you are stuck in an argument with someone. First
identify what is the problem you are arguing about. Then brainstorm all the things you can possible
do about the problem and the likely outcomes and then make a joint plan of action.
We talked earlier about how thoughts can keep us awake at night. Keep a pen and a pad of paper
for worries that come to you at night. Night worries can go around and around in our head
as it seems so important at the time to remember them. This can cause adrenaline to
start rising in your body which of course, keeps you
awake and your thoughts racing more. Writing the worry
down and then distracting yourself (read using a book light or do
one of the relaxation techniques) calms you physically and
mentally, allowing you to get to sleep.
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Simple Steps Stop Anxiety & Worrying
Stop Worry by Questioning the Worried Thought
We all worry sometimes, but if you constantly worry, chances are you look at the world in ways that
make it seem more negative than it really is. For example, you may overestimate the possibility that
things will turn out badly, jump immediately to worst-case scenarios or treat every negative thought
as if it were fact. These irrational, pessimistic attitudes are known as cognitive distortions. The first
step is noticing that you feel a negative emotion, worry, anger, sadness, etc. Next, ask yourself what
your thought is.
Here’s an example: Kate was feeling overwhelmed at work. Her inbox was piling up and she had back
to back meetings all day. She felt worried that she was so behind that her boss would be annoyed with
her. She noticed her shoulders and neck felt tensed up and she identified her feeling as anxiety. When
actively trying to identify her thoughts she realized she was thinking “I won’t ever be able to catch up”
and “My boss will think I am bad at my job”.
These are good questions to ask yourself in order to stop the worry:
• What’s the evidence that the thought is true? That it’s not true?
• Is there a more positive, realistic way of looking at the situation?
• What’s the probability that what I’m scared of will actually happen?
• If the probability is low, what are some more likely outcomes?
• Is the thought helpful? How will worrying about it help me and how will it
hurt me?
• What would I say to a friend who had this worry?
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When Kate asked herself those questions she realized that the probability that she would “never catch
up” was low and that looking back over the past year she could see that there were periods when
workload was high and periods when workload was lower. Also, she did
not have any evidence to support that her boss would think she was bad at
her job. She had had a very positive review 2 weeks before and a prior
time she had felt overwhelmed, he had helped her prioritize deadlines.
She saw that the way she was thinking about things wasn’t helpful. It was
more helpful to reassure herself that she would get things done eventually
and to sit down and prioritize tasks. She also felt more in control when she looked at next week’s
calendar. She could see that there were blocks of time that were meeting-free, so she would be able to
catch up then.
I have just shown you how challenging worries and negative thoughts is a very useful tool for
reducing the way that they make us feel bad about ourselves. This is part of the type of therapy I
practice and it is called Cognitive Behavior Therapy (CBT) or Cognitive Therapy for short. It is a short-
term "here and now" therapy that is a proven effective treatment for a wide range of problems
including depression, anxiety, stress, eating /weight issues
and relationship problems.
By learning to identify how your thoughts influence your
mood and behavior, you then learn how to turn the negative
thoughts around and feel better. I don’t just mean let’s turn
all your negative thoughts into positive sunny ones. That wouldn’t be realistic. Let’s do a reality check
instead. Ask yourself if your worries are in the present (and not the past or future) and whether the
situation is in your control or not. Then by looking at all the evidence you can challenge those
unhelpful thoughts and develop a more balanced perspective.
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Thank you for taking the time to read my booklet. I hope it has been helpful and will go on to be a
source of useful tips and tools you can use in everyday life. Remember though that you can’t change
everything at once. It is best to try to change one or two things at a time and work on those so they
become useful new habits. Then go on to incorporate more changes, one at a time.
For more information about Dr. Sarah Allen’s counseling services please visit her website at
www.drsarahallen.com or contact her to discuss whether you could benefit from working
with her on 847 791-7722 or email her on the contact form on this page
www.drsarahallen.com/contact.
Please note: Dr. Allen’s professional license only allows her to work with clients who travel
to her Northbrook office or via remote sessions within IL.
Unfortunately, Dr. Allen's professional license doesn’t allow her to offer personalized advice
by email which is why she likes to write blog posts and booklets so she can share information
with people who live too far to see her in person.
You can visit her blog on www.drsarahallen.com/blog or join her on Facebook
https:facebook.com/drsfcallen to read more psychologically based tips on how to lead the life
you want to live.
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About The Author
Dr. Sarah Allen is originally from the UK but has been
living and raising her family in Northbrook, a northern
suburb of Chicago, for over 20 years.
She received her doctorate in Clinical Psychology at
Southampton University, England, where she trained in a
psychotherapy treatment called cognitive behavior
therapy (CBT).
CBT is short-term "here and now" therapy that is a proven effective treatment for a
wide range of problems including depression, anxiety, stress, eating /weight issues and
relationship problems.
Her skills and 25+ years of experience allow her to get to the root of problems quickly
and show you practical ways to feel more in control of your life.
There are many ways we hold ourselves back from happiness. Sarah empowers her
clients with the tools necessary to deal with the stress that life and relationships bring,
both in the present and for when they show up again in the future.
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