Five scientific ways to help reduce feelings of anxiety

WHEN anxiety hits, how can you calm your whirring brain? For some people, worrying thoughts interfere with their daily lives, affecting their health and reducing their ability to maintain relationships. In these cases, the standard treatments are medications such as selective serotonin reuptake inhibitors (SSRIs) or a talking therapy like cognitive behavioural therapy (CBT). Alongside these, there are other techniques that may help. Here are five strategies that have the best evidence behind them.

Confront your demons

Exposure therapy, a variation of CBT, encourages people to confront the sources of their anxiety. To cope with their worries, many people practise “avoidance” which reduces short-term discomfort, but prevents them from learning how to deal with their fears. If a socially anxious person always backs out of engagements, for example, they will continue to believe that conversation with strangers is frightening, whereas if they attend, they might find that making small talk is easier than expected.

Virtual reality can help kick-start the process in a controlled environment. A meta-analysis of 22 studies involving 703 people showed that VR exposure therapy led to a significant reduction in anxiety for people with social anxiety disorder, and that this effect was still seen a year later. However, in-person exposure therapy had a stronger impact over the longer term. Multiple studies show that it is effective for many people with anxiety-related conditions, including post-traumatic stress disorder.

Get moving

A wealth of research shows that aerobic exercise has numerous psychological benefits, including for anxiety. One meta-analysis of 13 studies, with a total of more than 75,000 participants, found that those who reported doing more physical activity had a significantly lower risk of developing anxiety. Another study found anxiety and fear responses to predictable and unpredictable electric shocks were reduced in women who had spent 30 minutes on a treadmill.

There are many potential mechanisms behind this effect. Aerobic exercise can help the body to release its own cannabinoids, compounds similar in structure to those found in cannabis, which can bind to the receptors of neurons involved in emotional processing and mute our responses to potential threats. On a purely psychological level, exercise may distract the mind and break ruminative thinking cycles, offering temporary relief from worries.

Lift weights

In addition to aerobic activity, resistance training may also help. Exercises at moderate to low intensities – such as sit-ups, planks, squats and weightlifting – have been shown to reduce anxiety in the short and long term. One meta-analysis of 16 studies found this was the case for those with mental and physical illnesses, though the largest benefits were seen in those with no medical conditions. The sense of achievement associated with such training might increase someone’s self-esteem, which makes life’s challenges feel more manageable. It may also change the feedback that the brain receives from sensors within the body (see “The new evidence that explains what anxiety really is”); with stronger muscles, we may feel more physically resilient, which translates to improved mental well-being.

Change your diet

The health of our gut can influence our thinking and emotions (see “Why do some people experience anxiety more intensely than others?”), so changing diet may help with anxiety. In her book Calm Your Mind With Food, Uma Naidoo, a nutritional psychiatrist at Harvard Medical School, recommends eating complex carbs from vegetables or lentils, which favour a healthier gut microbiome, and increasing consumption of omega-3 fatty acids from fish, nuts or seaweed. “In many studies, dietary sources of omega-3s yielded better results than supplements,” she writes. Fatty acids form our neurons’ cell membrane and may influence cell signalling and neuroplasticity. They also reduce inflammation, which is linked to poorer mental health.

Sources of protein that are high in the amino acid tryptophan may also help, such as poultry, salmon, tuna, soya beans and chickpeas. The body can transform tryptophan into serotonin, which is an important neurotransmitter involved in emotional processing. One study of 25 people without an anxiety disorder found decreased levels of anxiety after they ate a diet high in tryptophan for four days compared with when they had a low-tryptophan diet for the same length of time.

Be mindful

Mindfulness-based stress reduction (MBSR) encourages people to develop a non-judgemental awareness of their thoughts, feelings and bodily sensations. Whenever a worry crops up, they may simply observe it before drawing their attention back to the steady rhythm of their breathing, for instance, or directing their attention to each part of the body in turn to notice their sensations.

A randomised controlled trial found that an eight-week course in MBSR was as effective as the SSRI drug escitalopram at treating people with various anxiety disorders. Not all studies find such consistent benefits, however, with one meta-analysis suggesting that mindfulness may be more effective when combined with elements of CBT.

Like all interventions, mindfulness won’t work for everyone. One alternative is to cultivate feelings of self-compassion, which has also been shown to ease anxiety.

Consult your doctor before making any changes to your treatment.