Verified by 
Key points
- Avoidance may help you feel safer in the short term but can keep you feeling anxious over time.
- Consider small ways you can safely approach the things that you are avoiding.
- Examine your thoughts for evidence to support more adaptive beliefs about your ability to cope.
Many aspects of daily life can leave you feeling anxious. The combination of high demands at work and home, compounded by experiences of microaggressions, traumatic events, and moral injury, can result in chronic levels of stress. Physically, you are likely to have higher cortisol production and experience tension in your muscles. Socially, your relationships may be negatively impacted, as you may not feel you have the energy or time to spend with others. And when you do spend time with others, anxiety may leave you feeling drained or distracted.
Avoidance is a common response to anxiety and is present in many anxiety disorders.1,2 You may fear social interactions and therefore avoid going to work events. You may fear becoming ill, so avoid things that you feel may put you at a higher risk for infection. You may fear flying, spiders, or public speaking. In any of these scenarios, it may seem reasonable to avoid those situations. Nevertheless, that avoidance, if it becomes your default way of coping, can end up keeping you feeling anxious.
Consider this: If you are afraid of social gatherings and avoid them for the rest of your life, doing so may keep you feeling safe but will ultimately hinder you from learning that not all people are scary or need to be avoided. The same argument could be made against avoiding public speaking, flying, spiders, and so on.
No one is saying that you need to put yourself into situations in which you don’t feel safe, however, it’s important to check your thinking to make sure you are not labeling all situations as unsafe. For instance, yes, some people may be judgmental and mean, but this is not a fair assumption to make about everyone.
Here are a few suggestions for ways to check your thinking and reduce your patterns of avoidance.
Use anxiety management strategies to reduce physical stress.
There are types of therapy that can help reduce avoidance. While considering if therapy is a good fit for you, you may want to add some stress management techniques to your toolbox. Relaxation techniques can help you calm yourself as you start to approach situations you have been avoiding. Examples include deep breathing and progressive muscle relaxation. Created initially to help people during the COVID-19 pandemic, the free COVID Coach app from the U.S. Department of Veterans Affairs is one option to help walk you through such strategies.3 The app’s Manage Stress section offers many evidence-based techniques.
Cope with anxiety by reducing avoidance and examining your thoughts.
Cognitive Behavioral Therapy (CBT) is an evidence-based way to help individuals manage and reduce anxiety, and it often involves exposure to what is producing the anxiety..4,5,6 In such therapy, you may be asked to safely and methodically identify all the things that are associated with the fears that cause your stress (e.g., talking on the phone, introducing yourself to a new coworker, giving a five-minute speech). Often this involves rating each activity from 0-10 on how distressing you find it and then slowly increasing your exposure to those things, in an effort to see a reduction in your physiological stress response over repeated exposure.
Use "catch, check, change" to handle anxious thoughts.
CBT helps individuals recognize and reframe the unhelpful thoughts that may be fueling their anxiety.
A helpful way to approach managing anxious thoughts includes catching the thought, checking the thought for unhelpful thinking habits (i.e., cognitive distortions), and changing the thought into one that is more balanced and realistic.
For example:
- Catch: Recognize the negative thought, “I will embarrass myself if I have to give a speech at work.”
- Check: This thought includes negative prediction. There may also be an underlying worry of getting fired (catastrophizing) or assuming others won’t like you (mindreading).
- Change: A more realistic thought would be, “I may make a mistake while speaking. Many people do. I can likely learn and grow from this experience.”
Notice how your negative thinking may be fueling your anxiety. Make an effort to try to change the negative thought into one that is more balanced (positive, neutral, and yes, maybe still somewhat negative).
If you are struggling with anxiety, reach out for help. I hope the above strategies will provide you with some ideas to consider when seeking care.
References
1. Barlow DH. Anxiety and its disorders: the nature and treatment of anxiety and panic. New York: Guilford Press; 2002.
2. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
3. Jaworski, B. K., Taylor, K., Ramsey, K. M., Heinz, A., Steinmetz, S., Pagano, I., Moraja, G., & Owen, J. E. (2021). Exploring usage of COVID Coach, a public mental health app designed for the COVID-19 pandemic: Evaluation of analytics data. Journal of Medical Internet Research, 23(3), Article e26559.
4. Kaczkurkin, Antonia N., and Edna B. Foa. (2015). Cognitive-Behavioral Therapy for Anxiety Disorders: An Update on the Empirical Evidence. Dialogues in Clinical Neuroscience 17 (3): 337-46.
5. Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JAJ, Hofmann SG. Cognitive-behavioral therapy for anxiety and related disorders: An updated meta-analysis for randomized placebo-controlled trials. Depression and Anxiety.
6. Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry. 2008;69:621–632.
