Anticipatory Anxiety: When Fear of the Future Takes Over

Ever have anxiety about having anxiety? If you've dreaded an upcoming event for weeks, imagining everything that could go wrong, you've experienced anticipatory anxiety. While not an official diagnosis, it's a very real experience that can significantly impact your life. At Next Step Psychiatry in Lilburn, Georgia, we help patients throughout Gwinnett County and Metro Atlanta learn to manage this challenging form of worry.

What Is Anticipatory Anxiety?

Anticipatory anxiety is the expectation of fear or distress about something in the future. It's sometimes described as a "sense of doom"—worrying that something bad will happen or won't go well. This fear often leads to avoidance, creating a cycle that can limit your life.

Common triggers include:

• Job interviews or presentations
• Social events and gatherings
• Medical appointments
• Travel or flying
• Performance situations
• Potential threats like natural disasters or health crises

How Anticipatory Anxiety Manifests

Anticipatory anxiety can begin days, weeks, or even months before an event. Symptoms may include:

• Feelings of panic or dread
• Difficulty sleeping
• Trouble concentrating
• Catastrophizing (dwelling on worst-case scenarios)
• Physical symptoms: racing heart, rapid breathing, dry mouth, trembling
• Avoiding the anticipated situation entirely

Connection to Anxiety Disorders

While anticipatory anxiety itself isn't a clinical diagnosis, it can be a symptom of recognized anxiety disorders like:

• Generalized Anxiety Disorder (GAD): Excessive worry occurring more days than not for at least six months
• Social Anxiety Disorder: Intense fear of social situations where you might be judged
• Obsessive-Compulsive Disorder (OCD): Uncontrollable, recurring thoughts and behaviors

4 Strategies for Managing Anticipatory Anxiety

1. Practice Mindfulness

Mindfulness brings you back to the present moment, reducing the power of anxious thoughts about the future. Techniques include:

• Belly breathing: Place one hand on your chest and one on your belly. Breathe in through your nose, feeling your belly rise while your chest stays still. Exhale through your lips.
• Journaling: Writing down your worries can help process and organize thoughts, reducing their grip on you.
• Body scan meditation: Focus attention on each part of your body, from toes to head, noticing sensations without judgment.

2. Try Progressive Muscle Relaxation

Anxiety causes muscle tension you may not even notice. Progressive muscle relaxation involves systematically tensing and relaxing muscle groups, starting from your forehead and working down to your feet. This technique signals your body to shift out of "fight or flight" mode.

3. Practice Positive Affirmations

Instead of "what if it goes wrong," try "what if it goes well?" Research shows that replacing worried thoughts with positive alternatives can reduce anxiety. Examples include:

• "I am capable of handling whatever comes my way."
• "I've done this before, and I can do it again."
• "I am prepared, and I will succeed."

4. Confide in Loved Ones

Sharing your worries with trusted friends or family can provide reassurance and perspective. Outside viewpoints often help you see that your fears may be larger in your mind than in reality.

When to Seek Professional Help

If anticipatory anxiety is significantly impacting your well-being, relationships, or ability to function, it's time to seek support from a mental health professional. You may be experiencing an anxiety disorder that responds well to treatment.

Dr. Aneel Ursani and Fathima Chowdhury, PA-C at Next Step Psychiatry provide comprehensive anxiety evaluation and treatment for patients throughout Metro Atlanta. Treatment options may include medication, cognitive behavioral therapy, or both.

This article is for educational purposes only. If you or someone you know is in crisis, call 911 or the National Suicide Prevention Lifeline at 988.