Dear Alice,

I am a graduate student, doing very well in my coursework and research. However, I feel extreme anxiety in doing anything, e.g., starting a problem set, writing a program, etc. I wonder, what are the common causes of anxiety and what I may be suffering from. I would like to be calm and relaxed and not anxious and stressed. I know about meditations, etc., but what I would really like is some psychological insight.

Thanks,
Anxiously Awaiting

Dear Anxiously Awaiting,

Many people feel apprehensive now and again. Whether it’s the stress of meeting a deadline at work or the anticipation of an upcoming test, there are many hurdles to navigate in life. Some stress can actually be helpful, as it can be the impetus to help prepare and perform well or may be in response to an exciting life event such as a new job or graduation. Stress can't be eliminated, but it can be managed. While it’s common to experience some tension in response to stressful situations, when these feelings linger and begin to interfere with work or relationships, it may be the result of anxiety. Sometimes stress and anxiety are used interchangeably, but they're distinct experiences. Generalized anxiety disorder (GAD) is characterized by frequent and intense feelings of worry that are hard to shake and may not be tied to anything specific. There’s also social anxiety disorder which manifests in response to particular activities or situations, such as a phobia or work responsibilities. In either case, anxiety can be frustrating and may disrupt daily activities, impacting overall well-being. It may be helpful to work with a health care provider to determine whether what you’re experiencing is anxiety, and if so, what type. They can then recommend a course of treatment for the anxiety and offer stress reduction strategies to help ease your worries.

Physically, most everyone responds to stressors in similar ways — heart races, sweat increases, and muscles tense. In fact, some anxiety exists as a form of protection through the “fight or flight” response to a perceived danger or threat. For people with anxiety, the body tends to find more situations threatening, leading to more frequent and intense physical reactions. One explanation is that people with anxiety have a more sensitive amygdala, which is the part of the brain that interprets emotions and tells the body how to respond. If the brain picks up on signals more easily, even when there isn’t a threat present, it may tell the body to react more often. According to Mayo Clinic, GAD can lead to a heightened response to daily worries, concern about worst-case scenarios, indecisiveness, and difficulty concentrating. Anxiety can also lead to a number of physical symptoms such as stomach upset, drowsiness, sweating, sleep disruption, and agitation. It’s good to mention that several other conditions share these symptoms or may occur alongside anxiety. For this reason, it’s best to leave the diagnosing up to a health care provider who can determine the source of your symptoms.    

Treatment options, such as psychotherapy and medication, work to change how the body reacts to these signals. These treatments include:

  • Behavioral therapy. Though it may be tough to reach out at first, there are many different types of therapists that offer techniques for reframing thoughts and solutions for managing stressors. If you're a student, you might consider looking for someone to speak with at your campus counseling center. For additional tips, check out the Go Ask Alice! Q&A How to find a therapist.
  • Medication options. Serotonin reuptake inhibitors (SSRIs) and dual serotonin and norepinephrine reuptake inhibitors (SNRIs) are most commonly prescribed for anxiety. For more information about how these medications work and what you may expect, you may want to check out the Go Ask Alice! Q&A Will anti-anxiety meds make me a zombie?.

Additionally, you might consider trying some of these stress management techniques to give you tools for handling and responding to the inevitable pressures life throws your way:

  • Invest in your overall health. Eating well-balanced meals, sticking to a physical activity schedule, and making sure to get enough sleep may keep your energy levels up and may help to burn off some of the stress that’s building up.
  • Reduce caffeine intake. Although the boost of energy after a cup of coffee or soda may feel like it’s helping, the caffeine high could also contribute to the anxious feeling you’re experiencing.
  • Try yoga or meditation. As you already mentioned, relaxation through activities such as yoga or meditation may help you refocus even when you’ve got a lot on your plate.
  • Make a plan. Creating a schedule of your commitments is helpful for better managing your time and recognizing where you want to scale back or fit in a few moments to relax and de-stress.
  • Cut yourself some slack. It’s okay if you can’t do everything on your to-do list. There will likely be other opportunities to do what you want to do, so try to go easy on yourself.

Feeling anxious is a common experience among students. The first step to overcoming your anxiety is being aware that it exists and exploring its sources. If you find that your anxiety level increases so much so that you're unable to follow your daily routines and keep up with your work, you may want to consider enlisting some help by working with a mental health professional. With these tips, hopefully you’ll be on the path to a less anxious graduate school experience.

Alice!

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