Why you need to understand anticipatory anxiety

Anticipatory Anxiety occurs when you experience the emotion of anxiety in response to an anticipated threat that may or may not happen in the future. 

What is anticipatory anxiety?

Anticipatory anxiety is not a diagnosis. It is a symptom that occurs within other anxiety disorders, and I shall talk about this later in the article once I define anticipatory anxiety in a way that hopefully makes sense.

If you were looking for my self-help course for anxiety, you read more about self-help here.

Like the emotion of anxiety, anticipatory anxiety can have a

  • subjective experience
  • physiological response
  • behavioural response

I shall explain this to you now regarding our ongoing pandemic before providing more general examples in terms of specific anxiety disorders.

I would recommend reading about emotions before continuing with this page, as it will help your understanding.

Example

Anticipatory anxiety and coronavirus

  • Subjective experience: Is your experience of living through a global pandemic – coronavirus
  • Physiological response: Feeling the symptoms of anxiety
  • Behavioural Response: More fearful behaviours

Subjective Experience

You might find that you are worrying

  • More about your health
  • What would happen if you got coronavirus?
  • What if you lost your job?
  • Will you be able to pay your bills?

These are all things that you are concerned about happening in the future. In other words, they are things that you are anticipating.  

But how does anticipating these things lead to the experience of anxiety?

If you have read my article on anxiety, you will know that anxiety responds to a perceived threat.

I’ve spoken about this before, but I shall give a quick recap here. Fear and anxiety are both similar emotions.

Fear is what you feel when you are in immediate danger, such as suddenly being confronted by a bear! Anxiety is what you feel when there is no bear (no real danger.) You are responding to a perceived threat that may or may not occur in the future.

When you feel fear (when you see the bear), the feelings you get, result from the stress response – fight or flight. Your stress response is activated in your brain1. When you see a probable danger, this sensory information, the sight and sound of the bear, go to your amygdala to get processed. If it detects danger, your brain gives you a stress response to equip you with the energy you need to escape danger.

This processing in your brain can also occur regardless of whether the threat is real or not. This means you get the stress response in the absence of the bear, i.e. in the absence of danger. In the case of anxiety, it is the perceived threat that can activate this response.

Hopefully, you can see that anticipating threatening events in the future can also activate your stress response, which ultimately gives you the physical and emotional symptoms of anxiety.

Subjective experience: Worry about coronavirus

Physiological response: Symptoms of anxiety

Behavioural Response: This could be anything from avoidance to sleep disturbances.

Anticipatory anxiety, and GAD

Some examples that you might worry about (or anticipate) are

  • Am I good enough?
  • How can I get through tomorrow?
  • What if I don’t get enough sleep tonight?
  • What if I can’t pay my bills, my mortgage?
  • What if I lose my job?
  • What if I fail?
  • What if my boss sees that I haven’t done my job correctly?
  • What if I mess up?

And the list goes on.

One thing you might notice is that none of these things is happening right now. If you are awake at 4 am, lying in bed, they are only occurring in your thought processes.

Anticipatory anxiety and panic attacks

If you have panic attacks, you will know that they can occur out of the blue, with no real thought processes present. Still, in this article, I will only talk to you about them concerning anticipatory anxiety.

Some examples are

  • What if I have a panic attack when I am out, when shopping, driving, or in places that have occurred before?
  • What if I make a fool of myself?
  • What if I end up in the hospital again thinking I am dying (been there, bought the tee-shirt on that one!)
  • What if I can’t catch my breath next time?

Similar to the anxiety examples, these are all worries about something that may or may not occur in the future.

Anticipatory anxiety and health anxiety

Examples

  • What if the doctors have missed something?
  • What if there is something seriously wrong with me?
  • What if I really do have cancer, tumours, MS, heart problems?

As in the other examples, you might be worried that these things could happen, but if you have been to the docs and got a clean bill of health, they are not happening right now.

Anticipatory anxiety and social anxiety

  • What if I blush?
  • What if I have nothing to say?
  • I won’t fit in
  • What if I get anxious?
  • What if I say something stupid?
  • I’m boring
  • No one is interested in what I have to say
  • They won’t remember who I am (something I struggled with for many years)
  • What will I talk about?
  • Planning out conversations so you have something to say

Hopefully, you will see from all the examples that they all have one major thing in common – they are all worries about something that may occur in the future, hence where the name comes from – anticipatory anxiety, as you anticipate that something bad may happen in the future.

Why does it happen?

In two words, repeated practice. Think of your worries as being the result of repeated experiences. The more often you have a particular type of thought, the more likely you will have it in the future.

How to stop anticipatory anxiety?

Two approaches immediately come to my mind – CBT and Mindfulness.

CBT (Cognitive Behavioural Therapy) will help you change the type of thoughts you have in your head, and Mindfulness will help you let them go.

Combining various approaches, you can Retrain Your Brain® to unlearn anticipatory anxiety.

Retrain Your Brain® to Unlearn Anxiety

More information
  1. Harvard.Edu Understanding the stress response