Treatment, involving psychotherapy & medications, can help relieve symptoms of generalized anxiety disorder. However, certain self-help strategies can make it easier to overcome anxiety disorders and make the recovery process faster.
Overcoming Generalized Anxiety Disorder (GAD)
Generalized anxiety disorder can be a seriously debilitating condition as constant worry can severely affect our physical, mental and emotional well-being. However, we can train our mind to stop worrying unnecessarily and excessively. Apart from attending therapy sessions and taking prescribed medications properly, we can utilize certain helpful coping strategies to reframe our thought process. Learning coping skills to overcome GAD is an essential aspect of the treatment process as persistent anxiety can lead to various symptoms in varying degrees, such as –
- Physical symptoms, like body aches and muscle tension
- Emotional symptoms, like severe anxiety, constant worry and intrusive thoughts
- Behavioral symptoms, like social withdrawal, isolation and procrastination
Learning different self-help techniques for generalized anxiety disorder can enable you to regulate and relieve these symptoms. The first step towards recovery from GAD begins with educating yourself. The more you learn about the symptoms, triggers, causes and treatments, the better you will be able to manage yourMunir S, Takov V. Generalized Anxiety Disorder. [Updated 2021 Mar 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/ )) suggests “The education of the patient is vital as it can help ease anxiety. The triggers for anxiety should be managed like avoiding caffeine, alcohol, nicotine, stress) and improving sleep.” When anxiety becomes overwhelming, ask yourself what you can do to control your emotions and accept certain facts of life that will help you reduce your anxiety and fear.
Ways To Cope With Generalized Anxiety Disorder
Coping techniques can enable you to manage your condition better and help in the recovery process. However, it should be noted that these strategies can only be effective when utilized along with medical treatment and under the supervision of a doctor or a mental health professional. Here are some self-help tips for coping with GAD:
1. Learn to identify & manage triggers
Certain triggers, like caffeine or alcohol, can be easy to identify, while some others can be harder to recognize as they are less obvious. This is why learning about your triggers, whether by yourself or with the help of your therapist, can be beneficial. Some common triggers may include stressful work environments, trauma, phobias, genetics, chronic illnesses, comorbid conditions, substance use and some daily life experiences like traveling or driving. Identifying your triggers can enable you to find a way to manage them better or even eliminate them with practice and effort. By limiting your exposure to certain triggers or having a plan for overcoming them when you face them, you will be better able to manage your worries, fears and generalized anxiety disorder.
By paying attention to anxiety-inducing situations, you can become increasingly aware of triggers. Even though you may not be able to avoid some of them, you can have better clarity, be aware of the triggers and practice emotion regulation in particular situations. It is only by understanding yourself, you can learn how to calm down and alleviate your anxious thoughts. Research 1 reveals that cognitive behavioral therapy (CBT) can be an effective tool “that focuses on helping individuals identify and modify characteristic maladaptive thinking patterns and beliefs that trigger and maintain symptoms.”
2. Talk to someone
GAD can often lead to unhealthy behavior patterns like social withdrawal and feelings of isolation and loneliness. People suffering from generalized anxiety disorder falsely believe that no one will understand them or will be able to relate to them. This is why it is crucial that you talk openly and honestly with a trusted loved one about your struggles. It could be a family member, relative, teacher, coach, supervisor or even a therapist. Let them know about your feelings, thoughts and experiences and try to connect with loved ones instead of isolating yourself. Talking to others can help you gain new perspectives and rational thinking.
Mindfulness refers to the practice of bringing our awareness and attention to the present moment. Using various mindfulness techniques like deep breathing & meditation, you can learn to observe your thoughts and emotions without judging them or being attached to them. It will also help you to calm down and manage your generalized anxiety disorder symptoms. A 2019 study 2 suggests that “meditation focusing on reducing worry and rumination,” can be beneficial in reducing the risk of developing anxiety & depression. Mindfulness enables us to pause and slow down by being aware of the present, instead of worrying about the past or the future. Focusing on the present helps to reduce anxiety and fears.
Mindfulness is a powerful yet simple anxiety coping strategy that can reduce the persistent flow of negative thoughts and worries. Research 3 shows that mindfulness-based interventions are becoming increasingly popular for coping with anxiety and depression due to strong evidence of efficacy. According to a 2010 study 4 , mindfulness-based therapy is a promising and effective intervention for treating anxiety and mood problems. Another 2013 study 5 found that mindfulness meditation is considered as a beneficial therapeutic strategy for anxiety disorders. The researchers explain that “Mindfulness-Based Stress Reduction (MBSR) may have a beneficial effect on anxiety symptoms in GAD, and may also improve stress reactivity and coping as measured in a laboratory stress challenge.” Research 6 on mindfulness-based interventions (MBIs) has shown “efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.”
4. Deep breathing
Shallow breathing or difficulty in breathing is one of the most common symptoms of generalized anxiety disorder. Shortness of breath can further lead to muscle tension and heart palpitations. During stressful situations, people with GAD often take rapid breaths as they tend to panic and forget to breathe. Hyperventilation and anxiety can cause lightheadedness, dizziness and breathlessness. These experiences can further add to the panic attacks. Taking deep and slow breaths from your belly, also known as diaphragmatic breathing, can help you calm down and reduce your anxiety. Diaphragmatic breathing helps to reduce tension, relax muscular spasm, enhance blood supply to muscle and increases oxygen supply in the body.
Studies 7 have found that deep breathing can be highly effective in improving mood and reducing stress, anxiety, heart rate & salivary cortisol levels. According to a recent 2020 study 8 , diaphragmatic breathing is “beneficial for reducing both physiological and psychological stress,” and “in treating eating disorders, chronic functional constipation, hypertension, migraine, and anxiety.” Moreover, box breathing 9 , another form of deep breathing can be especially effective with relaxation and overcoming generalized anxiety disorder. Yogic breathing techniques or Pranayama can also be “beneficial in reducing anxiety and depressive symptoms in patients with treatment-resistant GAD,” according to a 2019 study 10 .
5. Calm down using your senses
When you need to calm down quickly in a stressful situation then focusing on your physical senses can enable you to reduce anxiety symptoms almost instantaneously. We cannot always control situations that give rise to stress nor have someone by our side to support us all the time. In such circumstances, using our physical senses in a mindful manner can be an effective self-soothing strategy in the following way:
A. Sense of sight
You can use your sense of sight to look at relaxing things, like looking at nature or the sky, viewing photographs of your loved ones or even funny images and memes on the internet. According to a 2013 study 11 , nature images can help to improve recovery after a stressor. It states “viewing nature scenes prior to a stressor alters autonomic activity in the recovery period.”
B. Sense of taste
Treat yourself with your favorite meal and focus on your sense of taste. You can even enjoy a cup of coffee, a candy, mint or even gum to take your mind off from anxiety-inducing thoughts. According to a 2019 study 12 , dietary interventions can prove to be effective as “a novel intervention” for relieving symptoms of depression and generalized anxiety disorder.
C. Sense of smell
Take a deep breath and feel the fresh, clean air to activate your sense of smell. You may also smell a flower, put on a nice perfume or enjoy the aroma of scented candles. Research 13 shows that odor perception can affect our physiological and psychological states and can arouse certain emotional memories. A 2016 study 14 has found that olfactory stimulation plays a crucial role in regulating our mood, cognition and social behavior. It states “The sense of smell plays an important role in the physiological effects of mood, stress, and working capacity.”
D. Sense of sound
Using the right sound a person with generalized anxiety disorder can calm themselves down almost immediately. Listen to some relaxing music or simply enjoy the sounds of nature 15 , whether in person or on YouTube. You may also play a musical instrument. Studies 16 have found that natural sounds can be an effective non-pharmacological way to reduce anxiety. One 2013 study 17 found that listening to music can be beneficial for the human body as it can impact our psychobiological stress system. “Listening to music prior to a standardized stressor predominantly affected the autonomic nervous system (in terms of a faster recovery), and to a lesser degree the endocrine and psychological stress response,” states the study.
E. Sense of touch
Hug a loved one or a friend, pet your dog or cat, feel the breeze outside or simply enjoy a nice massage to focus on your sense of touch. According to a 2018 study 18 , non-sexual interpersonal touch can act as a general stress buffer 19 and improve well-being leading to enhanced ability to cope with generalized anxiety disorder. The study claims that people who frequently hug their loved ones “report less distress and show reduced cardiovascular reactivity, cortisol secretion, and activation of brain regions associated with emotional and behavioral threat.”
Moreover, it has also been observed 20 that playing with dogs can also buffer the stress response. According to a 2020 study 21 , animal-assisted activities (AAAs) with a dog have been found to be effective in improving mood and stress. Another 2012 study 22 found that human-animal interactions (HAI) can improve mental health conditions, mood, stress, self-reported fear & anxiety; and overall mental & physical health.
6. Learn to accept yourself
Acceptance of yourself, your thoughts and your emotions is an essential step in improving your overall mental and emotional health. Anxiety is not caused as a result of our flaws and imperfections. Research 23 indicates that generalized anxiety disorder may be caused by a wide range of factors, like genetics, life experiences, neurobiology etc. There is no specific cause for this common condition. By embracing your condition you will be better able to identify triggers, seek treatment and gain the necessary coping skills to overcome this disorder. A 2014 study 24 found that individuals affected with GAD and depression have high intolerance of uncertainty (IU 25 ) scores, which refers to “the inability to accept the possibility that a negative event may occur in the future, irrespective of the probability of its occurrence.” People with elevated IU can experience disruptions in emotional, behavioral and cognitive functioning and depletion of attentional resources due to uncertainty. This is why it can be beneficial to learn acceptance of yourself and your feelings.
Acceptance will allow you to engage your conscious awareness in the here and now with openness and without getting distracted by unhelpful thoughts. It will also enable you to allow your thoughts and emotions to come and go without getting attached to them or trying to control them. A 2018 study 26 suggests, “When we observe private experience (thoughts and feelings) with openness and acceptance, even the most painful of them are less threatening, and they seem more tolerable.” Another 2010 study 27 found that acceptance of negative experiences can prevent us from experiencing negative affect and reduce the chances of developing generalized anxiety disorder and depressive symptoms.
7. Be hopeful and positive
Having a positive attitude and being optimistic can help you be more hopeful about living a better, healthier life. Individuals struggling with chronic anxiety disorders, like generalized anxiety disorder, tend to live a guarded life in isolation due to worry and fear. “Negatively valenced thoughts are assumed to play a central role in the development and maintenance of anxiety,” explains a 2012 study 28 . Developing a positive mindset, connecting with trusted loved ones and building coping strategies can enable you to lead a productive, meaningful and joyful life. You can find inspiration in everyday life and among the people around you.
Research 29 indicates that having a positive attitude can greatly affect our physical and mental well-being by encouraging a healthy lifestyle. Moreover, it was found that optimism is also associated with greater flexibility, cognitive responses, adaptive behaviors, problem-solving capacity and effective elaboration of negative information. A 2016 study 30 on the power of positive thinking for people with generalized anxiety disorder found that replacing worry with optimism and “positive ideation, even when unrelated to the content of worry itself, seems to have certain beneficial effects, suggesting that any form of positive ideation can be used to effectively counter worry.”
8. Follow a healthy diet
Although food may not cause or cure anxiety, what we eat can certainly influence our emotions and mood 31 . Consuming food high in sugar or fat 32 or eating processed foods frequently can lead to unstable blood sugar levels and make us feel fatigued and restless. Moreover, not eating enough or at the right time can also lower blood sugar, making us feel irritated and anxious. This is why it is important to have a nutritious breakfast and have healthy meals throughout the day. You also need to consume enough vegetables and fruits as these can stabilize blood sugar and increase the hormone serotonin which regulates our happiness, mood and feelings of well-being.
A 2019 study 33 found that diet can be considered as a modifiable risk factor for psychiatric problems, like general anxiety disorder and depression. It states “a dietary pattern characterized by consumption of vegetables, fruit, beef, lamb, fish, and whole-grain foods has been related to a lower risk of a diagnosis of anxiety,” however, excessive consumption of “meats and sugar has been associated with more psychiatric symptoms.” Research 34 also shows that poor quality and inadequate diet causing insufficient intake of nutrients can cause mental health problems. A recent 2020 study 35 states that poor eating habits and unhealthy diets “may be a causal factor in the experience of low mood,”, however, a healthy diet can significantly help to improve mental and physical health. Hence, try to change your diet and have balanced meals. You can also take certain nutrients or supplements, like omega-3 fatty acids, kava, green tea or ashwagandha (withania somnifera), to reduce anxiety.
9. Avoid caffeine, nicotine & alcohol
Limit your consumption of caffeinated beverages like coffee, tea, soda and energy drinks as these can elevate anxiety levels. Studies 36 show that people with anxiety disorder have increased caffeine sensitivity. One 2016 study 37 found that caffeine consumption was positively related to the severity of anxiety and depression, while another 2015 study 38 found that caffeine intake through coffee can cause stress, anxiety, and depression. Caffeine can trigger anxiety and make GAD symptoms worse. Moreover, nicotine intake can also affect your anxiety as a strong association between chronic nicotine use 39 and anxiety disorders has been observed. According to a 2013 study 40 , “cigarette smoking may increase the risk of developing increased anxiety.”
Apart from caffeine and tobacco, alcohol consumption can also make symptoms worse for people with GAD. Although alcohol may temporarily make you feel less anxious and relaxed, it can make symptoms worse in the long run, especially once the effects wear off. Research 41 has found that high intake of alcohol is linked to anxiety and depression. In fact, alcohol use disorders (AUD) is one of the most common comorbid conditions 42 of GAD. It has been observed that in 67% of comorbid cases 43 , the onset of GAD was observed before AUD. As GAD sufferers are at increased risk 44 for chronic alcohol dependence, it is crucial that you limit or cut off alcohol consumption if you wish to overcome GAD. It is also important that you avoid recreational drugs as it can affect your treatment and recovery.
10. Get adequate sleep
Anxiety, stress and worry has been found to be associated with sleep disorders 45 like insomnia. Constantly worrying about things can affect your sleep and keep you up at night. Ironically, sleep deprivation adds to your anxiety and makes GAD symptoms even worse. Lack of sleep reduces our capacity to cope with stress. “Humans experiencing partial sleep restriction usually exhibit detrimental physiological responses,” explains a 2020 study 46 . As sleep disturbances are commonly linked 47 with generalized anxiety disorder, it is imperative that you practice good sleep hygiene and effective bedtime routines, like –
- Avoiding screen time before going to bed
- Following a relaxation practice, like reading a book or meditating before sleeping
- Getting at least 7-8 hours of undisturbed sleep every night
Being well rested will help you stabilize your mood and emotions, feel calmer and enable you to better cope with worry and anxiety.
11. Exercise regularly
Exercise is one of the most effective ways to reduce stress, anxiety and depression. Research 48 has found that “exercise and regular activity positively impacts the pathophysiological processes of anxiety.” Exercising helps to boost the happiness hormone serotonin and feel-good chemicals like endorphins, regulates stress hormones, and rewires the brain so that it is more resilient and less prone to anxiety. When you are trying to cope with generalized anxiety disorder, even as little as 30 minutes of regular physical activity for 3-4 days a week can be beneficial. You can do a variety of exercises that engage different parts of your body, like weight lifting, cardio exercises, martial arts, swimming, running, dancing, or even walking. This will not only improve your physical health, but also boost your mental and emotional health as well.
According to a 2016 study 49 , “as a treatment for elevated anxiety or anxiety disorders, exercise offers benefits comparable to established treatments, including medication or CBT, and better than those of placebo.” Another 2018 study 50 found that exercise is a viable useful treatment option for anxiety. However, it was found that high intensity exercise routines are more effective than low intensity training routines.
12. Create a strong support system
Research 51 shows that building a support network of caregivers and loved ones can be highly beneficial for people suffering from generalized anxiety disorder. As we are social beings, having a strong support system can help us avoid isolation and overcome distorted, intrusive thinking. Having the support of family and friends can make a lot of difference when you feel overwhelmed with negative emotions like fear. You may also join a local support group or an online community to connect with people who are coping with similar mental health issues and learn valuable coping strategies from their experiences.
Generalized Anxiety Disorder Can Be Treated Effectively
Generalized anxiety disorder can be a debilitating condition and may make the sufferer feel persistent worry, fear and anxiety. However, with effective treatment under the guidance of a licensed mental health professional combined with the above mentioned coping strategies, you can overcome the symptoms and lead a fuller, healthier life. Learning to identify and manage triggers, seeking help and having a positive attitude can be helpful when your negative thoughts and emotions feel overwhelming. If you or a loved one is suffering from GAD, then make sure to consult a doctor immediately.
- Chand SP, Marwaha R. Anxiety. [Updated 2020 Nov 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361/
- Parmentier, F., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Frontiers in psychology, 10, 506. https://doi.org/10.3389/fpsyg.2019.00506
- Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., Uchida, T., & Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators. BioPsychoSocial medicine, 13, 4. https://doi.org/10.1186/s13030-019-0145-4
- Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169–183. https://doi.org/10.1037/a0018555
- Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., Worthington, J. J., Pollack, M. H., & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. The Journal of clinical psychiatry, 74(8), 786–792. https://doi.org/10.4088/JCP.12m08083
- Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739–749. https://doi.org/10.1016/j.psc.2017.08.008
- Perciavalle V, Blandini M, Fecarotta P, Buscemi A, Di Corrado D, Bertolo L, Fichera F, Coco M. The role of deep breathing on stress. Neurol Sci. 2017 Mar;38(3):451-458. doi: 10.1007/s10072-016-2790-8. Epub 2016 Dec 19. PMID: 27995346.
- Hamasaki H. (2020). Effects of Diaphragmatic Breathing on Health: A Narrative Review. Medicines (Basel, Switzerland), 7(10), 65. https://doi.org/10.3390/medicines7100065
- Norelli SK, Long A, Krepps JM. Relaxation Techniques. [Updated 2020 Sep 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513238/
- Tiwari, N., Sutton, M., Garner, M., & Baldwin, D. S. (2019). Yogic Breathing Instruction in Patients with Treatment-Resistant Generalized Anxiety Disorder: Pilot Study. International journal of yoga, 12(1), 78–83. https://doi.org/10.4103/ijoy.IJOY_22_18
- Brown, D. K., Barton, J. L., & Gladwell, V. F. (2013). Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress. Environmental science & technology, 47(11), 5562–5569. https://doi.org/10.1021/es305019p
- Firth, J., Marx, W., Dash, S., Carney, R., Teasdale, S. B., Solmi, M., Stubbs, B., Schuch, F. B., Carvalho, A. F., Jacka, F., & Sarris, J. (2019). The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials. Psychosomatic medicine, 81(3), 265–280. https://doi.org/10.1097/PSY.0000000000000673
- Kadohisa M. (2013). Effects of odor on emotion, with implications. Frontiers in systems neuroscience, 7, 66. https://doi.org/10.3389/fnsys.2013.00066
- Sowndhararajan, K., & Kim, S. (2016). Influence of Fragrances on Human Psychophysiological Activity: With Special Reference to Human Electroencephalographic Response. Scientia pharmaceutica, 84(4), 724–751. https://doi.org/10.3390/scipharm84040724
- Thoma, M. V., Mewes, R., & Nater, U. M. (2018). Preliminary evidence: the stress-reducing effect of listening to water sounds depends on somatic complaints: A randomized trial. Medicine, 97(8), e9851. https://doi.org/10.1097/MD.0000000000009851
- Amiri, M. J., Sadeghi, T., & Negahban Bonabi, T. (2017). The effect of natural sounds on the anxiety of patients undergoing coronary artery bypass graft surgery. Perioperative medicine (London, England), 6, 17. https://doi.org/10.1186/s13741-017-0074-3
- Thoma, M. V., La Marca, R., Brönnimann, R., Finkel, L., Ehlert, U., & Nater, U. M. (2013). The effect of music on the human stress response. PloS one, 8(8), e70156. https://doi.org/10.1371/journal.pone.0070156
- Murphy, M., Janicki-Deverts, D., & Cohen, S. (2018). Receiving a hug is associated with the attenuation of negative mood that occurs on days with interpersonal conflict. PloS one, 13(10), e0203522. https://doi.org/10.1371/journal.pone.0203522
- Cohen, S., Janicki-Deverts, D., Turner, R. B., & Doyle, W. J. (2015). Does hugging provide stress-buffering social support? A study of susceptibility to upper respiratory infection and illness. Psychological science, 26(2), 135–147. https://doi.org/10.1177/0956797614559284
- Fiocco, A. J., & Hunse, A. M. (2017). The Buffer Effect of Therapy Dog Exposure on Stress Reactivity in Undergraduate Students. International journal of environmental research and public health, 14(7), 707. https://doi.org/10.3390/ijerph14070707
- Machová, K., Procházková, R., Vadroňová, M., Součková, M., & Prouzová, E. (2020). Effect of Dog Presence on Stress Levels in Students under Psychological Strain: A Pilot Study. International journal of environmental research and public health, 17(7), 2286. https://doi.org/10.3390/ijerph17072286
- Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: the possible role of oxytocin. Frontiers in psychology, 3, 234. https://doi.org/10.3389/fpsyg.2012.00234
- Morris-Rosendahl D. J. (2002). Are there anxious genes?. Dialogues in clinical neuroscience, 4(3), 251–260. https://doi.org/10.31887/DCNS.2002.4.3/dmrosendahl
- Grupe, D. W., & Nitschke, J. B. (2013). Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature reviews. Neuroscience, 14(7), 488–501. https://doi.org/10.1038/nrn3524
- Buhr K, Dugas MJ. The Intolerance of Uncertainty Scale: psychometric properties of the English version. Behav Res Ther. 2002 Aug;40(8):931-45. doi: 10.1016/s0005-7967(01)00092-4. PMID: 12186356.
- Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open access Macedonian journal of medical sciences, 6(2), 410–415. https://doi.org/10.3889/oamjms.2018.064
- Shallcross, A. J., Troy, A. S., Boland, M., & Mauss, I. B. (2010). Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behaviour research and therapy, 48(9), 921–929. https://doi.org/10.1016/j.brat.2010.05.025
- Hogendoorn SM, Prins PJ, Vervoort L, Wolters LH, Nauta MH, Hartman CA, Moorlag H, de Haan E, Boer F. Positive thinking in anxiety disordered children reconsidered. J Anxiety Disord. 2012 Jan;26(1):71-8. doi: 10.1016/j.janxdis.2011.09.003. Epub 2011 Sep 17. PMID: 21978721.
- Conversano, C., Rotondo, A., Lensi, E., Della Vista, O., Arpone, F., & Reda, M. A. (2010). Optimism and its impact on mental and physical well-being. Clinical practice and epidemiology in mental health : CP & EMH, 6, 25–29. https://doi.org/10.2174/1745017901006010025
- Eagleson, C., Hayes, S., Mathews, A., Perman, G., & Hirsch, C. R. (2016). The power of positive thinking: Pathological worry is reduced by thought replacement in Generalized Anxiety Disorder. Behaviour research and therapy, 78, 13–18. https://doi.org/10.1016/j.brat.2015.12.017
- Huang, Q., Liu, H., Suzuki, K., Ma, S., & Liu, C. (2019). Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression. Antioxidants (Basel, Switzerland), 8(9), 376. https://doi.org/10.3390/antiox8090376
- Murphy, M., & Mercer, J. G. (2013). Diet-regulated anxiety. International journal of endocrinology, 2013, 701967. https://doi.org/10.1155/2013/701967
- Masana, M. F., Tyrovolas, S., Kolia, N., Chrysohoou, C., Skoumas, J., Haro, J. M., Tousoulis, D., Papageorgiou, C., Pitsavos, C., & Panagiotakos, D. B. (2019). Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study. Nutrients, 11(6), 1250. https://doi.org/10.3390/nu11061250
- Weng TT, Hao JH, Qian QW, Cao H, Fu JL, Sun Y, Huang L, Tao FB. Is there any relationship between dietary patterns and depression and anxiety in Chinese adolescents? Public Health Nutr. 2012 Apr;15(4):673-82. doi: 10.1017/S1368980011003077. Epub 2011 Nov 25. PMID: 22115495.
- Firth, J., Gangwisch, J. E., Borisini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: how do diet and nutrition affect mental wellbeing?. BMJ (Clinical research ed.), 369, m2382. https://doi.org/10.1136/bmj.m2382
- Lee MA, Cameron OG, Greden JF. Anxiety and caffeine consumption in people with anxiety disorders. Psychiatry Res. 1985 Jul;15(3):211-7. doi: 10.1016/0165-1781(85)90078-2. PMID: 3862156.
- Jin, M. J., Yoon, C. H., Ko, H. J., Kim, H. M., Kim, A. S., Moon, H. N., & Jung, S. P. (2016). The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents. Korean journal of family medicine, 37(2), 111–116. https://doi.org/10.4082/kjfm.2016.37.2.111
- Richards, G., & Smith, A. (2015). Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. Journal of psychopharmacology (Oxford, England), 29(12), 1236–1247. https://doi.org/10.1177/0269881115612404
- Picciotto MR, Brunzell DH, Caldarone BJ. Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport. 2002 Jul 2;13(9):1097-106. doi: 10.1097/00001756-200207020-00006. PMID: 12151749.
- Moylan, S., Jacka, F. N., Pasco, J. A., & Berk, M. (2013). How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: a critical review of biological pathways. Brain and behavior, 3(3), 302–326. https://doi.org/10.1002/brb3.137
- Gibson-Smith D, Bot M, Brouwer IA, Visser M, Giltay EJ, Penninx BWJH. Association of food groups with depression and anxiety disorders. Eur J Nutr. 2020 Mar;59(2):767-778. doi: 10.1007/s00394-019-01943-4. Epub 2019 Apr 3. PMID: 30945032; PMCID: PMC7058560.
- Smith, J. P., & Randall, C. L. (2012). Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol research : current reviews, 34(4), 414–431.
- Smith, J. P., & Book, S. W. (2010). Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment. Addictive behaviors, 35(1), 42–45. https://doi.org/10.1016/j.addbeh.2009.07.002
- Anker, J. J., & Kushner, M. G. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol research : current reviews, 40(1), arcr.v40.1.03. https://doi.org/10.35946/arcr.v40.1.03
- Oh, C. M., Kim, H. Y., Na, H. K., Cho, K. H., & Chu, M. K. (2019). The Effect of Anxiety and Depression on Sleep Quality of Individuals With High Risk for Insomnia: A Population-Based Study. Frontiers in neurology, 10, 849. https://doi.org/10.3389/fneur.2019.00849
- Nollet, M., Wisden, W., & Franks, N. P. (2020). Sleep deprivation and stress: a reciprocal relationship. Interface focus, 10(3), 20190092. https://doi.org/10.1098/rsfs.2019.0092
- Mellman TA. Sleep and anxiety disorders. Psychiatr Clin North Am. 2006 Dec;29(4):1047-58; abstract x. doi: 10.1016/j.psc.2006.08.005. PMID: 17118281.
- Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in psychiatry, 4, 27. https://doi.org/10.3389/fpsyt.2013.00027
- Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as Treatment for Anxiety: Systematic Review and Analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9
- Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC health services research, 18(1), 559. https://doi.org/10.1186/s12913-018-3313-5
- National Collaborating Centre for Mental Health (UK). Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care. Leicester (UK): British Psychological Society; 2011. (NICE Clinical Guidelines, No. 113.) 4, EXPERIENCE OF CARE. Available from: https://www.ncbi.nlm.nih.gov/books/NBK83479/