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Ask a Therapist: I Need Help Creating Routine for My Anxiety

Coping Skills, Ask a Therapist
7 min read

Dear Therapist: If having a daily routine will help with anxiety, what am I supposed to do/how do I implement that if I don’t have any real hobbies? 

Frame Therapist Kim Lindley weighs in…
Thank you for asking a such an important question, as according to Dr. Wendy Susuki, Professor of Neuroscience and Psychology at the New York University Center for Neural Science, 90% of the US population identifies as suffering from Anxiety. 

That’s a big number, and if you think about how humans co-regulate, it can make it hard to regulate yourself if most of the people around you are equally anxious and we are cueing each other towards more anxiety and not away from it. 

In order to answer your question it will be helpful to break down how we understand anxiety, because it can mean different things in different contexts: 

  • The American Psychological Association (APA) and National Institute of Mental Health ( NIMH) define anxiety and stress as an emotion characterized by feelings of tension, thoughts of worry or panic, feelings of fear or doom, difficulty thinking clearly, sweating, and physical changes like increased blood pressure, rapid breathing or heart rate and feeling overwhelmed.  

  • Clinical Anxiety, is a diagnosable disorder that can interfere with functioning in daily life and negatively impact health, relationships, performance in school or the workplace and additionally be very uncomfortable. This characterization of anxiety is pretty unappealing, however, new research suggests that we  break it down further into unhealthy or bad anxiety, and heathy or good anxiety. Being curious and in conversation with your experience of anxiety can help to determine if it’s "the bad kind", or "the good kind".

    • The bad kind makes life feel hard, the good kind, believe it or not, is what gets you out of bed in the morning to use the bathroom, because your anxiety has taught you that confusing your bed with the toilet is not an option. 

Let’s dig a little deeper into the science:

Our senses are the first points of contact with the outside world. What we take in via sight, sound, touch, smell and taste, activates our nervous system to asses for safety. This happens four times every second. 

Our mind then jumps in to try to make meaning out of that information, marrying the present stimuli, with all past experiences. Think of stimuli as a kind of stressor, adding a load to the system to process. If there is danger we go in to Flight, Flight, Freeze or Fawn.

For instance, someone walks in to a room and is wearing cologne a particularly mean teacher in grade school wore, your nervous system is on alert to that scent, and activates a response. Your body responds first, and your mind may figure it out, or in some cases may lag behind.  This is when that unexplained feeling of unease can set in and make us feel worried, anxious, and unable self-regulate or feel calm. Conversely,  if there is no danger, for instance the time on the clock reminds you of a deadline for a project, you are similarly in an activated state, but this kind of anxiety may be motivational, and work in your favor. Both however take a toll, and it can become hard for the body to discern between the good or bad anxiety. In this time of human history, our senses, and in turn our nervous systems are on stimuli overload. It is hard to quantify the amount of raw data we have to process through our senses on any given day. 

So, what to do?

You mentioned not having hobbies in your question, and I am going to interpret that as not having “practices” that could help address the anxiety. 

  1. Think of anxiety as adaptive and essential and occurring on a spectrum 1 (low) through 10 (high).  Where would you like your normal to be? Does the load ( job, relationships, health, responsibilities, environment) you are expected to manage feel doable?  Does a 4 or 5 mean that you feel reasonably capable and enjoy a general sense of well-being? Can you rise to challenges, feel an acceleration without feeling out of control? What does that actually feel like, and what factors in your life keep you in that sweet spot – social support, steady job, a made bed, a full tank of gas, exercise, music, healthy meals?

  2. Notice when you find yourself at a 7 or an 8. What might the sensory trigger have been? Is it appropriate, meaning, does it fit the occasion?  If there is a storm, or a crisis, seek cover, act to protect yourself. Notice if you ease back down to your “normal” once the crisis has passed. The inability to toggle back and forth with some ease, meaning, getting stuck in overdrive, is when our adaptive anxiety becomes the kind we don’t like.  This may indicate underlying issues that should be addressed.

  3. Explore some bottom-up practices, in small and manageable steps to help coax the body, aka "the nervous system" back to equilibrium, practice them, and then use them daily to build up that muscle. Start small, and once you’ve found what feels good, build a practice that might begin to feel more like a hobby. Some proven examples are:
    • Take a walk for 10 minutes known as  “self-generated optic flow”. Walking has numerous health benefits.
    • Use a breathing technique called the ‘physiological sigh” - a pattern of two inhales through the nose, and then a long sign exhale through the mouth, do 3 or  4 times.
    • Use Box breathing where you sit quietly, inhale for 4, hold for 4, exhale for 4, and hold for 4. Repeat a few times and build up to 5 minutes.
    • Try a 5 minute mediation practice, just sit, and breathe without an agenda or judgement. Observe.
    • Try a 5 minute yoga practice, there are many free options on YouTube. YogawithAdriene is popular.
    • Attach a new practice to something you already do, breathe in the shower, do yoga upon waking, park a little further and walk to work.  It makes is easier to remember. 

Insofar as hobbies go, “trying” something is the goal, in small incremental ways to test out what you like. There is all too much pressure, from our early educational years to lean towards things we are good at. Trying and mastering don’t have to happen together. Being just ok, teaches us to recognize and accept our strengths and weaknesses and practice self-compassion. And have some fun!

I hope this is helpful. Of course, it’s a huge topic, and exploring your particular experience of anxiety and working to understand and manage it is a worthwhile work in progress. 

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About the therapist: Kim Richardson Lindley, MA, ICACD II, LMFT, LPCC, is dually licensed as a Marriage & Family Therapist and Professional Clinical Counselor, a Parnell Institute trained EMDR Therapist, and an Addiction Counselor with a private practice in West Los Angeles. Connect with Kim directly, and read more of her content, by viewing her Frame profile here.