How to Calm Anxiety: What Works Now and Long Term

How to calm anxiety right now

Slow your breathing

Anxiety makes breathing fast and shallow, high in the chest. That over-breathing upsets the balance of gases in your blood and makes the physical symptoms worse.¹ Slowing it down sends the opposite signal.

• Breathe in gently through your nose for a count of three
• Breathe out for a count of three, or longer²
• Let your belly move, not your shoulders¹
• Keep going for a few minutes

A meta-analysis of 20 randomised trials found that breathing exercises reduced anxiety, with a small-to-medium effect.³ In a one-month trial comparing five minutes a day of different techniques, breathing with a long, slow out-breath improved mood more than mindfulness meditation did.⁴

Relax your muscles

Work through your body, tensing each muscle group for a few seconds and then letting it go.² A review of 27 studies found that relaxation training reduced anxiety, with a medium effect.⁵

Move

A brisk walk, some stairs or a few stretches gives the adrenaline somewhere to go.

Come back to the present

Anxiety pulls your attention into the future. Naming what you can see, hear and feel around you pulls it back. Mindfulness practice builds the same skill.⁶

How to reduce anxiety over time

• Exercise regularly. An analysis of 15 trials found that aerobic exercise reduced anxiety compared with no treatment, and that harder sessions worked better than gentle ones.⁷
• Cut down on caffeine. Caffeine can increase anxiety and disturb sleep.⁸ People prone to panic are especially sensitive. In studies that gave a dose equal to about five cups of coffee, half of people with panic disorder had a panic attack, compared with fewer than 2 in 100 people without it.⁹
• Protect your sleep. Anxiety and poor sleep feed each other. See sleep hygiene and insomnia.
• Go easy on alcohol. It takes the edge off for an hour or two, and anxiety tends to rebound as it wears off.
• Stop avoiding. Dodging the things that make you anxious brings relief today and more anxiety tomorrow. Facing them in small, planned steps, known as exposure, is central to therapy for anxiety.¹⁰
• Contain the worry. See how to stop overthinking.
• Try meditation. A review of 47 trials found moderate evidence that mindfulness meditation programs improve anxiety over eight weeks.¹¹

Treatments that work

Anxiety disorders are the most common mental health conditions in Australia. About one in six adults has had one in the past 12 months, and one in four will at some stage of life.^8,12 They are treatable.

• Cognitive behavioural therapy (CBT). You learn to spot anxious thinking, test it, and gradually face what you fear. In a meta-analysis of trials against placebo, the odds of responding were about three times higher with CBT.¹⁰
• Online programs. Structured CBT courses can be done from home, on your own or with a clinician guiding you.¹³
• Prescription medicines. These are an option for some people, and your doctor can talk through whether they suit you.⁸

Your GP can set up a mental health treatment plan, which gives you Medicare rebates for sessions with a psychologist.

What makes anxiety worse

• Too much caffeine, and not enough sleep
• Avoiding things, which shrinks your world
• Seeking constant reassurance or searching symptoms online
• Waiting for the anxiety to vanish before you act

When to see a doctor

• Anxiety is affecting your ability to concentrate, sleep or carry out ordinary tasks⁸
• It has lasted for weeks or keeps coming back
• You are having panic attacks. See how to stop a panic attack
• You have physical symptoms such as chest pain, breathlessness or palpitations that haven’t been checked

If you are having thoughts of suicide, call Lifeline on 13 11 14. In an emergency, call 000.

References

1. Better Health Channel (Victorian Government). Breathing to reduce stress.
2. healthdirect. Relaxation techniques for stress relief.
3. Fincham GW, Strauss C, Montero-Marin J, et al. Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. 2023;13(1):432.
4. Balban MY, Neri E, Kogon MM, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023;4(1):100895.
5. Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 2008;8:41.
6. healthdirect. Mindfulness.
7. Aylett E, Small N, Bower P. Exercise in the treatment of clinical anxiety in general practice - a systematic review and meta-analysis. BMC Health Serv Res. 2018;18(1):559.
8. healthdirect. Anxiety.
9. Klevebrant L, Frick A. Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2022;74:22-31.
10. Carpenter JK, Andrews LA, Witcraft SM, et al. Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depress Anxiety. 2018;35(6):502-514.
11. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357-68.
12. Australian Bureau of Statistics. National Study of Mental Health and Wellbeing, 2020–2022.
13. THIS WAY UP (St Vincent’s Hospital Sydney). THIS WAY UP online programs.