Anticipatory anxiety: navigating the future with confidence

Exploring the causes of anticipatory anxiety, recognising its signs, and offering management strategies.

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Do you ever get a sense of unease about an upcoming event or date in your diary? This familiar sensation is known as 'anticipatory anxiety'. In this guide, we'll delve deeper into what it is, what triggers it, the signs to look out for, and steps you can take to manage it.

What is anticipatory anxiety?

Anticipatory anxiety is a type of anxiety about the future. It emerges when we think about future events, leading to discomfort, dread, nervousness or just general anxiety about something coming up in our lives. We fear facing the unknown and dream up potential outcomes which are almost always negative. For many, it’s the unsettling feeling before a big presentation, awaiting medical results, or even something as routine as meeting new people.

As humans, we have a natural instinct to anticipate threats and prepare for them - an evolved response from our ancestors, who needed to stay alert in order to survive. In modern times, the threats we face are different, but our reactions can be similar. It's our body's way of signalling that we're unsure about what lies ahead.

What triggers anticipatory anxiety?

It's normal to feel nervous about the future sometimes, but for some, the thought of what's to come can be paralysing. Several factors and triggers can intensify these feelings:

  • Past traumatic events: negative experiences from the past can amplify anticipatory anxiety. When we've faced harm, disappointment or failure before, the mind may fear a repeat and overemphasise potential risks in the future
  • Fear of the unknown: humans find comfort in predictability. Uncertain outcomes, where you can’t foresee or control the results, often cause feelings of vulnerability and stress. This fear is a significant trigger, especially in situations like moving to a new city, starting a new job, or even attending an unfamiliar social gathering
  • Perfectionism: for people who are perfectionists, the thought of not meeting their own or others' expectations can be a profound source of anticipatory anxiety. This often stems from a fear of judgement, criticism or perceived failure
  • Media and news: in our digital age, we're constantly bombarded with information – much of it negative or sensationalised. News about global issues can foster a heightened sense of dread about the future – driving things like climate anxiety - even if they might not directly impact your immediate environment
  • Personal health concerns: for someone with health issues or a phobia of medical settings, upcoming appointments or medical tests can trigger intense feelings of anticipatory anxiety. Excessive feelings of anxiety around your health, often in relation to mild illnesses, could be a sign of health anxiety
  • Social and interpersonal factors: similar to social anxiety disorder, concerns about social interactions, from public speaking to attending social events, can be anxiety-inducing. The fear of judgement, not fitting in, or facing confrontation can significantly heighten anxiety about mixing in social spaces
  • Overthinking and catastrophising: some people have a tendency to ruminate on potential outcomes, often imagining the worst-case scenario

Symptoms of anticipatory anxiety

The signs of anticipatory anxiety are similar to the core symptoms of many anxiety disorders, manifesting in various physical, emotional and behavioural ways. Recognising these symptoms is the first step to getting the right support.

Physical symptoms:

  • Rapid heartbeat: your heart rate may increase, leading to palpitations
  • Shortness of breath: some people may find it hard to breathe, like they're gasping for air or having a panic attack
  • Trembling or shaking: this can affect the hands, legs, or the whole body
  • Stomach issues: this includes nausea, diarrhoea, or even just an uneasy feeling in the abdomen
  • Muscle tension: you might notice stiffness in your neck, shoulders or back
  • Excessive sweating: this can occur even if it's not particularly warm and without any physical exertion

Psychological symptoms:

  • Persistent worry: an overwhelming and persistent feeling of dread about the upcoming situation
  • Difficulty concentrating: a scattered or ‘foggy’ mind, meaning that you find it hard to focus
  • Irritability: a shorter temper than usual, causing you to become easily frustrated or upset
  • Restlessness: a feeling of being 'on edge' or an inability to sit still
  • Sleep disturbances: this could be insomnia, frequent waking, or restless sleep due to persistent thoughts about the future

Behavioural symptoms:

  • Avoidance: actively avoiding situations or events that trigger the anxiety
  • Seeking reassurance: continually asking others for reassurance or comfort regarding the anticipated situation
  • Over-preparation: while being prepared is good, people with anticipatory anxiety might prepare excessively for an event, constantly checking and rechecking details

How to manage your anticipatory anxiety

Managing anticipatory anxiety involves putting the feared situations into context, increasing your self-awareness and integrating coping strategies into your daily routine. Everyone is unique, so it's essential to find what works best for you. Here are some approaches that can help you to cope with anxiety:

  • Stay present with mindfulness and meditation: our minds can often become consumed by worrying about the future and all the ‘what ifs?’, causing us to become overwhelmed. Practising mindfulness can help to ground you in the present moment. By focusing on your breathing, you can anchor yourself, reducing feelings of dread about the future. Regular meditation, even if it's just for a few minutes a day, can help train your mind to be more present
  • Preparation and familiarity: fear of the unknown is a common trigger for anticipatory anxiety. Prepare for upcoming events by researching, rehearsing or visualising positive outcomes. By being more prepared for what's ahead, it’s likely that you’ll feel more in control and less anxious, while balancing this against the potential drawback of over-preparing
  • Limit stimulants: excessive caffeine and sugar can heighten anxiety. Consider reducing your intake, especially in the build-up to an upcoming situation that you’re nervous about
  • Connect with others: humans are social creatures, so simply talking about your feelings can provide immense relief. Sharing your concerns with a trusted friend, family member, or therapist can offer new perspectives and strategies you hadn't considered
  • Physical activity: exercise isn’t just good for the body; it's beneficial for mental wellbeing too. Engaging in activities like jogging, yoga, or even brisk walking can release endorphins. These are natural chemicals in the body that reduce stress
  • Limit avoidance: while avoiding anxiety-inducing situations might seem beneficial in the short-term, in the long run, it can reinforce your fears. You could try a technique known as graded exposure, which is when you gradually and safely confront your fears. For example, if you’re worried about an upcoming presentation, try presenting in front of a small group of trusted friends or colleagues first. This can help desensitise and reduce the fear you have of something, over time
  • Deep breathing and relaxation techniques: these methods can help to calm a racing heart and reduce other physical symptoms of anxiety. Some of the techniques you could use include progressive muscle relaxation, guided imagery and deep breathing exercises
  • Establish a routine: keeping a regular routine can provide a feeling of normality and therefore, safety. It’s a good idea to decide on set times to wake up, eat, work, exercise, relax and go to bed. Try and stick to these as much as possible and it’s likely that you’ll start to feel more grounded
  • Cognitive behavioural therapy (CBT): this is a therapeutic approach that can help you to recognise and change negative thought patterns and behaviours. Through CBT, you can learn to challenge unhelpful thoughts about future events and replace them with more realistic, positive ones

Professional support for anxiety at Priory

Anticipatory anxiety can have a negative impact on your wellbeing and prevent you from leading the life you deserve. If you’re regularly becoming overwhelmed by anticipatory anxiety, it might be time to consider treatment options. Today, effective treatments for anxiety include therapy, medication and other activities aimed at improving your wellbeing.

Anxiety disorders can be diagnosed by a GP or a mental healthcare professional. Therefore, an important first step is to make an appointment with your GP – they’ll be able to assess your symptoms and explore treatment options with you. Alternatively, you could contact a private mental health treatment provider, like Priory, directly.

Our mental health treatment experts can help you to understand the reasons for your anxiety and develop a more positive, sustainable mindset for the future.

Overcome overthinking: a therapist's guide

If you're struggling with spiralling thoughts, or find your anxiety leads to overthinking, Charlie Carroll, a CBT therapist at Priory, offers five tips to overcome overthinking.

Page clinically reviewed by Charlie Carroll, CBT Therapist at Priory Wellbeing Centre Manchester.

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