having too much fear and worry. Some people have what's called generalized
anxiety disorder. They feel worried and stressed about many things. Often they
worry about even small things. Some people also may have
panic attacks. A panic attack is a sudden feeling of
People who have
social anxiety disorder worry that they will do or say
the wrong thing and embarrass themselves around others.
can cause physical symptoms like a fast heartbeat and sweaty hands. It can make
you limit your activities and can make it hard to enjoy your life.
Healthy thinking can help you prevent or control anxiety.
Negative thoughts can increase your worry or
Cognitive-behavioral therapy, or CBT, is a type of therapy
that can help you replace negative thoughts with accurate, encouraging
Changing your thinking will take some time. You need to
practice healthy thinking every day. After a while, healthy thinking will come
naturally to you.
Healthy thinking may not be enough to help some
people who have worry and anxiety. Call your doctor or therapist if you think
you need more help.
Healthy thinking is a way to help you stay well by changing how you think.
It's based on research that shows that you can change how you think. And how
you think affects how you feel.
Cognitive-behavioral therapy, or CBT, can help you know what thoughts of yours—both helpful and not helpful—affect problems or feelings that trouble you. With practice, you can replace negative thoughts that discourage you with accurate thoughts that encourage you.
Working on your own or with a
counselor, you can practice these three steps:
Stop. Notice your thoughts. When you notice a negative thought, stop it in its tracks and write it down.
Ask. Look at that thought and ask yourself whether it is helpful or unhelpful right now.
Choose. Choose a new, helpful thought to replace a negative one.
The goal is to have accurate, encouraging thoughts come naturally. It
may take some time to change the way you think. So you will need to practice
healthy thinking every day.
Test Your Knowledge
Cognitive-behavioral therapy (CBT) is a type of
therapy that can help change how you think about yourself.
Changing your thinking can help you stop the worry by replacing
negative thoughts with helpful ones. It's also helpful in controlling panic
Healthy thoughts can help stop the "fight or flight"
feelings that you have with anxiety. In a fight-or-flight response, your body
senses danger and the need to fight or run away. Your body releases hormones
like adrenaline, which makes your heart beat fast and your blood pressure rise.
Healthy thoughts can calm you and stop this response.
example, maybe you are about to have a job review. It's normal to be a little
nervous. But you have trouble sleeping and have a fast heartbeat and sweaty
hands. You think constantly about the review. You've been telling yourself that
your boss is going to say bad things about your performance—even though you
haven't been getting bad comments from her.
Or perhaps you have a
doctor's appointment coming up. And you're worried that he may find something
If you have anxiety, you may worry a lot about many things.
You are sure that something bad is going to happen, even though you have no
proof that something bad will happen.
The more you talk in a
negative way to yourself, the harder it is to keep a healthy outlook. The
negative thinking makes you feel bad. And that can make you feel more anxious,
which leads to more bad thoughts about yourself. It's a cycle that's hard to
But with practice, you can retrain your brain. After all,
you weren't born telling yourself negative things. You learned how to do it. So
there's no reason you can't teach your brain to unlearn it and replace negative
thinking with more helpful thoughts.
Healthy thinking also is
good for your health in other ways. If you feel bad about yourself, you could
depressed. Healthy thinking also can help you handle
stress better. Too much stress can raise your blood
pressure and make your heart work harder, which can increase your risk for a
heart attack. Stress also can weaken your
immune system, which can make you more open to
infection and disease.
Test Your Knowledge
Healthy thinking can help you stop negative thoughts
that make you anxious.
The first step is to notice and stop your negative thoughts or "self-talk." Self-talk is what you think and believe about
yourself and your experiences. It's like a running commentary in your head.
Your self-talk may be rational and helpful. Or it may be negative and not
Ask about your thoughts
The next step is to ask yourself whether your thoughts are helpful or unhelpful. Look at what you're saying to yourself. Does
the evidence support your negative thought? Some of your self-talk may be true.
Or it may be partly true but exaggerated.
One of the best ways
to see if you are worrying too much is to look at the odds. What are the odds,
or chances, that the bad thing you are worried about will happen? If you have a
job review that has one small criticism among many compliments, what are the
odds that you really are in danger of losing your job? The odds are probably
There are several kinds of irrational thoughts. Here are a
few types to look for:
Focusing on the negative: This is sometimes called filtering. You filter out the good
and focus only on the bad. Example: "I get so nervous speaking in public. I
just know that people are thinking about how bad I am at speaking." Reality:
Probably no one is more focused on your performance than you. It may help to
look for some evidence that good things happened after one of your
presentations. Did people applaud afterward? Did anyone tell you that you did a
Should: People sometimes have set
ideas about how they "should" act. If you hear yourself saying that you or
other people "should," "ought to," or "have to" do something, then you might be
setting yourself up to feel bad. Example: "I have to be in control all the time
or I can't cope with things." Reality: There's nothing wrong with wanting to
have some control over the things that you can control. But you may cause
yourself anxiety by worrying about things that you can't
Overgeneralizing: This is taking
one example and saying it's true for everything. Look for words such as "never"
and "always." Example: "I'll never feel normal. I worry about everything all
the time." Reality: You may worry about many things. But everything? Is it
possible you are exaggerating? Although you may worry about many things, you
also may find that you feel strong and calm about other
All-or-nothing thinking: This is
also called black-or-white thinking. Example: "If I don't get a perfect job
review, then I'll lose my job." Reality: Most performance reviews include some
constructive criticism—something you can work on to improve. If you get five
positive comments and one constructive suggestion, that is a good review. It
doesn't mean that you're in danger of losing your job.
Catastrophic thinking: This is assuming that the worst will
happen. This type of irrational thinking often includes "what if" questions.
Example: "I've been having headaches lately. I'm so worried. What if it's a
brain tumor?" Reality: If you have lots of headaches, you should see a doctor.
But the odds are that it's something more common and far less serious. You
might need glasses. You could have a sinus infection. Maybe you're getting
tension headaches from stress.
Choose your thoughts
The next step is to choose a helpful thought to replace the unhelpful one.
Keeping a journal of your thoughts
is one of the best ways to practice stopping, asking, and choosing your thoughts. It makes you aware of your self-talk. Write down any negative or
unhelpful thoughts you had during the day. If you think you might not remember
them at the end of your day, keep a notepad with you so that you can write down
any thoughts as they happen. Then write down helpful messages to correct the
If you do this every day, accurate, helpful
thoughts will soon come naturally to you.
But there may be some
truth in some of your negative thoughts. You may have some things you want to
work on. If you didn't perform as well as you would like on something, write
that down. You can work on a plan to correct or improve that area.
If you want, you also could write down what kind of irrational thought
you had. Journal entries might look something like this:
Stop your negative thought
Ask what type of negative thought you had
Choose an accurate, helpful thought
"I get so nervous speaking in
public. I just know that people are thinking about how bad I am at
"I'm probably better at public speaking
than I think I am. The last time I gave a talk, people applauded
"I have to be in control all the
time or I can't cope with things."
"I can only control how I think about things
or what I do. I can't control some things, like how other people feel and
"I'll never feel normal. I
worry about everything all the time."
"I've laughed and relaxed before. I can
practice letting go of my worries."
"My headaches must mean there
is something seriously wrong with me."
"A lot of things can cause headaches. Most
of them are minor and go away."
Test Your Knowledge
Which of these thoughts is an example of healthy
This is an example of an irrational thought
called overgeneralizing. You may have done poorly on some standardized tests.
But did you really do badly on every test you took? Chances are you're being
too hard on yourself. With some preparation—some extra studying and relaxation
exercises—you can do well on tests.
Writing in the journal
every day will help healthy thinking come naturally to you. It takes some
practice. It took a long time for negative thinking to become automatic. So it
may take some time to get used to having accurate, realistic thoughts.
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How this information was developed to help you make better health decisions.