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.
Notice and stop your thoughts
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."
Hart SL, Hart TA (2010). The future of cognitive behavioral interventions within behavioral medicine. Journal of Cognitive Psychotherapy: An International Quarterly, 24(4): 344–353.
Layous K et al. (2011). Delivering happiness: Translating positive psychology intervention research for treating major and minor depressive disorders. Journal of Alternative and Complementary Medicine, 17(8): 675–683.
Lightsey OR, et al. (2012). Can positive thinking reduce negative affect? A test of potential mediating mechanisms. Journal of Cognitive Psychotherapy: An International Quarterly, 26(1): 71–88.
McKay M, et al. (2011). Changing patterns of limited thinking. In Thoughts and Feelings: Taking Control of Your Moods and Your Life, 4th ed., pp. 27–45. Oakland, CA: New Harbinger.
McKay M, et al. (2011). Coping with panic. In Thoughts and Feelings: Taking Control of Your Moods and Your Life, 4th ed., pp. 85–104. Oakland, CA: New Harbinger.
McKay M, et al. (2011). Uncovering automatic thoughts. In Thoughts and Feelings: Taking Control of Your Moods and Your Life, 4th ed., pp. 15–25. Oakland, CA: New Harbinger.
Newman CF, Beck AT (2009). Cognitive therapy. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol 2., pp. 2857–2873. Philadelphia: Lippincott Williams and Wilkins.
How this information was developed to help you make better health decisions.