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How Can I Manage Anticipatory Anxiety?

By: Danielle Bertini, LPC

We can all relate to a situation in which you dread something before it happens. Maybe you spend weeks dreading the results of a recent medical appointment, only to find out that the news is mild and manageable. This is exactly what anticipatory anxiety is—the fear and dread you experience before the event. Although it’s not a standalone mental health diagnosis, anticipatory anxiety can be a symptom of other conditions such as panic disorder and generalized anxiety disorder. Esposito (2020) offers some tips to manage this anxiety.

Create a calm plan and a relaxation routine 

It’s important to act with intention, rather than reacting defensively. Try and find a consistent schedule that works for you, as this can help slow down your arousal system, which therefore can reduce anticipatory anxiety. Here are some common relaxation practices:

  • Journaling
  • Deep breathing
  • Guided meditation
  • Progressive muscle relaxation

Be mindful about your thought process

Mindfulness includes bringing awareness to the present moment. This can include things like recording your thoughts, which can help you see any patterns. Anxiety is a future-oriented state of mind, which can include things like catastrophizing. For example, you believe that it’s not a headache causing the pain in your head, but rather a brain tumor.

Track your thoughts 

A common tool in cognitive-behavioral therapy (CBT) is recording your thoughts, subsequent feelings, and how your feelings then inform your actions. Here is an example Esposito (2020) provides:

  • Thought: If things don’t go as planned, I will be miserable.
  • Feelings: Hopeless, afraid, worried, unsafe.
  • Behaviors: Isolating from friends and family, avoidance of activities, refusal to engage in problem-solving. 

Here is an example of a reframed thought:

  • Thought: Although I don’t like uncertainty and I’m worried about the future, I have agency over how much time and energy I spend worrying.
  • Feelings: Hopeful, somewhat sad, less worried, more in control.
  • Behaviors: Asking “Am I being realistic? Focusing on what’s going well in your life, choosing problem-solving over excessive worrying.

Watch for polarizing language 

This can include things like “always,” “never,” “everybody,” “nobody,” and so on. Instead, find the grey areas. That one time that you slightly messed up on your work presentation is simply a moment in time, not a representation of your entire skillset. Most of our experiences in life live in a grey area, we just need to be able to see it as such.

Check your control fallacies 

This distortion involves believing you are in complete control of every situation, by internal or external means. The fallacy of internal control means you see yourself as responsible for the suffering and happiness of those around you. When we feel externally controlled, we view ourselves as helpless victims of fate. For example, “The world is such a dangerous and predictable place. I can’t trust anyone. I don’t feel safe.”

Scroll social media and news outlets mindfully

When you struggle with anxiety, you often look for “proof” that your negative predictions are correct. Worst-case scenario seeking and the habit of a “mind full” versus a mindful existence are the causes. Instead, it’s useful to get comfortable with allowing the truth to unfold. When you let go of your need to know what’s coming, you’ll find things usually work in your favor.

Practice anxiety affirmations 

These affirmations can be useful when your stress levels rise. Esposito (2020) offers some examples:

  • “I have love and support from others.”
  • “I will not take on the weight of the world.”
  • “I am a capable problem-solver. I have options.”
  • “I will let go of those things outside my control.”
  • “I will inhale the good and exhale the bad energy.”
  • “Every day I have a choice to practice peace of mind.”
  • “My track record for overcoming anxiety attacks is 100%”

Seek help 

If you find yourself struggling with managing anticipatory anxiety, you may find it helpful to talk with one of our therapists at Symmetry Counseling. You can contact Symmetry today by calling 312-578-9990 to get matched with one of our licensed counselors. 


Esposito, L. (2020, November 4). How to Cope With Anticipatory Anxiety | Psychology Today. Psychology Today. Retrieved December 17, 2021, from 

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