• Lillian Hood, LPA

The 4 Best Ways To Manage Anxiety - You Can Do Them Right Now

Updated: Jul 24

Jamie looked at the clock and jumped out of bed. She had turned off her alarm and fallen back asleep. Fortunately, Jamie does a nightly prep pulling out clothes and arranging bags by the door so all that’s necessary is getting ready, grabbing the bags and heading out the door. Unfortunately, sleeping until the latest possible minute means that there’s no room for error. She plopped the k-cup into the Keurig and started the coffee first thing because… priorities? She managed to throw herself together with a pony tail and light make-up, grabbed her bag and headed for the kitchen. She was still going to be late for work. She grabbed her travel mug and reached for the lid to cover it simultaneously, but something went wrong. Now, there was coffee all over her, all over the counter, and on the floor.

“Ow!” Burnt, frantic and frustrated, Jamie changed her clothes, wiped up the mess and ran out the door. “I am so getting fired.” Jamie texted her boss that she’d be a little late. She raced toward work with a racing heart beat along for the ride. She started thinking about how she had some things she hadn’t gotten done on Friday, that she’d need to do today, if she still had a job. That’s one more reason for her boss to fire her. Jamie’s boss doesn’t like her anyway. With a high credit card bill because of some unexpected expenses, how would she get by until she found another job? By the time Jamie arrived at work, she was struggling to catch her breath and was struggling not to burst into tears.

Have you ever had a day like Jamie’s? Do you find yourself overwhelmed sometimes and struggling to cope? Is there anything you can do to manage your anxiety better? Today, I’m sharing my top four favorite exercises for managing anxiety. I have found these strategies to be especially effective. Maybe they can help you.

4-7-8 Breathing

The 4-7-8 breathing exercise has both an in-the-moment effect and an effect that increases over time. This exercise can be practiced by breathing in for a count of four, holding the breath for a count of seven, and breathing out for a count of eight. You then repeat these steps for three more sets for a total of four breaths. You breathe in quietly through your nose and audibly out through your mouth. Your tongue is held in position behind your upper front teeth throughout the breath including the audible exhale. This, once done correctly, brings a sense of calm and well-being in the moment. If practiced at least twice a day for four to six weeks, it helps regulate the fight or flight response. Those who suffer with anxiety experience the fight or flight response when they experience racing thoughts, distorted thoughts, an association with a disturbing memory, etc. This exercise slows the heart rate back down and helps the individual connect with the present moment in a way that is calming. It can also help a person relax at night to fall asleep. The technique was developed by Dr. Andrew Weil and is based on yogic breathing techniques.

Check out this video for guidance on practicing 4-7-8 Breathing.

Leaves On A Stream Skill

The “leaves on a stream” exercise was created by Dr. Hugo Alberts and Dr. Lucinda Poole. This exercise teaches the person to separate from their thoughts and notice them as temporary events that are passing through instead of absolute truths. For example, you might have the thought, “I’m going to blow this interview.” As you think it, you start to feel your heartbeat faster. You may believe that getting this job is necessary for your well-being or that of those in your care. You might start to think of all the horrible consequences to not getting the job. Before you know it, you are overwhelmed and panicking. If you can learn to recognize these thoughts as “only thoughts” and not a foretelling of your future, you can feel less anxiety. You notice the thought without trying to block it out, recognize it for what it is, and accept those types of thoughts as part of your natural nervousness in this type of situation. These types of thoughts will come and go like leaves floating down a stream, and they do not dictate what action you take or your abilities. In brief, this mindfulness exercise asks you to picture yourself sitting by a stream. As you sit there, you will have a variety of thoughts, positive, negative, and neutral thoughts. There are leaves floating down the stream in front of you. Each time you have a thought, you picture it on a leaf. It floats toward you for a while and eventually it floats by and away. Some may take longer than others to drift by, if for example, they get hung up on some debris. They will eventually float away. The key is to give them the space to do so, not trying to force them away, but allowing them to come and go. As they are coming and going, you, not those thoughts, choose what happens next. For example, you are waiting to be called back for that job interview and you have the above-mentioned thoughts. You notice these thoughts, possibly saying to yourself, “that’s my anxiety talking.” You may then focus your attention on the room you are in. You may wonder about what the décor and layout say about the company with whom you are interviewing. This skill, like the 4-7-8 breathing exercise, takes persistence and practice, however, it is amazingly effective once you master it.

Check out this video for guidance on using the “Leaves on a Stream” skill.

Progressive Muscle Relaxation

Progressive Muscle Relaxation (PMR) is another great skill. To practice it, get into a comfortable seated position. Take a few relaxing breaths where you exhale slowly. A slow exhale causes your heart rate to slow and helps you feel relaxed. Then, focusing on a few muscles at a time, tighten your muscles for a few seconds. Release the tension and notice how that feels. Don’t do anything that causes you pain or that is contrary to your doctor’s recommendation during the exercise. You continue to do this a little at a time until you have hit all your muscle groups. Remember to breathe throughout the exercise and notice the difference as you contract and relax your muscles. This helps make you aware of the physiological symptoms of anxiety that is tension and that you have the ability to do something about the tension once you notice it. This is a great exercise and definitely worth a try.

Check out this video for guidance on practicing progressive muscle relaxation.


Grounding exercises vary, but the goal here is to get connected with the present. Anxiety can send your mind racing into the future, “What if” or wandering in the past, “remember that terrible thing that happened”. Grounding is an effective way to remind your mind that, here, in the present, you are safe. The thing from the past isn’t happening right now, neither is the thing that you are worried might happen in the future. The basic idea with grounding is to use your five senses to bring your thoughts and emotions back in alignment with where and when you are right now, e.g. sitting in your car doing a grounding exercise, not sitting in your bosses office getting fired or being evicted from your apartment because you can’t pay the rent after you got fired… if you’re Jamie.

Check out this video for guidance on practicing grounding.

The Rest Of The Story

Remember Jamie? She pulled into the parking lot at work. She parked under a tree facing in a direction where no one walking by or looking out of a window would see her face. She unbuckled her seat belt. She remembered the conversation she had with her therapist about managing anxiety and distorted thinking. She decided to do a grounding exercise. She thought, I’m already late. This will take me 2-3 minutes. My boss knows I’m running late already. I’m going to get fired or reprimanded. Either way, I’ll do better if I take a moment to calm down. After taking some calming breaths, exhaling slowly, she did her favorite grounding exercise. She ended with a few more calming breaths. She went inside and accepted her reprimand from her boss… which wasn’t as bad as she thought. Her boss ended up sharing a story about one of those “everything that can go wrong did go wrong” days she had experienced. She suggested that Jamie might avoid being tardy if she planned her mornings with a bit of wiggle room for days when things go horribly wrong.

What About You?

You can put these strategies to work today, right now. You can start by practicing them when things are fine. Set aside some time daily, maybe at bedtime when you need to relax anyway, to practice one or two of these skills. Then, when you need to use them, you’ll remember them and feel comfortable doing them. Is your anxiety severe enough to need therapy? Check out my blog, 3 Signs That It’s Time To Go To Therapy.

~*~ Lillian Hood is a therapist offering online therapy for adults throughout the state of North Carolina. Her office is in Wilmington, NC. She offers PTSD therapy, anxiety therapy, binge eating therapy, OCD therapy, panic attack therapy, and phobia therapy. Text 910.742.0433 to schedule a free phone consultation, or visit our Contact Us page to get started. ~*~

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