Or it may be a visitor in the night as you lie in bed awake, worrying about your fraught relationship with your adult son or daughter or a unexpected bill or some troublesome symptoms you're afraid may signal a major health problem.
Or anxiety may hit you randomly, for reasons you don't understand. For some people, out-of-the blue panic attacks may be be life-changing.
Although anxiety happens to all of us, for a small number of people it can be life-changing, interfering with everyday life and requiring medication and psychotherapy.
For most people, however, anxiety is less limiting but still periodically distressing. What can you do when it happens to you?
1. Admit that you're anxious. That may mean paying attention to your physical symptoms and to the sudden fear you may be feeling. People who deny their anxiety may act and sound angry and irritable. Or they may become avoidant -- not driving on highways, expressways or freeways, for example -- on the premise that "I just don't like that. I prefer to drive locally." When you admit that you're anxious or that a specific situation creates anxiety for you, you're on the way to facing your fears and changing your situation.
2. Stop the spiral with a specific word or action. Many people find themselves in a spiral of anxious thoughts and feelings that can accelerate to paralyzing fear. It's important to stop this process well before you reach the point of inertia. There are several things you might try. Some people find it useful to wear a rubber band around their wrists and snap it at the first sign of anxiety -- a reminder to stop ruminating and take action. You might say "Stop!" and then try imagining a alternate scenario -- like your giving the presentation with pleasure and confidence. You might start deep breathing, releasing a little more of your tension with each breath out. It can also help to listen to music you enjoy, to spend time petting and cuddling your dog or cat or to take a brisk walk or try some other exercise you enjoy.
3. Try the "Just Do It!" three step approach. This can be particularly helpful if you find yourself anxious about something specific that you need to do, but fear tackling like that work presentation, that talk that you agreed to do for your church group or that drive into downtown to see a concert or play. When you find yourself dreading a task, fearing that it will be impossible for you, try the three step approach.
First, examine the evidence that this is beyond your capabilities. You might say to yourself "I've done this before. It wasn't easy. But I did it. I can do it again."
Second, examine your expectations. Are you making yourself anxious with impossibly high expectations? You don't have to make a spectacular presentation. You don't have to be the life of the party. You don't have to love driving in city traffic. You need to give yourself permission to be competent, to be present, to be able.
Third, just do it. Quite often, the more you do something, the less challenging it feels. Repeated exposure to something you fear can decrease your anxiety over time. It can help to enlist a therapist, a friend or family member in walking through your fears with you.
When I was younger, I had several valuable lessons in the value of just doing something I feared -- first, from a college professor who later became a dear friend and later, from a gruff co-worker who urged me onward.
When I was a college journalism student, I was terribly anxious about doing an interview. I cried during my first major interview assignment (with a very sweet and compassionate young Broadway star named David Jones, before he became Davy Jones of the Monkees). My professor looked over my tear-stained interview notes with a faint smile. "If you're willing to fight your fear, I'll be right there with you," she said. "You're going to do twice as many interviews as the other students. Maybe next time, you won't cry as much. Maybe the time after, you won't cry at all. And maybe eventually you'll even enjoy interviewing people." And, with her help, all of that came to pass.
A few years later, back in Los Angeles, my anxiety about driving kept me off the busy L.A. freeways, which added considerable time to my commute to work. One day, a co-worker who lived nearby asked me for a ride when her car was in the repair shop. She looked aghast when I told her I needed to avoid the freeway. "What???" this transplanted New Yorker barked. "Don't be ridiculous. Just get on the freeway. I'll talk you through it." And so she did, urging me to breathe deeply and keep my eyes on the road. She rode with me for a week. I haven't feared freeways since. And I think of her with quiet thanks whenever I head off on my periodic 500 mile solo drives on a busy, big-rig filled freeway from Phoenix to Los Angeles.
4. Ask yourself "What is this anxiety telling me?" Before you dismiss this with "Just that I'm afraid!" think about it.
Your anxiety may be a call to action. It may be telling you to call for a doctor's appointment if you have worrisome physical symptoms or to find new ways to reach out to an adult child with whom you have a difficult relationship. It may be telling you that procrastination in these instances is not helpful.
Your anxiety could be telling you that you are feeling overwhelmed, perhaps by your own perfectionism. It could be a sign that you need to take a deep breath and then that first step. Or it could be a sign that you're letting a voice from the past predict your performance today.
My friend Jane, for example, has a great deal of social anxiety, dreading parties and meetings. On reflection, she remembered her mother's voice, years ago, observing that "You're just like me. You're so socially awkward. You always say the wrong thing!" Then, examining the evidence from her own life experience, Jane decided that her mother was wrong.
"I'll never be a social butterfly or the life of any party," she told me. "But I'm good enough in social situations. I'm a nice person. I'm a good listener. And that's just fine. When I stop hearing those words of my Mom from long ago and start listening to myself, I'm much less anxious about walking into a room filled with people."
5. Embrace your challenge. You may need to take it gradually, step by step. My former client Allie had tremendous anxiety about being in airport waiting areas. She didn't fear flying itself. But she felt closed in and near panic in a crowded airport boarding gate area. We worked out a plan -- modified in the wake of 9/11 regulations that precluded her spending time in actual boarding areas. Instead, she went to the nearest airport and sat in crowded areas before the security check-in point. She felt her anxiety rise as crowds swirled around her and practiced deep breathing and affirmations that she was safe. In time, she found that her anxiety decreased considerably and she celebrated with a trip to Hawaii with her husband. She reported that, finally, she was able to fly not simply minus an emotional meltdown, but that she actually enjoyed the experience with her travel-loving husband.
Whether you tackle anxiety-producing situations step by step as Allie did or with a voluntary (or semi-voluntary) leap of faith as I did on the L.A. freeways, you may find that facing your anxiety and overcoming it to meet your own challenges can bring an incomparable feeling of accomplishment and joy!