Anticipatory anxiety, or excessive worry about the future, is a symptom of many types of anxiety disorder.
While most people tend to wonder or even stress about future events or situations to some extent, extreme levels of anticipatory anxiety can negatively impact a person’s everyday life and functioning.
In this article, we explore anticipatory anxiety, including its symptoms, causes, and what people can try in order to cope with it.
Anticipatory anxiety involves feeling high levels of anxiety about a future event or situation.
While some level of concern about the future is common and acceptable, anticipatory anxiety involves an excessive or debilitating level of worry that tends to focus on negative outcomes.
People with anticipatory anxiety may feel anxious for hours, days, weeks, or months before an event.
People may experience anticipatory anxiety before:
- work meetings or presentations
- musical or athletic performances
- a date or social event
Individuals may also have anticipatory anxiety about potential future occurrences, such as:
- natural disasters
- being attacked
- the death of a loved one
- relationship breakdown
Anticipatory anxiety is not a disorder, but a symptom of other anxiety disorders, such as social anxiety disorder.
Anticipatory anxiety causes people to feel nervous, concerned, or fearful about the future. People may spend time dwelling on the worst-case scenarios regarding future situations.
Those who experience anticipatory anxiety will typically have other anxiety symptoms, which can differ from one person to another. Each anxiety disorder has its own symptoms, which can vary in intensity and duration.
Some symptoms of anxiety include:
- feelings of apprehension or dread
- feeling tense or jumpy
- restlessness or irritability
- anticipating the worst
- being watchful for signs of danger
- pounding or racing heart and shortness of breath
- headaches, fatigue, and insomnia
- sweating, tremors, and twitches
- upset stomach, frequent urination, or diarrhea
Anticipatory anxiety is a normal human process and a reaction to stress. Anxiety only becomes a problem when it involves excessive fear or worries that impact a person’s wellbeing and functioning.
Anticipatory anxiety is a symptom of other anxiety disorders, such as:
- Generalized anxiety disorder (GAD): Affecting 3.1% of the population in any given year, GAD causes persistent and excessive anxiety about various activities and events. Learn more.
- Social anxiety disorder: This disorder, which has affected an estimated 7.1% of U.S. adults in the past year, is characterized by anxiety and avoidance of social situations due to embarrassment or self-consciousness. Learn more.
- Specific phobias: People with phobias experience major anxiety and fear when they anticipate or are in the presence of a specific object, place, or situation. In the past year, an estimated 9.1% of U.S. adults had specific phobia. Learn more.
- Panic disorder: Affecting 2–3% of Americans in a given year, panic disorder causes repeated attacks of panic and intense anxiety that peak within a few minutes. Learn more.
Experts still do not fully understand the causes of anxiety disorders. However, they may result from a combination of:
- Genetics: Anxiety disorders often run in families.
- Life experiences: Traumatic events or high levels of stress, for example, can trigger anxiety in some people.
- Medical conditions: Some medical illnesses, such as heart disease or thyroid disorders, can contribute to anxiety.
- Medications: Anxiety can be a side effect of some medications, or withdrawal from medications or drugs.
Risk factors for anxiety disorders include:
- a family history of anxiety disorders
- having other mental health issues
- experiencing trauma or high levels of stress
- using drugs or alcohol
A doctor or mental health specialist, such as a psychiatrist or psychologist, can diagnose an anxiety disorder. To make a diagnosis they may:
- carry out a psychological evaluation
- compare symptoms to the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- perform blood tests or other tests to rule out a physical cause of symptoms
The following tips may help people with anticipatory anxiety to reduce their fear and cope with uncertainty about the future:
Look after basic needs
Good self-care begins with taking care of basic needs.
- Reduce sources of stress where possible.
- Eat a balanced diet, and limit caffeine and sugar, which can make anxiety worse.
- Exercise regularly, as research indicates it can reduce anxiety.
Sleep is another important area for those with anxiety. Individuals should try to get enough sleep by going to bed at the same time each night and getting up at the same time each morning.
However, anticipatory anxiety causes sleep disturbance and insomnia, and a lack of sleep worsens anxiety. Breathing exercises or meditation can help people fall asleep more easily. People struggling with chronic sleep disturbance should see a doctor if mindfulness activities do not help.
Practice relaxation and grounding
Techniques to help relaxation can reduce anxiety over time. They also improve sleep quality. Useful techniques include:
- deep breathing
- progressive muscle relaxation
- guided imagery
- grounding techniques
People can learn more about these techniques from a therapist. There are also numerous apps or online videos that can help guide people through each process.
People should also note that these techniques are not a cure for anxiety. If a person uses them incorrectly, for example when they feel anxious, they can serve as avoidant coping.
Ideally, people should practice these exercises at certain scheduled times, rather than when they feel anxious. A healthcare professional can help a person mindfully incorporate relaxation techniques into cognitive behavior therapy (CBT) or exposure therapy.
Journaling may help people to reduce anxiety and explore their fears and triggers. People with avoidance disorders should do this with the guidance of a trained mental health professional, as it could lead to rumination (dwelling on negative thoughts), or a compulsion that functions as avoidant coping.
Address negative thoughts
Changing a person’s thinking can help change their moods. People can do this by considering the source of the anxiety and the negative thoughts it produces.
Then, explore how realistic these thoughts are. Often, people with anxiety imagine the worst-case scenario. If they continue to challenge negative thoughts when they arise, these thoughts should become less frequent over time.
Self-compassion — treating oneself with kindness and care in negative situations — may reduce anticipatory anxiety.
One way individuals can practice self-compassion is to explore how they might treat a friend who was having anticipatory anxiety. Often, people are kinder to others than they are to themselves. This exercise highlights the importance of self-compassion.
Find more self-compassion exercises here.
Take charge of the situation
As anticipatory anxiety occurs when people worry about a future event or situation, it can be helpful to take charge of the situation.
For example, if someone is anxious about a job interview, it may be helpful to practice answering interview questions with a friend or family member.
There are several natural ways of reducing anxiety. Learn about them here.
Anxiety disorders are highly treatable. The primary treatments are:
During therapy, a person can discover and address sources of stress and anxiety. Therapists can also help people learn healthy coping techniques.
Some types of therapy may be more effective than others for anxiety.
CBT is generally an
CBT teaches people to change their thinking in order to improve their mood and change their behaviors.
Research also demonstrates that exposure therapy is helpful for these issues. Exposure therapy involves gradual exposure to anxiety-inducing situations to help people build confidence and manage their symptoms.
Medication can help ease anticipatory anxiety and other anxiety symptoms. It may work better when people combine it with therapy. Common medications for anxiety include anti-anxiety medications, such as buspirone, and antidepressants.
Sometimes, a doctor may prescribe other drugs for short-term use, such as benzodiazepines or beta-blockers. Individuals should discuss their options and the benefits and risks of each one with their doctor.
Individuals should talk with their doctor or a mental health professional if:
- they experience excessive anticipatory anxiety or other anxiety symptoms
- symptoms interfere with their everyday life, work, or relationships
- anxiety is difficult to control
- people have other mental health concerns, or are using alcohol or drugs to cope
- they have other symptoms of a physical health condition
While some anxiety before events and situations is common, excessive levels of anticipatory anxiety can suggest an anxiety disorder.
Individuals who have overwhelming fears, or worry about the future, should speak to their doctor or a mental health professional.
Living with an anxiety disorder can be challenging, but they are highly treatable with therapy, medications, or both.