How to Manage Anxiety
A therapist-written guide to managing anxiety day to day — what helps in the moment, a step-by-step plan you can follow, six guided exercises, and answers to the questions people ask most.
Try this now
If anxiety is high right now, don't read first — do this first. Box breathing takes about 90 seconds and is the quickest way to slow a racing heart. You can come back to the guide straight after.
Prefer to read first? The full steps are just below.
What managing anxiety actually means
Managing anxiety is not the same as never feeling anxious. Anxiety is a normal, protective response — the problem is when it fires too often, too strongly, or in situations that aren't dangerous. So the goal isn't to delete the feeling. It's to shorten it, soften it, and stop it from making your decisions for you.
In practice that means three things: something to do in the moment when anxiety spikes, a small daily practice that lowers your baseline, and a sense of when to get help. This guide covers all three.
In the moment: the first 90 seconds
When anxiety surges, your body is in fight-or-flight — heart rate up, breathing shallow, thinking narrowed. You can't reason your way out of that state, but you can change it physically.
- Lengthen the out-breath. Breathe in through the nose for 4, out slowly through the mouth for 6–8. A longer exhale stimulates the vagus nerve and begins lowering heart rate within a few cycles.
- Put weight into the ground. Press both feet flat into the floor. Feel the pressure through your heels.
- Name what's in the room. Five things you can see, out loud if you can. Sensory detail cannot coexist with abstract catastrophising.
- Say what's happening. "This is anxiety. It's uncomfortable and it will pass." Naming the state reduces its intensity.
If you'd rather be walked through it, the Emergency Calm exercise does all four in one guided flow.
A step-by-step plan for managing anxiety
Long-term change comes from small, repeatable steps rather than one big fix. Work through these in order.
- Learn your early signals. Most people have a tell before the spike — jaw tension, shallow breath, a tight stomach, snappiness. Catching it early is the single biggest advantage you can give yourself.
- Pick one grounding technique and practise it daily. Five minutes when you're calm builds the pathway you'll need when you're not.
- Write the worry down. Anxious thoughts loop because they're unfinished. Getting them onto paper interrupts the loop — try therapeutic journaling.
- Separate what you control from what you don't. The circle of control exercise is designed for exactly this.
- Protect the basics. Sleep, movement, food and caffeine affect anxiety more than most people expect. Reducing caffeine alone often lowers baseline symptoms noticeably.
- Approach, don't avoid. Avoidance shrinks anxiety today and grows it tomorrow. Take small, deliberate steps back toward what you're avoiding — with a grounding tool in your pocket.
- Review weekly. Notice what helped and what didn't. Managing anxiety is a skill you refine, not a switch you flip.
Grounding exercises to manage anxiety
Different moments need different tools. Each of these is free and guided — start with the one that matches how you feel right now.
Box Breathing
Inhale 4, hold 4, exhale 4, hold 4. The steadiest way to slow a racing heart.
Use when anxiety is rising fast or you feel breathless.
5-4-3-2-1 Senses
Name 5 things you see, 4 you touch, 3 you hear, 2 you smell, 1 you taste.
Use when your thoughts are spiralling or you feel unreal.
Body Scan
Move attention slowly through the body, softening tension as you find it.
Use for background, all-day anxiety held in the body.
Wave Breathing
Longer exhales than inhales, in the rhythm of a wave reaching the shore.
Use at bedtime or when you can't switch off.
Loving Kindness
Gentle phrases of goodwill that soften anxious, critical self-talk.
Use when anxiety comes with harsh self-judgement.
Emergency Calm
A single guided flow combining paced breathing and sensory grounding.
Use during a panic attack or acute overwhelm.
Managing anxiety without medication
Many people manage anxiety well without medication, particularly when symptoms are mild to moderate. The approaches with the strongest evidence are talking therapy (especially CBT), regular physical activity, paced breathing and grounding practice, consistent sleep, and reducing alcohol and caffeine. Medication can be the right choice too — that's a conversation for your GP, not something to decide out of fear either way.
When to seek professional support
Self-help tools are genuinely effective, but they aren't a replacement for care. Speak to your GP or a qualified therapist if anxiety is persistent, stops you doing things you want to do, disrupts sleep or appetite for weeks, or connects to past trauma. The UK mental health resources page lists helplines and services. If you are in crisis, call Samaritans on 116 123 (free, 24/7).