The impact of anxiety disorders and how to manage them

Alice Bertoldo, psychologist (GGZ, NIP) and psychosomatic psychotherapist, trained in Cognitive Behaviour Therapy and Psychodrama, tells us how to deal with an anxiety disorder.

Anxiety disorders are among the most common mental health conditions. Often, they are paired with other mental health issues, such as major depressive disorder or personality disorders. Most people who are experiencing anxiety disorders try to cope with life using alcohol or drugs.

Cognitive schema

A cognitive schema is a mental framework that helps individuals to process and organise information. Cognitive schemas come from Core Beliefs; the way we see the world, ourselves and our future. When Cognitive schemas are biased they process ambiguous stimuli from the environment as a “catastrophe” or as a “threat”. Thus, the mind perceives as ‘dangerous’ stimuli that otherwise might be neutral.

How an anxiety disorder can impact your life

Anxiety disorders can impact life in a variety of ways, such as:

  • You avoid feared places and situations
  • You can’t sleep, suffer from insomnia
  • You postpone tasks
  • You isolate yourself socially
  • You suffer from indecisiveness
  • You overthink everything
  • You have difficulty trying new things

Key factors

There are several factors that play a part in developing anxiety such as:

  • Genes
  • Chemical imbalance in the brain
  • Trauma
  • Social media and isolation
  • A lifestyle that does not suit your needs and wants

Four types of fear

Anxiety can be grouped into four different conceptualisations of fear:

1. Catastrophic

The fear that something very negative and catastrophic like the “worst-case scenario” is going to happen. It includes separation anxiety, arachnophobia (the fear of spiders), ophidiophobia (the fear of snakes).

2. Evaluation

The fear of being watched and judged, such as in social anxiety, selective mutism and glossophobia (fear of public speaking).

3. Losing control

The fear of losing control (panic attacks and agoraphobia).

4. Uncertainty

Feeling uncertain (generalised anxiety disorder and obsessive-compulsive disorder).

How to overcome and manage anxiety

Let’s have a look at the different ways you can help overcome and manage anxiety:

Cognitive Behaviour Therapy (CBT)

This is particularly useful to treat anxiety disorders. In particular, exposure techniques (in-vivo or imaginal) have proven to be highly effective.


This is the very first step to help the person realising that avoidance of feared situations and places maintains anxiety.


This can help as it will teach you to pay attention to the present moment, to accept thoughts and feelings without judging them and focusing on breathing.


When you lay or sit comfortably, close your eyes and start to scan your body from your toes to your head and whenever you feel tension, relax that spot. Focus on your breathing and on the present moment.

Walking meditation

While you walk, slowly focus on the sensations you are experiencing while walking. Focus on your toes, and feet and your legs’ movement. Do this for 15 minutes.

Deep breathing

This is a fantastic tool to thin out the “white fog” (anxiety) in your mind and to feel grounded. Sit comfortably and breathe for six seconds, making sure that your stomach fills in with air. Leave your shoulders and chest still and relaxed. Let the air in via your stomach only. Breathe out the air from your stomach and then breathe in again. 


Exercising can reduce anxiety.

Walks in nature

Exercising while being in nature can help reduce anxiety even more.

Alcohol smoking

Limit your intake of alcohol (especially in the evening) and smoking.

Do something fun and creative!

Use your passions to momentarily distract yourself from the problem. Do activities in which you can use your hands such as painting for instance.

Don’t be afraid to seek professional help

In conclusion, to overcome anxiety disorders, it’s advisable to ask for professional help. Therapy allows you to get to know yourself and your vulnerabilities and acquire a different and more healthy perspective of yourself. Moreover, there are several ways through which it’s possible to manage anxiety, for instance with mindfulness, sports, art, and by surrounding yourself with nice people.

Alice Bertoldo, psychologist and psychosomatic psychotherapist, offers in-person and online therapy sessions to treat anxiety disorders, depression and trauma.