Updated 3/24/2022

Anticipatory anxiety is a discomforting and disquieting mind game you play on yourself.

Here are a few examples: You’re going to the dentist and you feel anxious. You’re about to go take a test and you feel anxious. You’ve been asked to have a meeting with your supervisor and you feel anxious. Do you see a pattern? Each anxious thought is due to an event that could lead to stress, anticipation, uncertainty, fear, or panic. This is what it means to experience anticipatory anxiety — you dread the future without evidential cause.

Anticipatory Anxiety Defined

Anticipatory anxiety is a common anticipation symptom that is a part of a larger social anxiety disorder diagnosis. Anticipatory anxiety symptoms include an increased heart rate, a faster pulse, shallow rapid breathing, growing tension that can cause upset stomachs and bring on headaches, as well as sweaty palms, all of which arise when thinking about an upcoming event, adventure, or simple trip to the grocery store.

Anticipatory anxiety tends to occur when we think about what may happen in a particular setting or situation (that hasn’t happened yet), with usually a negative outcome, which can then cause us great anxiety, stress, or panic.

Our imaginations magnify the potential problems we may (or may not) encounter, and as a result, our anxiety can peak, making us dizzy with uncertainty. The difference between incapacitating anticipatory anxiety and being moderately self-conscious and uncomfortable is entirely rooted in what we are thinking about the upcoming event. When thinking about the future, we guess, fabricate, and imagine, and yet we don’t know how it’s actually going to turn out — which in itself can bring about anxiety and negative thoughts. Nevertheless, because we fabricate outcomes (usually negative ones) for events that haven’t happened yet, we tend to become anxious. However, if we were to imagine positive outcomes we would be much less anxious — maybe even excited.

Recognizing Anticipatory Anxiety

The key to reducing anticipatory anxiety is becoming aware of your cognitive processes. But first, you must recognize that you’re experiencing anxiety in the first place.

If we can recognize fleeting negative thoughts and images that we’ve imagined about an anticipated situation, we can analyze them — cooly and rationally. And, more often than not, these unwanted intrusive thoughts are not realistic.

Think about these anticipatory anxiety example scenarios:

  • We may see ourselves at the dentist’s office in excruciating pain.
  • We may imagine ourselves taking a test and being totally unable to answer any question.
  • We foresee the meeting with our supervisor as an opportunity to be reprimanded or even fired.

All of these scenarios take place in our minds without a shred of evidence. Yet, the mind reacts as if it’s a fact, and the body reacts accordingly — spewing anxiety producing chemicals into the bloodstream.

“The first step to recognizing anxiety is to become aware of our anxious thoughts. Anxious thoughts cause feelings of anxiety and can ultimately impact our actions and behaviors. It can make us become more and more anxious so that our performance at work or in school could be impacted negatively. By having more awareness around our anxiety and learning how to manage it we can stop our anxiety from getting out of control.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

How to Combat Anticipatory Anxiety

1. Be Aware of Your Thoughts and Emotions

Recognize all of the anticipatory anxiety symptoms and take a moment to decompress when you feel them coming on. You can do this by practicing mindful breathing by taking a few deep inhales and exhales. Then, examine what you’re thinking about — the internal dialogue and the mental pictures that occurred when you feel your anxiety creeping up.

2. Reason with Yourself

Next, it’s important to counter the unwanted intrusive thoughts with more realistic and evidence-based thoughts. For example, if you see yourself in excruciating pain at the dentist’s office, counter that with the knowledge that you will actually be feeling no pain due to the Novocaine or other pain inhibitors you will receive. If you’re feeling anxious or intense fear about an upcoming test, counter it by preparing adequately, envisioning yourself answering the questions, and getting an awesome grade.

3. Affirm Your Thoughts with Evidence

The key to dispelling anticipatory anxiety is purely a matter of imagining something negative vs something positive. In most cases, you may even find that the positive will happen more often than the worst-case scenario. This is because evidence usually supports that your upcoming event won’t be a total disaster. For example, if you know that you have studied for the test and know the material, then it’s far more realistic for you to have a positive outcome than a negative one.

Anticipatory anxiety is a discomforting and disquieting mind game you play on yourself. But you can win if you become more aware of your anxious thoughts, and begin to challenge irrational and unrealistic thinking by replacing it with a more realistic, evidence-based thought. Realistic thinking is not necessarily positive thinking, but it is more objective. Sometimes, people refer to it as scientific thinking, because it is based on evidence, not conjecture. And, more often than not, scientific thinking will help you avoid an anxiety-riddled outcome.

So, the next time you start to feel anxious or intense fear, try to implement realistic thinking and examine the evidence before you. You may find yourself pleasantly surprised that the sources of your anticipatory anxiety vanish like clouds dispersing after a storm. If you feel like your anticipatory anxiety starts feeling unmanagement, it might be time to look into getting help. Talkspace offers online therapy that works with your schedule.

“It is really important to “reality check” your thoughts so you do not let them take over. Question them and push back on what these thoughts are telling you. Don’t let your anxious thoughts take over and cause you more anxiety. By challenging your thoughts you are not letting yourself be ruled by anxiety. This process can become easier if you are in therapy because someone else can help you do this “reality checking.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC