8 common causes of anxiety and how to cope with them

In an edited extract from his new book, psychotherapist Padraig O’Morain describes key causes of worry and mindful techniques for dealing with them

‘Many people have panic attacks. It doesn’t mean there’s anything wrong with you.’ Photograph: Thinkstock
‘Many people have panic attacks. It doesn’t mean there’s anything wrong with you.’ Photograph: Thinkstock

These eight worries are representative of issues brought to me by people participating in my mindfulness workshops and courses over the years. In other words, they are common human dilemmas. Mindfulness is an approach that has been employed for thousands of years to help people to relate to their worries in a helpful way. Everybody with any of the issues mentioned here would benefit from engaging in the mindfulness practices outlined in my book, Mindfulness for Worriers, but I have included some other ideas as well.

I suffer from panic attacks  

“For the past two years, I have suffered from panic attacks. They can happen anywhere. Usually I feel terrified and sweaty and am afraid of what other people must think of me when I suddenly leave their company.”

A great many people have panic attacks – far more than you might think, because those who suffer from them don’t usually talk about it. So having panic attacks doesn’t mean there’s anything wrong with you.

If you have not been to see a doctor or spoken to a therapist about your panic attacks, I would recommend you do so. I would also advise you to look at sources of stress in your life and see if you can address these.

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Mindfulness suggestion: Learn to observe the onset of a panic attack calmly. By “calmly”, I mean without telling yourself how catastrophic it is that you are having a panic attack. A panic attack can be under way for some time before you actually notice it, so the good news is that, by the time you notice it, the attack is on the way to being over.

I am terrified of public speaking  

“My job means that I often have to speak in public, both to groups of customers and to people in our office. Although people say that I come across well, I am always terrified at these events and I worry about them for days beforehand.”

There’s something about standing up in front of a group of people and saying your piece that attracts some but terrifies others. And then there’s that dread of being “found out” – of showing that you don’t really know what you are talking about.

Mindfulness suggestion: When planning a presentation, you need to continually return from thoughts of what might go wrong, which are really just fantasies, and bring your attention back to your planning. If the presentation is already planned and you don’t need to do any more work on it, continually bring your attention back to what you are doing right now. That might be going for a walk, or working on another project, or cooking – but whatever it is, practise bringing your attention back to it.

 I don’t know how I’ll fill my days once I retire  

“I am due to retire in six months’ time. Everybody tells me how wonderful it’s going to be but I worry constantly about it. I don’t know what I’m going to do with my time, and most of my friends are people I work with.”

For some, retirement is a long-awaited blessing but for others it is not such a joyful prospect. Unfortunately, everybody is supposed to be jolly about the whole thing, which leaves no room at all for expressing your fears.

Mindfulness suggestion: In a sense, you are in a “don’t know” space. You know you’re retiring but you don’t really know what comes afterwards, and you’re worried about that. So you’re filling that space with worry.

Fill the space with present-moment preparations for your impending retirement; perhaps these could include a pre- retirement course. But from a mindfulness point of view, it is not so much the content of the space that is important as your need to deal with your dilemma in the present moment without feeling miserable about a future that has not yet happened.

My marriage is breaking up  

“My partner and I have drifted apart over the past few years and lately we have been fighting a lot. Although we have been to marriage counselling, it hasn’t helped. I’m very afraid of the future, and I worry about living alone and dealing with all the legal and financial problems that arise after a divorce.” 

The fears you express are probably of the sort that encourage many people to stay with marriages they would be better off leaving. You are looking at the future right now through an entirely negative lens, and that is understandable. Mindfulness cannot resolve the practical challenges of a marriage break-up – dealing with legal issues, accommodation and finances, for example – but it can help you to be in the most constructive frame of mind for addressing them.

Mindfulness suggestion: The Morita Therapy approach is summed up in three slogans: know your purpose, acknowledge your feelings, and do what needs to be done. So your purpose may be to get through this experience as well as you can; your feelings may be that you’re scared; and what needs to be done may be to make a list of steps to take – who you need to consult and what you need to arrange – and then to start working through it.

I worry about how I’ll pay the bills  

“I am facing financial insecurity and I worry about paying the bills and about my future. I can get by, but I have nothing in reserve for a rainy day. Also, my job is insecure. I worry an awful lot about this, and my family have noticed that I am moody and irritable. I find it difficult to sleep.”

Financial insecurity is one of those gnawing problems that can take away so much of our peace of mind. It’s really important to know how to preserve your strength in the face of such worries, and many people have succeeded in doing that even though they still have money problems. Even if some, or maybe most, of your financial problems are outside your control, working on your own peace of mind is within your control.

Mindfulness suggestion: Mindfulness is not going to take your financial insecurity away. What it can do, though, is help you take care of yourself as you deal with whatever issues arise. It can, for example, help with sleep issues. They say that your health is your wealth but it doesn’t necessarily feel like that when money is very, very tight. Nonetheless, you yourself, ideally with the help of family and friends, can cultivate your emotional and mental wellbeing.

I feel overwhelmed with guilt  

“I let a friend down and I can’t stop worrying about the situation. I failed to defend her when a catty remark was made about her by a group at work. Now I worry that she will find out and despise me for it and I also worry that this means I am not a genuine friend.”

Your sense of remorse is very much to your credit. It is clear that you care about your friend and want to do the right thing. Many of us, I fear, have kept silent in a group when we should have defended somebody. Worrying that your friend may find out what happened is an additional stress on top of your feelings about yourself.

Mindfulness suggestion: Allow yourself to experience that sense of regret and remorse, but without necessarily going into a storm of thoughts about it. One way to do this is to note the physical sensation of remorse or regret, and allow your attention to rest on the sensation until it changes. Physical sensations always change, whereas thoughts can keep a feeling going for a very long time. Each time the feeling comes back, practise returning to awareness of that physical sensation. In this way, you are not denying your feelings but nor are you recycling the same thoughts endlessly and pointlessly.

I feel incapable of juggling work and home life  

“I spend three hours commuting every day, my job is stressful and my children need my full attention when I get home. Very often I feel like I have nothing left to give and I worry that everything is going to fall apart. I feel completely overwhelmed.”

A severe work-life imbalance can certainly make you feel quite trapped and unable to see a way out. You try to do your best in your circumstances but this exacts an exhausting physical and emotional price. However, while you may have very little time for sitting down and putting your feet up, you can take steps to bring some calm into your experience.

Mindfulness suggestion: In this situation, it’s useful to practise what I call “out-the-door” mindfulness. In other words, you need to be mindful when you’re fighting your way out the front door to work while getting the kids off to school.

I fear for my health  

“I’ve been ill and now I can’t stop worrying that I’m going to get ill again. I had never been ill before, beyond having a cold or flu, and it actually came as a shock to me when I had to go to hospital. It wasn’t a very serious illness but now I know I’m just as vulnerable as anybody else. I find it plays on my mind that I may not be able to do what I need to for my family, or for my business. I have been told to ‘live in the now’ but that is easier said than done.” 

Illness comes as quite a shock to those of us who go around imagining that it’s something that happens to other people.

Mindfulness suggestion: What you need to do from a mindfulness point of view is to respect the fact that you have this fear, and recognise that it probably came out of that realisation of vulnerability that the illness brought on. Allow yourself to feel the fear, but without catastrophising – in other words, without building a series of scary scenarios in your head: if I get sick will I lose my business and then my home and then my family? That sort of thing.

The aim of using mindfulness isn’t so much to take away the fear of being ill but to drop these exaggerated imaginings, which only make things worse. So practise noticing the fear and then returning your attention calmly to awareness of your breathing, or of walking or working.

  • Mindfulness for Worriers by Padraig O'Morain is published by Yellow Kite