How to Manage Anxiety Without Medication
Anxiety, while natural and unavoidable, is an unwelcome guest for many people. Whether it’s occasional jitters or a constant sense of dread, knowing effective ways to calm anxiety — with or without the additional support of medication — makes a big difference in your ability to regain control of big emotions. Kristin Yaneff, UnityPoint Health therapist, shares 14 alternative treatments for anxiety and how to recognize when a deeper level of care is needed.
14 Coping Skills for Anxiety
While medication can play a role in managing anxiety, it's important to remember that people experience anxiety in different ways. Some outwardly struggle, while others appear successful and capable despite significant internal worry. Informally, this is called 'high-functioning anxiety.' Regardless of how anxiety presents, Yaneff says practical coping strategies are essential.
“In many cases, anxiety is manageable without psychiatric medication. Of course, it can be helpful, but coping strategies are fundamental to any anxiety disorder self-care plan.”
Here are 14 techniques worth exploring.
1. Try Aromatherapy
Clinical research is mixed on the best essential oils for anxiety and depression. In several studies, citrus aurantium L, also known as bitter orange, was the most recommended. Whiffing a lavender and lemon oil scent may also be natural mood boosters, while peppermint oil may relieve an upset stomach or headaches associated with the physical symptoms of anxiety.
Before trying essential oils, it’s a good idea to ensure quality ingredients and how to safely use them.
2. Avoid Triggers
Understanding your anxiety triggers — specific situations, people, limiting thoughts and even stimulants — that set off intrusive feelings is a key coping skill. Of course, it’s not always possible avoid anxiety triggers, so focus on what you can control.
For instance, alcohol, caffeine, nicotine and vaping can all heighten anxious feelings. If that’s your experience, too, try to cut back. If social gatherings make you feel on edge, limit how many you attend until you’re in a better place. Or, if seeing people online from your past makes you anxious, give social media a break.
3. Listen to Calming Music
Whether instrumental pieces or nature sounds, calming music for anxiety is a simple and powerful way to promote a sense of peace.
Physically, it can slow your heart rate and breathing, lower blood pressure and reduce stress hormones. Mentally, it may boost chemicals that make you feel at ease.
Yaneff adds, “It’s a good way to occupy your mind and give yourself a mental break from anxious thoughts.”
4. Explore Cognitive Behavioral Therapy
There are many types of therapy used to treat anxiety. Cognitive behavioral therapy (CBT) is one of the most common and effective. Through CBT, you learn to understand thinking patterns that negatively impact your life. By exploring the connection between your thoughts, feelings and behaviors, you can view challenging situations with more clarity and learn to handle them better.
CBT is a favorite of Yaneff’s, too.
“In cognitive behavioral therapy, we focus on working through cognitive distortions, transforming negative self-talk, learning coping skills, identifying triggers, naming and understanding emotions, establishing healthy communication strategies and setting healthy boundaries. These tools are all essential for managing anxiety and its symptoms.”
5. Try Emotional Freedom Technique (EFT) aka Tapping
Scientists are still studying it, but EFT, also called “tapping,” is an evidence-based practice used to help people with anxiety and post-traumatic stress syndrome.
Mental health experts who use it believe tapping on certain spots on your body can balance your energy and ease symptoms of anxiety or pain.
Tapping uses a similar method as acupuncture. It focuses on “meridian points” in your body. Based on Chinese medicine, these are energy paths thought to keep you healthy. Instead of needles used in acupuncture, tapping uses your fingers to gently tap on these points.
While research shows the most promise in reducing anxiety levels, more studies are needed to fully understand its effectiveness compared to established treatments like CBT.
6. Exercise
Engaging in regular physical activity, whether high-intensity cardio, weightlifting, walking or calming practices like yoga for anxiety, helps regulate your body's stress response.
Yaneff says, "When our mental health suffers, our physical health often does, too, and the other way around. So, it's important to care for both. Simple exercise like walking and relaxation can ease anxiety. Plus, when you're active, your brain releases a feel-good chemical that helps with anxiety and encourages healthy habits.”
7. Use Fidget Tools and Toys
Fidget tools and toys for anxiety provide a physical outlet for nervous energy and redirecting focus.
“The idea is that engaging with a fidget — such as anxiety rings, bracelets, pens, necklaces or toys — occupies the mind, shifting attention away from anxious thoughts and stressors. These tools are particularly beneficial for individuals, especially children, who need help focusing,” Yaneff says.
8. Practice Grounding and Breathing Exercises
Grounding and breathing exercises for anxiety are powerful tools to help you reconnect with reality when your thoughts take you elsewhere. Yaneff recommends several coping mechanisms to anchor yourself in the present.
"Simple actions, like placing your hand on a table to bring yourself back to the present when you’re feeling overwhelmed, doing a body scan or box breathing, can refocus the mind away from negative thoughts. Similarly, aromatherapy, yoga and meditation offer pathways back to the present moment, too."
Box breathing, also called square or 4x4 breathing, is an effective way to calm your nerves. It involves a balanced four-part breathing pattern:
- Exhale: Slowly breathe all the air out of your lungs.
- Inhale: Slowly breathe in deeply through your nose while counting to four.
- Hold: Hold your breath for a count of four.
- Exhale: Slowly breathe out through your mouth for a count of four.
- Hold: Hold your breath again for a count of four.
- Repeat: Continue this cycle for a few minutes or until you feel calmer.
Yaneff says, “Any form of deep breathing is important for managing anxiety. It helps ground us and keeps us in the here and now and focused on our breathing.”
To perform a body scan, lie or sit comfortably and slowly bring awareness to each part of your body, noticing any sensations. This practice helps you become more aware of how anxiety feels in your body, such as muscle tightness or a fast heartbeat. Grounding you in the present moment, body scans shift your focus away from worries and can ease the physical tension anxiety creates.
The core of both grounding and mindfulness is in using various coping skills to stay present, which is crucial for overcoming negative thoughts fueled by anxiety.
9. Drink Herbal Tea
Some people find herbal teas to be soothing when they’re feeling anxious. Like aromatherapy, the natural compounds in certain herbs may promote relaxation. While scientific evidence is limited, sipping a warm cup of chamomile tea for anxiety can be a comforting self-care practice.
10. Get a Massage or Acupuncture
Massage and acupuncture can help with anxiety by calming your body's reaction to stress. Massage uses pressure to relax muscles and may release chemicals in your brain that make you feel less stressed. Acupuncture, using tiny needles on targeted pressure points for anxiety, is thought to balance your body's systems and release calming chemicals.
While studies show promise, the scientific evidence isn't firm enough yet to say for sure that massage and acupuncture help all kinds of anxiety.
11. Repeat Positive Affirmations and Mantras
"One of my favorite approaches for managing anxiety is called thought blocking,” Yaneff says. "It involves actively interrupting negative thoughts and replacing them with positive, more rational ones.”
Thought blocking can be supported with positive affirmations and mantras — simple, encouraging statements you repeat to yourself.
“For instance, when faced with an irrational fear, thought blocking, coupled with affirmations like 'I am safe' or 'I am in control,' involves reminding yourself of past, safe experiences and focusing on what you can control. This active use of self-talk, reinforced by positive affirmations, helps to counter negative, intrusive thoughts and maintain a more balanced perspective.”
12. Practice Meditation or Journaling
Guided meditation for anxiety trains the mind to focus on the present moment. Through practices like mindful breathing or body scans, you learn to observe thoughts and feelings without judgment. Regular meditation for anxiety also creates a sense of calm and inner peace, helping to regulate your nervous system and promote a more balanced emotional state over time.
Journaling creates a safe space for exploring your emotions. Regularly writing down worries externalizes them, making them feel less overwhelming. This practice allows for self-reflection, identifying anxiety triggers and patterns and developing coping skills, too.
13. Get Quality Sleep
It’s common for anxiety to be worse at night. Worrying about sleep can make your anxiety worse as bedtime approaches. Also, when the day's activities quiet down, it's easier for intrusive thoughts to materialize.
Yaneff gives a few self-care suggestions on how to calm anxiety at night.
“If we’re not sleeping, our brain isn’t getting the rest and nutrients it needs. Our mental health is negatively impacted by that. Positive self-talk is helpful, along with taking deep breaths and practicing relaxation techniques like prayer, meditation or listening to a sound machine. Having a good sleep routine is also important for calming yourself down before you physically lay down. Taking a hot shower, bubble bath, doing your skin care routine or reading a book are all good self-care strategies.”
14. Try a Weighted Blanket
Weighted blankets provide deep touch pressure, which is thought to calm the nervous system by activating the "rest and digest" response. The grounding sensation of the weight also promotes feelings of security and can improve sleep, which reduces feelings of anxiety. Many people find them helpful, but research is limited on their science-backed benefits.
When to Talk to Your Doctor about Anxiety
Building coping skills is essential for preventing anxiety and negative thinking from taking over your life.
Yaneff says, “Your feelings aren't always facts. Recognizing and naming your emotions can lessen their impact. Understanding that some thoughts are just irrational or intrusive, not reality, is key to managing anxiety.”
While natural approaches help, don't hesitate to reach out to your primary care doctor if anxiety persists, disrupts your daily life or causes physical symptoms like chest pain or difficulty breathing. They can assess your situation, rule out other causes and discuss helpful treatments, including therapy, medication or a combination. Seeking help is a sign of strength and can prevent anxiety from worsening.