How Do We Keep Fear and Anxiety from Diminishing Our Lives?

Sign up for my 1 page action guides and newsletter Fear and anxiety are part of being human. But sometimes they interfere with activities we enjoy, cause us to worry about things that may never happen, or leave us feeling ashamed of being afraid. During a recent endurance race, I experienced intense panic while swimming in extremely cold water. I felt embarrassed that, despite decades of competing in triathlons, I couldn't control my fear. When I shared the experience with a friend, he offered a different perspective: He admired my willingness to continue racing, knowing that the fear might return. I saw weakness. He saw courage. That conversation led me to explore how common anxiety really is, why shame can make it more burdensome, and what clinical research tells us about reducing its impact. In this episode Anxiety is remarkably common. One large U.S. survey found that 44% of adults reported anxiety or measurable symptoms, although far fewer met diagnostic criteria for an anxiety disorder. Fear can create three burdens: The distress itself, avoidance of meaningful activities, and shame about being afraid. Some fears are highly treatable. Exposure-based cognitive behavioral therapy (CBT) has strong evidence for specific phobias, including fear of heights. Other anxiety may persist. Acceptance and Commitment Therapy (ACT), structured mindfulness, and other treatments can help reduce symptoms or their impact. Shame is not inevitable. Psychological interventions may reduce the additional suffering caused by harsh self-judgment. We also explore breathwork, EMDR, my own experience with morning anxiety, and the surprising effect of my beloved cup of coffee. Three questions to consider Inspired by the Serenity Prayer: Is this a fear or anxiety I could meaningfully reduce with treatment? If some anxiety remains, how can I prevent it from limiting what I do or enjoy? Can I stop adding shame and self-criticism to an already uncomfortable experience? Key research and references How common is anxiety? Kavelaars et al., 2023 — The Burden of Anxiety Among a Nationally Representative US Adult Population. A large survey found that 44% reported anxiety or had measurable symptoms. Anxiety was associated with poorer health-related quality of life. Kessler et al., 2005 — Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders. Approximately 18% met diagnostic criteria for an anxiety disorder over 12 months in an older national survey. Fisher et al., 2021 — Men's Anxiety: A Systematic Review. Examines anxiety, masculine norms, disclosure, and barriers to seeking help. Shame and anxiety Cândea & Szentagotai-Tătar, 2018 — Shame-proneness, Guilt-proneness and Anxiety Symptoms. Meta-analysis examining the association between shame and anxiety. Clement et al., 2015 — Impact of Mental Health-Related Stigma on Help-Seeking. Systematic review examining how stigma may discourage people from seeking assistance. Goffnett et al., 2020 — Interventions to Reduce Shame. Systematic review finding promising reductions in shame with several psychological interventions. Treating fears and anxiety Wolitzky-Taylor et al., 2008 — Psychological Approaches in the Treatment of Specific Phobias. Meta-analysis supporting exposure-based treatment. Freeman et al., 2018 — Automated Virtual Reality Treatment for Fear of Heights. Randomized trial demonstrating substantial improvement in height-related fear. Haller et al., 2021 — Acceptance- and Mindfulness-Based Interventions for Anxiety Disorders. Systematic review and meta-analysis of randomized trials. Hoge et al., 2023 — Mindfulness-Based Stress Reduction vs Escitalopram. Randomized trial finding structured mindfulness training noninferior to escitalopram on the primary anxiety measure. Fincham et al., 2023 — Effect of Breathwork on Stress and Mental Health. Meta-analysis finding modest benefits, with methodological limitations. Valiente-Gómez et al., 2017 — EMDR Beyond PTSD. Systematic review examining applications of EMDR to other conditions, including anxiety. Liu et al., 2024 — Caffeine and Anxiety. Meta-analysis finding that caffeine generally increases anxiety, particularly at higher doses. The takeaway Anxiety doesn't have to be disabling to diminish our lives. And experiencing fear doesn't mean we lack courage. Some fears can be substantially reduced. Others can become more manageable. And even when anxiety persists, we may be able to lessen the shame we attach to it. If fear or anxiety is interfering with your enjoyment of life, consider discussing it with someone you trust or a healthcare professional. Effective treatments are available. Living long and well isn't just about preventing disease or adding years to our lives. It's also about finding more joy in the years we have. This podcast provides educational information and is not a substitute for individualized medical or mental health care. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com