You might expect a cognitive psychoanalyst, former NHS mental health lead and author of How to Be Your Own Therapist and Addicted to Anxiety, to offer fairly familiar advice to anyone struggling with anxiety. Yet view is refreshingly different. Rather than seeing anxiety as something to eliminate, he argues that it is something we need to embrace. In fact, contrary to the popular brain-based advice that dominates social media, he believes the most effective place to begin is not the mind but the body. Here, he tells Â鶹´«Ă˝ the three things we should be doing to reframe our relationship with anxiety – and live well alongside an anxious mind.

1. Rethink your relationship with anxiety – it’s trying to help you out!

Scientific studies on anxiety will often point to treatments that help you to “switch off this part of your brain” or “reduce this or that hormone”. I fundamentally believe that is the wrong way to deal with anxiety. Before we even start thinking about the brain, we have to form a better relationship with our anxiety. We need to get to know it. Work with it. Negotiate with it. Understand why it is there.

There is a part of you that is sometimes scared, and when that feeling bubbles up, it will manifest itself as anxiety to get your attention. It does that so that you respond – it’s a helpful mechanism that protects you from harm. If you think of anxiety as a person, it feels like it’s doing the right thing. If you’re worried about mucking up a presentation, it’s saying “okay, I can make sure you don’t feel bad about this, that it doesn’t go wrong. I can get you out of here in 30 seconds”.

But if you treat your anxiety like an enemy, that’s exactly what it will become. This heightened sense also means you could lose a job or opportunity. But, if you’re still thinking of it as a person, your anxiety doesn’t care about your losses, it’s doing its damnedest to make you safe.

If you don’t start by forming a relationship with anxiety and understanding that yes, it’s uncomfortable, but that’s because it’s making you pay attention, then everything else is just a sticking plaster. It will push your anxiety down but it’ll come back up eventually. Anyone who promises you tools to get rid of anxiety is lying to you. Anxiety has to be there, and you have to accept that to improve anything.

2. Think about changing your body, not your brain

Many psychiatrists focus immediately on the brain, trying to help you change your thoughts. But my key starting point is the body. Most people can feel anxiety somewhere in their body – in their heart, their shoulders, their neck. When anxiety is presenting itself in the body, the body is in a state of alarm. It sends a message to the brain that something isn’t right. The brain will then accept that information and subsequently, the prefrontal cortex – the part of the brain that helps us be a bit more rational and measured – is suppressed.

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When you’ve noticed your body reacting, do whatever works to release that state of threat. It might be breathing, or exercise or an ice bath. Whatever regulates your body. And do it with the understanding that you’re not doing it to get rid of the anxiety, but so that you can send a new message to the brain to switch off this threat response so that your prefrontal cortex can get back online and enable you to work with the anxiety in a much more measured, calm way.

3. Write about what really happened to increase your tolerance for uncertainty

We have , according to neuroscientists. And studies suggest that a  or fearful in nature. That’s a lot of dark, scary thoughts. Most of them aren’t factual but when you’re in a state of anxiety, you’re going to be dealing with these thoughts as if they are scientific evidence, creating a loop of anxiety.

After you have accepted that anxiety is trying to help you, and worked out what helps your body regulate, I would encourage you to start taking note of what happened when these anxious thoughts came up. List the spiral of worries and think about how many came true. Start examining the evidence. This can allow you to be a bit more rational about them next time they appear.

Someone with anxiety might say: but what about that x per cent of the time when the bad thing does happen? I tell them they can’t have certainty all the time, the world we live in is uncertain. The definition of anxiety that I agree with is that it’s an intolerance of uncertainty. You have to get comfortable with not knowing and being ok with the idea that not everything has to be perfect. That’s a bit of a dance, but for someone with a lot of anxiety, the reality is that there isn’t any other choice, you can either stay as you are, or you can try this alternative view of uncertainty. Ask yourself what it would be like to let that control go, to surrender to the unpredictability. All of this is very difficult, but every time you change the way you react to anxiety, you are creating new neural pathways in the brain that will help you live more comfortably with anxiety.

As told to Helen Thomson

A type of psychotherapy available on the national health service (NHS) in England seems to benefit teens and young adults with anxiety and depression less than their working-age counterparts.

Clinical trials looking into effects of psychotherapy for common conditions such as anxiety and depression have mostly targeted working-age adults, despite , says at University College London.

In 2008, NHS England initiated a programme to increase people’s access to science-based self-help interventions and psychotherapy. Now known as the NHS talking therapies for anxiety and depression, it offers researchers a large database of anonymous information about users, therapies and outcomes.

Stringaris and his colleagues used this data to analyse outcomes for more than 1.5 million people who used the talking therapies from 2015 to 2019. Just over 1.2 million of them were aged 25 to 65, while the rest were aged 16 to 24. Around two-thirds in both groups were girls or women.

The researchers compared changes in their symptom severity before and after therapy, measured via answers to two standard self-assessment surveys used for this, the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Scale 7-item.

They found that the scores on these improved by about 35 per cent in people aged 16 to 24, compared with around 41 per cent in those aged 25 to 65. Those in the younger age group were also about 20 to 25 per cent less likely to be considered recovered or to reach a level of improvement that counts as a significant change.

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This translates into thousands of young people each year who might have recovered if they had responded to treatment as effectively as older adults, says Stringaris. “It is critical that mental health services think about potentially tailoring their pathways towards care that better suits younger people.”

Several factors could play a role in these differences, such as a generational gap in the effects of things like social media and online dating on mental well-being, says Stringaris. Data also indicates that young people are more likely to skip scheduled sessions without cancelling, .

Five scientific ways to help reduce feelings of anxiety

There are several evidence-backed ways of calming an anxious mind – from eating specific foods to adding certain exercises to your routine

The paper highlights an imbalance that warrants further investigation, says at the University of Oxford. “Once you start probing, you find lots of things – and you can change them. I view this paper as the start of what should be a fairly successful journey.”

Still, it is important to consider the “incremental benefit” of therapy, meaning how users fare now compared with how they might have done without any treatment at all, he adds. “You’re getting [young] people at a time of enormous transition in their lives, as they’re going in and out of colleges and trying to get jobs, with things quite unstable in terms of their living circumstances,” says Clark. “So it’s possible that the young people in this paper would have had worse outcomes without therapy than the older people, and the incremental benefit of therapy may not be lower.”

at NHS England says the talking therapies provide support to more than 1 million people a year, most of whom receive treatment within six weeks. “We would urge them to come forward for care,” he says.