Breaking the Cycle of Anxiety and Avoidance

Avoidance behaviors are common in those with anxiety disorders, but they can be overcome through therapeutic treatment plans.

As human beings, it’s normal for us to avoid the things that make us feel anxious or afraid. After all, you likely wouldn’t pet an angry dog if you thought it was going to bite you — or do something harmful that would put yourself or someone you love in danger.

For the most part, avoiding these kinds of situations is totally normal, and helps to keep us safe.

For some people, though, excessive anxiety can lead to unnecessary and extreme avoidance. In turn, this avoidance can have a hugely negative impact on the way that they function and their overall quality of life. So, let’s look at what anxiety avoidance is, including when it becomes a problem and how to treat it.

In psychology, avoidance is defined as the act of staying away from certain things — such as situations, people, or environments — in order to prevent negative or unwanted thoughts, feelings, or consequences. While avoidance is a natural human behavior, it’s also known to be a common feature of many different anxiety disorders.

According to the literature , there are multiple theories for how avoidance can develop into anxiety disorders as well as help to maintain them. For example, some theories suggest that avoidance is a response to the development of fear or anxiety, while other theories suggest that avoidance is a way to protect oneself from a perceived threat.

Although researchers are still exploring the neuroscience behind avoidance, what we do know is that it’s an extremely common behavior for people living with anxiety disorders. Your avoidance behaviors will likely be based on your individual stressors and triggers.

Avoidance can be a tricky thing, because while you may feel like it’s helping at the time, avoiding the things that make you anxious can actually do more harm than good. In fact, this is known as the anxiety cycle in psychology, which looks like this:

Share on Pinterest Illustration by Alyssa Kiefer

• Anxiety: You experience symptoms of anxiety — these may be physical feelings, such as increased heart rate, or mental symptoms, such as racing or intrusive thoughts.
• Avoidance: You feel uncomfortable and want to make these feelings stop, so you “avoid” the situation, person, or thing that’s causing them.
• Relief: By avoiding the situation that causes fear and anxiety, your symptoms disappear — but only for a short time, until they arise again in the same situation.
• Reinforcement: You’ve now taught your brain that you can’t handle this anxiety or fear, which decreases your self-confidence, increases your anxiety, and leads to more avoidance.

Ultimately, continuing to engage in avoidance to prevent feelings of fear or anxiety fuels the cycle and allows both your anxiety and avoidance to grow.

Avoidance in anxiety disorders always revolves around the specific thing that causes anxiety.

For example, if your attention deficit hyperactivity disorder (ADHD) causes you to experience test-related anxiety, you may avoid going to school on test days. Or if you experience separation anxiety when away from your spouse, you may avoid hanging out with friends or going out alone.

Below, we’ve shared some of the more common examples of avoidance behaviors that can accompany different anxiety disorders.

Specific phobias

A specific phobia is an intense, persistent, and irrational fear of a specific object, situation, or thing. If you have a phobia of dogs, for example, you might avoid going to places where dogs are or avoid looking at pictures of dogs online.

Or if you live with agoraphobia — which is fueled by a fear of panicking outside of one’s “safe spaces” — you might avoid going to certain stores or leaving your home whenever possible.

Social anxiety

Social anxiety is defined as anxiety that appears in social situations, most often due to fear or judgement, or embarrassment. When you have social anxiety, you experience extreme discomfort in social situations and will go to great lengths to avoid them.

So, this may involve avoiding things such as being out in public places (like shops or restaurants), talking with strangers, or giving presentations at work or in class.

Relationship anxiety

While most people experience some nervousness and even anxiety related to relationships, for people with relationship anxiety, these feelings can be intense and persistent. If you experience relationship anxiety, you might avoid healthy behaviors such as being honest with your partner or refusing to do anything that might jeopardize your relationship.

Health anxiety

Health anxiety, also called hypochondria, involves irrational fear and anxiety related to health-related situations — particularly, overestimating the likelihood that something serious is wrong with your health.

With health anxiety, avoidance behaviors may include things such as not reading articles about health conditions, not watching TV shows involving medical themes, or not going to your doctor’s appointments.

Research shows that one of the best approaches for tackling avoidance behaviors is a type of cognitive behavioral therapy (CBT) called exposure therapy. Exposure therapy is a technique that involves gradually exposing a person to the thing that causes them fear or anxiety. As a result, the anxiety and avoidance diminish over time.

One review of the literature from 2015 explored the overall role of CBT in treating anxiety disorders. According to the research, exposure-based therapies are especially effective for anxiety disorders that frequently cause avoidance behaviors, such as social anxiety, specific phobias, and obsessive-compulsive disorder (OCD).

Exposure therapy is one of the most effective ways to stop avoidance coping, but it can be hard to figure out how to do exposure therapy on your own. So, if you’re someone who has been engaging in avoidance and other safety habits because of anxiety, reach out to a licensed mental health professional to discuss your options for treatment.

Getting help with your anxiety

Anxiety is a natural human emotion that everyone experiences from time to time. But if your anxiety is making it hard for you to function and do the things you enjoy, there is help and support available:

• Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA’s treatment locator can help you search for mental health professionals in your area.
• Anxiety and Depression Association of America (ADAA): ADAA’s therapist directory is another tool to help you find anxiety and depression therapists near you.
• National Alliance on Mental Illness (NAMI): NAMI’s national helpline is a free helpline that can help connect you to the mental health resources you need.