Managing anxiety

Key words: anxiety, stress, exam, anxiety audit, relaxation

Most students experience some degree of anxiety some time during their course of study, particularly at exam time. Because anxiety is caused by the way we interpret and react to events, anxiety can be managed by using a combination of three different actions: managing your thoughts, managing your behaviour and managing your physical response to fear.

What causes anxiety?

We often think we become anxious and stressed because of what is happening to us. In fact, anxiety is caused by the way we interpret and react to events. Consider this fight or flight example of anxiety.

If a masked, armed person suddenly jumped through your window, your body would immediately and automatically mobilise itself into alarm reaction in readiness for dealing with the danger – by either fighting it or running away from it. You would probably suck in air and stop breathing; your muscles would be tight; your heart rate and blood pressure would increase; your digestive system would stop working; and adrenalin would be released in your body. When you had dealt with the danger in some way, your body would return to normal. In order to deal with danger, this automatic reaction is necessary in both humans and animals.

The ‘fight or flight’ example illustrates a realistic alarm reaction. However, humans can also imagine danger. Humans can think that something is going to be very threatening, and this will be enough to prompt the alarm reaction. However, because the danger is only imagined, the body cannot properly deal with the danger by fighting it or running away from it. Instead, the alarm reaction remains, and the sufferer begins to look like an anxious person.

If your anxiety is such that it starts to affect your everyday life, for example your ability to study, or your exam preparation or performance, you could be suffering from excess anxiety and you may need to seek help from your doctor, university counsellor or mentor.

There are many and varied signs of excess anxiety. Do you …

  • lie awake worrying?
  • find yourself getting frustrated, irritable, moody, tearful?
  • get palpitations (pounding heart, accelerated heart rate)?
  • experience sweating, trembling or shaking?
  • feel apprehensive and worried?
  • feel guilty when you aren’t working?
  • feel indecisive?
  • smoke or drink to ‘unwind’?
  • experience feelings of panic?
  • grit or grind your teeth?
  • feel nauseas (upset stomach)?

If you are experiencing some of these signs, you may need to seek help from your doctor, university counsellor or mentor.

What about exam anxiety?

How does the ‘fight or flight’ response fit with anxiety about exams? ‘Exam anxious’ people tell themselves that exams are a danger, and their bodies react. They cannot fight an exam; and most people don’t want to run away from it – the consequences are too dramatic! They can, however, change certain thoughts and behaviours so that anxiety does not reach unhealthy levels.

How to manage exam anxiety positively

Exam anxiety can be managed by using a combination of three different actions: challenging and changing your thoughts; changing your behaviour; and changing your physical response to being scared.

1. Manage your thoughts

Exercise 1: Manage your thoughts

Think about your exams. Imagine them being fairly close. What messages do you give yourself (i.e. your thoughts or self-talk) that could be promoting your exam anxiety?

Here are some common anxiety-producing thoughts about exams.

Click those thoughts that you have experienced, and follow the suggestions to help challenge your anxiety-producing thoughts.

I won't know enough to pass.

QUESTION your thoughts:

  • Have I been working reasonably steadily all year?
  • Will I revise to a plan?

REPLACE your thoughts with positive thoughts:

  • If I keep to my plan, I WILL know enough to pass.
I haven't done enough work.

QUESTION your thoughts:

  • How sure am I that I haven’t done enough work?
  • How much work have I actually done?
  • Am I sure I won’t be able to achieve 50%?
  • What is a reasonable amount I could learn between now and the exam?

REPLACE your thoughts with positive thoughts:

  • Even though I haven’t done enough work, I must have learned something during the semester/year. It could be enough to pass, especially if I work hard between now and the exam. If I fail, my whole world won’t fall apart!
If I fail, my parents/friends/partner will be disappointed.

QUESTION your thoughts:

  • How sure am I that my parents/friends/partner will be very disappointed if I fail?
  • How do I know?
  • Why is it so important that I please them?
  • What will happen if they are not pleased?
  • Do they measure me by what I achieve, or by who I am?
  • Will my whole world fall apart if they are disappointed?

REPLACE your thoughts with positive thoughts:

  • My parents/friends/partner may or may not be disappointed with my results. Even if they are disappointed, they will still love me. The important thing is for me not to lose sight of the ‘big picture’ and to do better next time!
If I fail, I won't be able to face people.

QUESTION your thoughts:

  • Do people’s feelings towards me depend on my academic success?
  • How have I coped in the past when I have felt embarrassed about my behaviour?
  • How have others treated me at that time?

REPLACE your thoughts with positive thoughts:

  • I may or may not be able to face people if I fail. In the past, I have coped with feeling embarrassed. I won’t know how I will feel until I do face people. Even it if is hard, my whole world won’t fall apart!
If I fail, I won't be able to afford to repeat the semester/year.

QUESTION your thoughts:

  • How sure am I that I will not be able to afford to repeat the semester/year?
  • When will I be able to afford it?
  • What would be constructive use of my time while I wait?
  • What are some other positives in having to wait before I repeat?

REPLACE your thoughts with positive thoughts:

  • I may not be able to afford to repeat the year NEXT year, but I will at some point. There are some benefits in having to wait.
If I fail, it will prove that I am no good.

QUESTION your thoughts:

  • Why do I measure my self-worth by my academic performance?
  • Who taught me to do that?
  • Do I measure other people by their academic performance? Why?
  • Can I still value a person even though I may not like a part of their behaviour?

REPLACE your thoughts with positive thoughts:

  • Even if I fail, I am still OK. I may prefer not to fail, but even if I do, I am still me, and I am OK.

Here are some techniques to help you change your negative thoughts to more positive, productive ones:

  • Say your positive thoughts over and over out loud.
  • Write your positive thoughts on post-its and place them where you can see them regularly.
  • Each time a negative thought about the exams comes up, see a red flashing light saying STOP! Then, replace this thought with your more positive statement, stating it out loud if possible.
  • Notice how differently you feel and act when you think positive thoughts.
  • Imagine your negative thoughts in a bizarre context, so they will begin to seem like the unhelpful thoughts they are. For example, imagine your negative thoughts are coming from a yapping dog tied to a tree. Now, shut your eyes, take a few good breaths, and imagine yourself walking past the yapping dog in a strong, dismissive way, paying it no heed.

2. Manage your behaviour

The best way to minimise anxiety before an exam is to be well prepared – avoid last minute cramming. DO whatever makes you feel you are in control of your study. For example:

  • Become an independent learner.
  • Manage your time.
  • Plan your revision.
  • Reward yourself when you reach your revision goals.
  • Organise your study material.
  • Celebrate your successes.
  • Focus on your good points.
  • Set realistic goals. Remember we’re all different.
  • Be kind to yourself.
  • Exercise regularly.
  • Have a balanced lifestyle.
  • Eat a balanced diet.
  • Get adequate sleep (8 hours every night).
  • Have a few belly-laughs a day.
  • Ask for help when necessary.

3. Manage your physical responses 

As part of your total management of exam anxiety, you need to manage your physical response to anxiety. When you think you are in danger, the alarm reaction takes over: your heart rate and blood pressure increase; your muscles tense. You can counteract the alarm reaction by teaching your body to relax – to lower your heart rate and blood pressure and relax your muscles and mind.

Physical responses to anxiety include:

  • shallow breath
  • quickened breath
  • clammy hands
  • tight muscles
  • pursed lips
  • flushing
  • furrowed brow
  • dry mouth
  • acne
  • sleeplessness
  • trembling
  • pallor

There are many ways to relax.

Click on any of the following techniques for more information:


Meditation is usually practised with the person sitting on the floor or on a chair. Their mind is usually focusing on something (such as a mantra or their breathing), and their body is relaxed. People who take meditation seriously, meditate at least once a day for twenty minutes. There are various forms of meditation, and meditation classes are becoming increasingly popular.

Relaxation tapes and CDs

The person sits in a comfortable chair or lies down and does what the voice on the tape instructs. Instructions can include asking the person to do something (e.g. breathe slowly, tense and relax a set of muscles) or imagine something (e.g. a beach scene or other relaxing imagery). Sometimes, relaxing music is played in the background. The tapes usually last from 20 to 30 minutes.


The word ‘centering’ comes from the spiritual practices of the East. In general, centering is a way of breathing in order to focus your energy, and in this way, you also become relaxed.


Massage for relaxation is a great way to teach your body the relaxation response. Massage works directly on the muscles, but as you begin to relax, the relaxation response takes over. If you cannot afford a professional masseur, buy a book and take turns with a friend.


Yoga is an ancient physical discipline, and although it is a form of exercise, the postures are designed to evoke the relaxation response. The discipline includes breathing and relaxation activities that, together with the postures, make it a very valuable form of relaxation. Most communities run yoga classes. Ask at your local Community Health Centre about classes; or buy a book.

Specific home-based activities

If the above list does not excite you, or if cost is a worry, there are some activities that you can do very easily in your own home. Taking a long bath or listening to soothing music produces the relaxation response.

Positive image rehearsals

Positive image rehearsals can help you to manage exam anxiety. First, make yourself comfortable and relax your body and your mind. Once relaxed, imagine going to the exam and doing it calmly and well. This fantasy should last about 15 minutes. If you are very anxious about exams, you will probably become anxious during the imagery, even though you were relaxed when you began. Persevere, and after several attempts you should be able to remain relaxed during the imagery. When you get to this point, you should remain relatively relaxed when you are actually in the exam room. Remember, some degree of ‘stress’ is normal and helpful.

Remember that the three areas (thoughts, behaviours and physical response) are part of a system. By intervening in one area, the whole system will benefit. Intervening positively in all three areas will speed up your management of exam anxiety.

In the exam – how to manage anxiety

For many of us, panicking in the exam is our worst fear! Panicking in an exam will cause your heart rate to increase; you will begin to sweat; and you will have difficulty recalling information. If you feel this happening, use some calming techniques.

Calming techniques you can use in the exam room

Practise these calming techniques so you can employ them with confidence if you begin to feel anxious in the exam room:

  • Breathe calmly – long, slow deep breaths. Exhale slowly and completely, letting your shoulders relax.
  • Use a relaxation exercise. For example, imagine yourself in a calm and beautiful place. Slowly repeat a calming word until you begin to relax.
  • Sit upright in your chair, grip the seat of the chair and tense all your muscles. Then, let your muscles relax totally, breathing out as you do so.
  • Think positively – tell yourself ‘I CAN do it; I AM well prepared’.
  • Don’t think about the fear – just concentrate on completing one step at a time.
  • Answer the easiest questions first – this will help build your confidence; or, if you are in the middle of a question, leave the question and come back to it after attempting another question.

Complete an anxiety audit

Everyone experiences anxiety differently.

Exercise 2: Anxiety audit

Print and complete this anxiety audit. It will help you understand your own system so you are better able to keep your anxiety at healthy levels.

Early warning signs of anxiety

What are the first things you notice that prompt you to say: ‘I am getting anxious’?

Exercise 3: Early warning signs

Print and complete this activity to identify your early warning signs of anxiety.

Is there a pattern to your early warning signs? Are they mainly in one area? If so, this is the area to begin the positive management strategies previously discussed in this workshop.