Tailor Made Psychiatry  ·  Dr. Sunny Kang, MD, FRCPC

Understanding
Anxiety

One of the most common human experiences — and one of the most treatable.

Anxiety is your nervous system’s alarm — built to protect you. When it misfires, it fires that same intense response at things that aren’t truly dangerous. Your body means well; it has simply learned to overestimate threat. That is something you can change.

What contributes to anxiety

Anxiety rarely has one cause. It builds through several layers at once — and understanding yours is the first step toward addressing them.

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Biology & genetics

Anxiety runs in families. Some people are simply wired with a more reactive nervous system — not a flaw, just wiring you can work with.

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Early life & trauma

An unpredictable or overwhelming past can leave the nervous system stuck in “on alert,” long after the danger has passed.

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Thinking patterns

Catastrophizing, overestimating danger, and perfectionism keep the anxiety cycle running.

Chronic stress

Sustained stress with no real recovery — work, money, relationships, health — can lock the system in overdrive.

Substances

Caffeine, alcohol, and cannabis can trigger or worsen anxiety, even when they feel calming in the moment. The rebound is real.

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Physical health

Thyroid issues, hormonal shifts, poor sleep, and some medications can all mimic or fuel anxiety.

The anxiety cycle

A trigger sparks a thought (“I can’t handle this”), which sparks a body sensation (racing heart), which feels like proof something is wrong — fuelling more anxious thoughts. Avoidance brings short-term relief but teaches the brain the situation really was dangerous, making the cycle stronger. Recovery means learning to interrupt it: through the body, the mind, or your behaviour.

More of this is in your hands than it feels

Some of what shapes anxiety is fixed. Much of it responds directly to what you do — which is exactly why anxiety is so treatable.

What you can’t change

Fixed factors

  • Genetic predisposition / temperament
  • A naturally reactive nervous system
  • Past experiences that have already happened
  • Some physical-health contributors
Within your influence

Modifiable factors

  • Sleep quality and consistency
  • Caffeine, alcohol, and cannabis use
  • Avoidance vs. gradual facing of fears
  • Breathing and body-regulation skills
  • Patterns of thinking (with therapy)
  • Movement and daily structure

Anxiety shrinks when you stop avoiding and start regulating. The right column is where that work lives.

Levers within your control

Skills and habits with real evidence for calming an overactive alarm system. Begin with one and build.

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Breathing & the body

Strong evidence

Slow diaphragmatic breathing directly switches on your body’s calm response. Progressive muscle relaxation, yoga, and tai chi work through the same pathway. These are trainable skills, not tricks.

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Movement

Strong evidence

Regular aerobic exercise is one of the most effective anxiety treatments available. 20–30 minutes of brisk activity most days measurably lowers baseline tension and improves sleep.

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Sleep

Strong evidence

Anxiety and poor sleep feed each other. A tired brain is a more anxious brain, so steady sleep habits are foundational — not optional.

Caffeine & alcohol

Strong evidence

Caffeine mimics anxiety symptoms; alcohol calms briefly then rebounds into more anxiety and worse sleep. Cutting back often brings quick, noticeable relief.

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Connection

Strong evidence

Isolation drives anxiety; a few meaningful relationships buffer it. Investing in connection is protective. For some people, faith or a spiritual community is one of the strongest sources of this connection and meaning — if it’s part of your life, it’s worth bringing into your care rather than setting aside.

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Mindfulness

Strong evidence

Paying deliberate, non-judgmental attention to the present moment loosens the grip of “what-if” spirals and rumination. Brief daily practice is enough.

Therapy and medication

The most effective long-term treatment for anxiety is skills-based therapy — with medication as a helpful support when needed.

Therapy

CBT is the gold standard for all anxiety disorders, with strong evidence. It targets distorted thinking and — crucially — uses gradual exposure to teach the brain that feared situations are survivable. ACT and somatic or trauma-focused therapies add value, especially where trauma is part of the picture. Much of this fits within a brief, focused course.

Medication

SSRIs and SNRIs are first-line and safe for long-term use. They don’t sedate you or change who you are — they lower the baseline “noise” so therapy and your own efforts can take hold. Allow 4–6 weeks for a meaningful effect.

A different relationship with fear

Recovery is not the absence of anxiety

It is reaching a point where anxiety no longer runs your choices or defines your life. Progress is rarely linear — there are harder and easier days. What matters is the overall direction and your willingness to keep moving. You are not broken; your nervous system learned some unhelpful patterns, and patterns can be unlearned.

If you’re in crisis

If you’re thinking about suicide or harming yourself, you don’t have to wait for an appointment. Call or text 988 (Suicide Crisis Helpline, 24/7), call or text the Distress Centre Calgary at 403-266-HELP (4357), or for health advice call Health Link 811. If you are in immediate danger, call 911 or go to your nearest emergency department.