Journaling for anxiety: a simple template for anxious moments

In the NHS's words, feeling anxious is a perfectly natural reaction to some situations. Feeling restless or tense before an exam, or while you wait for a result, is part of being human. Anxiety shows up in the body too: shakiness, dizziness, sweating, headaches, a faster heartbeat.

This guide is about those everyday anxious moments. One boundary up front: according to the NHS, most people feel anxious sometimes, but when worry is there most of the time, is hard to control and affects daily life, it may be something a doctor should assess. A condition such as generalized anxiety disorder (GAD) can only be diagnosed by a professional, and a journal is not a substitute for that.

The most concrete benefit of writing is that it splits a vague sense that “something bad will happen” into thoughts you can examine one at a time. Arguing with a worry in your head is hard; arguing with a sentence on paper is easier.

Naming the feeling has an effect of its own: in an fMRI study published in 2007, when people put the emotion in negative images into words, the amygdala's response went down. To get from “tense” to “on edge about tomorrow's meeting”, the word list in our feelings wheel guide can help.

Studies that look at anxiety directly are few and small. In a preliminary trial published in JMIR Mental Health in 2018, 70 adults with various medical conditions and high levels of anxiety symptoms were randomly split into two groups. One group wrote an online journal focused on positive emotions for 15 minutes, three days a week, for 12 weeks. After one month, that group had fewer anxiety and depressive symptoms than the group receiving usual care. It was a small study with a specific group of patients, but it suggests writing is a cheap tool worth trying.

NHS Every Mind Matters suggests a thought record, a self-help exercise adapted from cognitive behavioral therapy (CBT). Pick a difficult situation you went through recently and fill in these seven headings in order, as honestly as you can:

1. 1The situation: What happened? Who, where, when?
2. 2My feelings: What did I feel at first?
3. 3Unhelpful thoughts: What went through my mind?
4. 4Evidence for those thoughts: What supports the thought?
5. 5Evidence against those thoughts: What contradicts it?
6. 6Alternative thoughts: What would a more realistic or neutral view be?
7. 7How I feel now: How has my feeling changed after finishing the record?

• Situation: At 6 p.m. my manager wrote “Can we have a quick chat tomorrow?” with no agenda.
• Feelings: Anxious, tense. Strength: 8.
• Thoughts: “I made a mistake. This is the first step toward being let go.”
• For: She gave me short answers last week.
• Against: Previous quick chats were about schedules and assignments. My last review was good. Everyone was swamped last week.
• Alternative: “I don't know what it is about. It could be routine. I can ask for the agenda in the morning.”
• Now: Still a little uneasy, but less tense. Strength: 5.

The record did not erase the anxiety, and that was never the point. But going from “I'm being let go” to “I don't know what it's about” can change the whole evening.

The NHS describes it in three steps: catch it, check it, change it. First, learn the common unhelpful thinking patterns so you can catch them: always expecting the worst, focusing only on the bad, black and white thinking, and blaming yourself for everything that goes wrong. Then, before you accept the thought, step back and ask:

• How likely is the outcome I am worried about?
• Is there good evidence for it?
• Are there other explanations or possible outcomes?
• Is there good evidence for other ways of seeing the situation?
• What would I say to a friend who was thinking this way?

As the NHS also notes, not every thought can be changed, and this method does not solve the underlying problem. What it does is make your thinking more flexible and help break a negative spiral.

1. 1What exactly am I worried about right now? One sentence.
2. 2Where do I feel this worry in my body?
3. 3What is the worst case, and what is the most likely case?
4. 4Which part of this situation is in my hands?
5. 5How did I get through a similar worry before?
6. 6How much will this matter a year from now?
7. 7What is one small, kind thing I can do for myself right now?
8. 8Who could I talk to about this?
9. 9Is there something I am avoiding? What is the first small step toward it?
10. 10What did I do today despite feeling anxious?

For more questions, see our list of journal prompts.

• When you rewrite the same worry every day. That can turn into repeating the thought rather than testing it. To break the loop, see the methods in our guide on how to stop overthinking.
• When you only write the worst case. Do not skip the “evidence against” and “alternative” steps; that is where the real work happens.
• When the journal becomes a way to avoid something. The NHS suggests facing fears gradually. The record should help you plan the next step, not replace it.

Pixmood is a mood journal. You mark the day by tapping one of five moods; if you like, you add a one word tag such as “uneasy” or “presentation” and a note of up to 1,000 characters. A note is enough for a short version of the thought record: situation, thought, alternative. The free insights include a 30 day chart of how each day of the week has felt, and Pixmood Pro's insights also show which tags tend to come with heavier days.

The limits: Pixmood has no thought record form, no writing prompts for the daily entry and no breathing exercises, and a note is capped at 1,000 characters. Use a notebook for long records; Pixmood keeps the tone of the day and the pattern.

The NHS advises talking to a doctor if anxiety is affecting your daily life. If you have felt anxious most of the time for a long while, find the worry hard to control, or your sleep, work or relationships are suffering, do not put this step off; in the US, your primary care doctor or a licensed therapist is a good place to start. If you are not sure whether a symptom such as shortness of breath comes from anxiety, see a doctor too. If you are thinking about harming yourself or you are in danger, call your local emergency number now (911 in the US and Canada, 999 in the UK, 000 in Australia, 112 in the EU). In the US and Canada you can also call or text 988, any time. In the UK and Ireland, Samaritans answer free on 116 123, day or night. In Australia, call Lifeline on 13 11 14.