Taming the Storm: How DBT Skills Can Help Manage Anxiety

If you live with anxiety, you know you often live with a constant feeling as if something bad is going to happen but you are not sure what, you can feel nervous, tense, and on edge all the time. Then sometimes for no reason your heart races, your thoughts begin to spiral, and suddenly, the present moment feels completely out of your control. For many, anxiety isn't just a mental state; it’s a physical experience—a tightness in the chest, a churning stomach, and an overwhelming urge to run or hide. As a therapist, I see many clients who feel exhausted by this constant, cycling into a fight, flight, or freeze response.

While anxiety often tricks us into believing we are helpless, to control these symptoms, there are ways to reduce the impact of anxiety. Whatever level of anxiety you experience there are ways to cope with these symptoms better. I want to offer you a different perspective: you possess the capacity to regulate your nervous system. One of the most effective frameworks I use in my practice is Dialectical Behavior Therapy (DBT).

Originally developed to help people navigate intense emotions, DBT has become a powerful, practical toolkit for anyone struggling with the gripping fear and constant "what-ifs" of anxiety. Here are three core concepts that can help you find your footing when the storm begins to pick up.

1. Radical Acceptance

Anxiety often intensifies because we allow ourselves to race down the rabbit hole your fears and anxiety send you. We also tend to judge our thoughts and feelings as being weak or bad. We think, “I shouldn’t feel this way,” or “I need to make this stop immediately.” This resistance creates a secondary layer of suffering. Radical Acceptance isn't about liking your anxiety; it’s about acknowledging, “I am feeling anxious right now, and that is my current reality.” 

What this looks like in real life: Next time you feel that familiar spike of panic, pause. Instead of saying, "It is hopeless, I can't do anything right.” Focus on the facts of the situation and not how you are feeling about the facts. Do not let your mind judge the situation but only focus on the facts of the situation, separate your feelings from the facts and learn to accept the facts. 

The more you allow yourself to judge the situation the more you leave room for your anxiety to spike. Then tell yourself the situation is the situation and focus on the facts and respond accordingly to the facts of the situation and not how you feel about the situation. 

2. Opposite Action

Anxiety is a master of avoidance. It tells us to stay home, to avoid the difficult email, or to skip the social gathering. The problem is that avoidance feeds anxiety. Opposite Action encourages you to identify the urge associated with your anxiety—such as hiding or withdrawing—and do the exact opposite. Do what you know you have to do and not what you want to do. 

What this looks like in real life: If you feel the urge to cancel plans because of social anxiety, commit to going for just 20 minutes with the option to leave. By gently engaging with the world, you send a message to your brain that you are safe and capable, which gradually rewires your anxiety response.

3. TIPP Skills (Body-Based Regulation)

When anxiety is at a 10 out of 10, your brain is too dysregulated to "think" your way out of it. You need your body to calm your mind. TIPP skills (Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation) are designed to physically lower your heart rate. 

What this looks like in real life:

• Use the "T" for Temperature. Splashing cold water on your face or holding an ice pack against your chest for 30 seconds triggers the "mammalian dive reflex," which naturally slows down your heart rate and signals your body to shift out of a state of panic into a state of calm.
• Intense exercise. Find an exercise routine you enjoy or can do and start to exercise. If you are not able to do intense exercise, start small and do as much as you can. The goal is to push your body past what you think it can do. This will trick your brain into focusing on the present and not allow you to hyperfocus on what you are worried about. In addition to this, exercise releases endorphins, serotonin, and dopamine, which help combat anxiety. In as little as 10 minutes of exercise you can change your anxiety level. 
• Paced breathing, or controlling your breaths, can be very effective in coping with anxiety. When anxiety starts to increase we tend to start taking short shallow breaths, which can increase our heart rate, our flight or fight response, and our anxiety. Instead use square breathing or box breathing, to help lower your pulse and control your heart rate. This is done by bringing you attention to your breath. Breathe in for four seconds, hold your breath for four seconds, breathe out for four seconds, pause for four seconds. Continue to square breathe until your anxiety and pulse are back under control. 
• Muscle Relaxation can be helpful in that it forces your brain to focus on the present activity and not on whatever your anxiety wants you to focus on. Start with your feet and squeeze your feet for a count of five, then squeeze your calves, then your thighs, then your stomach, then your chest, then your arms and hands, then your neck, then your head, and lastly squeeze your entire body for a count of five. While you do this, it helps to slow your breathing. Breathe in slowly through your mouth and out through your nose or square breathing. It can help to do this with your eyes closed, if you feel safe enough; if not, pick a blank spot on the wall to focus on so you are less likely to be distracted or over stimulated. 

You Are More Than Your Anxiety

Learning these skills takes practice, and it’s okay if you don’t master them overnight. Dialectical Behavior Therapy isn’t about eliminating anxiety entirely; it’s about changing your relationship with it. You don't have to be a prisoner to your thoughts. 

Try this today: Pick just one of the skills mentioned above—perhaps the cold water splash or simply acknowledging a moment of anxiety ("Radical Acceptance")—and use it the next time you feel a bit of tension. Notice what happens. You have the tools to navigate the storm, and eventually, find your way back to calm.

If you struggle to cope with your anxiety or want to develop more skills to cope with your anxiety, find a therapist who specializes in DBT and set up a session.