When Anxiety Arrives as a Wave: One Strategy to Shift Out of Hypervigilance

Anxiety does not always feel like persistent worry. Sometimes it arrives as a sudden wave through the head or body, accompanied by a sense that something is wrong, an unsettled stomach, dizziness, nausea, dread or an urgent need to escape. It may occur even when a person appears to be safe, relaxed or doing something completely ordinary.

This experience is not imagined. Anxiety involves a genuine biochemical and physiological response. When the brain detects potential danger, the sympathetic nervous system and the hypothalamic pituitary adrenal axis can release adrenaline, noradrenaline and cortisol. These changes prepare the body to respond to a threat by increasing alertness, changing breathing and heart rate, and temporarily altering digestion. The difficulty is that this alarm system can sometimes activate when no immediate danger is present.

Does This Sound Like You Right Now? One Strategy to Use Today: The Safety Orienting Reset

When a wave begins, the first goal is not to argue with it or force it to disappear. The immediate goal is to help the brain notice that, despite the alarm, the present environment is safe.

Step One: Orient to the Environment

Keep your eyes open and slowly look around you. Turn your head gently rather than moving only your eyes. Name five neutral things you can see, such as a window, chair, light, cup or door.

Then identify three sounds you can hear and two physical sensations, such as your feet touching the floor or your back resting against a chair.

This redirects attention away from internal threat monitoring and towards current sensory information. It gives the brain an opportunity to update its assessment of the situation.

Step Two: Create Physical Support

Press both feet into the floor or place your hands firmly against a table, wall or chair. Notice the pressure and support beneath you.

Say quietly:

“This is an alarm response. It feels frightening, but I am here, and I am safe in this moment.”

This statement acknowledges the experience without treating the sensation as proof that something terrible is about to happen.

Step Three: Lengthen the Exhale

Breathe in gently through the nose for approximately four seconds and breathe out slowly for approximately six seconds. Continue for four or five comfortable breaths.

The breath should remain gentle. Very deep or rapid breathing can increase light headedness in some people. Slow breathing, particularly when the exhalation is slightly longer, may help reduce physiological arousal and support autonomic regulation (Zaccaro et al., 2018). Controlled breathing has also demonstrated potential benefits for mood and anxiety, although individual responses vary (Balban et al., 2023).

The complete strategy takes approximately one minute:

“Look around. Feel the support beneath me. Breathe out slowly. Name what is happening.”

Practising this strategy when calm is important because repetition makes it more accessible when the nervous system is activated.

Why the Stomach Often Reacts

The digestive system and brain communicate continuously through neural, hormonal, metabolic and immune pathways. During an anxiety response, the body may temporarily change digestion and blood flow. This can create nausea, cramping, butterflies, reflux, diarrhoea or an urgent need to use the toilet.

These stomach sensations can then become part of the anxiety cycle. The person notices the sensation, interprets it as evidence that something is wrong, becomes more frightened and experiences an even stronger physical response.

Understanding this cycle can reduce secondary fear. The stomach reaction is real, but it does not automatically mean that the person is physically unsafe.

Supporting the Gut Brain System

The gut microbiome contains microorganisms that interact with the nervous, endocrine and immune systems. Gut bacteria also break down certain fibres and produce compounds such as short chain fatty acids, which help support the intestinal lining and participate in metabolic and immune regulation (Cryan et al., 2019).

This does not mean that poor gut health is the sole cause of anxiety or that changing the diet will cure it. Anxiety is usually influenced by several interacting factors, including biology, hormones, sleep, previous experiences, ongoing pressure, learned responses and the current environment.

Probiotics and Prebiotics

Probiotics are specific live microorganisms that may provide a health benefit when consumed in adequate amounts. Prebiotics are substances, usually particular types of fibre, that are used by beneficial microorganisms within the gut (Gibson et al., 2017; Hill et al., 2014).

Research into probiotics, prebiotics and anxiety is developing, but the findings are mixed. Some studies report modest psychological benefits, while others do not find a clear effect. Outcomes may depend on the bacterial strain, dose, duration, existing diet and characteristics of the individual. Probiotic products should therefore be regarded as a possible support rather than an established treatment for anxiety (Liu et al., 2019).

A food based approach can support gut microbial diversity while also contributing to general nutrition.

Foods That May Support Gut Health

1. Fermented foods containing live cultures: Natural yoghurt, kefir, kimchi, refrigerated sauerkraut containing live cultures, miso and tempeh can introduce microorganisms or fermentation products. Not every fermented food contains live probiotics, particularly if it has been pasteurised.
2. Prebiotic foods: Oats, barley, onions, garlic, leeks, asparagus, apples, slightly green bananas, beans, lentils and chickpeas provide fibres that beneficial gut microorganisms can use.
3. Resistant starch: Cooked and cooled potatoes, rice and pasta contain resistant starch. Oats, legumes and slightly green bananas are additional sources.
4. A variety of plant foods: Vegetables, fruit, whole grains, nuts, seeds, herbs and spices provide different fibres and plant compounds. Variety is generally more useful than relying heavily on one supposed superfood.
5. Polyphenol rich foods: Berries, colourful vegetables, extra virgin olive oil, herbs, spices and unsweetened cocoa contain plant compounds that may interact beneficially with gut microorganisms.

Fermented foods may support microbial diversity and immune functioning, but the research does not establish them as a stand alone anxiety treatment (Wastyk et al., 2021). New foods and additional fibre should be introduced gradually because a sudden increase can cause bloating, abdominal discomfort or changes in bowel habits.

People with irritable bowel syndrome or other digestive conditions may react to foods such as onions, garlic and legumes. A registered dietitian can help develop an individual approach without unnecessarily restricting the diet.

Probiotic supplements are not interchangeable because benefits are specific to particular strains and conditions. Anyone who is immunocompromised, seriously unwell, pregnant, receiving cancer treatment or taking medication should discuss probiotic supplements with a doctor or pharmacist. Claims about detoxing, curing anxiety or “sealing the gut” should be treated cautiously.

Additional Lifestyle Factors

Regular meals can help prevent hunger, dehydration or fluctuations in energy from being mistaken for danger signals. Caffeine, nicotine, vaping products, alcohol and highly caffeinated energy drinks may increase palpitations, stomach discomfort, restlessness and nervous system arousal. Monitoring when episodes occur in relation to these substances may reveal useful patterns.

Movement can also support anxiety management, but it does not need to begin as an intensive exercise or weight loss programme. A slow ten minute walk, stretching outside or standing in daylight can be enough to start. When someone already feels overwhelmed, making the goal very small can reduce the risk of it becoming another source of pressure.

The Evening Brain Dump

Hypervigilance is often maintained by the feeling that the brain must continue remembering, monitoring and solving everything. An evening brain dump allows information to be stored somewhere external rather than repeatedly rehearsed mentally.

Before bedtime, spend five minutes writing down:

1. Anything that is worrying you.
2. Tasks you need to remember.
3. Situations that require a decision.
4. Questions you want to revisit.
5. One action you can take tomorrow.

Finish by writing:

“This information is recorded. I do not need to hold it in my mind tonight. I can return to it tomorrow.”

Writing a specific list before bed may help some people fall asleep more quickly by reducing the perceived need to mentally rehearse unfinished tasks (Scullin et al., 2018). The journal can also help identify patterns involving sleep, food, caffeine, hormonal changes, stressful events and anxiety episodes.

Other Factors Worth Exploring

Sudden anxiety can be influenced by accumulated stress, previous experiences, hormonal changes, perimenopause, disrupted sleep, thyroid difficulties, iron or vitamin B12 deficiency, low vitamin D, medication effects and substance use. A medical review can help consider these possibilities rather than assuming that every symptom is purely psychological.

Vitamin D deficiency should be corrected according to a clinician’s advice, but vitamin D is not a stand alone treatment for anxiety. Improvement in energy or general wellbeing may take several weeks or longer, depending on the degree of deficiency, prescribed dose and individual absorption. Excessive supplementation can be harmful, so the total amount contained in all supplements should be considered.

Occasionally, recurrent neurological events can initially be mistaken for panic. A focal seizure can produce a sudden unusual feeling, rising stomach sensation, fear, altered awareness, unusual smell or taste, staring, repetitive movements or confusion afterwards. This does not mean that every wave of anxiety is a seizure. However, new, highly stereotyped episodes, altered awareness, memory gaps, unusual movements or confusion should be discussed promptly with a doctor, who can determine whether neurological assessment is appropriate.

When Professional Support Is Important

A GP or qualified mental health professional should be consulted when episodes are new, worsening, interfering with everyday life or leading to avoidance of work, travel, social activities or unfamiliar places. Cognitive behavioural therapy and related evidence based approaches can help a person understand bodily sensations, reduce catastrophic interpretations, gradually reverse avoidance and build confidence in managing future episodes.

Urgent medical assistance should be sought for loss of consciousness, a first suspected seizure, new weakness, severe chest pain, significant breathing difficulty, new neurological symptoms or any concern that the symptoms may represent an immediate medical emergency.

Be Kind To Yourself In Your Starting Point

Anxiety is not a failure to cope. Sometimes it reflects a nervous system that has spent too long being responsible, watchful or prepared for the next problem. The system may continue sounding the alarm even when no immediate threat is present.

Recovery does not require changing everything at once. Begin with the Safety Orienting Reset, practise it briefly each day, support the body with regular food and sleep, and use the evening brain dump to give the mind somewhere safe to place unfinished thoughts. Small, repeated actions can gradually teach the nervous system that it does not have to remain on guard all the time.

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You are welcome to explore more free, evidence based strategies and practical resources on the Collins Psychology blog.

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References

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Cryan, J. F., O’Riordan, K. J., Cowan, C. S. M., Sandhu, K. V., Bastiaanssen, T. F. S., Boehme, M., Codagnone, M. G., Cussotto, S., Fulling, C., Golubeva, A. V., Guzzetta, K. E., Jaggar, M., Long Smith, C. M., Lyte, J. M., Martin, J. A., Molinero Perez, A., Moloney, G., Morelli, E., Morillas, E., O’Connor, R., Cruz Pereira, J. S., Peterson, V. L., Rea, K., Ritz, N. L., Sherwin, E., Spichak, S., Teichman, E. M., van de Wouw, M., Ventura Silva, A. P., Wallace Fitzsimons, S. E., Hyland, N., Clarke, G., & Dinan, T. G. (2019). The microbiota gut brain axis. Physiological Reviews, 99(4), 1877–2013. https://doi.org/10.1152/physrev.00018.2018

Gibson, G. R., Hutkins, R., Sanders, M. E., Prescott, S. L., Reimer, R. A., Salminen, S. J., Scott, K., Stanton, C., Swanson, K. S., Cani, P. D., Verbeke, K., & Reid, G. (2017). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the definition and scope of prebiotics. Nature Reviews Gastroenterology & Hepatology, 14(8), 491–502. https://doi.org/10.1038/nrgastro.2017.75

Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., Morelli, L., Canani, R. B., Flint, H. J., Salminen, S., Calder, P. C., & Sanders, M. E. (2014). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506–514. https://doi.org/10.1038/nrgastro.2014.66

Liu, R. T., Walsh, R. F. L., & Sheehan, A. E. (2019). Prebiotics and probiotics for depression and anxiety: A systematic review and meta analysis of controlled clinical trials. Neuroscience & Biobehavioral Reviews, 102, 13–23. https://doi.org/10.1016/j.neubiorev.2019.03.023

Scullin, M. K., Krueger, M. L., Ballard, H. K., Pruett, N., & Bliwise, D. L. (2018). The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to do lists and completed activity lists. Journal of Experimental Psychology: General, 147(1), 139–146. https://doi.org/10.1037/xge0000374

Wastyk, H. C., Fragiadakis, G. K., Perelman, D., Dahan, D., Merrill, B. D., Yu, F. B., Topf, M., Gonzalez, C. G., van Treuren, W., Han, S., Robinson, J. L., Elias, J. E., Sonnenburg, E. D., Gardner, C. D., & Sonnenburg, J. L. (2021). Gut microbiota targeted diets modulate human immune status. Cell, 184(16), 4137–4153.e14. https://doi.org/10.1016/j.cell.2021.06.019

Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath control can change your life: A systematic review on psychophysiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, Article 353. https://doi.org/10.3389/fnhum.2018.00353

Medical and Mental Health Disclaimer

This article is for general educational purposes only and is not a substitute for individual medical, psychological or psychiatric assessment, diagnosis or treatment. Anyone experiencing new, severe or worsening symptoms, significant impairment, thoughts of self harm or concerns about their immediate safety should seek professional or emergency support promptly.