Understanding Why Anxiety Persists
- Stella Ong
- 22 hours ago
- 5 min read
Why does anxiety keep showing up, even when you try to push it away? When anxious thoughts surface, most people's immediate response is to try to shut them down. You might distract yourself, reason your way out of the worry, or tell yourself to stop catastrophizing. The discomfort feels urgent, like something requiring immediate resolution.
What typically happens instead is that the thought returns, and often with even greater intensity. Any attempts to control or get rid of anxious thinking frequently amplify it, instead of diminishing it. This pattern isn't a personal failure, but reflects how anxiety maintains itself through specific psychological mechanisms.
Distinguishing anxiety from fear
Anxiety and fear are often used interchangeably, but they're responding to different things. Fear shows up when there is something actually happening right now, an actual threat that is concrete for instance: encountering an aggressive animal, or stepping off a curb into oncoming traffic.
Anxiety, by contrast, is activated by threats that are anticipated, perceived or ambiguous. Your nervous system responds to what your mind interprets as potentially dangerous, regardless of whether that danger is imminent or even likely. This is why you can experience a full anxiety response whilst sitting safely at home thinking about a work presentation next week, or whilst replying to an ambiguous text message from someone whose opinion matters to you.
The physiological response can be nearly identical, such as increased heart rate, muscle tension, heightened alertness - even though in one case you're responding to actual danger and in the other you're responding to possibility.
How do I stop being anxious?
The impulse to suppress unwanted thoughts is understandable, but it has consistently shown that thought suppression tends to produce the opposite of its intended effect. Actively trying not to think about something requires your brain to monitor whether you are succeeding (or not), which means repeatedly checking for the presence of the unwanted thought.
Essentially, to avoid thinking about something, you have to keep reminding yourself what you're not supposed to think about. This creates a paradox where suppression attempts actually increase the frequency and intensity of the unwanted thoughts.
The same mechanism applies to emotional suppression. When you try to push away anxious feelings, you often end up in a struggle with them that makes them more prominent rather than less.
The effort itself becomes exhausting, and the anxiety frequently returns with additional layers - now you're anxious about being anxious, or frustrated that you "should" be handling this better.
The maintenance cycle
Anxiety maintains itself through a reinforcing cycle that involves several interconnected components. Research on transdiagnostic approaches to anxiety has identified how this cycle operates across different anxiety presentations, making it particularly persistent even in complex cases (Reinholt et al., 2017).
The cycle typically begins with a trigger, for e.g., some form of uncertainty that your mind identifies as potentially problematic. This might be an upcoming event with an unknown outcome, an ambiguous social interaction, physical sensations that seem concerning, or a reminder of past difficulties.
Your cognitive system immediately attempts to resolve this uncertainty by generating interpretations and predictions. In anxiety, these interpretations tend to be threat-focused and catastrophic. Rather than considering a range of possible outcomes, your mind narrows in on worst-case scenarios. These automatic thoughts aren't necessarily based on evidence or probability, but they activate as if they represent accurate assessments of reality.
These threat-focused thoughts trigger a physiological anxiety response - tension, increased heart rate, difficulty concentrating, urges to escape or seek reassurance. These physical sensations are uncomfortable, which creates additional pressure to make them stop.
Most people respond to this discomfort through some form of avoidance or safety behaviour. You might avoid the situation triggering anxiety, seek reassurance from others, engage in extensive planning to eliminate all possible risks, or use distraction to avoid thinking about the concern. These responses provide temporary relief, which reinforces them as coping strategies.
However, avoidance and safety behaviours prevent you from learning that the feared outcome is unlikely or manageable. Each time you avoid or seek reassurance, you reinforce the belief that the situation was genuinely threatening and that your anxiety response was necessary and protective. This strengthens the cycle rather than interrupting it.
What cognitive behavioural approaches offer
Cognitive behavioural therapy (CBT) represents one of the most extensively researched approaches for anxiety disorders. Research has shown that CBT produces significant improvements in both anxiety symptoms and overall functioning, with effect sizes ranging from moderate to large even when working with individuals who have multiple co-occurring difficulties (Reinholt et al., 2017).
CBT doesn't aim to eliminate anxiety or teach you to replace every anxious thought with a positive one. That approach would be both unrealistic and potentially counterproductive, as it can feel invalidating when you have legitimate concerns. Instead, it focuses on developing a different relationship with anxious thoughts: one characterized by curiosity and flexibility, instead of automatic acceptance or desperate avoidance.
The process involves learning to recognize cognitive distortions, such as the predictable ways that anxious thinking diverges from balanced assessment. These include catastrophizing (jumping to worst-case scenarios), probability overestimation (treating unlikely outcomes as probable), mind reading (assuming you know what others think), and emotional reasoning (treating feelings as evidence of reality).
Studies comparing different therapeutic approaches has shown that whilst CBT effectively targets anxiety symptoms directly, other approaches such as mindfulness-based interventions may be more effective for reducing worry specifically. Both approaches can help individuals develop new ways of relating to their internal experiences, though they work through different mechanisms (Aisenberg-Shafran & Shturm, 2022).
Learning to coexist with uncertainty
Working effectively with anxiety doesn't mean achieving a state where you never feel anxious. Anxiety is part of normal human functioning, and some degree of it will persist regardless of intervention. What changes through effective approaches is how much space anxiety occupies in your life and how much it determines your behaviour.
Interrupting the maintenance cycle requires recognizing when you are in it and choosing responses that differ from your usual patterns of avoidance or suppression. This involves building tolerance for discomfort and uncertainty rather than treating them as problems requiring immediate resolution.
The work is about changing your relationship with anxious thoughts and sensations rather than eliminating them. When you can notice anxiety without immediately trying to fix it or letting it dictate your choices, it gradually loses its power to control your life.
If anxiety is significantly impacting your functioning or quality of life, evidence-based therapy can help you. Our counselling and therapy services in the East side of Singapore offer a safe, non-judgmental space where you can explore your thoughts and feelings with a qualified therapist, with flexible scheduling options to fit your hectic lifestyle. We use approaches like CBT, CTRT and ACT to help you develop more flexible responses to anxiety.
If you are ready to take the next step in managing your anxiety, contact us today to schedule an appointment. Taking care of your mental well-being is one of the most important investments you can make in yourself.
Stella Ong is a clinical member and registered counsellor with the Singapore Association for Counselling, registration number (C0940). Click here for more information on Stella Ong.
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References
Aisenberg-Shafran, D., & Shturm, L. (2022). The effects of mindfulness meditation versus CBT for anxiety on emotional distress and attitudes toward seeking mental health treatment: A semi-randomized trial. Scientific Reports, 12, Article 19711. https://doi.org/10.1038/s41598-022-24256-9
Reinholt, N., Aharoni, R., Winding, C., Rosenberg, N., Rosenbaum, B., & Arnfred, S. (2017). Transdiagnostic group CBT for anxiety disorders: The unified protocol in mental health services. Cognitive Behaviour Therapy, 46(1), 29–43. https://doi.org/10.1080/16506073.2016.1227360
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