Avoidance and it's Relationship to Anxiety, Stress and Depression

by Kristen McClure, Therapist
(Charlotte NC)

Avoidance is one of the number one contributing factors to anxiety and stress that I see in my practice. Avoidance is a strategy that may temporarily decrease our anxiety, but really, serves to increase it.



Take the following example. Sally, who is 32, is nervous about what her doctor will tell her about the symptoms she is experiencing. Therefore she doesn’t go, perhaps trying to forget about it, or rationalizing it away somehow. Temporarily, that saves her the anxiety (or so she thinks ) of having to deal with this situation. However, her medical conditions get worse, and by the time she goes to the doctor she learns that she has a condition that if treated earlier, would have been easily remedied but has now grown into something more serious. How does sally feel when she learns this? How does she cope with this new stress?


The patterns we use to deal with stress become our default patterns. If they way we deal with uncomfortable things on a regular basis is to avoid, push down or deny, then it becomes difficult to use another skill to handle our problems. Inevitably this makes our anxiety worse, our problems worse, and our stress worse.


Here is another example. Jennifer has a project to do at work that she feels anxious about. She doesn’t sit down to do it because she is worried about it being challenging, she knows it will take a lot of concentration, and she is unsure exactly how her boss wants it done. In this situation, Jennifer does not start the project, but she worries about it for a week. What exactly is happening? The worry is serving as an avoidance strategy. Often we think of worry as helping us to get control and keep in control, but in fact it is the exact opposite! Jennifer isn’t sitting down to do the project or to solve her problem in any meaningful way. The way she is handling this situation is exacerbating her anxiety and stress.

This pattern of behavior is certainly something I see in many of my clients who have anxiety, but also, who have depression. This makes sense because the level of stress one has in their life is a contributing factor to depression.

Avoidance is also at the core of all of anxiety disorders. In phobias, for example, avoidance of the feared object helps maintain anxiety. If one is fearful of something, the treatment for it is to face it, confront it, and be exposed to it. Often that cures the anxious reaction. Virtually all anxiety treatment involves a measure of exposure, whether it is exposure to feared thoughts and emotions in the office, or exposure on a greater scale to the specific things that a client is avoiding.


I teach all my clients dealing with anxiety and depression, to face the issues they have not been confronting not to avoid them. I also teach them to avoid worrying, because in fact, worrying is enabling them to avoid problem solving in a meaningful way. In fact, often that’s what therapy is about. Teaching clients that the strategies they are using to deal with life are really not the most effective way to go about it.

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Sep 21, 2015
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making it worse NEW
by: Anonymous

what if confrontation makes it worse?
i have social anxiety and sensory issues. when confronted with going to a (even small) farmer's market, shopping clothes or things like that i easily get an overload. even when i go into the situation relaxed and don't think about it. quickly i get overly exhausted, start panicking, have breakdowns.
i think your advice only works for very very mild forms of depression/anxiety. if you don't mention thay – or that further guidance/therapy might be needed – it makes it worse. the guilt factor adds on with articles like this (if it's that easy, why can't i...? i should at least be able to confront myself...).
thanks for adding more stress.

Oct 29, 2011
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Bravo
by: Anonymous

The only way out, is in!

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