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Your vision starts to get blurry, and you feel the walls coming up around you.  As your anxiety rises, you feel this sense of inevitability, that nothing will change and nothing you do will change the way you feel.

Of course, when we're most anxious, we're least likely to feel that anxiety can be controlled by our actions.  Don't get me wrong; I'm not saying anxiety is easy to control, but there are consistent steps you can take to limit the feeling of anxiety and help restore your sense of balance.

Strategy #2 - Your actions can decrease your anxiety.

I hope this next strategy shows you a path forward - if you work hard at the following habits, you can regain (some) control over your thoughts and feelings:

a) Meditation - Consistent meditation has been shown to change the physical structure of the brain.  

It has also been shown to have a beneficial effect on reducing anxiety, along with other benefits.

How do you get started with meditation?  Try an app on your smartphone (it may seem paradoxical that your smart phone can be used to escape the stresses of the modern world, but people swear by these apps).

Remember, meditation is hard.  If you're looking for help in how to get started, Zen blogger Leo Babauta has you covered.

b) Exercise - Consistent exercise reduces anxiety.

Which type of exercise should you choose?  Whatever works for you.  If you like running, run.  If you like going to the gym, go.  If you need something more to stay active, find it.  There are so many varieties of exercise that if you haven't found one that you enjoy, you haven't looked hard enough.  I didn't find the type of exercise that inspires me until I was 34 (6 months ago), but I never stopped searching.

Think you're too busy to have time to exercise?  Exercising makes you study more efficiently.

c) Spend time with animals

Taking time to spend with animals - whether yours or someone else's - has been shown to have physiological benefits.

Harvard Med School even has a dog that you can borrow from their library -just as you would a book - to provide stress relief.

d) Break projects into smaller chunks

Much of our anxiety is focused on outcomes we cannot control: whether we will get in to medical school, whether we will get a good score on our MCAT, whether we will write a good personal statement.  Anxiety about big-picture outcomes often spirals - worrying that we don't have enough volunteer experiences spirals into worrying about whether we can get in at all which spirals into worrying about disappointing our friends and family.  Before you know it, you have spent the better part of two hours lost in your own head, and you feel like crap.

Instead, we should focus our anxiety productively on the steps we can take toward those goals.  When our brains are anxious, we need a super simple list of things to do next so that we don't have to think about it.  This means having a plan, staying organized, and breaking projects into smaller chunks.

• Having a plan - you need a timeline for what to do and when to do it for the application process. A good med school advisor can help you make one. You need a study plan for how you're going to prepare for your MCAT and what to do each day. You can find good ones online, and the test prep companies will usually have ones too.
• Staying organized - you need to have all of the materials you need in one place and all of the components of your plan in a calendar that you check often. Technology is great (Google Calendar especially), but sometimes having a printed calendar to put up on the wall of your room is the best way to remember what you have to do and when.
• Break your projects into smaller chunks - instead of writing on your calendar, "write personal statement," you need to have this Herculean task broken into smaller chunks. A good book on personal statements for medical school will help you figure out how to do just that. Each chunk should be an easy action to take, ideally no more than 15-30 minutes. The actions have to be so specific that even during our most anxiety-ridden stage, we can say, "okay, I can take this step next."
• Keep the list of next actions somewhere accessible - Evernote, a notebook, a great to-do list manager - so that you're never wanting for what to do next.

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