Overcoming Decision Making Problems in Anxiety

by Jerry Kennard, Ph.D. Medical Reviewer

A huge proportion of our time is spent making decisions. We make so many that we’re not even particularly aware of what we’re doing. As a psychologist I regard decision making as series of cognitive processes, a problem-solving activity if you will, that usually concludes with a satisfactory outcome. For example: I feel thirsty so I go for a coffee. I find the coffee is jar is empty so I opt for tea instead. Outcome - thirst quenched so on with the day. Seems almost too obvious to spell out doesn’t it? Yet some extreme anxiety sufferers find such decision-making tasks extremely problematic.

You’ve maybe heard the term ‘analysis paralysis’? This represents a not uncommon decision-making problem. Analysis paralysis comes about when a decision is perceived as over-complicated, either because there appear too many options or none of the outcomes are viewed as satisfactory. Ever watched a young child trying to choose between toys, or cakes? When the value seems equal it can lead to a point where no decision is made. In adults who suffer acute anxiety or stress analysis paralysis can result in some difficult moments.

A recent study published in The Journal of Neuroscience points to the biological mechanism that could hold the key to understanding decision-making problems. The research team from the University of Pittsburgh believes that anxiety disengages a region of the brain called the prefrontal cortex, which is essential for flexible decision-making. Rats injected with an anxiety inducing substance were found to problem-solve in tasks reasonably well but they made more bad choices and mistakes. Professor Bita Moghaddam, lead author of the study, says that monitoring the brain cell activity of rats suggests anxiety ‘disengages brain cells in a highly specialized manner.’ Biologically, we are quite similar to species such as mice and rats, because we have practically the same set of genes. Their bodies respond to disease and treatments much as ours do, yet there is always an element of doubt as to the reliability and validity of animal studies. The human brain, for example, has far a more complex structure than that of a rat. As things stand we need a better understanding of brain mechanics to assess how this knowledge may be put to use in the treatment of anxiety disorders.

There are things we can do to alleviate decision-making problems. Because anxiety is a process of arousal it can be enormously helpful to take calming measures. Simple breathing techniques, or a hug or some kind words from a loved one, can go a long way.

Relaxing when anxious may appear the obvious to do but let’s not forget this has to be an active decision. Like all skills it gets better with time and practice. Once you make the connection between anxiety and the need to relax you’ll find things get easier. I’ve sometimes suggested using a combination of thought stopping and calming thoughts. It works for some people better than others but it goes like this:

Thought stopping is about applying the brakes to indecision and worry. You say in a strong and strident voice ‘Stop, stop it, NOW’. Of course you’ll need to think it if you’re within hearing distance of others. It’s a little jolt-to-self, but it can help if you follow this up quickly with your own set of pre-planned calming thoughts. It’s best if you invent your own but they will be along the lines of, ‘I’m doing just fine, just settle back for a moment,’ which combines a reassuring statement followed by a course of action.


University of Pittsburgh. “Just made a bad decision? Perhaps anxiety is to blame.” ScienceDaily. ScienceDaily, 15 March 2016. www.sciencedaily.com/releases/2016/03/160315182709.

Jerry Kennard, Ph.D.
Meet Our Writer
Jerry Kennard, Ph.D.

Jerry Kennard, Ph.D., is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry’s work background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.