Anticipatory Anxiety: How to Break Out of Decision-Paralysis

We’ve all been there – spending a wild amount of mental energy on thinking through a decision, running through every possible outcome of a scenario. And somehow the more we think, the less clear the decision becomes. Frustrated by uncertainty and mentally exhausted after considering every possible “but” and “what if.” Should I stay or go? Change jobs? Make the move? Have the hard talk? Reach out or hold back? Ruminating thoughts create headache and confusion, tightness can grip our chest and gut, and eventually it all becomes so overwhelming that instead of acting…we freeze.

Welcome to the world of anticipatory anxiety, the dread that shows up well before a decision is ever made. This isn’t just basic nerves; it’s the fear of regret, the fear of discomfort, and often, the fear of not being able to handle what comes next.

Let’s talk about it. And maybe find a way to release the pressure of needing to have the “right” or “perfect” choice dialed in, before we act at all.

What Anxiety Really Is, and How Pop Culture Hijacked Its True Meaning

These days, it feels like everything is labeled anxiety. On social media, in casual conversation, even in memes - “anxiety” has become a blanket term for anything remotely uncomfortable. We’ve started using it as a personality trait, a punchline, or shorthand for stress.

Sometimes that’s valid. But also… sometimes it’s not. Sometimes it’s possible we’re just going through something hard. Maybe we’re in a season of life that’s stretching us, and our nervous system is doing its best to keep up. Maybe the coffee shop not getting our order right isn’t making us ‘anxious’ or causing us ‘stress’, maybe it just fucking sucked to spend $6 on a less-than-perfect order.

Anxiety isn’t always pathology. Sometimes it’s just an experience in a difficult moment.

Biologically, anxiety is not a flaw - it’s a signal. It’s our body’s way of saying, “Hey, something’s happening here. Pay attention.” It primes us to become alert, cautious, and reflective. It’s the system that kept our ancestors alive, like when they needed their brain to tell their body - ‘yeah…probably best to run from the bear’. And it’s still doing its job today. Although sometimes it has a flare for the drama, and overreacts.

And here’s another layer:

Anxiety often shows up around the things we care about most.
That big choice we’re sweating? The conversation we’re avoiding? The thing we can’t stop thinking about? That’s not always random panic. That’s often happening around things that really matter to us, showing we give a shit.

Feeling anxious doesn’t always mean something’s wrong. Sometimes it means something is really important, and we’re feeling the urge to handle it with caution and care. Choosing a path forward, making a bold move, putting yourself out there - those are high-stakes, high-meaning moments. They involve vulnerability, which inherently come with risk. Some anxiety is not only normal - it’s necessary.

What Is Anticipatory Anxiety (and Why It Grips Us So Tightly)

Anticipatory anxiety is a specific form of anxiety that shows up before an event happens, often focused on the uncertainty of outcomes or a fear of negative consequences. It doesn’t just live in our mind - it can impact our body, our relationships, personal confidence, and our ability to take meaningful action.

It might show up as:

• Overthinking and over-researching (Dr. Google report is in, we’re already dead).

• Hyper-focusing on something to the point where the overwhelm leads to avoiding a decision entirely.

• Seeking constant reassurance or validation due to second-guessing yourself.

• Physical symptoms like muscle tension, stomach aches, increased heart rate, sleep disturbance; pick the way your body shows you you’re stressed...you’ll find it here.

The discomfort of this anxiety often pushes us into one of two modes: freeze (avoidance) or fawn (people-pleasing, outsourcing the decision). Either way, we stay stuck. Not because we’re incapable, but because our bodies are trying to protect us from perceived danger - often the danger of regret, embarrassment, or loss.

Ouch.

And here’s what happens if that cycle continues...

Over time, it can lead to:

• Chronic stress and fatigue, as our nervous system stays in a prolonged state of hypervigilance.

• Decision paralysis, where fear of making the wrong move keeps us stuck in endless loops of overthinking, leaving us mentally exhausted.

• Eroded self-trust, as we begin to doubt our own judgment or outsource choices to others.

• Avoidance behaviors, like procrastination, numbing, or checking out of situations that feel overwhelming.

When anticipatory anxiety builds up, it doesn’t just delay decisions - it can have ripple effects throughout other areas of our lives.

The good news? This isn’t permanent. We can build the internal safety and tolerance needed to take brave, aligned steps - even when the outcome isn’t guaranteed.

Distress Tolerance: The Hidden Skill Behind Every Brave Decision

Here’s where therapy and personal growth come in: to make decisions with more ease, we don’t need more certainty - we need more capacity to tolerate uncertainty.

This is what we often refer to in counseling as distress tolerance - or our ability to stay present and grounded through uncomfortable emotional states without rushing to escape or fix them.

Research from Dialectical Behavior Therapy (Linehan, 1993) highlights that distress tolerance is a key skill for navigating emotionally intense situations - especially those involving uncertainty or risk, like making a major decision. The goal isn’t to eliminate discomfort or force clarity in the moment. It’s to expand our capacity to sit with emotional discomfort without reacting impulsively or shutting down.

When we build distress tolerance, we begin to trust that we can handle big feelings like fear, doubt, or regret without needing to escape them immediately. This creates space for more grounded decision-making, improves emotional regulation over time, and increases long-term resilience - because we’re no longer ruled by the urge to avoid discomfort at all costs.

In short: It’s not about being fearless. It’s about learning we can feel fear - and move forward anyway.

Distress tolerance helps us:

• Sit with the “what ifs” without spiraling.

• Recognize fear without letting it drive the car.

• Choose based on values, not immediate relief or gratification.

• Feel our nerves without interpreting them as danger.

In other words, we can feel anxious and still make a clear, empowered choice.

Here’s where practical tools come in. While building distress tolerance takes time, we don’t have to start from scratch. Dialectical Behavior Therapy offers concrete strategies we can practice in the moment to ride out distressing situations or emotional waves without getting swept away. One helpful framework is the IMPROVE skill - designed to help soothe the nervous system and stay grounded when things feel overwhelming. Check out the infographic below for a quick guide:.

The Trap of the “Right” Decision

We’re often taught to believe there’s a single correct path - and choosing wrong could cause damage beyond repair. But here’s the truth:

There’s rarely one right decision. There are just different stories and paths to get to a destination. There’s power in choice, and we get to be the author. The idea that we have to know the outcome before we choose is an impossible standard. Life isn’t a test with perfect answers - it’s a story that unfolds through experience, flexibility, and risk.

Even if the path takes an unexpected detour, that’s not failure. That’s adaptation.  And the ability to handle adaptation leads to resilience.

Also…you can change your mind.

Making a “right” or “perfect” choice isn’t representative of a good person. The most resilient people I know have the ability to remain flexible, and know when to pivot. Change is inevitable. We have to trust ourselves enough to make the decision, not because it’s guaranteed to work – but because action outside of fear is how we grow, gain clarity, and evolve.

What it Looks Like in Therapy

If decision-making often leaves you spiraling or shut down, therapy can help. These are some of the ways we build resilience in the face of anticipatory anxiety:

• Regulating the nervous system so we can approach choices from a grounded place.

• Clarifying values, so your decisions reflect your integrity.

• Practicing distress tolerance, so anxiety doesn’t control your actions…or inaction.

• Reframing self-doubt, so changing your mind becomes a sign of growth - not failure.

• Developing the confidence to make the decision, no matter how hard – trusting you have the ability to adapt and handle distress that creates personal growth.

If You’re Feeling Stuck, Ask Yourself…

• What am I afraid will happen if I choose “wrong”?

• What choices would I make if I trusted myself to handle what comes next?

• Is discomfort a sign of danger - or a sign I’m doing something meaningful and moving toward growth?

If anticipatory anxiety and decision-paralysis are holding you back, and you want to learn more about building the skill of distress tolerance with therapeutic support - reach out!

Resources:

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.