Checklists and Anxiety 

By Alphonso Gaita, LCSW

Introduction: When the List Becomes the Day

“I feel better once I write it all down,” A statement told to me, while my patients eyes fixed on the small spiral notebook she carried everywhere.

Her checklist had started six months earlier as a gentle coping tool, one page of daily reminders: drink water, take a walk, breathe. She liked the structure. It calmed the morning rush in her mind. But by the time we met, the list had quietly evolved.

There were now three separate notebooks, plus an app on her phone. She wasn’t just noting tasks; she was recording every heartbeat she thought felt “off,” every moment of worry, every time she needed to confirm she’d locked the door. If she couldn’t check everything off, she felt uneasy until she went back and re‑checked.

In her words: “The list started helping me live. Now I feel like I’m living for the list.”

Her experience isn’t rare. Checklists can help organize overwhelm, track what matters, and bring a sense of control. But, left unchecked, they can become something else entirely, a quiet, well‑intentioned anchor holding you in anxiety’s waters.

How checklists help (when used intentionally)

• Clarity in the chaos Anxiety jumbles thought. Lists externalize that jumble, making patterns visible and helping you separate what’s in your control from what isn’t (Beck & Clark, 1997).

• Tracking progress that’s otherwise invisible Measures like the GAD‑7 or Beck Anxiety Inventory can reveal steady improvement you might not feel day‑to‑day (Spitzer et al., 2006). That makes sticking with care plans easier.

• Consistency without perfection Gentle, daily checklists, hydration, ten minutes of movement, one grounding practice, keep self‑care anchored in your routine without demanding you “do it all” (Grossman et al., 2004).

• A bridge to action The most effective lists connect awareness to a concrete choice: send the email, go for the walk, speak up in the meeting.

The hidden risks

• Safety behaviors in disguise Relying on a checklist to face certain situations can reinforce the belief you can’tcope without it (Craske et al., 2014).

• Hyper‑monitoring Checking symptoms multiple times a day can make them feel more intense, keeping your attention trained on threat cues (Ehlers & Margraf, 1993).

• Reassurance loops The short calm from re‑scoring or re‑reading is often followed by a spike in doubt, feeding the cycle (Parrish et al., 2016).

• Numbers without context Data points are helpful, but without context, the story of your week, your stressors, your supports, they risk misleading you.

A balanced, human‑centered approach

1. Lead with your “why” Decide the intention before you check: “I’m here to choose one coping tool” instead of “I need to make sure I’m okay.”

2. Minimum effective dose Smaller lists are easier to honor, and less likely to tip into overwhelm. Five items or fewer is a good upper limit.

3. Time‑limit tracking Contain checklist time to five minutes a day, then close it and step back into your life.

4. Pair with approach behaviors Link checklist use to taking one small step toward something anxiety tells you to avoid. Progress comes from approach, not avoidance.

5. Weekly sunset review Every week, ask: “Is this list still moving me toward a fuller life?” If not, tweak or retire it.

6. Share the load Bring your patterns to a therapist or trusted person. Let them help you notice shifts you might miss.

Healthy Anxiety Checklist Template 

Five steps to try:

• Two minutes grounding (5‑4‑3‑2‑1 senses or deep breathing)

• Ten minutes movement

• One “approach” action

• Connection: reach out to one person

• Reflection: “What I did with anxiety today”

Closing: Let the list lead you forward

A checklist is paper and ink, or pixels and code. Its power lies in whether it points you toward what you care about, or pulls you deeper into fear’s routines.

When you use it to step into life with anxiety at your side, not steering the wheel, it’s a tool for growth. When it keeps you circling the runway, it’s time to set it down and trust yourself to take off.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988).

 An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. Beck, A. T., & Clark, D. A. (1997). 

An information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy, 35(1), 49–58. Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). 

Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. Ehlers, A., & Margraf, J. (1993). 

The psychophysiological model of panic: A critical evaluation. Biological Psychology, 34(2–3), 107–130. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). 

Mindfulness‑based stress reduction and health benefits: A meta‑analysis. Journal of Psychosomatic Research, 57(1), 35–43. Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007). 

Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146(5), 317–325. Parrish, C. L., Radomsky, A. S., & Dugas, M. J. (2016). 

Anxiety‑control strategies: Is it time to rethink the way we measure them? Journal of Anxiety Disorders, 38, 33–44. Salkovskis, P. M., Rachman, S., & Ladouceur, R. (1999). 

Safety‑seeking behaviours in obsessive compulsive disorder. Behaviour Research and Therapy, 37(6), 559–574. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). 

A brief measure for assessing generalized anxiety disorder: The GAD‑7. Archives of Internal Medicine, 166(10), 1092–1097.