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I'm A Neuroscientist Psychiatrist: This Is My Go-To Trick For Conquering Anxiety

Daniel Amen, M.D.
November 12, 2021
Daniel Amen, M.D.
Clinical neuroscientist psychiatrist
By Daniel Amen, M.D.
Clinical neuroscientist psychiatrist
Daniel Amen, MD, is a clinical neuroscientist psychiatrist, physician, professor and 10-time New York Times bestselling author. He is a double board-certified child and adult psychiatrist and founder of Amen Clinics, Inc.
Image by Pansfun Images / Stocksy
November 12, 2021

Do unto others as you would have them do unto you. No running with scissors. No talking at the movies. Life's full of rules. But there's one powerful rule you've probably never learned that can change your life. In 40 years of practicing psychiatry, I've seen this simple rule improve the lives of many of my patients. What is it?

I call it the 18-40-60 Rule.

Here's the breakdown. At age 18, you tend to worry about what everybody else is thinking of you. When you hit age 40, you couldn't care less what others think of you. And by the time you reach age 60, you finally come to the conclusion that nobody else has been thinking about you at all. People typically only think about themselves, not you!

I love sharing this little tidbit of insight into how our brains stay focused on ourselves because it is so enlightening. Regardless of how old you are when you learn this lesson, it can help calm anxiety, decrease negativity, and soothe worries. At the same time, it boosts self-confidence, moods, and your general sense of contentment. 

A 2021 survey of 2,000 older adults backs this up: An overwhelming 72% of the respondents said that in their 40s, they quit worrying about what other people thought of them—and doing so increased confidence and happiness. 

What's wrong with worrying about what people think?

We all care about what people think about us to some extent, but focusing too much on how others perceive you could damage your mental health. It can also have a negative impact on your brain function.  

Do you wake up in the middle of the night worrying about that time you burped on a Zoom call when you thought you were on mute? Do you replay conversations in your head thinking of all the things you should have said but didn't? Do you beat yourself up whenever you hit send on an email, then notice a spelling error?

When your self-esteem is based on gaining approval from others, it increases self-criticism, feelings of failure, anxiety, and depression. This is especially apparent on social media. With the advent of social media, depression among adolescents rose from nearly 9% in 2005 to over 11% in 2014, according to a 2020 study in the International Review of Psychiatry1

Some people-pleasers are so wrapped up in gaining the approval of others they develop rejection sensitivity dysphoria, a condition that causes extreme emotional responses to even the most minimal critiques.

Approval seeking puts your brain at risk, too. A brain-imaging study2 revealed specific chemical reactions in the brain to both positive feedback and negative criticism. This means that others' evaluations of you can literally change your brain, and those changes may not be beneficial to you. Additional research in the Journal of Anxiety Disorders3 shows that fear of negative evaluation is associated with social anxiety.

How to put the 18-40-60 rule into action now.

Don't worry, you don't have to wait until you turn 60 to take advantage of the 18-40-60 Rule. Here are a few tips to implement it at any age:


Kill the mind-reading ANTs (automatic negative thoughts).

If you tend to believe that others are thinking critically of you—"She's not very smart" or "He didn't deserve that promotion"—your mind is likely infested with what I call mind-reading ANTs. Even trained psychiatrists with 40 years of clinical experience like me can't tell what someone else is thinking unless they ask them. A negative look from someone doesn't mean they are mad at you. It could just mean they are constipated! You just don't know. If you catch yourself mind-reading, remind yourself that you can't know what they're thinking.


Remember that everyone messes up.

Stop beating yourself up for making mistakes. We all do it. If someone points out something you've done wrong, just remember that they've slipped up at some time in their life, too. Nobody is perfect.


Know your values.

When you have clarity about your sense of self, it's much easier to know if your behavior fits your values. This way, if someone criticizes you for something that isn't truly important in your life, it won't sting as badly.  


Breathe through the hurt.

People's words can cut like a knife. To minimize the pain someone's critique may cause, take a few deep breaths to calm yourself.


Notice what you like about yourself.

Whenever you feel like you might have let someone down or haven't lived up to their expectations, take time to focus on your best attributes. Write down a list of your achievements in life, your best qualities, and the names of people who support you. Likely, you will see that you have far more positive attributes and supporters than you thought.


Post the 18-40-60 Rule somewhere you can see it every day.

Put it on your desk, tape it to your bathroom mirror, or store it in the notes app on your phone. Whenever you find yourself fretting about what other people are thinking of you, look at it and remember that most people are thinking about themselves, not you.

Daniel Amen, M.D. author page.
Daniel Amen, M.D.
Clinical neuroscientist psychiatrist

Daniel Amen, MD, is a clinical neuroscientist psychiatrist, physician, professor and 10-time New York Times bestselling author. He is a double board-certified child and adult psychiatrist and founder of Amen Clinics, Inc., which has eight clinics across the country with one of the highest published success rates for treating complex psychiatric issues with the world’s largest database of functional brain scans relating to behavior, with more than 160,000 scans on patients from 121 countries. Amen is the lead researcher for the largest brain imaging and rehabilitation study for professional football players that demonstrates high levels of brain damage in players with solutions for significant recovery as a result of his extensive work. His research on post-traumatic stress disorder and traumatic brain injury was recognized by Discover magazine’s Year in Science issue as one of the “100 Top Stories of 2015.” Amen has authored and co-authored more than 70 professional articles, seven scientific book chapters and 40-plus books, including the No. 1 New York Times bestsellers, “The Daniel Plan” and “Change Your Brain, Change Your Life.” His most recent book, “Change Your Brain, Change Your Grades,” includes editorial contributions from his teenage daughter, Chloe Amen, and niece, Alizé Castellanos.