How to Manage Anxiety

Anxiety disorders are the most common psychiatric illness in the United States. Around 40 million people struggle with anxiety that is at debilitating levels. ​That's one in five people! 

So what's going on in anxiety? Basically your sympathetic nervous system, which is designed to help you fight or run from predators (think a bear chasing you in the woods) has gone a bit haywire. Things that should not provoke this response (racing heart, dilated pupils, cold sweat, massive amounts of adrenaline in your bloodstream) have triggered this response. Which feels pretty terrible. Some people experience intense anxiety only occasionally, like before giving a talk in front of an audience, but other people experience anxiety on a daily basis. 

Regardless of how much anxiety you have or when it comes on the treatments are essentially the same (except for simple phobias like fear of snakes or fear of flying, which really needs exposure therapy). You can reduce your overall anxiety by following any of these tips:

• Try probiotics. Research on animals has shown significant reduction in anxious behavior with the use of probiotics. Research in humans is still being fine-tuned but I have every reason to believe that we will find the same thing. At a recent trip to my local grocery store I was able to determine that most kefir products have a wide variety of probiotics so they are an easy way to try this out. Just have one glass of kefir (a drinkable yogurt) every day for 6-8 weeks and see if you can notice any difference in your anxiety levels. And keep an eye and ear out for research on probiotics and anxiety because I strongly believe we will be hearing more about this in the future. 
• Try gratitude. A daily 5-minute gratitude practice has been shown to reduce both anxiety and depression as well as promote overall satisfaction in life. For a 5 minute investment the results are quite impressive! 
• Exercise. There is lots of research showing that exercise helps reduce symptoms of anxiety and depression. What kind of exercise and how long you need to do it seem to be different for different people. To try exercise to manage anxiety do it at least 3x/week for at least 20 minutes and keep a mood chart for a month. Then see if you notice an impact on your mood that relates to your exercise. If that level of exercise is not helping, you can always try adding more. I know for me I need at least 3 days/week of one-hour sessions to keep my mood in check. So it's likely to be different for everyone. 
• Consider talk therapy. Sharing your fears, concerns, worries and burdens with a professional can really help. Not only does it give you a place to unload but a therapist can help you develop tools to manage anxiety and may see patterns of how you end up feeling so anxious and help you develop new ways of being that will alleviate anxiety. 
• Consider medications. Unfortunately the medications that were originally designed for anxiety-- things like Valium and Xanax, are extremely addictive. They can only really be used on a VERY occasional basis. Anyone who uses these medications regularly is at very high risk of dependency. However the good news is that many antidepressants also help with anxiety, usually an SSRI or SNRI. Talk to your doctor if you want to try this approach. Antidepressants are not addictive and there is some research that they actually may be good for the brain in that they help with new neuron growth. 
• Cut back on stimulants. As a culture we are "go, go, go!!" So many of us have adopted habits of several cups of coffee in the morning, a few glasses of soda or iced tea at lunch and an energy drink for our afternoon slump. Caffeine, taurine, theanine, ginsing, ginko, guarana, tobacco...these are all central nervous system stimulants. If you struggle with a lot of anxiety consider slowly tapering down on your stimulants and see if that helps. I find that often people use a lot more stimulants than they realize. 
• Try meditation. I hate to say it but yes, it's true, meditation is pretty much good for everything. Especially anxiety. But also depression, attention, concentration and sleep. You don't need to do it all at once. Start with 2 minutes and each night add 30 more seconds. Once you have gotten up to 15 minutes keep that up for at least 6 weeks since research shows that it takes about that long to change the brain in the ways that help with anxiety. And yes, you can use an ap for that!
• Breathe. Not the lazy way you are doing right now. Even though I can't see you I am pretty sure you are "chest breathing". Most of us over the age of 4 do it that way and unfortunately it does not create a relaxed state in the body. In order to really get relaxed and combat anxiety and stress you need to breath down into the belly or diaphragm. I wrote a blog on this a while back that has videos you can watch to learn this. I promise it's easy, you can learn it in 5 minutes and do it anywhere. If you doubt that breathing is linked to anxiety try breathing shallowly for 5 minutes. You will have a panic attack. So, the inverse is true. Breath slowly and into your diaphragm and you can reverse the anxiety response in the body. 
• Get enough sleep. I can't emphasize enough how important sleep is for your physical and mental health. Everyone seems to think they are the exception to the rule but I am here to tell you that you, yes, you, need 8 hours of sleep each night. Evolution would not have kept sleep in our repertoire if it were not essential to our survival. Think about it. We don't mate while we are asleep (well, most of us). We don't eat while we are asleep (again, most of us). And we can't defend ourselves from predators while we sleep. So mother nature must have REALLY, REALLY needed to keep sleep in our behavior and physiology because it is kind of a waste of time in terms of reproduction and survival. Except that if you don't get good sleep you will die sooner. No kidding. So get your 8 hours and you may notice that you feel less stressed and more balanced. 
  

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As always wishing you health and happiness,

Dr. Jordan

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