Category: Stress

How to Manage Anxiety

12/13/2019

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.

As always wishing you health and happiness,

Dr. Jordan

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Flippin' Your Lid

5/7/2015

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We've all been there. Someone cuts you off in traffic, or your spouse pushes a particular button, or your child whines for just a few minutes too long and...wham! You have devolved into a stress-ball and can no longer stay calm and act rationally. You yell, or snipe, or attack, or shut down. In short, you have "flipped your lid". The "smart parts" of your brain have been hijacked by the emotional center and you now cannot access the higher areas of your brain that normally allow us to be rational and reasonable people.

As the "hand model" of the brain to the left illustrates, our brain is made up of lots of different parts. If your hand is clenched in a fist the fingers that are visible will represent your higher cortical areas such as the frontal lobe. This is, as I like to refer to it, the "Spock center". It's the part of the brain that can help us not intentionally ram the car in front of us when they cut us off in traffic. It helps us to inhibit responses and respond rationally and calmly.

Sadly that part of the brain gets disconnected under high levels of stress. Yes, folks, just when we need it most our higher cortical areas literally go "off-line". So who is running the show at that point? You guessed it, our emotional center. The limbic system, represented in our hand model by the thumb, is now in charge. Which is why when we are highly triggered we tend to say and do things we regret later, when our higher cortical areas come back online and assess the damage.

Under normal circumstance when we are not too stressed out our limbic system is still active and reacting but the cerebral cortex is "wrapped" around it (as in the illustration of the fist) so that it "hugs" the emotional center and keeps it relatively quiet. There are literally bundles of nerves that carry information from our frontal lobe to our limbic systems when things are running smoothly. This keeps us from killing people whenever we get slightly stressed out. Normally this system works well enough to keep most of us out of trouble most of the time. However, when the stress gets too high, those fibers stop carrying information from the cortex (as in the illustration with the hand extended upwards) and the limbic system has free reign. It's like letting your 3 year old drive the car on the freeway. Not such a good idea and we should not be surprised when there is a multi-car pile-up!

So, what can one do in this situation? Well, here is what most of us try, which incidentally doesn't work: we try to talk rationally to the other person. We try to explain or rationalize or educate them out of their feelings. The problem here is that we are talking from our cerebral cortex and their cerebral cortex is not operational. So it can't hear us. And the limbic system doesn't speak that language. In fact it doesn't really understand language. It's much more influenced by things like tone and volume of voice, gestures and facial expressions. So if you can see that someone has flipped their lid, the best thing you can do is to show that person that you understand how they feel. This is creating a connection between your limbic system/emotional center and theirs. So if my friend is frustrated with me and I show her that I understand that feeling through my facial expressions, voice and gestures our brains are now connected. At that point I have the opportunity to influence her brain because we have an "open channel" between the two systems. So I can now start to offer calming words, sounds and gestures (such as smiling, gentle touching, quiet and low tones of voice) that will start to calm down her nervous system. As her limbic system begins to get more calm her cerebral cortex will come back on-line and now I can communicate with her logical brain from my logical brain.

Notice that this strategy is about how to manage another person when they come unglued. That's because the fastest and most efficient way for a human brain to get calm is to use another human brain. If we have to calm ourselves it takes more oxygen and glucose (the power sources for our brains) so it's more resource-intense. We can, of course, calm ourselves if we have to. Other people are not always available. But the optimal way to handle a flipped lid is to have another person who can connect to our brains and calm us down. Humans are, after all, pack animals and we derive numerous benefits from living in groups.

So next time you flip your lid, or observe one of your pack flip theirs, remember to get the emotional connection established FIRST and then, only after the emotional intensity has dissipated, try to connect to the logical parts.

For more information on interpersonal neurobiology and the science of our connection to others see the work of Dan Siegel, MD, and Stan Tatkin, PsyD. Or stay tuned for more blog posts on this website.

Warm wishes,

Dr. Jordan

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Reflections on all things psychological and the science of being human

How to Manage Anxiety

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Flippin' Your Lid

Krista Jordan, Ph.D.

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