Not everyone has a diagnosed anxiety disorder, but everyone experiences anxiety.
The symptoms of anxiety.
And we’re supposed to.
We have a sense that it’s not normal.
Or that because it’s uncomfortable we need to seek medical attention immediately.
And it is uncomfortable! Symptoms of anxiety can include heart palpitations, racing thoughts, uncontrollable crying, sweating, dizziness, hyperventilating, chest pain, tingling in limbs, general agitation, inability to relax, muscle tension/spasm, an inability to stop worrying…
It’s no picnic. And an anxiety attack will be all those raging at once making you feel like you’re going to explode and die.
In terms of Self Regulation Therapy – the goal is a health, regulated nervous system where we start at a baseline and then when an event or other triggering moment happens (including a memory, the perception of threat, an exam we have to take, a competition or race we’re in, going on a blind date, running into an ex) we have a response – in mind and body – then the event passes and we come back down to baseline.
That’s what normal anxiety would look like in a perfect world.
But we all have variations of extremes of that depending on how full our container already is.
With decreased resilience, our symptoms of anxiety will be more profound. But still, entirely normal.
These incidents don’t have to be an actual threat to life to cause a reaction – they are new or unpredicted and the fight/flight/freeze center in the brain activates.
In a healthy nervous system, we push through the jitters and come back to base line when the event or incident is over, or we realize that there isn’t an “actual” threat and the same thing happens.
Anxiety is very physical and triggered in sensation first with the limbic system registering emotion and the frontal lobes trying to make meaning out of it after.
A dysregulated system has this mechanism and procedure stuck in high alert and has difficult distinguishing between novelty and threat. It is slow to come back down to baseline, and sometimes doesn’t quite make it there at all. These are the circumstances where over time we would see someone potentially receive a diagnosis of generalized anxiety disorder (GAD). But the truth is – it’s just activation – that got stuck and is just a symptom of dysregulation.
Regulate the nervous system, the symptoms dissipate and disappear and the diagnosis (and arsenal of medications) is no longer applicable.
The problem with all states of anxiety is that they elicit various fear responses and are uncomfortable, and so we tend to pathologize them and think they need to be medicated immediately.
A better approach is to assume that anxiety that we aren’t able to manage and interferes with the function of our lives should be treated through a neurobiological therapy modality.
Resolving trauma, and learning how to hack anxiety in your brain reduces the impact of overwhelming moments in your life but also increases longterm resilience.
A healthy nervous system can experience every human emotion in the scope of human emotions.
Anxiety can actually serve us – it can make us perform better – facts first presented in research from 1908!
Furthermore, many anxiety disorders are misdiagnosed. Patients are diagnosed with bipolar disorder after a trauma without the diagnostician taking into consideration that states of hyperarousal are consistent with post traumatic symptoms. Or clients are diagnosed with anxiety when in reality they were suffering from anemia or low B12 levels or hyperthyroidism. Similarly some clients are diagnosed and medicated for depression when they have hypothyroidism or other vitamin deficiencies. And many are diagnosed with mental illness when the fluctuations in mood have been related to alcohol, marijuana, or opiod use.
So before we all rush to get medications which can have dangerous side effects and be a special brand of hell to come off of, here’s how to keep your anxiety in check.
1. Depersonalize – it’s just activation.
Language is powerful. Emotion is fuel to the fire.
What if, it’s just activation?
What if every time you felt your heart race, your palms sweat, your thoughts race, or your respiration increase and that jittery nervous feeling come up you simply brought awareness to it as normal.
“Whoa…I’m feeling my heart pound – hmmm… it’s just activation.”
And then ask yourself “I wonder why I’m feeling so activated?”
(And yes I know this is cognitive so if you’re actually in the throws of a panic attack this won’t be helpful- which incidentally is also a normal experience of high activation that’s built up and the body needs to release all this charged up energy through).
Are you hungry, sleep deprived, on medication, off medication, vitamin or mineral deficient, not taking care of yourself?
If you don’t eat to regulate your blood sugar levels, your HPA axis will be activated signalling that you have run out of food and stir up that primal part of your brain geared to maintaining homeostasis and ensuring survival.
Are you taking cold medications? What’s your caffeine intake like? Sugar/Carbs? These all impact and can mimic anxiety in the body and often doctor’s don’t think to ask these questions to break it down.
Sleep deprivation can cause symptoms related to multiple mental health disorders. Once sleep patterns are restored, the symptoms disappear – but again a common area of misdiagnosis and over zealous medicating.
When you’re in a situation where anxiety is to be expected… your wedding day, a job interview, or waiting for your kids to come home and they’re past curfew… reframe it. “I’m feeling normal anxiety because of this…this is completely normal.”
Or find a way to bring humor to it. “Oh crap there it is again… I’m all nervous like a pimply teenager” and imagine yourself in some funny movie scene getting through it.
Then start redirecting your thoughts after you normalize the experience.
“This is normal and temporary – it’s going to pass and I’ll know it’s starting to go away when my heart rate slows down or my breath slows down”. And then look for those things – as you look for the end of it, you’ll get there sooner.
Also employ imagination in this – “phew I’m feeling the stress… where would I rather be right now to relax?” and your brain will come up with a comfort spot or a vacation zone, a spa environment, or your most relaxed space – as you imagine being there, transporting your mind into that space and imagining what it would be like to be there instead, your brain will start to release chemicals to support that state and you’ll start to notice yourself relax.
The mantra in my clinic for this is often… “butt in the chair, mind in Maui”. Ground yourself by feeling how your butt can sit heavy in the chair and imagine being somewhere else. For me it’s always Maui.
2. Lifestyle changes
In some cases over 50% (and in some cases ALL) anxiety can be reduced with pre-emptive, supportive lifestyle changes.
Active and ongoing self care practices that include spending time in nature, looking at beautiful scenery, making time to connect with people that make you feel good and that you care about, and overall doing things that make you feel good. Your time that is uncompromised for others.
Nutrition and exercise are a one-two punch for anxiety treatment and regulation.
People that follow a Mediterranean diet have lower anxiety and reduced stress responses. In part due to the high Omega 3 content and healthy fats present in that program – it also still is favored for reduce cardiovascular disease.
Consider an even more aggressive anti-inflammatory approach by removing inflammatory foods altogether including gluten, all grains, dairy, and corn. Grain Brain For Life and any of Perlmutter’s work in this area shows the impact of the foods we eat in triggering anxiety and other mental health imbalances.
There’s even an Anti Anxiety Food Solution worth checking into if this is becoming an issue for you.
Exercise – 30 min of something you enjoy every day. Preferably outdoors in nature, but when seasons interfere, make sure you are making daily activity a regular part of your mental health care.
Add in yoga for it’s grounding effects and breathing that stimulates the vagus nerve and promotes a calmer state. Avoid fight/flight type activities while you’re dealing with anxiety – boxing and running can amp up those fight or flight pathways and actually increase stress response in the body. This is the time for walking, embodied, grounded movement and breathing.
And then consider supplements to help your body cope with stress more effectively.
In patients that took 3-5000 mg of Omega 3s (fish oils) a day, they saw reduced anxiety and increased focus.
L-theanine is one of my favorite recommendations. I like Natural Factors, Mental Calmness – safe for ages 10 and up and very effective. It’s a safe alternative to ativan for both acute and chronic anxiety.
I also like a combination called Endorphinate out of Pandora Pharmaceuticals – created by a psychiatrist, he uses this with his own patients in current practice. Dr. Daniel Amen also has a nice one called GABA-Calming Support.
Ashwaganda, rhodiola, ginseng, magnesium, and B vitamins are all supportive for helping soothe the nervous system.
3. Neurobiological psychotherapy
It’s a mouthful right?
Basically somatically informed therapy.
Or any kind of therapy is better than no therapy.
If you talk to your doctor about anxiety and they don’t recommend addressing your sleep, diet, exercise levels, check for deficiencies, AND refer you to a psychotherapist (not a psychiatrist) then you need a second opinion.
Drugs do not help the brain change – they don’t build new neural pathways. They tend to suppress activity and some, like SSRIs when prescribed for anxiety can actually increase not just anxiety, but suicidality and psychosis. (and mania in people with bipolar disorder).
Anxiety is experienced in such a physical way that you want an approach that’s going to work not just with coping “skills” or the thinking brain – but with the reptilian brain that’s governing the nervous system.
Working with someone psychophysiologically means you are teaching the brain how to settle, assisting it to do so and helping it discharge extra energy in session so it can come back to baseline – and at the same time creating new neural pathways in the brain for health and resilience.
This will give you symptom relief, without side effects and long term health and well being.
When you add the right therapy modality to the healthy practices you have implemented for your body, you have the winning formula. These adjustments can make high anxiety, more moderate, and moderate anxiety, almost non existent – except when it’s normal and beneficial for performance.
When we run away from anxiety – when we fail to normalize it and reframe it, we give it power. The power of fear. When panic attacks come, we layer onto that fear and create a cycle that spins out of control with a nervous system that is never able to come back to baseline.
Much fewer instances of actual mood disorders would fit diagnostic criteria if these 3 areas were addressed first. If you’re still struggling with focus and action in these areas, please do talk to your doctor and ask for a referral to a reputable psychologist or psychiatrist for proper assessment and diagnosis. Resist prescriptions for psychoactive drugs of any kind initially and seek treatment with better long term prognosis and no side effects. If you’re still suffering, ask your doctor about gabapentin as a low-side effect, safe alternative with a short half life for a temporary pharmaceutical approach.
For most however, anxiety is a state that is uncomfortable, but within the range of normal. And highly treatable – and even curable (except for the normal, human parts of it that are part of a healthy human experience!).
Download my free e-book for strategies you can use right now to increase your resiliency and feel more regulated and in control.