Monday, February 11, 2013

A Non-medical Approach to Anxiety!

Dear Dr. Deena,
I am 30 years old and I have significant anxiety. This was diagnosed by my doctor last year, but I really do not want to begin medications or see a therapist.
Are there any ways I can control this without starting meds?
Anna

Anna -
Congratulations on taking the first, and most difficult, step to controlling anxiety which is recognizing and accepting that you have it!  

It's amazing how anxiety can play tricks on the mind and body. Some people will say that anxiety makes them feel nervous, jittery, or "on edge." Anxiety can even manifest itself as a medical symptom, such as body pains (abdominal pain,back pain, and/or generalized muscle pains), fevers, chills, diarrhea, nausea, vomiting or light-headedness. Some patients may undergo an extensive workup to evaluate these medical symptoms with many different physicians, only to find that every test performed was normal. However, once these same patients relax and de-stress they find their symptoms improve, with the leading diagnosis being anxiety. So if you find yourself suffering from medical symptoms which cannot be diagnosed by a physician- it is important to evaluate for the presence of stressors in your life and how you can overcome them.

Most anxiety is associated with triggers. It is important to figure out what most often brings about your anxiety. Is it a certain circumstance - i.e. driving, taking an exam, a work project, or an upcoming job interview? Is it related to a certain person, a stressful relationship or a memory? Once you isolate these triggers, you can begin to  address them one by one. If you find that there are no specific triggers for your anxiety, then try following my tips to de-stress and breathe that I have addressed below.

The next few steps are key to cognitive behavioral therapy - which is one treatment option for anxiety. Write down the answers to the following questions: 
-Why does this certain trigger make you worried or scared?
-How can you overcome it?  
-What are the pros and cons of overcoming it?
-Name the times (if any) that you have been successful at overcoming this trigger in the past
- What are the real (actual) risks and dangers associated with each trigger? 

Try to isolate the thoughts and beliefs that you can and cannot change. For those that you can change, develop a plan to how you can address them. For those beliefs which you cannot change, write down all the limitations and negative impacts that it will have on your life if you continue to have anxiety over them. This is the most time consuming and emotional step, but needs to be done for every trigger of your anxiety.

Luckily we can control our brain and its thought processes. Remind yourself of that. The only time we are not in control of our brains, is while we are dreaming. 
When a negative thought enters your mind, tell yourself: "Stop, because I know this is just a thought, and it is not true because of X, Y, and Z reasons." Tell yourself why you should not feel afraid or anxious over a certain thought and what you can do to defeat it. You can even say this out loud if that helps you to feel in control.Talking to yourself in a constructive and rationale manner will help you direct your mind and thought processes.  

If there is a way to overcome a trigger (like taking an exam) be brave and take a practice exam...tackle your fears one by one. Building confidence in yourself will vanquish some of the anxiety.

If you have supportive friends or family, involve them in your life and tell them about your anxiety and triggers. Its easier to cope with anxiety when you can speak to others about your fears and everyone can help you conquer them together. 

If you feel that you are stressed out or filled with negativity, identify this to yourself and do something to de-stress and distract your mind from negative thoughts which can lead to a negative cycle of anxiety. You can de-stress through exercise, going to the park, shopping, music, yoga, cooking- really anything you enjoy! Avoid risky behaviors like over-eating, drinking alcohol or drug use.

Another way to tackle anxiety is by deep breathing. When you are overcome with anxiety, it is very easy to take rapid shallow breaths - this is known as "hyperventilation" which can easily lead to you passing out. Learn to be aware of your breathing when you are faced with anxiety and then concentrate on taking slow deep breaths. Take a deep breath in through your nose, hold the breath for 3-4 seconds, and exhale through your mouth for 3-4 seconds. As you breathe in, you should feel your entire abdomen expanding and moving downwards. Repeat this as many times as you need,until you feel like your anxiety has passed.


I hope this helps you cope with some of your anxiety. Anxiety is quite difficult to control. It takes time to learn how to control your mind and body, but with practice and determination you can defeat anything! If you feel that you cannot overcome your anxiety alone or it is worsening, I would recommend consulting with a physician for extra help and therapy options.


If you have any more questions, please email DoctorDeenaMD@gmail.com and leave comments below!


**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**











1 comment:

  1. Dr Deena,
    I am 70 years old and had quite a few trauma in my life, including now a chronically ill adult daughter.

    I wake up depressed but it tends to dissipate. In the evening I became very anxious, sometimes more and sometimes less, but it seems to be always there.

    I am on antidepressants and therapy. I try to think of anxiety the way I think about my arthritis which flares up with the rain, while my anxiety flares up right after crises pertaining to my daughter health. I can't fix them, but I try to do my best...

    My doctor and therapist are members of a clinic specializing in geriatrics. Doctors with that speciality are a different sort than other doctors because they know and accept that their patients will die.

    I am going to read the rest of your blog because I laud you for caring for others. At the same time, there are things that no amount of caring, no amount of preventive medicine, can fix, and in your profession you'll be facing those all the time...

    PS: I did read your profile which is certainly great. I'm a bit concerned about the bit about "I knew I was destined to become a leader in preventive medicine". Ambition is great but humility might take you further because it keeps you mind opened to science as well as to life....

    ReplyDelete