Mental Health Series
Feeling anxious or nervous is a natural and often healthy emotion that everyone experiences from time to time. However, when anxiety becomes chronic, it can interfere with daily life and one’s overall well-being. What exactly is anxiety?
Anxiety and its associated disorders are classified into three main types: generalized anxiety disorder, panic disorder, and phobias. Obsessive compulsive disorder also falls under the anxiety umbrella. Anxiety symptoms can include agitation, difficulty concentrating, irritability, and sleep problems. Physical symptoms are oftentimes also present, these include chest pain, rapid heart rate, shortness of breath, and muscle tension.
Anxiety can be caused by a variety of factors, including genetics, life experiences, and chemical imbalances in the brain, or a combination of multiple factors. It’s important to remember that everyone experiences anxiety in very unique ways, and what works for one person might not work for another.
Treatment for anxiety may include therapy, medication, or a combination of the two. Cognitive-behavioral therapy (CBT) is a form of therapy that teaches people how to recognize and change negative thought and behavior patterns. Anxiety can be reduced with medications such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. This post on Depression details how serotonin and dopamine work in the body.
Benzodiazepines work by increasing the activity of the neurotransmitter GABA (gamma-aminobutyric acid) in the brain. GABA is a chemical that functions as an inhibitory neurotransmitter, which means it reduces neuron activity in the brain. GABA reduces neuron activity when it binds to its receptors on neurons, resulting in a calming or sedative effect. Benzodiazepines boost GABA activity by extending the time GABA can bind to its receptors on neurons. This increases GABA inhibitory activity, resulting in the benzodiazepine’s calming and sedative effects.
***Benzodiazepines should only be used for short term results, never for long term treatment. Benzodiazepines, such as Ativan, Valium and Xanax are highly habit forming and can lead to addiction. If you become addicted to Benzodiazepines, please DO NOT quit cold turkey as it could be life threatening to do so, call your primary care provider or seek medical help to quit.
There are several ways to reduce or eliminate anxiety, including:
- Getting regular exercise: Exercise can help reduce anxiety by producing a number of physiological changes in the body that can have a positive effect on mood and stress levels.
- Getting enough sleep: Lack of sleep can contribute to feelings of anxiety, so it is important to get enough rest (minimum of 6 hours is acceptable, but one should prioritize getting more sleep). Some people can function on less sleep, so pay attention to how you feel after different lengths of sleep and try to maintain the hours that work best for you. Exercise can improve your sleep as well.
- Eating a healthy diet: A healthy diet can help to improve mood and reduce feelings of anxiety. This Harvard article will provide a comprehensive list of beneficial dietary changes that can be made to improve feelings of anxiety. They suggest increasing your intake of magnesium (which is great for numerous health concerns), zinc, omega-3 fatty acids, probiotics, and B vitamin rich foods. The list they provide is expansive.
- Practicing relaxation techniques: Techniques such as deep breathing, progressive muscle relaxation, and meditation can help to reduce anxiety. Check out my related post on the meditation and mindfulness apps I love.
- Limiting caffeine and alcohol: Both caffeine and alcohol can increase anxiety, so it is important to limit consumption of these substances. This study elaborates on the caffeine/anxiety connection. If you need caffeine to get going, consider taking a supplement that includes L-Theanine. Combining L-Theanine with caffeine has been shown to improve cognition and mitigate the negative effects of caffeine. Tim Ferriss is a big fan of this combination. He discusses it in this video. Theanine has also been shown to boost levels of GABA, which we learned significantly impacts anxiety levels.
- Getting support: Talking to a trusted friend or family member, or seeking support from a mental health professional, can help to reduce feelings of anxiety. Talking about what is going on in general can help purge negativity that might be contributing to anxiety.
- Avoiding or limiting exposure to triggers: Identifying and avoiding situations that trigger feelings of anxiety can help to prevent anxiety.
Exercise is a key factor in reducing anxiety because it releases endorphins, which are chemicals produced in the brain that act as natural painkillers and mood elevators. When you exercise, your body produces more endorphins, which can help you improve your mood and reduce anxiety.
Exercise can also help to reduce anxiety by reducing levels of stress hormones, such as cortisol, in the body. When you are under stress, your body produces higher levels of cortisol, which can contribute to feelings of stress and anxiety (along with many other physical issues).
Increasing your physical activity reduces anxiety by improving your sleep quality and duration. Additionally, exercise can help to reduce anxiety by providing a sense of accomplishment and helping to improve self-esteem. As you become healthier, more physically fit, and active, you may feel better about yourself and your ability to handle stress, which can help to reduce anxiety overall.
Sometimes panic attacks and anxiety and strike out of nowhere, so it’s not always preventable. It is important to find the strategies that work best for you and to practice them regularly.
Anxiety can be caused by our subconscious mind. The subconscious mind is the part of the mind that operates below the level of conscious awareness and is always “running in the background.” It can also save memories and experiences that may be contributing to anxiety symptoms.
For example, if someone has previously experienced a traumatic event, their subconscious mind may store that experience and trigger feelings of anxiety when confronted with similar situations in the present (or for no apparent reason at all). This is because the subconscious mind is constantly working to protect us from perceived threats, and it may perceive certain situations as being dangerous or threatening even if they are not.
Additionally, the subconscious mind may also play a role in anxiety by influencing our thoughts and behaviors. For example, if someone has negative thought patterns (like “all or nothing” thinking and catastrophizing) or beliefs about themselves or the world, their subconscious mind may lead them to engage in behaviors that contribute to anxiety. I recently heard that the subconscious doesn’t actually realize others exist, thus everything you tell yourself, it believes to be true of oneself. I don’t know how accurate that is, but it kinda makes sense. So, practice telling yourself kind things and try to work through things you are fearful of.
Fear and anxiety go hand in hand. Many times, our anxiety is fear based. Fear and anxiety are closely related emotions that can both have a significant impact on our mental and physical health. Fear is an emotion that is triggered by a perceived threat or danger, and it is often accompanied by physical sensations such as a racing heart and increased adrenaline. Anxiety, on the other hand, is a feeling of worry or unease that can be more chronic and persistent.
In some cases, fear can lead to anxiety. For example, if someone is afraid of speaking in public, they may experience anxiety about having to give a presentation. Similarly, if someone is afraid of flying, they may experience anxiety about getting on an airplane. In these cases, the fear serves as a trigger for the anxiety.
On the other hand, anxiety can also lead to fear. For example, if someone is anxious about their health, they may fear that they have a serious illness. Or if someone is anxious about their financial situation, they may fear that they will not be able to pay their bills. In these cases, the anxiety leads to fear about a specific outcome or situation.
If you have anxiety about something over and over again, ask yourself if you are scared or fearful of something related to that particular thing. Let’s say you get anxious about going to work, are you worried or scared that something might happen to you at work or are you fearful that the work you are doing is not fulfilling? It might not seem clear at first but start digging.
The first time I ever experienced a panic attack I was in my mid 30’s when I started working for the crisis line. I felt nauseous and on edge and called out of work thinking that I was getting sick. Throughout the day I felt much better and thought it must have been a fluke. The following morning, I felt the same way and called out again. Within a few hours I felt good again. The 3rd morning, I had actually vomited before work, and I knew something wasn’t right. I called my boss and spoke with her, then broke down crying because I didn’t know what was happening. Luckily, the employer I was working for was really accommodating and said to take a few more days off and to keep her posted.
When I finally returned to work, I had the same symptoms in the morning, but I pushed myself to go to work. When I arrived, I my heart started to race, and I felt even more sick to my stomach. After taking a few phone calls I realized that I was miserable being there. I just started this job, but I was doing tasks that I wasn’t experienced with, and I did not have the same since of accomplishment that I had at my previous job.
I remember one time it was an unusually busy day and I remember getting a repeat caller who was known for not having a “real” crisis, but always said that she needed help because she keeps trying to kill herself, but it never worked. This particular caller had been seen numerous times by our team and was always “well” by the time we got to her. She lived very far from most people so most of us surmised that she was probably really lonely, and this was her way of getting some social connection, as we had several “regulars” like that.
On this day, she just wanted to talk and not have a team come evaluate her, so I spoke with her for about 20 minutes, and we ended the call. She called back to the line 6 more times just chatting with agents taking up valuable time for other callers that might need emergent help and I got really frustrated. I picked up the line the very last time she called and again she attempted to talk in circles and decline actual help. I ended the call professionally, but the next thought I had really scared me. I thought, “next time she calls, I’m going to tell her exactly how to do it, so she might have a valid reason to call.” I was clearly angry and really heated. That line of thinking was unprofessional and inappropriate.
I had never felt that way towards a patient ever before. I knew right then and there that I needed to get help. I ended up seeing my doctor the next day and they diagnosed me with anxiety and started me on an as needed Benzodiazepine and depression medication. I was honest with my employer, which they completely understood with the nature of the job and was granted a month off work to ensure I was feeling better.
After all was said and done, I talked to a lot of my friends about what had happened, and I was able to sort out that I wasn’t sure if I even wanted to continue being a nurse. Upon my return, I was feeling better, and I did end up excelling at that job, but it definitely took a toll on me mentally. I remained on medication for about 4 years after that.
Never had I experienced “real” anxiety until that moment in my life, so you never know what might trigger it. Anxiety does not discriminate no matter what age you are, what gender you are and what life experiences you’ve had.
It’s important to seek help if anxiety is affecting your daily life and well-being. A mental health professional can help you identify the cause of your anxiety and develop a treatment plan that works for you.
Remember, it’s okay to not feel okay all the time. It’s important to take care of your mental health just as you would your physical health. Your brain is physical part of your body too and it should be treated with care just like any injury would be treated. If you or a loved one is struggling with anxiety, don’t hesitate to seek help.
When to get emergency help
If you think you may hurt yourself, someone else or attempt suicide, call 911 in the U.S. or your local emergency number immediately.
Also consider these options if you’re having suicidal thoughts:
- Call your doctor or mental health professional. Or 211 to speak to a live person about mental health options.
- Contact a suicide hotline.
- In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
- U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
- The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
- Numerous Apps are now available to talk with someone in the privacy of your own home. Click here for a free app list. Other Apps include: Talkspace, BetterHelp, and Sanvello.
- Reach out to a close friend or loved one.
- Contact a spiritual leader or someone else in your faith community.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room. DO NOT leave them alone.
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