All you need to know about how to deal with anxiety
Has anxiety made your life miserable? I hear ya. Been there, done that. Anxiety is like a modern plague. I mean, doesn’t everyone want to learn how to deal with anxiety at work? My own interest in managing anxiety developed when when I was a paediatric doctor working in the National Health Service in Northern Ireland in the UK. I found myself working my way into an early grave… and anxiety was one of my most hated symptoms. Anxiety is THE WORST!
You’re probably wondering whether anxiety can be cured. Well, I’m going to tell you in detail how to deal with anxiety. But before I do, I should explain why I know so much about living with a generalised anxiety disorder.
How did I hit rock bottom?
I spent too many years letting my health take a back seat.
As I’m sure you know, to become a paediatric consultant you have to work ridiculous hours and be devoted to your job. You have to work a lot of nights and you get called to all the emergencies. It’s very disruptive to your sleep cycle, so I had a solid decade and a half of chronic sleep deprivation under my belt.
Having said that, stressful as emergencies are, the things that got my goat tended to be the excessively bureaucratic admin stuff that was soul-destroying. Bureaucracy is often one of the things that hard-working professionals resent the most, am I right?
Do you find box-ticking exercises suck the joy out of your life, too?
That and having to follow a bunch of rules made up by people interpreting poorly done research that’s already several decades out of date.
Well, about half the treatments we use in medicine are clearly wrong. That still leaves a lot that’s bang on the nose. But it’s still hard not to resent the pseudoscientific, dangerous codswallop that puts patients at risk every day. Vested interests are intent on maintaining the status quo and preventing patients from finding out the truth. But if you’d like a sneak peak at the medical cabal’s dirty laundry, have a look at this post. It’ll be sure to have some surprises. I’ve also gotta say, like many enormous, impersonal businesses, the NHS stifles innovation.
But on top of that, I often felt like a cog in the machine.
You know how that feels, right? Like you’re stuck on a stationary peloton bike and you have to keep peddling as fast as you can, all the while going nowhere. You’ve got deadlines and there’s constant pressure on you to perform. It’s unrelenting. You burn the midnight oil trying to finish off one job or report, and you’re already behind on the next one.
Long story short, I ended up with career burnout and moral injury.
When you’re spread thinner than melted butter on hot toast
You’ve got far too much on your plate between your excessive workload and trying to adult in your spare time. There’s not much time left over to kick back, relax, and have fun. Plus you find yourself mentally and physically drained at the end of the day after you leave work (late…again).
With all that’s going on in the world, it’s not a bit of wonder you can’t switch off. On your way home from work, do you grab yet another coffee, a takeaway and a sugary treat to keep you going?
When you get home, get the kids sorted, fire a wash on and put your feet up, do you only have enough energy left to start surfing the channels while flicking through Facebook? Then start nodding off on the sofa?
Yet when it’s time to go to bed, you’re suddenly wide awake and running through lists of things you meant to finish today, not to mention all the things you need to do tomorrow. Then you toss and turn all night worrying.
You have constant waking up during the night. You might have even googled “why do I keep waking up at 3 am for no reason?” when you struggled to get back over. Eventually, it’s time to get up but you’re exhausted, feeling like you haven’t slept a wink.
Insecurity, inferiority complexes and being dog-tired
The inner critic inside your head won’t shut up about what a disappointment you are because you didn’t complete all your tasks perfectly.
“What if I’m not good enough?” That thought keeps going round and round.
You’re scared of failing, but fear of being judged holds you back from asking for help. You don’t want people to think you’re not coping.
Chronic anxiety is a curse. It robs you of your joy and spontaneity. You feel depleted, disheartened, and distraught.
While you’re running around like a headless chicken, you’re distracted and unfocused. With all the demands for your attention, you try to multitask. You’re spinning all the plates. With so many different things on the go and feeling exhausted, you’re also more prone to making silly mistakes. And this makes you worry even more.
That's why it's crucial to learn how to deal with anxiety
You don’t want to end up on the next train from Panic Station getting dropped off at Depression Drive. Which is where I landed.
I ran out of steam completely. I suffered from debilitating, intense anxiety, crushing fatigue, god-awful insomnia, disillusionment, and moral injury. I ended up so broken, downtrodden and demoralised, I became physically, mentally and emotionally ill.
My mojo had flatlined and needed resuscitation… STAT.
So I did the only thing I could under the circumstances: I took time off work to focus on my own health. It took donkey’s years to recover. But there was no choice for me but to learn how to deal with anxiety.
Here’s why it matters how you deal with anxiety
Have you ever heard of the fight, flight or freeze response? It’s an ancient physiological response to dangerous threats. And it kept our hunter-gatherer ancestors alive in challenging times. Our ancestors had to deal with marauding gangs and vicious wild animals. Kill or be killed. So they had to be at the top of their game any time they wandered out of their camps.
At the first sign of danger, they needed a reaction that would increase their strength, reflexes and speed.
Hormones like adrenaline, dopamine and cortisol could do that. To this day, our stress response remains identical.
So at the first sign of a perceived threat, the same hormones flood our bodies, get our hearts pounding out of our chests, leave us panting for breath, and send our blood pressures rocketing.
We divert blood away from our digestive systems to our muscles, hearts and vital organs. We even start to sweat in advance because our bodies anticipate either legging it out of there pronto or a sudden fight to the death.
What happens when you try to match an ancient response with a modern situation?
Naturally, your boss frowns upon you either hightailing it or decking him. So you bite your tongue and hold on to your stress. This means it can’t dissipate. Instead, the prolonged fight, flight or freeze response suppresses your immune system and thyroid gland, upsets your digestion and throws the delicate balance of microbes in your gut into chaos. It also interferes with your ability to get a good night’s sleep,
This leads to all sorts of physical symptoms. You:
- can’t digest and absorb your food properly, which contributes to nausea, altered appetite, and malnutrition
- feel run down and depleted
- suffer from increased inflammation, headaches, and chronic pain
- develop digestive complaints, like irritable bowel syndrome and reflux
- pick up lots of viral and other infections
- suffer from fatigue
- might start to experience severe panic attacks, social anxiety disorder, extreme fear, or agoraphobia
- develop insulin resistance, which is a rung on the ladder to type 2 diabetes and ages you prematurely
- start to feel depressed
- complain of chest pain, shortness of breath, and heart palpitations
- struggle to perform your normal daily activities
You likely also lose your confidence and self-belief, your motivation and assertiveness.
How to deal with anxiety: Coping strategies you might already have in play
Now, we all develop coping strategies when we’re young. Some of these may be more adaptive than others. Here are some common ways that we manage severe or long-lasting stress:
- comfort eating and binge eating
- barely eating at all because you’re too worried, nauseous and busy
- drinking alcohol and using other drugs of abuse
- taking over-the-counter or prescribed medications like benzodiazepines, or other treatments for anxiety, headaches, and to help us sleep
- grabbing takeaways and eating out (especially when you’re too knackered to think about cooking)
- retail therapy
- distracting yourself with social media and vegging-out in front of the TV
- locking yourself away from the world and having a duvet day (or weekend)
- venting to others
- taking your frustrations out on other people
- going for a walk somewhere quiet
- self-care, like going for a massage or a manicure
- spirituality, prayer and meditation
- deep breathing exercises
- eating healthier
- using traditional herbal remedies
- calling a friend and chatting
- taking a break or even getting away for a few days
- practicing gratitude
- talking to a therapist
Just when you thought 2019 was bad, along came 2020; the year of constant stress, anxiety and uncertainty
In 2020, we have Covid-19 to worry about as well. Chaos, uncertainty and job insecurity, with many firms going bankrupt, has added new dimensions of stress many would have never anticipated. There’s so little left in life these days that you remain in control of. As a result, it’s become even more important to learn how to deal with anxiety at work.
Worse than that, lockdown has stolen many people’s healthy coping strategies for anxiety right from under their noses. Lockdown has made it hard to connect with people in a casual and meaningful way.
Large and even medium sized congregations have been banned in many places. This has complicated how many folks access both their spiritual side and the community that often ties in with worship.
With gyms, pools, and sports centres shut, it’s not as easy for some to exercise, attend classes, train, and even compete.
Booking in for a massage, sauna or some other form of self-care has to be postponed, too. Not being able to enjoy the comfort of physical touch can leave your stress levels high.
Loneliness and isolation make it harder to cope with how to deal with anxiety
There are a lot more reasons why so many of us are struggling with loneliness and isolation right now. It’s hard to even spend time with your own family, friends and loved ones. Celebrations like birthdays, graduations, and weddings are suspended or passing quietly.
And if you have a loved one living in a care home you might not even be sure you’ll ever get the chance to see them face to face again.
Coronavirus lockdown has also meant parks, beaches and outdoor areas like public gardens are closed, curtailing even more people’s chances to get away from it all.
No wonder so many people are comfort eating and drinking a lot more, both to deal with intense fear and relentless stress, and to combat sheer boredom.
And social media… well, don’t even get me started.
The whole thing is a recipe for burnout and awful mental health concerns.
Has the coronavirus pandemic of 2020 put your stress levels through the roof? If so, you’re not alone. But what can you do now to boost your resilience? There are of course many types of therapy you can use to help you respond to stress. Many practical strategies are effective in reducing anxiety but often aren’t covered in much detail by mental health therapists, psychiatrists, or other mental health professionals.
Use these science-based strategies to help you cope with stress
How to deal with anxiety — 1 Stress management
When you’re anxious, you’ve got to manage your stress. This is the most obvious tenet when it comes to how to deal with anxiety. But being obvious doesn’t make it any less important.
The goal of effective stress management is to abort the fight, flight or freeze response and move you into the rest, digest and repair response.
The simple act of regularly triggering your body’s rest, digest and repair mechanisms helps to:
- soothe an inflamed gut,
- reduce tension and pain,
- improve your digestion,
- lower your stress hormones,
- improve insulin sensitivity,
- make it easier to sleep better,
As a result, you’ll feel calmer, happier, and more resilient.
There are lots of wonderful relaxation techniques you can use to help manage constant stress. You can do deep breathing exercises, listen to music, mindfulness meditation, and practice gratitude. One of my favourite strategies to help cope with stress and anxiety is to practice self-compassion. Self-compassion is a type of positive psychology practice. It actually includes the exercises I mentioned above and more. The important thing is to practice relaxation techniques consistently so that they become a habit. This has the added benefit that when you need them in an emergency, it’s easier to use them.
When you sign up for my newsletter, you’ll get access to a self-compassion course that walks you through 15 powerful, stress-busting exercises to help you start feeling calmer today. How does that sound?
How to deal with anxiety — 2 Diet
Diet is one of the most powerful ways to modulate your anxiety levels.
Malnutrition is endemic and it’s driven by our dangerous, pseudoscientific dietary guidelines. I’ve written about how our dietary guidelines are causing malnutrition and fatigue before. And as we’ve already discussed, comfort eating is a very common coping strategy.
But comfort foods are usually junk foods, low in vitamins, minerals, healthy fats, and high quality protein, while simultaneously high in sugars, highly addictive and inflammatory food-like substances, rancid and dangerous fats from vegetable oils like canola and rapeseed, and toxins.
You get that immediate high from them that’s short-lived. But then you want another. And another. This is one of the ways that eating the wrong foods can contribute to ending up stuck in an anxiety cycle.
To make matters worse, junk foods full of sugar and starch tend to send your blood sugars on a roller coaster ride. Your blood sugar goes stratospheric for a brief spell shortly after you eat them. But within a couple of hours it comes crashing down, causing you to feel lousy, tired, and hangry. Maybe even sweaty, clammy and bloated. And of course, it makes your anxiety worse.
So you reach for your next fix to bring your blood sugars back up. You might even feel guilty or disgusted with yourself for what you see as evidence you’re weak.
And while some authorities claim that you need to eat a colossal 150-300g of sugar a day (because in your gut even starchy carbohydrates like bread, rice and potatoes are digested into simple sugars and absorbed as sugar into your bloodstream) for your brain to function, this is fallacious. Otherwise every time you went to sleep at night or had a tummy bug for a couple of days, you’d end up in a coma from not eating.
Instead, your body makes exactly the right amount of the sugar, glucose, as and when it needs to. Your brain uses this as well as another form of energy called ketones when you eat very little carbs. And your brain thrives on ketones when it’s had a chance to readapt to using them.
So what should you eat for your brain?
Brain foods are real foods. Your brain is made of healthy animal fats. The sort you find in small oily fish, like wild salmon, mackerel, anchovies, sardines and herrings. Healthy brain fats are also found in abundance in pastured animal products. Foods like red meat, pastured organic pork, pastured poultry and their eggs, and wild game. And in their fat and organs.
Your brain also contains huge amounts of the nutrient cholesterol, which is vital for us to live.
And your brain needs high quality, digestible, complete protein, which is best found in animal products. You need protein to make the signalling molecules your brain cells use to communicate with each other. These are called neurotransmitters.
Not only that, your brain has astronomical requirements for vitamins, minerals and antioxidants.
I'd like to introduce you to the SMILES trial
You might be wondering what sort of evidence there is that diet can alter your mental health. Let me tell you about the SMILES Trial. The SMILES Trial was an Australian experiment where people were recommended to ditch junk foods and cook lots of real food to reduce depression.
The results of the SMILES Trial provide evidence that a healthy diet is a powerful strategy for supporting mental health in adults. It outperformed social support, and it also outperformed antidepressants when compared with the results of well run antidepressant studies.
The diet used in the SMILES trial was:
- rich in animal foods,
- moderately low in carbohydrates,
- moderately high in traditional fats,
- moderately high in protein,
- rich in vegetables,
- low in sugar and junk,
- low in alcohol, and
- low in vegetable oils like rapeseed, canola, sunflower oil, and margarine
Clearly if you want to look after your brain, you need to eat the most nutritious foods to provide you with all the right nutrients. And those foods are traditional, real foods, particularly those of animal origin and not intensively farmed.
What’s that? Eat more meat?
Yep. You heard me right. You don’t need to reduce your intake of red meat. But do choose meats, fish, dairy and eggs that are not factory farmed, if you can.
So focus on basing your diet on pastured beef, lamb, venison, goat, pork, rabbit, poultry and wild game. The organs are usually more nutritious than the muscles.
Also eat those small, wild, oily fish I just talked about. And eat shellfish from sustainable, high quality fisheries.
The award for most nutritious food goes too...
Want to know which food is the most nutritious of all? That would be pastured liver! This is the reason I make sure I eat lots of liver every single week without fail.
There are also plenty of nutritious foods that don’t come from animals or even plants. But I’ll leave them for another post.
The role of food intolerances in driving anxiety
Let me let you into a little secret. Food intolerances are one of the most under-recognised causes of anxiety and emotional distress. Food intolerances create a type of physiological stress that triggers your immune system and causes the release of stress hormones. The stress hormones jack up your anxiety levels.
But the relationship goes both ways. When you’re suffering from chronic anxiety, the digestive issues I’ve already mentioned screw up the permeability of your gut lining so that particles of food, bacteria and poop leak into your bloodstream where they trigger your immune system to attack them. Yuck. This in turn leads to increased food intolerances. Which make you feel even more stressed and anxious. Vicious cycle.
So which really did come first; the chicken or the egg (intolerance)?
When you identify your food intolerances, you won’t believe the difference you’ll see in your energy levels, physical and mental health.
In fact, one of my clients recently told me that her sense of humour and love of punny jokes came back within a few weeks of eliminating food intolerances. Her boss told her she was getting back to her old self.
Another client asked me whether the autoimmune protocol (AIP) diet could change your personality because she suddenly felt effortlessly assertive and stopped worrying about how people would react. Her motivation also increased.
And I also feel pretty zen when my diet is squeaky clean and almost 100% AIP. But woe betide if I get glutened, even just a teensy, weensy bit. I start to unravel. Anxiety and nervousness are some of the many symptoms that start creeping (or steamrolling) back in.
Beware "healthy foods"
The problem is that some very nutritious, popular foods are common causes of food intolerances for many. Particularly people with autoimmune issues and those who’ve been exposed to gadolinium contrast agents. These foods are often referred to as “grey-area foods.”
Grey-area foods include dairy, eggs, nuts, seeds, legumes/pulses, nightshades, and grains.
So to summarise, eat real food and cut the CRAP (Carbonated beverages, Refined carbohydrates, Artificial colours and sweeteners, and Processed foods). Do an elimination diet to identify your food intolerances.
How to deal with anxiety — 3 Movement
We’re meant to move. That’s why we have brains! Most people agree that being active is great for your physical health (so long as you don’t get injured, of course). Many are already aware that physical activity is also wonderful for your mental health. And that includes anxiety and depression.
So what sort of movement should you do for mental health? The type that you enjoy and you can do regularly. You don’t have to be a gym bunny or have a personal trainer (although of course you can do that if it floats your boat).
You can enjoy movement on your own or with company. Go for nice long walks to get away from it all and enjoy some peace and solitude. Or go hiking with your family. Join a walking group if you love company or if you need a reason and some accountability to get outdoors. Or how about this for an idea? Start having walking meetings during your work day!
It's all fun and games...
Are you competitive? Why not see if you can commit to some sort of sport? It could be something you were already good at or something completely new. It could be indoors or outdoors, but extra brownie points for doing something that gets you outside and into nature or at the very least, the sunshine. You can do team sports or individual. Dealer’s choice.
Of course, this should be something that’s fun. If your competitive streak makes you more anxious or worked up try calming physical activities instead.
How about martial arts or dance classes? Whether you’re tussling with someone at Brazilian jujitsu or stepping out to do salsa classes, you can get some laughs in while you’re getting fit.
Then there’s the sort of exercise that gets you from A to B, like running, cycling, riding, rowing, kayaking, or swimming. I once rode an ostrich in South Africa. True story. It was a lot of fun. At the time I had my hair in braids with beads at the ends and the ostriches kept trying to eat them because they looked to them like corn.
And of course there’s restorative exercise. Yoga, pilates, qigong, tai chai and similar disciplines are popular for good reason. They help improve your strength, flexibility, coordination, and calm your racing mind.
How to deal with anxiety — 4 Connection
It’s true what people say about how the more connected we are digitally, the lonelier we become. Smart phones, computers, tablets and the internet are double edged swords. Even Zoom and Skype conversations over the internet don’t give you the same human connection you get from talking to someone face to face.
So focus on cultivating your relationships with family, friends, colleagues and in your communities. You can even combine your movement activities with human connection by getting involved in team sports and groups. Or you can learn new skills in a group setting, like cookery classes, flower arranging, art classes, or creative writing.
But do give people your full attention when you’re with them. Try not to get distracted with your phone. Unplug from social media for a while.
And don’t forget your spiritual connections with others. You can spend time with people who are on your wavelength spiritually in worship or in meditation.
How to deal with anxiety — 5 Nature
This is something a lot of people overlook but it was one of the things that helped me the most when I was at my most anxious, stressed, depressed and miserable. Just getting outside and strolling through nature soothes the soul.
Noticing the birdsong, the gentle rustle of leaves in the breeze, the faint drone of bees, the sound of the ocean, and the tinkle of running water is indescribably calming.
Fill all your senses with the scent of flowers, the warmth of the sun on your skin, or the feeling of rain on your face. Catch the quick flash as a squirrel jumps from one branch to the next. Learn to identify bird species from their song.
This sort of immersion is an antidote to modern stress.
How to deal with anxiety — 6 Sleep
Adequate sleep is a cornerstone of good mental health. How can you deal with anxiety when you’re sleep deprived and irritable? You can’t. And sleep deprivation doesn’t only affect your mood, it also profoundly affects your physical health.
Stimulants, anxiety and sleep
Who can forget the importance of stimulants for keeping you awake? But did you know that if you have a cup of coffee at midday, a quarter of that caffeine will still be circulating in your body at midnight? So if you’re going to drink coffee at all (and not everyone can get away with it… coffee winds me up, makes me more anxious and gives me body odour. It does the same thing to a close friend), keep it to the morning and limit yourself to a couple of cups a day.
Watch out for caffeine withdrawal headaches and other symptoms if you suddenly decide to stop, though.
Energy drinks are even worse. They’re a heady and disturbing cocktail of sugar or toxic artificial sweeteners and other additives. They play havoc with your metabolism, upset your gut microbes and alter your mood.
When I was a paediatrician working in Derry and Coleraine in Northern Ireland, I lost count of the number of adolescents who came to clinic with migraine headaches that disappeared when all they did was ditch the energy drinks.
You might think sedatives are a useful addition when you're trying to figure out how to deal with anxiety... but they can be counterproductive
We also need to talk about alcohol. While alcohol is a sedative and it may help you to pass out, it doesn’t help you get that restorative sleep that leaves you waking up refreshed. In fact, alcohol impairs your sleep quality. And it doesn’t take much booze to do it either.
So don’t kid yourself if you’re trying to come up with excuses to drink more often to help you sleep. Your intuition will tell you otherwise, if you quieten your mind and listen to your inner voice. Waking up knackered in the morning after drinking is not a sign that you’ve had a good night’s sleep, even if you seem to remember falling asleep faster the night before.
Also take care when you exercise and how intense your exercise is. If you do more stressful exercise like high intensity stuff in the evening, your stress hormones may be too high to permit you to get a good night’s sleep.
Instead focus on winding down in the evenings with a soothing bedtime routine.
Stay away from things that make you more agitated, like TV, news and social media.
Try having an Epsom salts bath or even a shower before bed and wash away the day.
Dump your worries, lists of things to do the next day and stuff you didn’t get done today onto a piece of paper.
Read a book. Chill out. Listen to a story.
Diet has been crucial in helping me sleep through the night. It turns out food intolerances can make you wake up regularly. Who knew?
How to deal with anxiety — 7 Toxins
This is something that’s very near and dear to my heart after I suffered some insane side effects from a single MRI contrast. It caused a bunch of symptoms which you can read more about here and here. I’ve also talked about this gadolinium toxicity in a lot more detail in my book, Contrasts: More than meets the MRI. But one of the worst side effects for me was horrible agitation and anxiety.
And it’s not just me. Anxiety is one of the chief complaints that clients who come to me with MRI contrast toxicity experience. Some have even tried antidepressants and benzos with no success before seeing me.
If you were thinking that gadolinium contrasts for MRIs are the only toxins associated with anxiety, think again.
Just some toxins that are associated with anxiety symptoms
Even only marginally elevated blood levels of the well known neurotoxin, lead, which used to be used in petrol, to make pipes for drinking water and for household paints, have been associated with increased risk of anxiety disorders and depression.
It’s not only heavy metals that can result in anxiety and anxiety and depression-like behaviours. Check out what happens when you feed mice glyphosate (one of the ingredients in the popular herbicide, Roundup): Glyphosate acted as an antibiotic that shifts gut microbes towards a more inflammatory and unhealthy pattern. Glyphosate led to despair behaviour in these mice.
You can find chemicals like BPA and phthalates contaminating your food from plastics and tin cans. While your skincare, makeup, perfumes, and household cleaners are also full of toxic chemicals that can enter through your skin and cause anxiety, fatigue, depression and other health problems. Then there are work exposures to consider on top of that. These chemicals, collectively known as persistent organic pollutants, have a track record of causing psychiatric reactions. So be aware and minimise your exposures as much as possible.
You can’t even escape from toxins in the natural world. Mould toxins are every bit as bad and can cause all sorts of very unpleasant neurological and psychiatric problems. Although mould toxins are often found in damp damaged buildings and places with too much condensation, they can also be found in your food, particularly peanuts, coffee, and grains like wheat and oats.
Phew. We covered a lot in this post about how to deal with anxiety, didn’t we? Your head may be spinning a bit. So let’s sum things up.
If you suffer from anxiety and stress, you’re not alone. A hectic and demanding work life with added stressors from home life can prove to be a massive strain. This can leave you feeling depleted and mentally exhausted. Before too long you can discover you’re burned out.
But today we’ve covered the 7 areas where you can make changes to ease your burden, start feeling the anxiety melting away and start enjoying life again. These are:
- Stress management (today I’m giving away access to a FREE stress reduction course on self-compassion. See the link below for details)
- A real food diet
- Getting into nature
- Toxin avoidance
If you can find balance with each of these 7 areas in your life, not only will you feel less anxious, you’ll sleep like a baby and wake up feeling refreshed and energised. You’ll feel like a million dollars because you’ll be healthier. Imagine feeling calm, confident and fulfilled. What would that mean to you? Find out what it meant for my client, Claire, in this post.
To avoid feelings of overwhelm, pick 1 single thing to try today. Keep doing it for a few days before starting to add in another.
You can bookmark this post to return to it next week to help you brainstorm for another small change you can make. Every small change adds up.
And that’s how to deal with anxiety, even when you’re in the midst of a pandemic.
An amazing freebie for stressed-out professionals to help you deal with anxiety
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