by Jill Weber
Take a few minutes to reflect and journal in your notebook about the following topic:
If you did not fill your conscious mind with thinking about your medical condition or physical symptoms, the causes, the worries, the what-ifs, and fears that go along with it, what would you be thinking about instead?
Explore what you may be avoiding or missing by engaging in your obsessive thinking. Then, see if you can talk yourself through those deeper emotions and find a way to accept them. Remember, acceptance is not submission; it’s a way to take different steps to protect yourself than the ones you’ve already taken.
STRATEGY: TAKING CARE OF YOUR PHYSICAL HEALTH
It’s important to know exactly what your medical situation is, otherwise the mind is free to imagine all sorts of alarming scenarios. And appropriate medical intervention is essential. If you have not done so already, consider making an appointment with a medical doctor who considers the whole picture of physical and emotional health. Tell your doctor about your physical symptoms and also your struggle with anxiety. Ask your doctor for a medical physical with blood work as well as a full thyroid panel test.
Thyroid imbalances impact anxiety and need appropriate medication. Also, make sure your doctor checks your vitamin D level. Vitamin D deficiency can impact mood and energy level. After you talk through the results with your doctor, make three columns in your notebook:
1.Your specific medical issue(s)
Example: High blood pressure
2.How you’re going to address it medically
Example: Take high blood pressure medication
3.How you’re going to address it in terms of anxiety intervention
Example: Become aware of anxiety triggers; practice mindful breathing 15 minutes a day; exercise four days a week; positive self-talk (“Better managing of my anxiety will improve my physical health”)
The Mind-Body Connection
I want you to remember the last time you were genuinely frightened. When it happened, you probably experienced an increase in your heart rate, change in your breathing pattern, or became sweaty, shaky, or jittery. These physical symptoms may have then reinforced your original fearful thoughts. The mind and the body constantly communicate. If your mind is filled with a sense of emotional peace, you are much better equipped to handle medical/physical challenges.
The mind-body connection is empowering because your anxiety symptoms will likely improve, or even disappear, simply by taking good, consistent care of yourself. Healthy sleep, exercise, and nutrition habits usually swiftly improve anxiety symptoms.
STRATEGY: SLEEP
Sleep is restorative in all respects: mood, cognitive functioning, energy, and health. Unfortunately, when we’re anxious we do not reap these benefits because anxiety typically interferes with sleep. People who struggle with anxiety wake up to intrusive worries during the night, can’t fall asleep, or wake up too early.
Creating a nightly sleep routine places cues in the brain. When practiced regularly, the cues remind us that it’s time to start unwinding. The key is to follow the routine consistently so you become accustomed to the cues. Eventually, you will need only to start your routine to feel more at ease and even sleepy.
Many expect to go from alert to asleep with no downshift in between. There’s a middle gear: relaxation. Here’s an example of a good nightly routine that will help you get into a relaxed, sleepy state. Work to develop one of your own or use this one.
One hour before your desired bedtime (ideally the same time each night), start your routine.
•Unplug from technology. Dock your phone, tablet, or computer away from your bedroom.
•Take a warm bath or shower.
•Change into sleep clothes.
•Drink a warm decaffeinated beverage, such as chamomile tea.
•Do a relaxation exercise: meditate through deep breathing, visualize relaxing imagery, practice progressive muscle relaxation.
•Lie down comfortably and read fiction or something light.
•Turn off your lights when you feel sleepy and your eyes start closing.
•When you can’t sleep, don’t think, “Why can’t I sleep?!” Tell yourself, “It’s okay if I don’t fall asleep, at least I’m resting.” If waking up continues, try progressive muscle relaxation with the lights off.
•Don’t worry about the time on the clock. The goal is to relax even if you can’t sleep.
•Wake up at the same time each morning.
•If you didn’t sleep well the night before, don’t take a nap or go to bed at an earlier time; stick with the same routine.
IMPORTANT NOTE: Worry often appears at night because we have been so busy during the day we haven’t been able to emotionally connect with ourselves so all the things we haven’t thought about crash in once the lights are out. To counteract this, set aside 30 minutes each day for what I call “total worry time.” Take out your notebook and put all your worries on the page: Consider how you’re feeling, what needs to get done, and what worries you about the days or weeks ahead. Then when the lights are out, your brain won’t have to remind you of everything you haven’t thought about earlier.
STRATEGY: EXERCISE
Anxious energy needs a release or it will continue to run amok. Adding regular exercise into your life will pay off. Thirty minutes of aerobic exercise five days a week will lessen your stress, increase your self-esteem, improve your sleep, and improve your physical and emotional functioning. Feeling good about yourself means you’re more likely to cope well because you believe in your ability to do so.
Exercise also increases endorphins, the body’s natural painkiller, and decreases the stress hormone cortisol. It’s worth it! And if 30 minutes feels like too much too quickly, keep in mind that research is showing that even a 20-minute vigorous walk improves cognitive functioning and mood.
Make a realistic exercise goal. Pick something you enjoy doing so you will continue to do it. For example, walk every day for 15 to 20 minutes. Then after two weeks increase the amount of time or increase to a light jog. Be sure to check with your medical doctor that exercise is safe for your physical condition.
Write down now what your exercise goal is—no goal is too small; any physical movement is better than none. However, each time you exercise, your mood will improve and your anxiety will decrease, so consider doing something on a daily basis.
When experiencing acute anxiety, employ the “10-minute remedy.” If you’re anxious and you vigorously exercise for 10 minutes—a brisk walk, jogging, bouncing on a trampoline, jumping jacks—your anxiety will decrease almost immediately. Lifting heavy objects or weights for a short time can also relieve anxiety and tension. Endorphins are released and you will feel naturally at ease. It will wear off, but the 10-minute remedy is a quick hit for anxiety.
STRATEGY: NUTRITION
Start looking at food as not only one of the great pleasures in life but also as a natural means to improving your emotional functioning. The goal is to eat a varied diet with plenty of fruits and vegetables. Rid your pantry of all processed foods and sugar. Adding a variety of nutrients and decreasing sugar helps the body regulate insulin and hormone levels, which directly impact mood, anxiety, and energy levels.
A few specific tips about diet and anxiety:
Water: Our body needs water to function, and if it isn’t functioning properly, mood will suffer. Make sure you’re drinking 8 to 10 glasses of water daily. When experiencing an acute bout of anxiety, pour yourself a tall, icy glass of water. This will quickly change your physiology, turn the brain’s attention to the cold sensation, and reduce your anxiety.
Caffeine: It’s astounding how many people who struggle with anxiety also drink a lot of caffeinated beverages. Make no mistake: Caffeine increases anxiety. Decreasing or eliminating caffeine and other stimulants from your diet will immediately lessen the intensity of your anxiety. Consider removing all caffeine from your diet, and if that’s too hard, halve it and work down from there.
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Nicotine and alcohol: Both nicotine and alcohol have short-term rewarding effects on the brain but increase anxiety in the long term. If you drink or smoke regularly, take a break and see how you feel. For some people this change alone cures their anxiety overload.
Nutrients: If you have any vitamin deficiencies (check with your physician), you may benefit from taking specific supplements, such as vitamin D or a daily multivitamin.
Go Deeper
Goal Setting for Exercise & Sleep (1-Week Program)
In order to make a long-term impact on your anxiety and give yourself an emotional boost, consider centering your goals this week on regular exercise and sleep hygiene.
Think now about how you can fit in 30 minutes of exercise each day this week. It doesn’t necessarily have to be at the same time each day but remember: Consistency makes it easier to stick with a routine. Taking care of yourself needs to be a higher priority in your life, so you might have to give something up or put to the side something that’s important to you.
Then, each day do aerobic exercise for at least 30 minutes. Jog, speed walk, bike, hike, play a vigorous sport (soccer, basketball, tag with your kids), take an exercise class. Force yourself to do some kind of activity every day no matter what else is going on in your life. Even when you don’t want to do it, remind yourself little in life pays off as much as an investment in exercise. You will improve your physical health, your emotional health, and probably live a longer more fulfilled life—simply by dedicating 30 minutes each day. Bonus: The release of endorphins and other rewarding hormones will help you feel good about yourself.
As we’ve seen, good sleep hygiene is perhaps the most impactful way to improve mood and anxiety. A regular nightly wind-down ritual cues the brain to calm and switch into sleep mode. Make that a goal, starting with a regular bedtime. Identify which sleep aid techniques discussed previously you will incorporate into your wind-down habit. It’s essential to do the routine consistently and at roughly the same time each night.
After a week, journal about how you feel physically and emotionally compared to last week. Do you feel any more positive about your ability to cope? Have you experienced even slightly less physical tension/anxiety this week? Could you continue this for another week?
Everyday Body Awareness
When we’re anxious, one worried thought replaces another and another. This can keep us so stuck that even a few moments away from anxiety feels impossible, but it is possible to short-circuit anxious thinking by shifting our attention to our physical sensations.
Try this: Imagine looking at the sky and focusing intently on one small black cloud. Now pull back your perspective so you take in the entire sky, horizon to horizon. From that perspective, the black cloud loses its significance. In the same way, switching your attention from your anxious thoughts to the physical sensations created by those thoughts can alter your perspective.
When you experience an anxious-thought spiral, observe your physical sensations—tight chest, tense shoulders, racing heartbeat, whatever they are—and give them your full attention, breathing in and out. As you acknowledge it (“I see you” or “There you are”), it will likely change to a different sensation. Recognize these sensations are communicating how alive you are in this moment.
STRATEGY: MINDFUL MOVEMENT
Use the simple act of mindful walking to ground yourself into the here and now and to let go of or decrease the intensity of obsessive thinking. You can do this anywhere and at any time—walking to your car, walking around the grocery store, walking around your neighborhood, or walking to work.
While walking, focus less on your thinking self and more on your physical experience. For example, what does your foot feel like as you lift it and lower it to the ground? How do your arms feel as you move?
Try to feel the earth from within your body. What is that sensation like? Does the sole of your foot on the ground feel heavy? Can you make it soft?
Explore each of your senses. Notice what you feel on your skin; is the air hot or cool? Do you smell anything as you inhale and exhale?
Simply observe any sounds you hear. Notice what you see. You are here in this moment; feel your presence and your alert state of mind.
With each step, mindfully breathe in, and breathe out. Count your steps as you inhale and as you exhale. How many steps does it take as you inhale? How many as you exhale? Keep your attention on the steps and your breathing.
Each time you become aware of your mind drifting, gently bring your attention back to observing what it feels like in your body to walk. There is no rush; all that matters in this moment is to be aware of your body as it glides through space.
WRAP-UP
•Anxiety impacts the body and the body impacts anxiety.
•Learn to identify and observe (without judgment) where anxiety manifests in your body.
•Anxiety is associated with a variety of medical conditions.
•Healthy sleep, nutrition, and exercise habits typically improve anxious symptoms.
•Practicing body awareness exercises helps reduce anxious-thinking spirals.
CHAPTER FOUR
Putting the Tools to Work
Your intention is set. Anxiety will no longer rule your life. Now you know it’s within your reach to experience a peaceful emotional life and to feel physically at ease. The techniques you’re learning in this book can reduce anxiety on the spot, in the moment that it arises. Repeated use of the strategies will give you consistent, sustainable symptom reduction. Here’s how to start taking the techniques to the next level through building longer-term habits and goals.
From Strategies to Habits
The great pioneering neuropsychologist Donald Hebb observed, “neurons that fire together wire together.” Whether it be learning a new language or responding to an abusive parent, repeated experiences over time trigger the same patterns of neuronal activity. At some point, only a tiny cue will trigger that pattern of activity, and you can expect the same events to occur that have always occurred in the past. For example, when you see a red circle in the distance, your brain automatically registers “stop sign ahead.” You realize as you approach that it’s actually an advertisement on a red circle, but your initial perception told you it would be a stop sign, so you had already started downshifting or easing your foot off the gas. Because old patterns of neuronal activity fire quickly and before we have time to consciously think, changing automatic habits can feel hard.
It takes about 90 days to build a new habit. This is roughly enough time to rewire a bit of your brain. It does take discipline and effort at the beginning, but with practice, the new coping strategies become a natural part of your functioning and routine. Eventually you won’t even have to think about what to do to reduce your anxiety. You will automatically have a more peaceful way of being with yourself and coping with the world. This is the payout! To cultivate the ease and calm you want, stick with the strategies and put in steady, consistent effort.
Planning
Take a wide-angle look at how your life is organized so you can begin to think through how and when you will integrate the techniques into your day-to-day routine.
Outside of your responsibilities—work, school, volunteering, childcare, social life, family obligations—what do you do for yourself? When you do have downtime, how do you currently spend it? People with anxiety often feel as if their downtime is unpredictable, that they are at the mercy of others, their schedules, or their anxiety. Stop this pattern by looking at the big picture of your life. Look for opportunities where you can deliberately schedule periods of time to work on your anxiety strategies.
Review what you learned in the last two chapters (looking at your notebook can help) and identify which techniques you want to start with. How often? What times or days of the week are best? You don’t have to try every technique; start with two or three that particularly resonate with you. Try to do your anxiety work at the same time or times each day. A consistent time
gives the brain a cue that will speed the “neurons that fire together wire together” process.
Track Your Progress
Tracking progress works for many things, like losing weight or saving money. And tracking works with anxiety reduction, too. It’s essential to long-term progress that you set up a system where you track on a daily basis the strategies you’re using, and the intensity of your anxiety. Here’s an example of a quick and easy way to track progress. Each day, check any and all strategies you use from chapters 2 and 3. Also be sure to rate your anxiety for the day, using a 1 to 10 scale, with 1 being entirely relaxed and 10 being full anxiety meltdown. For example, you could create a table like this:
STRATEGY MON TUES WEDS THURS FRI SAT SUN
How Do You Feel Right Now? ✓
Express Yourself
Exploring Anger ✓
Exploring Sadness ✓
Judging Anger
Judging Sadness
Let Go of Judgment (Meditation) ✓
Practice Acceptance ✓
Sitting with Difficult Emotions (Meditation)
Body Scan
Progressive Muscle Relaxation
What Stories Are You Telling? ✓
Take Care of Medical Health
Practice Good Sleep Hygiene ✓
Exercise
Nutrition
Mindful Movement (Walking Meditation)
Rate Your Anxiety 1 to 10 Scale 6 7 2 5 3 5 8
The 1 to 10 scale is a way to look back and see your progress. At first you may have quite a few 8s or even 10s, but ideally over the course of a month you are going to have more days with 5s or even 4s.
Goal Setting
One way we sabotage our goals is by telling ourselves that we don’t have the time it takes to make a change. If you’re reading this book, you spend time worried and anxious, yet you don’t spend quality time making the changes that will nurture your mental health. Take a moment now to make a goal to tackle your anxiety by doing anxiety strategies on a daily/weekly basis.
You may feel vulnerable acknowledging to yourself, and the people close to you, that you want to improve your anxiety and that you are going to take deliberate steps to do so. You might worry that you won’t be successful. It’s sometimes easier, particularly in the beginning, to say, “I can’t do it,” or “I don’t need this.” If you hear yourself saying these things, it might be because you’re afraid of failure. If so, dig deep; believe in your ability to change. You can and will find relief from anxiety, provided you learn to believe in yourself.