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Managing High Anxiety Without the Drugs - Mind Body Connections

Sunday, 22 August 2010 20:51

Written by Joseph Hart

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Article Index
Managing High Anxiety Without the Drugs
The myth of magic cure
Mind Body Connections
Mix your own cure
All Pages

Mind-Body Connections
The biological processes triggered by anxiety- sweaty hands, shallow breathing, increased heart rate, dizziness- are hardwired human responses to stressful situations. Most of these responses serve some biological purpose, such as preparing our bodies to react (fight or flee), or they are the byproduct of the chemicals, such as cortisol and adrenaline, that such a reaction might require. It’s when we perceive a major threat in situations where, anxietyobjectively speaking, there is little or none- for example, in a crowded elevator (claustrophobia), crossing a bridge (fear of heights), leaving the house (agoraphobia) or at an office mixer (social anxiety) that anxiety is classified as a disorder.

 

Although pharmaceutical drugs can help moderate our bodies’ physical response to stressful thoughts or stimuli, nonpharmaceutical treatments- like cognitive behavioral therapy (CBT) are beginning to replace drugs as the preferred treatment for anxiety disorders.

Unlike medications that attempt to suppress our physiological responses to perceived threats, CBT is aimed at correcting our perception of those threats, and thus encouraging a self-moderating response.

The first goal of CBT is simply education, says Abramowitz. “We teach people about their symptoms,” he explains. “We explain that when you feel nauseated, it’s not because you’re going to throw up; when your heart races, it’s not because you’re having a heart attack. “For many, just recognizing the symptoms of anxiety for what they are- and realizing that they do not represent an immediate danger- can prevent an attack from worsening.

The second phase of CBT focuses on exposure and response protection. Some CBT therapists actually place the sufferer in the situation that causes him or her fear- whether that situation is external, like playing with a large dog, or internal, like experiencing an accelerated heart rate. “When a person repeatedly confronts their fears, they learn that the outcomes they worry about aren’t nearly as likely as they think,” Abramowitz explains.

Moreover, they learn that the initial fight-or-flight response is transitory; anxiety eases when you’re able to stay in a situation and your fears aren’t realized.

It can take 10 to 15 sessions of CBT to produce lasting results, says Abramowitz, and the success rate is fairly high as many as 70 percent of patients conquer their anxieties. (To find a cognitive-behavioral therapist near you, visit the National Association of Cognitive-Behavioral Therapists at http://nacbt.org/searchfortherapists.asp.)

Anxiety as a Physical Condition
Patricia Gerbarg, PhD, MD, a clinical psychiatrist at the New York Medical College and coauthor of How to Use Herbs, Nutrients, and Yoga in Mental Health Care (Norton, 2009), is studying how to activate the parasympathetic nervous system to quiet anxiety. She and her colleagues have discovered that some ancient practices are highly effective.

In particular, yoga breathing induces a very calm, clear-minded state the opposite of the anxious fight-or-flight state of the sympathetic nervous system. “When you change the pattern of breathing,” explains Gerbarg, “it changes what happens in your emotion centers and thinking centers,” slowing the fight-or- flight actions of the amygdala and quieting the areas of the cortex that process worry.

Gerbarg and her colleagues have been able to quantify the effects of breathing techniques on the parasympathetic nervous system, and they are using what they’ve learned to train patients to interrupt anxiety with breathing. “We have seen some very rapid effects,” she says. “In five minutes, people may go from severe anxiety to complete relaxation.”

Gerbarg still prescribes medications when necessary to help relieve acute, debilitating symptoms and give alternative interventions a chance but her long-term goal is to build the strength of the parasympathetic system, rather than to suppress the sympathetic.

Exercise quiets the anxiety response, not by changing the situation that is causing anxiety, he explains, but by changing the vessel of your worry, the physical state of your body and brain. He notes that exercise produces a variety of chemicals, such as endorphins, corticosteroids and neurotrophins, as well as various neurotransmitters like serotonin that can help soothe the worried mind.

If you start to feel anxiety welling up and you have even just a few free minutes, a couple treks up and down the stairs or a brisk walk around the block can work wonders, says Hallowell. You won’t always have the opportunity to break into a sprint when you feel your anxiety spiking, but, he continues, A regular exercise program exercise three or four times a week will almost always cut down on worry. Exercise should be incorporated into any plan to reduce anxiety and control worry.

Finally, no approach to anxiety management can be optimally successful unless it is supported by proper nutrition. Our brains require certain fats, proteins and nutrients to function normally and regulate mood and no amount of yogic breathing or CBT can compensate for a mineral or omega-3-fat deficiency. (To learn more about what to eat to reduce anxiety and stabilize mood, see Comfort Food for Your Brain.) It is also important to limit your intake of stimulants such as caffeine, which prime the body and brain for heightened anxiety.

Next: Mix Your own Cure



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