Super quick ways to slay your ‘Panic Vampire’: No one would blame you for feeling anxious at the moment. But in a life-changing – and very timely – new book, a top psychiatrist shares her tips to reduce anxiety
- Dr Ellen Vora says it’s often best to use a holistic approach when feeling uneasy
- Dealing with physiological stresses can reduce levels of stress hormones
- Psychiatrist shares steps that will dial down the volume on your anxiety
There can’t be anyone who hasn’t felt a bubbling sense of panic about the pandemic or the recent events unfolding in Ukraine. Such is the unrelenting pace of modern life and our unlimited access to 24‑hour news that anxiety levels are creeping ever higher.
When feelings of apprehension and unease start to interfere with your ability to function properly, it can be tempting to seek counselling or medication. But as a psychiatrist with a busy practice, I’ve found it’s often best to use a holistic approach — without resorting to drugs.
Anxiety can often be as grounded in the body as it is in the mind, and the solutions are disarmingly simple.
When you notice feelings of anxiety — that hypervigilant feeling that escalates swiftly to a sense of catastrophe and doom — it can seem as if everything is conspiring to overwhelm you: relationships become confounding; work presses and prods; and the world can feel as if it’s barrelling towards certain disaster.
Dr Ellen Vora shares advice for taking a holistic approach, when feelings of apprehension and unease start to interfere with your ability to function properly (file image)
But many of these dreadful feelings and terrifying thoughts are, I believe, more likely to be the brain’s attempts to justify the stress messages it is receiving from your body. The brain then offers a narrative for why we feel uneasy, perhaps picking work, a toxic relationship or the terrifying situation in Ukraine.
Micro-stresses such as a sleepless night, too much caffeine, a blood-sugar rollercoaster, hormonal imbalances, inflammation or unhappy gut bacteria can each trigger the release of stress hormones which, over time, signal a state of emergency to the brain, telling us something is not right. By dealing with the physiological stresses (e.g. limiting your access to 24-hour news), you really can reduce levels of the stress hormones enough to silence the brain’s imaginings and find a sense of calm.
I encourage my patients to consider anxiety as an invitation to explore what might be subtly out of balance in their body and life. Changing these are your initial quick wins and will give you a clearer headspace to assess whether you need to tackle more challenging forms of anxiety that might lie beneath.
Profound anxiety that exists beyond the physiological — such as the death of a loved one, loss of a job, significant relationship break-up or fear for your life — can’t be addressed so easily. But even if your anxiety comes from being in a dead-end job or a toxic marriage, my process can still help you identify your cue to act and leave that job or set relationship boundaries. Instead of feeling helpless and afraid, these first steps will dial down the volume on your anxiety.
FIRST: TAKE THIS ANXIETY QUIZ
Run through the below questions whenever you feel anxious. It will identify possible triggers and match them with effective remedies.
I’m anxious and I’m not sure why. Am I…
- Hungry? (Eat something!)
- Having a blood sugar crash or a chemical come down? (Did I recently eat something sweet, processed or laden with food colouring or preservatives? Have a healthy snack and recognise your triggers next time.)
- Overcaffeinated? (Perhaps this jittery anxiety is caffeine sensitivity; tomorrow, drink one less cup.)
- Undercaffeinated? (I drank less caffeine today than usual; dose up and aim for consistent daily caffeine consumption going forward.)
- Tired? (Have a nap; prioritise an early bedtime tonight.)
- Dehydrated? (Drink some water.)
- Feeling sluggish? (Take a quick walk outside or dance.)
- Drunk or hungover? (File this away to help inform future choices around drink.)
Dr Ellen Vora said numerous studies have shown exercise to be an effective anti-anxiety agent, finding a form of exercise that works for your life is key (file image)
RULE OUT IF YOU HAVE ‘HANXIETY’
With most of my patients I start with the assumption that their anxiety is a blood sugar issue until proven otherwise. That’s because our bodies are vulnerable to glitches in blood sugar regulation causing us to swing up and down throughout the day, with every blood sugar crash generating a stress response.
Given that the modern diet is so blood-sugar destabilising, these stress responses are at the root of much of the anxiety I see.
If you know you can be ‘hangry’, you probably also get ‘hanxious’ too, when your blood sugar is low. Take a good look at your diet and the role blood sugar plays in your mood. I’ll bet stabilising your blood sugar — with regular meals packed with protein, fibre and healthy fats — will help your anxiety.
Try this: eat a spoonful of almond butter or coconut oil at regular intervals throughout the day to keep your blood sugar stable.
SITTING DOWN IS THE NEW SMOKING
COME OFF COFFEE CAREFULLY
Dr Ellen Vora said gradually change your coffee-drinking habits to avoid headaches and fatigue (file image)
Any changes to your coffee-drinking habits should be gradual. Remember: caffeine feels so good, in part, because it’s the antidote to its =own withdrawal — we wake up with caffeine withdrawal, and then coffee gets the credit for being the salvation to the very problem it created.
To avoid headaches, irritability and fatigue, taper off slowly over the course of several weeks.
Sitting at a desk for long periods can be enough to prompt anxiety. The neck and shoulder position we hold during extended hours at the computer and staring at our phones can impact blood flow to the brain. Desk work puts tension in the muscles of the neck, upper back and jaw, all of which are connected with our sympathetic nervous system, which controls stress, cumulatively telling our brains that we are anxious.
Similarly, the fixed position of our eyes on the screen and the clenching of the jaw and the ‘shrug’ muscles which link our shoulders to our neck unconsciously signal to our brains that we’re in a stressful situation — whether we are or not. When we focus on the screen, at times our eyes widen just as they would in a state of fear. This prompts levels of stress hormones to build.
Check your working ergonomics, take periodic breaks to rest your eyes and when you can, put the technology aside to take a few unplugged minutes outside.
. . . BUT EXERCISE IS THE NEW XANAX
One way to shake off anxiety is to get moving. Finding a form of exercise that works for your life is key. Numerous studies have shown exercise to be an effective anti-anxiety agent. One reason is the way it encourages our body to release home-grown pain relief (endorphins), but even small amounts of movement can significantly reduce anxiety and improve energy levels.
The right prescription is anything that feels good for you and can realistically fit into your life. When it comes to health and anxiety management, something you can actually do is 100 per cent better than any loftier but more unrealistic goal.
RESTART YOUR BODY BY SHAKING IT OFF
When you feel overwhelmed by stress put on rhythmic music, close your eyes, allow a soft bend in your knees and let your body feel loose like a ragdoll. Then shake. Stress can freeze you into a locked state but full body shaking is like pressing ctrl-alt-delete on your keyboard, breaking you out of the stress response. It appears to tell the nervous system, in an old and hardwired manner, that the threat has passed and you are safe now.
PULL YOURSELF BACK TO THE PRESENT
Dr Ellen Vora said an effective grounding technique is to count five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste (file image)
Pure panic can escalate fast if you find yourself ‘future tripping’ (predicting imminent disaster) or dwelling on the past. The key is finding the strength to pull yourself back to the present. I think of present moment awareness as garlic to the panic vampire. For a first quick fix, try splashing cold water on your face or opening a window for a blast of fresh air.
Another effective grounding technique is to count five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. This trains your attention on the present moment.
Finally, aim to shift your perspective so you see panic as an indication that your body is functioning properly, rather than an indication that something is going wrong. This takes the emotional power out of the reaction, reframing it with curiosity and appreciation, rather than fear.
If you experience panic attacks regularly, try running through this list of fast and effective interventions:
- Go outside and move your body to release accumulated adrenaline (run, jump, pace on the spot).
- Count five things you see.
- After that do a 4-7-8 breath (inhale for a count of 4, hold for 7, exhale for 8).
- Count four things you’re touching (e.g. legs, sweater, ground and chair).
- Do a 4-7-8 breath.
- Now count three things you can hear.
- Do a 4-7-8 breath.
- Count two things you can smell near you.
- Do a 4-7-8 breath.
- Count one thing you can taste.
- Take box breaths — inhale for 4 counts, hold for 4, exhale for 4, hold for 4, and repeat.
- Ground your feet and push into a wall with both hands.
- Count backward from one hundred by sevens.
- Run your hands or feet through something sensory such as water, earth or sand.
THE MAGIC OF MAGNESIUM
Dr Ellen Vora suggests eating dark chocolate, pumpkin seeds, avocados (pictured), bananas and almonds to avoid being deficient in magnesium
The connection between sleep and anxiety is a critical, two- way conversation: anxiety contributes to insomnia, and chronic lack of sleep makes us prone to anxiety.
Anxiety at night is largely determined by how well we manage stress during the day. The more you build relaxation into your daylight hours, the calmer you will feel in the dark.
Fortunately, our body wants to sleep and knows how to do it — the trick is to listen to its cues, provide it with the right conditions and get out of its way.
But one tip which can really help is taking a nightly magnesium supplement. The mineral is involved in hundreds of biochemical reactions in the body and supplements have been shown to help with insomnia, anxiety, depression, migraines, menstrual cramps, muscle tension and many other ailments.
Most of us are deficient in magnesium, so I recommend taking 100–400mg of magnesium glycinate at bedtime or upping your food sources (dark chocolate, pumpkin seeds, avocados, bananas and almonds), or allowing it to absorb through your skin during an Epsom salt bath.
- Adapted by Louise Atkinson from The Anatomy Of Anxiety: Understanding And Overcoming The Body’s Fear Response, by Dr Ellen Vora (£14.99, Orion Books), to be published March 22. ©Dr Ellen Vora 2022. To order a copy for £13.49 (offer valid to April 5, 2022; UK P&P free on orders over £20), visit mailshop.co.uk/books or call 020 3176 2937.
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