Everyone has felt nervous, anxious, on edge, frightened, or worried at some point in time, and none of us enjoy feeling like this. As unpleasant as these feelings might be, most of us can cope effectively with the feelings and the situations that evoke them—at least most of the time. However, for some people these feelings can be so intense and intrusive that they interfere with their life and happiness. By anxiety I mean, “A state of arousal that is subjectively experienced as aversive.” In addition, anxiety usually includes feelings of apprehension, uncertainty and/or fear as well as negative thinking. Clearly, anxiety is not something that people enjoy or want to experience, and it can be very unpleasant.
Although most people have felt anxious from time to time that does not mean that everyone suffers from an anxiety disorder. Symptoms of anxiety include irritability, intense fear, worry, difficulty concentrating, and a general “keyed up” feeling. Physical symptoms of anxiety often include sweating, dry mouth, hot flashes or chills, dizziness, heart palpitations, muscle tension, trembling, nausea, and restlessness. When anxiety is very severe, lasts for a long time or frequently recurs, and is disruptive to a person’s life and comfort it may be a diagnosable Anxiety Disorder. Although Anxiety Disorders are one of the more common forms of psychological disorders and millions of people suffer from diagnosable anxiety problems, it is also true that Anxiety Disorders are among the most treatable of mental health conditions. Of major concern, however, is the fact that only about 25% of people with actual anxiety disorders will receive appropriate treatment—this is not acceptable, particularly when the appropriate treatments are not nearly as expensive as the costs of anxiety disorders in terms of lost work and school time and money spent on unneeded medical tests or inadequate treatments that are not focused on the anxiety itself.
The difference between “normal” anxiety and clinically relevant anxiety has to do with the impact the anxiety has on the person. For example, if the anxiety is only situational and goes away quickly it probably does not require treatment. Thus, to be diagnosable, the anxiety must persist over time. Further, it must be something that causes distress in the patient—they are suffering and very unhappy with the way they feel. Finally, the anxiety must interfere significantly with the patient’s normal functioning in important areas of their life—e.g., work, school, family, friends, recreation, sports, etc.). When anxiety is severe enough to cause these types of problems it is very likely that the anxiety will not go away by itself and professional help is warranted.
There are, however, some things that all of us can do to help more effectively manage stress and anxiety, and these are good health habits for anyone. Certainly I will have all of my patients who are suffering from anxiety disorders to do these things, but these are things that will help anyone deal more effectively with the “bumps in the road” that we all confront:
Regularly (at least three or four times per week)
Vary the exercise activities; do things that you enjoy but aerobic exercise is best (walking, jogging or running, swimming, biking, hiking, etc.)
Learn techniques for deep muscle relaxation, meditation, or yoga
Regularly 3-7 times per week
Learn regulated breathing techniques
Use a formal or informal organizing strategy such as a calendar, journal, lists, a cell phone, a personal digital assistant (PDA), a computer or tablet that you can carry with you, etc.
Prioritize your activities
Do not over-book yourself—schedule time for rest
Avoid time wasters like TV and video games (a little is OK, but do not overdo it)
Schedule short break periods throughout the day
Organize chores by the time you will spend rather than the tasks you will do
Recreation—doing things just for fun
Activities enjoyed alone (hobbies, reading, listening to or playing music)
Activities enjoyed with a significant other (take a walk, go on a date, take a day or weekend trip, go on vacation)
Activities enjoyed with family or friends
Stay socially involved and active—keep in touch with the people who are important to you, but do not overdo it
Minimize or eliminate caffeine and other stimulants
Minimize or eliminate depressant drugs like alcohol—they may initially have a calming effect but when they wear off, intensified anxiety or panic attacks will return
Regulate sleep patterns
Get up at about the same time each day
Do not extend sleep on weekends by more than an hour
Get enough sleep (most Americans are sleep deprived—it takes a toll on your health)
Develop good nutrition
Talk to your physician or a nutritionist
Do not overeat carbohydrates: white pasta and bread, potatoes, other starches
Eat lots of vegetables, fruits, and proteins; they are your friends
Good nutrition is not punishment
Many people will say that these things sound good, but who has enough time to do all of this? What most people find is that if you pay attention to these healthy habits you feel better, are more productive and get more work done, you are sick less frequently, and you do not experience as much stress and anxiety. Of course, these techniques are not a substitute for professional help, and people with a diagnosed Anxiety Disorder will benefit from these activities and patterns, but to really treat the condition they will need help from a professional as well. The good news is that these are all things within our grasp—things that we actually have control over—and they will help any and all of us stay healthier, happier, and less stressed and anxious.
Rudy Nydegger, PhD, ABPP
Chief of the Division of Psychology at Ellis Hospital Clinical and Consulting Psychologist in practice over 30 years Former President of the New York Psychological Association, and current Chair of the Legal and Legislative Committee.