First Do No Harm

AnxietyIs There Something Better than Ativan?

I have Post Traumatic Stress Disorder. One horrible facet to this disorder is anxiety attacks.

In the past, the VA has put me on drugs, but I don’t like the side effects and I’ve had to work my way off of them. Personally, I do qigong/tai chi, meditation, and breathing exercises, and up until my injuries, I played tennis 20 hours a week. Now, I go to the gym and workout.

Friends have asked me for more things they can do, natural things, so they don’t have to put their bodies out of whack with drugs, and this page is my response. I will start with the things I do to avoid/handle anxiety.

Live In the Moment

Anxiety comes at us out of the past or the future. It terrorizes us in the moment, but it’s not from the moment. It’s from the past or the future.

What you have to do (what I do) is grab onto an ounce of rational thought and “realize” that the attack is not real.

Quickly take inventory and find out what happened to cause it, to bring it on. It’s usually something very tiny; something quite insignificant.

NOTE: this takes a rational mind. When anxiety attacks you, you are most likely not in a rational state of mind. So the following things can be done to bring you there so that you can be in the moment.

Deep Breathing

There is a yoga breathing exercise in which you stand or sit relaxed, and then breathe in to the count of 4, hold it to the count of 7, and then breathe out slowly to the count of 8. Breathe in through the nose, exhale out the mouth.

In less than a couple of minutes, the anxiety can start to dissipate.

Exercise!

Anything. Jumping jacks, jump rope, go for a walk. Anything.

Story: I had a friend who was disabled with depression and intermittent anxiety attacks. I taught her to play tennis. Never, in my experiences with her, had she been happier than when she was on the tennis courts. Never.

But there is one thing about humans that is puzzling: we sabotage our own recovery.

The hardest thing to do is what you need to do at the moment.

Internally, intellectually, we might know exactly what we need to do, but when we are in our funk, the last thing we are going to do is what we need to do. This is a weird but common human trait.

One solution? FIND A PARTNER!

Find someone who can shake you out of your lethargy and into your sanity. Find someone who will grab your hand and take you for a walk.

A twenty minute walk just lights up the happiness centers of your brain.

And if you exercise on a regular basis, anxiety attacks will become more infrequent, and you’ll feel healthier, and as you feel healthier, your anxiety attacks will become more infrequent. Start a cycle of healing. [www.DrewRamseyMD.com]

The photo posted here is of a brain after a 20 minute walk, but Dr Ramsey’s research points to a 21 minute threshold: "If you're really anxious and you hop on a treadmill, you will feel more calm after the workout," he says.

And if you don’t exercise regularly or you don’t have equipment or a home gym or you don’t belong to a gym, Dr Ramsey recommends the exercise that the father of medicine, Hippocrates, felt was the best exercise of all: Go for a brisk walk.

Eat Something

Dr Ramsey co-authored The Happiness Diet. He says, “Almost universally, people get more anxious and irritable when they are hungry,” and that many anxiety attacks start when blood sugar is dropping. Almost anything will do, but the best is a piece of dark chocolate. Dark chocolate is healthy and helps fight anxiety. If you don’t have dark chocolate available, a handful of almonds, walnuts, or raisins will do.

Diet is very important for people who battle anxiety. Toss out your white sugar, white salt, white flour. The only thing white that should be in your kitchen is cauliflower.

Use Celtic Sea Salt, Dead Sea Salt, Alaea Salt, or Himalayan Salt. Avoid high fructose corn syrup and white sugar and especially artificial sugars that destroy your colon bacteria: 80% of your serotonin is created in your gut. Find a good probiotic to supplement and build your good bacteria. (I use BioTrusts Pro-X10™). Eat yogurt, Kimchi, real sauerkraut; foods naturally fermented that contain probiotics. And eat foods that feed your good bacteria, like resistant starches.

Use Sucanat, Honey, Stevia, or Erythritol.

Eat whole foods, and possibly avoid wheat. Many people sensitive to wheat and/or gluten suffer from anxiety attacks when eating these things.

Lots of leafy greens like kale (more nutrition found in kale when steamed rather than raw), and fresh vegetables, because phytonutrients (especially folate) help fight anxiety.

And do NOT skip breakfast. At least have a poached egg. One egg contains choline, which is a nutrient that fights anxiety. Fresh farm eggs are best, and avoid scrambled eggs or omelets, as you are oxidizing the wonderfully healthy fats in the yolk. Sunny side up is the third best way to fix an egg; soft boiled is the second, poached is the first. Do not harm the yolk.

Omega-3 Essential Fatty Acids

They are good for your heart, and they protect against depression. Getting them from your food is best. I take Omegasentials daily (it’s a Minnesota product). There are hundreds of studies on essential fatty acids and anxiety/depression. You can get them from fish too, cold water salmon being the best form. Then there are sardines, anchovies, and mussels. These are closer to the bottom of the food chain, so they are less likely to be brimming with mercury.

The last advice Dr Ramsey has for us is…

STOP CATASTROPHIZING!

Mark Twain once said, “I am an old man and have known a great many troubles, but most of them have never happened.” 

Most of the things we worry about have two things in common:

  1. We have no control over them

  2. They’ll never happen.

The problem is it is only a rational mind that knows this. When you are in the throes of an anxiety attack, you are less than rational. This is why you must:

  1. breathe

  2. exercise

  3. eat something

  4. AND THEN: step into the moment and stop catastrophizing

HOWEVER: for many of you who experience debilitating anxiety attacks, most of the above is impossible unless you are drugged up. So, to get to a stage where you can actually reach your “rational mind” when you need it most, you might need assistance. The following will help you get there.

Herbal Remedies for Anxiety (and supplements)

Chamomile: A cup of chamomile tea does the trick for some; it is very soothing and calming. There are compounds in chamomile that bind to the same brain receptors as drugs such as Valium.

The active ingredient in chamomile is apigenin and if you are not a tea drinker, you can take this in supplement form. However, you must take it on a regular basis if you are going to recapitulate the studies that have been done on it that showed that those who took it for eight weeks had significantly decreased their anxiety symptoms (compared to the control group).

Green Tea Extract: has been shown in studies to curb rising heart rate and blood pressure, as well as alleviate anxiety. The active ingredient, the amino acid L-theanine, seems to be responsible for this and the dosage is 200 milligrams.

Inositol: is part of the B-vitamin complex, and is also remarkably effective against depression, panic attacks, and obsessive-compulsive disorder (OCD) in several studies. The effective dose was 12 grams per day for four weeks. Inositol has no side effects and is as effective as prescription drugs.

There is a good article here: Inositol - The Nervous System's Pony Express that talks about studies and how high a dose you have to be on to work. You might see results right away, or after two weeks, or after four weeks. The amount is quite high, so finding a powdered form and putting it in a smoothie might help, besides taking pills (4 - 5 times a day). There can be reactions, but they are rare. And you should be aware that at 12 grams per day, you gut might have some difficulties. However, as she points out in the article, it's very promising, even for those who don't respond to traditional medications. 

I've found a variety of sources for inositol: Inositol Powder, 5 kg (11 lbs): GL (yes, that's 5 kilos of it), or NOW Foods (800mg), and finally NOW Foods 4oz Powdered Inositol. These are the best prices I've found on the web.

Hops: are very bitter, so you’ll have to take them in a pill form or add them go your tea. It is often used as a sedative and promotes sleep just like the next herb:

Valerian: acts as a sedative and can help promote sleep. In Germany it is prescribed by physicians as a sleep aid. It is nasty tasting, so most take it in a capsule. There are supplements that contain valerian, along with other sedative herbs such as chamomile, hops, and this next herb:

Lemon Balm: has been used since the Middle Ages to reduce stress and anxiety, not to mention as a sleep aid. The dosage is about 600mg of a standardized extract. Again, Lemon Balm is backed by studies and is considered generally safe, though too much has been shown to work in the opposite direction, causing anxiety.

Passionflower: has nothing to do with love, unless you can’t love while anxious. The Germans (they are quite ahead of us in some ways) have approved it for nervousness, and it is often recommended for insomnia.

You should be careful not to mix Passionflower with any of the above herbs, or find a brand that has already been mixed for you. Never take Passionflower for more than a month.

Lavender: is loved by all. Its essential oils are often used in massage therapy and applied to burns. Just the smell of lavender is soothing to most people, and one really neat study out of Greece showed that when a waiting room was scented with lavender oil, dental patients became less anxious than the control group (who got some store bought air freshener). In a Florida study [http://www.ncbi.nlm.nih.gov/pubmed/19258850], students who inhaled lavender essential oil prior to an exam were less anxious: however, some reported that it made their brains a bit “fuzzy.”

SAMe: is another dietary supplement that has been used in treatment of anxiety.

Probiotics: A French study published in the British Journal of Nutrition showed that probiotics [Lactobacillus helveticus and Bifidobacterium longum], in both rats and humans, decreased stress-induced gastrointestinal discomfort, overall levels of stress and anxiety, and cut cortisol levels quite significantly.

However:

NONE OF THE ABOVE SHOULD BE TAKEN IF YOU ARE ALREADY ON A PRESCRIPTION SEDATIVE OR ANTI-ANXIETY DRUG. (With the exception of probiotics.)

Finally, cut out those things that are making you anxious. Caffeine, alcohol, and all those sugary things mentioned above. To cut caffeine, do it slowly mixing decaf in with your regular coffee, and take about 200mg of magnesium daily.

Proper Support of Your Neurotransmitters

The nutrients that contribute to proper health and function of the nervous system, as well as support your neurotransmitters, are calcium, magnesium, and a B complex (though B-12 is a must). Many people have trouble absorbing B-12, so take it in the form of a sublingual lozenge. Methylcobalim is the BEST form of B-12 your brain. And never forget that the first symptoms of a B-12 deficiency are depression and anxiety. People who have English/Irish roots are often deficient in B-12 since they lack “intrinsic factor” which aids in absorption (hence the sublingual lozenge).

Mindfulness

Once you’ve gotten the proper nutrition, along with, perhaps, a few herbs and supplements, living mindfully will become easier.

There is a STOP meditation I perform once in a while: No matter what I am doing, I stop, for just one minute and heighten my awareness of everything around me: the humming of my computer, the birds outside, the sun, the trees, everything, for just one minute.

The Japanese have this thing they call Shinrin-yoku, or literally “forest bath." It’s basically a walk in the woods. I am lucky in that I actually live in the woods (and let me tell you, it has saved my life), but to city dwellers, the woods are a long way off. So find a park. We have them everywhere. Go find one and spend at least 20 minutes a day walking and enjoying the sights and smells and sounds. Researchers have measured bodily changes, hormonal changes, in people who do this, and there is hardly anything better to calm a person.

Those who contemplate the beauty of the earth find reserves of strength that will endure as long as life lasts. There is something infinitely healing in the repeated refrains of nature -- the assurance that dawn comes after night, and spring after winter.”  Rachel CarsonSilent Spring

Being in nature will bring you back to “mindfulness,” which is simply living in the present, aware of everything, and worried by nothing.

In The Power of Now, Eckhart Tolle points out all worries spring from the past over things we did or from the future over things that haven’t happened, both of which we have no control over. To live in the present is to live free from the anxiety of the past and of the future. In the present, he says, we have no problems.

And when an anxious thought occurs, be aware of it. Be aware that they are just thoughts and that you are doing the thinking.

Again, Tolle points out that when you realize you are NOT in the present, that is the FIRST STEP to being in the present.

And congratulate yourself that you are aware of this. It’s a pretty big step you’ve taken.

In the past, anxiety has controlled you. If you can keep your mindfulness and open your awareness to the thought you are thinking, that alone is one huge step toward conquering anxiety.


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