7 Strategies To Reduce Anxiety

Hi friends,

Happy Sunday 🙂 

This week I had the opportunity to speak to future doctors at the University of Miami. I shared my story of becoming a doctor in hopes of inspiring them to never give up on their dreams of becoming physicians. I also discussed the high prevalence of mental health conditions experienced by medical students and physicians, and ways that we can protect our mental health in this stressful career.

Don’t let the smile in the above photo fool you though.

This was a stressful week for me, and unfortunately anxiety poked its ugly head out again. I’ve shared my journey with anxiety with many of you on this newsletter but anxiety is something that I’ve been experiencing on and off since college. Over the years I’ve become much better at recognizing when anxiety starts to creep in so that I can nip it in the bud before it gets worse.

Fun fact: I thought the phrase “nip it in the bud” was actually “nip it in the butt” for my entire life and nobody ever corrected me until like a year ago when my wife called me out on it…

Anyways, I’ve developed numerous strategies to help ease the thoughts and feelings associated with anxiety - and I’ve already began enacting them this week which has helped tremendously.

I share this with you all for two reasons:

1. Many of you experience anxiety too. And I want to let you know that you are not alone. And yes, even though I’m a doctor who treats anxiety as my literal job, I experience it too. Anxiety doesn’t give me a free pass because I’m a doctor.

2. Today, I’m going to walk you through evidence-based techniques that I use (and that I discuss with my patients), in hopes that it can help you on your journey to improve your relationship with anxiety.

Understanding Anxiety

Anxiety is an adaptive response to stress. 10,000 years ago when a Saber-toothed tiger came into your cave, feeling anxious allowed you to react fast, grab your sharp stick, and poke the cat in the eye to save your tribe.

Anxiety can be protective.

The thing is… there are no more Saber-toothed tigers trying to eat us. What was once protective, has now become a pain in the butt.

Anxiety becomes a problem when it becomes overwhelming or disproportionate to the situation, and can interfere with daily functioning and well-being. Anxiety Disorders are actually one of the most common mental health disorders, with a estimated 31.1% of U.S. adults experiencing an anxiety disorder in their lives. That’s essentially 1 in 3 people. If that’s you, you are NOT alone.

It's essential to recognize the signs of anxiety (such as racing thoughts, restlessness, muscle tension, and rapid heartbeat) so that we can implement timely interventions.

Evidence-Based Strategies for Reducing Anxiety

1. Deep Breathing Exercises: Deep breathing techniques, such as diaphragmatic breathing (where the stomach, rather than the chest, moves with each breath) or box breathing (see below), activate the body's relaxation response, calming the nervous system and reducing anxiety symptoms. I try to do breathing exercises once or twice during the day when I notice that I’m feeling particularly overwhelmed.

2. Progressive Muscle Relaxation (PMR): PMR involves tensing and then relaxing different muscle groups in a systematic manner. This practice promotes physical relaxation, easing tension associated with anxiety. Start from your toes and work your way up to your head, tensing and releasing each muscle group. I personally don’t use this, but there’s some strong data supporting it’s use in reducing anxiety and depression and I teach it to some of my patients.

3. Mindfulness Meditation: Meditation cultivates present-moment awareness without judgment. It allows us to focus on our breath, sensations in our body, or the sounds around us instead of focusing on anxiety itself. There’s an ENORMOUS amount of data showing that mindfulness practices reduce anxiety in the short and long term. Last week, I shared with you all my experience with meditation, and I’ve personally ramped up my practice by an extra 5 minutes a day during this time.

4. Grounding Techniques: Grounding techniques help anchor you to the present reality during moments of intense anxiety or panic. Try the 5-4-3-2-1 method, where you identify and name five things you see, four things you touch, three things you hear, two things you smell, and one thing you taste. I teach this technique to some of my patients who experience panic attacks and many tell me that it works!

5. Cognitive Behavioral Techniques (CBT): CBT strategies challenge and reframe negative thought patterns associated with anxiety and identify irrational thoughts and replace them with realistic, balanced thoughts. I haven’t been in therapy the last few months but it’s time to resume. I scheduled a session for next week.

6. Physical Activity: Regular exercise, such as walking, yoga, or sports, releases endorphins and reduces stress hormones like cortisol. Exercise is one of the best strategies that we know to reduce anxiety. I have ramped up my focus on movement during this time and I am about ready to lose to Ari in another game of basketball.

7. Medication: As a psychiatry doctor, I often prescribe medication to help relieve symptoms of anxiety disorders. In general, many people will show improvement on medication, however this can and should only be done with the direct supervision of a physician, as it’s critical to evaluate benefits, risks, and possible side effects of medications. I’ll do a breakdown of medications that are approved for the treatment of anxiety in a future newsletter.

Closing Thoughts

Anxiety sucks. And for anyone out there experiencing an anxiety disorder, it’s not your fault, and you are not alone. Most importantly, please know that anxiety disorders are treatable. I’ve personally treated hundreds of people with different anxiety disorders throughout my training and I’ve seen people improve and live balanced and healthy lives.

Remember, managing anxiety is a journey that involves experimentation and finding what works best for you.

Keep your head up. One day at a time. One moment at a time. I’m proud of you.

See you next week. Thank you for being here.

Jake

For more information and resources on anxiety disorders:

My Favorite Things

Each week, I’ll include a few of my favorite things. Feel free to send me your favorite recipe, gift idea, book, etc and I may even feature it here. Just respond to this email!

Recipe of the week - I made these blueberry crumble bars from Laura Fuentes cookbook, Clean Treats For Everyone, this weekend. They were delicious! And full of blueberries 🙂 Link to the cookbook here!

Item of the week - Sometimes it helps to have a visible prompt when in a state of anxiety. You can purchase this print to help! Link here

Person to follow this week - Lindsay Fleming is a therapist who often discusses ways that we can cope with anxiety in the moment. I have been following her for years, and I love the way that she talks about anxiety, as well as how open and vulnerable she is about her own mental health. Follow her here!

Book to read this week - Psychiatry for Kids! I know this has been the book to read before, BUT it is now available in Hardcover!! And this cool guy I know named Jake wrote it for kids. You can buy it here 🙂 As always thank you for your support!

Dr. Goodman’s Psychiatry tip of the week -

Since anxiety is so common, there’s a ton of wellness guru’s on social media that will try to sell you some BS snake oil product to treat anxiety. Be careful who you listen to and who you take advice from when it comes to mental health. One of the reasons I’m on social media is to combat all the misinformation out there about mental health. If it sounds to good to be true, it probably is.

Sources:

Disclaimer: These emails do not assume a doctor-patient relationship and my information is not intended to substitute for medical advice. I offer science-backed educational information aimed at empowering you to live your best life. Always consult your personal doctor before starting any treatment. My newsletter will always be free.