Coping with anxiety

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A few years ago, I started having heart palpitations – rapid and/or pounding heartbeats. My resting heart rate would stay elevated for as much as 16 hours at a time, even keeping me awake at night. The symptoms came without warning, and then they would disappear as mysteriously… until next time. I thought there might be something seriously wrong with me, but the more I researched my symptoms the more it sounded like anxiety attacks. And yet, I wasn’t feeling particularly anxious – just the usual stress.

Getting the diagnosis

My first step was to see a doctor* and rule out any physical problems. Anxiety attacks produce a lot of strange symptoms: heart palpitations, numbness of extremities, even loose stools and plenty of others you’d probably never think of as having an emotional basis. But it’s all connected to adrenaline. Since any of these symptoms could belong to another ailment, it’s crucial to see a general practitioner or internist for the appropriate tests and make sure your symptoms really are just “in your head.”

My doctor was able to quickly rule out every possibility he knew of other than anxiety. Now, I was usually quite calm when my heart rate suddenly spiked, but apparently that doesn’t matter. Sometimes in order to cope, we repress our feelings but sooner or later they tend to burst through anyway. I was pushing myself too hard and dealing with too much pressure, and this was causing what doctors call “free-floating anxiety.” I’d feel fine, but have an attack anyway. And then the symptoms of the attack would worry me, and that would just make it worse.

The good news about heart palpitations is, they can’t hurt you or shorten your lifespan. If your doctor rules out all the dangerous causes, then you are safe from harm, no matter how annoying and frightening this problem is. The main problem for me was that they tended to happen at night and therefore prevent me getting enough rest. Apparently, it’s a top reason why people end up in the emergency room, thinking they’re dying, only to find out they’re just fine and wasted a trip. So getting your heart checked out can help you relax: if you know you’re healthy, then you can at least stop worrying about the weird symptoms.

Anxiety is really common, and having it doesn’t mean you’re crazy or weak. Our bodies and brains evolved to handle immediate stresses, such as tigers coming to eat us – our response to these stresses was to run or fight. But in our insulated modern world where the tigers can’t get us, all our stresses are abstract and intangible: financial security, the state of the nation, the health of our relationships. We feel the pressure, but instead of running or fighting, we think and worry. That’s not what our bodies are designed to do, so it’s no wonder some of our bodies get confused and start having symptoms like heart palpitations. All that pent up adrenaline has nowhere to go.

Doctors can prescribe medications to help. There are several sedative/anti-depressant type medications that will calm you down, as well as beta-blockers, which have a similar effect. The lists of side effects on these meds are scary, of course; but most people will experience few if any of these effects, and a good doctor will monitor you and let you know what to watch out for. And you may not need these medicines for more than a few weeks to break a cycle.

Another very valid option is cognitive behavioral therapy. Not all psychotherapy means talking about your parents for hours on end. This type of therapist simply helps you discover how to live better. For example, maybe your problem is simply that neither of your parents knew how to cope with stress very well so you never learned those skills. The therapist will just help you learn those skills and send you on your way – no navel gazing required. On the other hand, if you do have an underlying issue such as a past trauma, the therapist will help you work through it, but quickly because their goal is to get you happy now and in the future, not to analyze your past until they have enough material to write a book about it.

What you can do for yourself

There are also plenty of ways you can help yourself. Again, you need to check with a doctor before using any of these: for example, yoga can be too strenuous for some people (including pregnant women).

• Meditation. Meditation is the easiest way to get big results fast. You don’t have to take classes or buy DVDs. You can simply find a quiet place to sit with your eyes closed and do your best to think about nothing. When thoughts come into your head, as they will, imagine putting them in bubbles and watching the bubbles float away. After a while, you’ll get to focused on the bubbles that this will be all that’s in your mind, and it’s a peaceful visualization. Once the thoughts have stopped coming so fast, you might want to imagine sitting somewhere peaceful – beach, waterfall, park, or a particularly beautiful landmark. Whenever you catch yourself getting worked up about something, take a moment to close your eyes and go to your meditation place and remember that at least 99% of the things we worry about never happen.
• Dump caffeine. While caffeine probably isn’t the cause of your anxiety, reducing or eliminating your caffeine intake can do wonders very quickly. Caffeine fuels your adrenal glands, which are already working overtime – without that fuel, they immediately stop producing so much adrenaline, and that will make you calmer overall. (Don’t worry, you can go back to it once you have the condition under control.)
• Yoga. I bought a DVD years ago called Yoga Conditioning for Weight Loss. I started working out with it when I was having the attacks, and it really helped. I imagine any yoga DVD will be helpful, as long as you’re comfortable with the routine (some are more strenuous than others). Feel free to search for others and read reviews to get a sense of whether you’ll like the instructor’s style and approach.
• Deep breathing exercises. This particular exercise brought my heart rate down significantly when it was palpitating: exhale completely, squeezing your abs to get all the air out of your body, then inhale deeply, until your lungs almost hurt. Then exhale slowly, again squeezing out all the air. Do this three times. Yoga also does this for you, but the beauty of this exercise is that you can do it anytime, anywhere that you start noticing symptoms.
• Herbs. Herbs should be regarded as just like medicines: they do tend to have less adverse effects, but there are limits to how often you should take them, what dosage you should use, and whether you (with your medical history and/or other medications) should be taking a particular herb at all. Therefore, I won’t recommend any specifics, but encourage you to do your own research and once again, check with a doctor first. Always, always, always let your doctor know what herbs you’re taking.
• Ignore your symptoms. Once your doctor has ruled out anything dangerous, you really must make an effort to ignore your symptoms. I tried to distract myself with reading something, having an interesting conversation, or playing a game that really absorbed my attention. I quickly found that having fun was the best distraction, so calling up a friend who always made me laugh, watching a funny movie, etc., became my go-to activities. Playing with kids and pets can be awesome, too.
• Getting plenty of rest. If you’re having heart palpitations at night, it’s very hard to get enough sleep. If you can make up for it with naps or an earlier bedtime, it’ll do you some favors. Otherwise, yoga and meditation can give you some of the benefits of rest in less time. They’re not a substitute for sleep, but they will make you feel refreshed and more confident.
• Remove stressful things from my life. This is not easy – for most of us, the big stress comes from work, which we can’t survive without. If you can eliminate any stressful situations – or people! – from your life, do it.
• Changing my thinking. Oh, boy, if it was that simple – presto, change-o! – we’d all be perfect, wouldn’t we? But there’s nothing like thinking you’re going to die of a heart attack to help you make a major lifestyle change, even when you find out you’re okay. I chose to let go of a few things permanently and allowed myself temporary breaks from certain responsibilities without guilt or the feeling I wasn’t performing up to standard. I’m still realizing that a part (not all) of coping with stress is how you deal with it and allow it to make you feel. It’s really hard to change the responses you learned in your formative years; but once you become aware of what they are, you can often catch yourself responding in an unhealthy way and remind yourself not to do that.
• Affirmations. This is one of the tricks in the cognitive therapist’s bag, and there are books and articles on the subject everywhere. In a nutshell, affirmations are positive statements you say to yourself (doesn’t have to be out loud) quite a few times a day, plus whenever you catch yourself thinking negatively. The trick to writing a good affirmation is: make it present tense and include zero negative words such as “not.” Instead of “someday I will have financial security” when you’re deeply anxious about finances, say “I have financial security.” Yes, it may be a lie, but the “fake it until you make it” principle applies. Instead of “I don’t have low self-esteem”, which involves a negative word go with something like “I am confident and care about myself.” Make your affirmations as specific to your worries as you can.
• Keep an anxiety journal. Write down everything you worry about every day. You’ll be astounded at how many things you’re worrying about, and many of them will be so unlikely to happen or so far our of your control that it’ll all seem silly. If you’re concerned about anyone finding this and reading it, use codes – initials for names, shortened terms for events. This can be just as effective as the next tool I’m about to mention.
• Find a confidence-boosting partner. Find someone in your life who’s got a positive outlook and explain to them that whenever you’re discouraged or worked up about something, you’d like permission to call them up and discuss it so they can remind you that this, too, shall pass.
• Red tea. Red tea, or rooibos tea, or bush tea, is native to South Africa and has a sort of earthy vanilla flavor. Many varieties in stores will be flavored somehow, and they’re delicious. Red tea is naturally caffeine free and full of antioxidants and minerals. I don’t know of any studies to prove it, but a lot of people (including me) have found it helps make you more tranquil. It’s been said to help lower blood pressure, improve sleep quality, and promote a general feeling of well-being. That’s definitely been my experience with it. I found drinking a cup at bedtime especially helpful.
• Green tea. Green tea is filled with L-theanine, an amino acid that calms the mind and promotes a feeling of well-being. It also contains caffeine so be aware of this if you’re reducing your caffeine intake. But because of the L-theanine, it can be a worthwhile trade-off. Don’t like the flavor? Try our green tea recipes.