MANAGING ANXIETY THIS WINTER FOR STRESS FREE DAYS

Everybody, even those with the best of health, will experience anxiety and stress. It is a normal part of life to feel that every now and then.  We forgot an important appointment, the kids are coming home for Christmas and we need to have their bedroom organized, and the front left tire looks as if it may be slowly leaking air.  Anxiety and stress help us to make sure that these everyday-but-important elements be attended to.  We will phone the person we accidentally stood up, apologize and set up a new appointment; we order a bed and mattress on Amazon; and we go to the gas station and get the tire pressure fixed. Our everyday anxiety does not need to be treated.

Sometimes our anxiety can be excessive and it needs to be managed other than by just solving the things we worry about.

If we find that we worry about many ordinary things, that we tend to worry about them the whole day long, and that we keep on worrying about them even if we try to stop worrying, then there may be a problem.  If added to that, we feel more tired and exhausted than usual, we are more irritable than usual, or we feel that our muscles are sore and stiff, or we notice that we are having some difficulty focusing and concentrating, or we worry about excessively worrying, or we have stress about making decisions for fear of making the wrong decision; then we are probably suffering from a specific anxiety as a problem. This type of anxiety is called Generalized Anxiety Disorder (GAD).

Although it will usually take our happiness away, make our work harder and make us more prone to burnout or even depression, we seldom recognize its insidious and serious nature.  It is much more common than we think. Each year, one in fifty people will suffer from it.

WHERE DOES SUCH ANXIETY COME FROM?

It may be medical in origin: thyroid problems, asthma, irritable bowel syndrome, premenstrual hormonal shifts, diabetes, and the side effects of certain medications can all contribute to GAD. Stress buildup (whether one big event or a buildup of smaller stressful life situations) may trigger it as well.  A family history of GAD may also be the reason.

Why is GAD a big deal?  People who suffer from this may be more likely to treat themselves with alcohol and other substances which alleviate tension on a short-term basis.  GAD steals one’s quality of life—everybody else around us may be having a whale of a time at the Christmas party, and we will not.  Headaches, digestive, heart health issues and sleeping problems also occur much more frequently when we have this.

How can we manage this if we have it? It is a good idea to ask our doctor to do a physical examination to check for underlying causes of such anxiety and order blood tests and other laboratory tests if another physical reason is suspected, and also to do a psychological screening test to see if we have it. Once we know that we have it, there are several treatment options to explore.

FIRST OF ALL, LIFESTYLE ADJUSTMENTS CAN MAKE A BIG DIFFERENCE.  THERE ARE FIVE THINGS TO CONSIDER:

  1. Exercise at least three times a week, for at least an hour a week. Exercise is a strong stress reducer.
  2. Stop smoking and cut back to only one cup of coffee a day, as both nicotine and caffeine worsen anxiety.
  3. Sleep enough and sleep healthily.
  4. Do not take alcohol or any other sedatives as they can cause addition and worsen anxiety as soon as their concentration in our blood stream drops.
  5. Eat healthy. There is early evidence that a diet that has lots of vegetables, whole grain, fish and fruits may be causing anxiety to decrease.
If we do all that, some herbal remedies may also be helpful, although more research is needed to completely understand the risks and benefits of these.  Passionflower, valerian, chamomile and lemon balm all can help decrease the anxiety. (Kava showed promise, but there are reports of serious liver damage even after short-term use which should let us at this stage avoid that as a method to calm GAD).
More often, cognitive behavioural therapy is the most effective way to go. It lasts not much longer than twelve weeks and teaches us specific thinking skill which helps us gradually return to the activities we started to avoid due to the stress and anxiety.

In addition, there are also medications that can help with this if all of the above methods have failed to make a dent in the GAD.   Some antidepressants, specifically the serotonin reuptake inhibitors such as fluoxetine, sertraline and escitalopram are very useful. Buspirone is an anti-anxiety agent which may give great results but has to be used on an ongoing basis. Benzodiazepines, such as Ativan, can be used, but must be used only for very short periods, as it can quickly become habit-forming and may flare up old problems with alcohol and other substance use.

With this holiday season, it is worthy to remember that worrying will not stop the bad things from happening, but it surely will prevent us from enjoying the good.  If this is the case with any of our readers, please visit a medical professional to help you manage and get back to feeling positive and happy so that the good times can roll!

About Dr. Pieter Strauss:

Dr. Strauss was born in South Africa, emigrating to Canada with his family in 1995. He has a private practice in the Fraser Valley and sees patients with mental health issues in his community. He was Head of the Psychiatry Department at a regional hospital with a staff of nine psychiatrists until last year when he decided to focus on his practice and his work at our hotel. Dr. Strauss has always been interested in long-term human relationships and envisioned enhancing relationships.

Saturday, December 12 2015

Posted by: Dr. Pieter Strauss

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