The other day a friend texted me asking if I had any idea how to reduce anxiety without using prescribed or self-medication. People often ask me for recommendations about anxiety reduction, not because I work in mental health but because I have been vocally living with anxiety for the better half of my life. While I’m quick to offer a few suggestions of what has worked for me in the past, I’m pretty sure that if I had figured it out I wouldn’t find myself as panic-stricken and lost as frequently as I do. The problem with anxiety – at least my experience of it – is that it is a shape-shifter.
I grew up in Vancouver, meaning that I smoked a fair amount of pot as a teenager. It was an especially strong joint that sent me to the emergency room with a panic attack for the first time at sixteen. That first episode was a ‘heart attack’ panic attack, and this remained a common manifestation of my anxiety throughout my life. A tightening in the chest, pain running down my arm, a stiff neck, a stiff jaw, a pounding heart, a cold sweat. The unshakeable belief that death is just a few wonky heartbeats away.
I soon learned that young women complaining of heart symptoms in the ER are often treated as hysterical. Stern male doctors would give me the most cursory of look overs before accusing me of being fine. In the early days of my anxiety this didn’t matter to me at all. I was so convinced that I was going to drop dead, the only thing that would soothe me was being in the hospital hooked up to a heart monitor and an oxygen mask.
For the first seven or eight years of my anxiety I spent a fair amount of time in the ER. The panic would come out of nowhere like a tsunami, always convincing me that this time was the real deal and I was going to die. After my mother passed away when I was 25, my feeling of the hospital as a safe space diminished. Also, I started to see a psychiatrist who taught me to label the different sensations I was feeling as anxiety. Gradually, I got to a point where I could recognise a panic attack well enough to be able to cram an Ativan under my tongue and hope for the best.
After 20 years of anxiety it still catches me off guard though. Instead of the full blown panic attacks of my youth, now I get episodes of persistent anxiety that can last weeks at a time. During these times it feels like every cell of my body is on guard. I become extremely sensitive to sensory stimuli – noise, temperature, light. I still feel like I’m going to die, but the notion of slow painful death has overtaken the quick demise. There is no more rushing to hospital, instead there are visits to the GP and referrals to specialists who might be able to ferret out the darkened masses accumulating inside me. I’m older now, and a cancer survivor, so all my empty complaints are taken seriously. I have photo library of my inner workings and yet still I know there is something inside that isn’t being picked up.
Once I become anxious there is not much I can do. It’s a bit like water, there’s no stopping it, you just have to let it flow. For me, coping with anxiety is mostly a preventative, rather than a curative, exercise.
So what helps?
Avoiding Alcohol. There are several reasons for this. Too regularly in my life I’ve chosen self-medication as a way of coping, leaving me lacking in other strategies. Alcohol screws terribly with my sleep which is essential for feeling well. When I drink I always end up eating badly, not just the night of but the day after, leading to a shame spiral. And hangovers are anxiety embodied.
Sleeping Well. This is all well and good to say, but as an anxious person often sleep is the first thing to go. I try to reduce insomnia by getting up really early (even if I haven’t slept well) so that I’ll be tired that night. The extra time in my morning I try to spend doing outdoor exercise or yoga or meditation. I try to have a maximum of two coffees a day and have them both before 10 am. If I can’t sleep I to listen to an audiobook or a podcast that I’ve heard before so I don’t get too intellectually invested in it. When I’m super anxious I like to listen to TV shows I love, I visualise what’s going on in each scene which helps me to shut down my other thoughts.
Exercise and Conscious Relaxation. I try to exercise outside as much as possible because NATURE. Walking long distances is my jive. As is swimming. I like to dance, in classes or alone at home with my dog as an audience. I like to do yoga, but alone with an app. Recently I’ve been trying to meditate every day for ten minutes. It’s a short enough time that I can commit without avoidance and excuses. There are a ton of guided meditations on YouTube. 4-7-8 breathing works well for me too. Hell, sometimes pacing the house and massaging my hands is the only way to stop it. Whatever works. I just try to keep moving and remembering to breathe.
Doing Shit. I’m an occupational therapist, I think doing shit is essential. I try to pick things that enrich and connect me, and don’t cost much.
Some shit I like to do: Hanging with my dog. Knitting. Writing. Reading. Standing looking at the ocean. Checking out painfully pretentious art exhibits. Cooking elaborate meals. Listening to music. Organising my crap in different ways. Crocheting. Baking. Snorkelling. Thrift Shopping. Going to the library and finding random subjects to research. Self-massage. Drawing. Making bread. Watering my ever-dying garden. Talking to friends in person, on the phone, via text. Learning new skills. Taking photos of my dog.
Anything that is personally meaningful and fulfilling is good for building up well-being.
I don’t always make the right decisions. I often completely ignore my own knowledge and self sabotage instead. If I’ve gotten to full blown anxiety mode I’ll often drink too much and stay up all night and spend days motionless on the couch barely absorbing reality tv. The key is, the older I get, the more I focus on these things that keep me well and the less anxious I become. There are fewer episodes, and for now, that is good enough.
How do you cope with anxiety?