If we don’t watch out we can all struggle with significant anxiety. Life is stressful. No one is immune to that. But besides just “gittin‘er done”, how else can we manage? As a provider I have a special interest in mental health and integrative approaches on managing. As a mother and full-time physician I routinely feel anxious about things professionally and personally.I learned in my training many modalities for managing and wanted to share whatI personally have found to be effective.

Breathing. Yes. Duh. Breathing. It truly works. You can make it simple and take five or ten slow deep breaths when feeling stressed out. You can also use one of the evidence-based methods, my favorite one, called 4-7-8 breathing. To practice this:

·     BREATHE IN to a count of FOUR

·     HOLD your breath to a count of SEVEN

·     EXHALE to a count of EIGHT

The COUNT is NOT in seconds, unless you want it to be that.The 4-7-8 COUNT is your own timing. Why does this work? Breathing in oxygen and holding it allows for increased time for gas exchange (IE oxygen goes out into the body and carbon dioxide comes in for “waste” removal). The longer exhalation allows the carbon dioxide to be released. Too much carbon dioxide in the body tells our brain we don’t have enough oxygen (called hypoxia). This activates our sympathetic nervous system and puts us into fight or flight mode, which can exacerbate and cause anxiety. Working to restore the oxygen and get rid of the carbon dioxide simply by breathing can reduce anxiety on a metabolic level. Try it.

Progressive muscle relaxation (or as I like to call it, Tense and Let Go). This can be done anywhere, anytime and lying down or sitting up. I really like it at nighttime when I’ve gotten in bed too wound up to fall asleep immediately. It’s my alternative to counting sheep. To practice this:

·     Starting from the bottom, gently curl your toes and squeeze enough to cause contraction but not too much to cause a cramp; hold for a count of FIVE and deliberately RELEASE

·     Contract your lower and upper leg muscles; hold for a count of FIVE and deliberately RELEASE

·     Contract your pelvic floor, glutes and abdominal muscles for a count of FIVE and deliberately RELEASE

·     Curl your hands into a fist and squeeze squeeze squeeze for a count of FIVE and deliberately RELEASE

·     Scrunch your face up like you just ate a lemon and hold for a count of FIVE and then deliberately RELEASE

At any time you can just practice with your hands or your abdomen or your feet or all at the same time. What I love so much about this isI am consciously and physically creating a sensation of stress in my body and I am then consciously and physically relaxing that sensation. It works. It really does.

Supplements

Ashwagandha:

-      Good for mental clarity and focus

-      Helpful in anxiety

-      Usually taken as a daily supplement

-      Contra-indicated in pregnant women

Ashwagandha is an adaptogen which means it mimics neurotransmitters to actually have a effects on our central nervous system. Ashwagandha acts to suppress that “fight or flight” response.

Fish oil:

-      High dosage (4-6g/day)

-      High Omega 3 to Omega 6 ratio (ie you want moreOmega 3)

-      Taken daily

Fish oil has shown more than any other supplement in clinical trials to decrease anxiety. This is one supplement you definitely want quality control over. The best delivery is taking shots of fish oil and one of the best brands out there is called Omega Cure. You can also buy at a local health food store. Most come flavored and contrary to what you expect do not cause “fish burps”. The repeating of fish oil after you take supplements is often due to the gelatin capsule breaking down in the stomach. Other brands I love are PURE,Thorne, Ortho-molecular and Nordic Naturals.

Motherwort:

-      Also an adaptogen motherwort acts to suppress your beta receptors of your heart, or your fight or flight response

Comes in a convenient tincture to take when you are “in the moment”.