Escitalopram (Lexapro)

Pros: An SSRI often prescribedl for anxiety and depressive symptoms. Along with other SSRIs, its considered a top choice by some for use during pregnancy and lactation.Cons: Potential for sexual dysfunction and weight gain.Possible side effects: nausea, headache, dry mouth, dizziness, weakness, excessive sweating

Sertraline (Zoloft)

Pros: An SSRI that is used to treat depressive symptoms and other mental health conditions like obsessive-compulsive disorder (OCD) and panic disorder. Generally considered safe for use in pregnancy and lactation. Less expensive than other medications.Cons: Potential for sexual dysfunction.Possible common side effects: Nausea, sleep issues, headache, diarrhea, loss of appetite, dry mouth

Duloxetine (Cymbalta)

Pros: An SNRI used for anxiety and depression. It can also be used to treat pain from medical conditions like fibromyalgia and diabetic neuropathy.Cons: Potential for severe drug interactions.Possible common side effects: sleepiness, headache, insomnia, dizziness, blurred vision, diarrhea, lack of energy, constipation

Venlafaxine (Effexor)

Pros: An SNRI prescribed for anxiety and depression, and generally well tolerated. May help reduce menopause-related hot flashes.Cons: Safety concerns to consider with pregnancy.Possible common side effects: nausea, sweating, headache, drowsiness, dry mouth, dizziness

Bupropion (Wellbutrin, Aplenzin, Zyban)

Pros: An NDRI used for depression, seasonal affective disorder and smoking cessation. It may help improve focus, concentration and motivation, and help with coping with fatigue.Cons: May be too stimulating for some; may aggravate anxiety symptoms and insomnia. Not always suitable for those with an eating disorder or who are prone to seizures.Possible common side effects: agitation, drowsiness, difficulty falling asleep or staying asleep, dry mouth, dizziness

Mirtazapine (Remeron)

Pros: A tetracyclic drug used to treat symptoms of depression and anxiety. Promotes sleep and improves insomnia with low reports of sexual dysfunction. It can also increase appetite, which is beneficial for individuals who are underweight.Cons: Its strong sedation effect causes excessive tiredness. Some experience unwanted weight gain. Can, on rare occasions, cause changes in menstrual cycle, which is considered to be a severe side effect.Possible common side effects: dry mouth, headache, sleepiness, nausea, vomiting, diarrhea, constipation

Vortioxetine (Trintellix)

Pros: An SSRI that also modulates serotonin receptors. Its used to treat major depressive disorder and has been shown to be helpful with improving cognitive impairment associated with depression. Low reports of sexual dysfunction and weight gain.Cons: It can be expensive compared to other antidepressants. Nausea is quite prevalent in the first two weeks of treatment.Possible common side effects: nausea, constipation, vomiting, dizziness, dry mouth, diarrhea, headacheNext: Frustrated Your Antidepressants Arent Working? Heres What You Need To Know

The post The Right Antidepressant for You, According to a Clinical Pharmacist appeared first on Best Health.

What is a mental health gym?

I dont think theres a single or widely accepted definition, but most are trying to rethink how mental health services are perceived and delivered. The entire process of seeking out psychological services is imbued with medical undertonesyoure a patient, youre seeking treatment for a disorder from a clinician. Can you imagine if those terms were being used at your local gym? Of course not.When I started my private practice, I wanted to do things differently. I wanted the concept of mental health support to be accessible, destigmatized and non-judgmental. I thought, what better way than to encourage people to think about mental health improvement the same way we think about our physical health improvement. So, at our practice we dont have clinicians, we have coaches. We dont have treatment plans, we have programs. We dont have appointments, we have workouts. We dont have patients, we have members. We embed that language into everything we do.

Rightso taking care of your mental health becomes as straightforward and reflexive as taking care of your physical health?

Exactly. We should be taking care of our mental health in the same way were taking care of, say, our dental health. Its acceptable to miss a day of work because youre feeling physically sick. Why is it not acceptable to miss a day of work because youre not feeling mentally well? People should be able to say, Im feeling terribly stressed. And I just need to go for a walk and connect with some friends and do some mindfulness today. But we are unfortunately far from that point.

Its fair to say most people seek psychological help when theyre already in crisis. How do we make the shift to think of mental wellness as something that deserves consistent attention and tending?

So, in the past, the field of psychology was very much focused on how to get people from a minus-five to a zeroi.e., from a state of anxiety, depression and stress to a neutral, normal state. But now we also ask, how do we get people to go from zero to a plus-five, a state where we flourish? Like with physical health, that takes ongoing effort. Sleep, diet, exercise for sure, but also mental fitness workouts, which are evidence-based practices like mindfulness, relaxation, realistic thinking and connecting with others.So, you could come to a mental health gym because you want to learn specific skills to continue to build resilience, and you want to learn strategies to cope with stress and face the challenges of the past couple years, which have been extremely difficult for all of us. You dont have to wait until youre at a minus-five to reach out for support.

And yet, many people pay attention only when their mental health is clearly deteriorating. Even then they dont always get help.

Listen, weve got a long way to go to reduce the stigma around addressing mental health. Having more places that are designed to be both accessible and offer time-limited treatments might help.Also, shifting our mindset. Most people prefer to take, say, vitamins rather than antibiotics to maintain health. There are strategies that I see as our [mental health] vitamins. Mindfulness and connecting with friends and doing yoga and movement and learning realistic thinking strategies and putting belly breathing in your lifethese are not strategies that take a long time to do, but theyre very effective.

And honestly, who doesnt want to be living in a plus-5 state?

Thats what positive psychology is all about. Dr. Martin Seligman launched a whole new way for us to explore which character strengths and virtues and values are universal. They transcend cultures, gender, socioeconomic status, and they allow people to thrive and live meaningful, resilient lives. Research shows that about 50 percent of the variance in your well-being is due to your genetics, and then theres another 10 percent thats due to your circumstances, like where you live, whether youre married or single, your age, your gender, all that kind of stuff. But that leaves about 40 percent variability. And so, well-being can be influenced by our everyday practices, like sleep, diet, exercise, mindfulness, realistic thinking and connecting with our friends. Even gratitude practices. You dont have to spend 10 hours a day focused on this stuff.

How are mental health gym workouts different from traditional therapy sessions?

We are essentially providing comprehensive psychological services, but were trying to do it in a destigmatized, accessible, compassionate and structured manner. They can be less time-intensive than traditional therapy sessions, and less costly. Its where people are learning skills and applying them to everyday life. We want people to leave our programs with a toolbox of strategies for getting and staying in emotional shape. And we want them to use those strategies, to embed them in their daily lives so they can learn to manage future obstacles.When treatment is unstructured, it can go on indefinitely, without clear goals or objectives. Theres definitely a place for long-term therapy for certain challenges and individuals. However, a lot of people would benefit from a short series of sessions to learn strategies and aim for results that are tangible and measurable.

Is it less daunting for people, too, if they know theres a beginning and an end?

Absolutely. I do a lot of work with kids and teens. And one of the things they really appreciate from the first time we meet is knowing that theres a structured plan and an end goal. They participate in about eight to 12 weekly sessions. And they leave with a binder of handouts, which becomes their toolbox of strategies and skills.

Its clear were living through a mental health crisis. How can mental health gyms help?

Resilience doesnt mean you never have stress or challenge in life. It means youre someone who is able to bounce back from a difficult situation. What mental health gyms are trying to do is boost our psychological immune system and give people the tools to be resilient. And then, when the next bump comes along, we have some strategies and ways to realistically think about and engage with the situation.Now that you know about mental health gyms in Canada, learn why one woman celebrates her birthday with therapy.

The post How a Mental Health Gym Can Transform Your Emotional Well-Being appeared first on Best Health.

Picking up my old guitar

In September, my fatherwho has been playing guitar for more than 50 years started a business giving virtual music lessons. Hed always intended to teach, but had never gotten around to it. When the pandemic freed up his time and guitar sales skyrocketed, he finally took the leap.Around that same time, I picked up my old acoustic. I had fiddled with it for a short time as a teenager, but it had since sat quiet in the corner of my room. With Torontos shops, restaurants and public spaces shut down, I figured learning the guitar would pass the time while also allowing me to spend time with my dad, who lives outside of Montreal. I never expected playing guitar to improve my mental stateuntil I experienced the benefits firsthand.After each one-hour Zoom lesson with my dad, I felt refreshed and fulfilled in a way I hadnt experienced in a long time.My dad called me a quick study, but there were plenty of occasions where I felt frustrated and discouraged over a chord that wouldnt sound or a fingerpicking technique that seemed too difficult. Still, each time I picked up the guitar to work on a tune I loved, like Dannys Song by Loggins and Messinathe song my father sang to my mother at their weddingI became laser-focused on getting it right. Everything else just seemed to fall away. My mind was clearer, calmer and fog-freeand these benefits lasted long after I finished practicing each day.

The benefits of learning a musical instrument

We know that listening to music has a number of health benefits in terms of being able to help reduce anxiety, help with relaxation, help with breathing, it helps to regulate the bodys system, but that actively engaging in it is even more impactful, says Amy Clements-Cortes, a music therapist, psychotherapist and assistant professor at the University of Toronto. Taking up a new instrument actually creates new pathways in the brain, she explains, which helps to keep the mind active and alert and can also enhance overall cognitive functioning.While some believe learning a musical instrument is reserved for young children with sponge-like brains, Clements-Cortes says there are distinct benefits for adults. Research indicates that playing music can help adults with everything from communication skills to reducing stress and anxiety. A 2017 study of 1,101 seniors, aged 64 and older, found that playing an instrument once every two weeks boosted participants attention spans, memory and executive function. More recently, data from Spotify showed that 89 percent of UK adults who learned the ukulele during COVID-19 lockdowns reported mental health benefits from the practiceincluding but not limited to an increase in feelings of happiness and relaxation.(Related: How Music Helps Your Brain)

I wasnt the only one taking music lessons during the pandemic

Ed Lettner, owner of The Music Studio in the Greater Toronto Area, saw far more adults seeking lessons at his school during COVID-19, even as classes went virtual. Lettner teaches piano, and one of his adult students recently told him that he began playing every day before work after discovering how good it made him feel. Others told him they pursued new instruments specifically for the mental health benefits.In some cases, they just thought they needed something to just take their minds off things, Lettner tells me. “They just saw that as a way to have a break from everything else that was going on in their lives.Clements-Cortes says making music is often an emotional experience and can serve as a cathartic outlet. It helps people channel their creativity, and it improves self-esteem and confidencethree benefits which I personally experienced.Its engaging in that kind of way which can release those-feel good hormones, and with that can bring this added clarity, she says. Really depending on why a person seeks it out and whats happening in their life can perhaps influence the particular benefits they might get out of the experience.(Related: The Importance of Making Memories During Pandemic Life)The mental health benefits of music extend beyond playing an instrumentOf course, not everyone has the time, money or desire to take up a new instrument, but Clement-Cortes says even listening to your favourite song can benefit your wellbeing, especially during times of isolation.If you want to change your mood and just have it enhanced a little bit, engaging in music can do that, and who doesnt want that? she says.Its been nearly a year since I began my music journey, and my mental health is the best its been since before the pandemic. Much of that has to do with the fact that I made the decision to prioritize my healthboth mental and physicalonce I started feeling off-kilter. But I also have my trusty old acoustic to thank for my improved state, and I intend to make sure it never spends years collecting dust in the corner of my bedroom ever again.Next, find out 10 reasons you should always exercise with music.

The post How Learning an Instrument as an Adult Helped Me With Brain Fog and Anxiety appeared first on Best Health.

Given the circumstances, there’s a good chance you’ve felt overwhelmed and anxious at some point.

So, wouldn’t it be nice to just be able to relax? To do something really simple and feel instantly better, even if the relief is temporary? Deep breathing can provide temporary but satisfying anxiety relief.

(Related: Do You Have Morning Anxiety?)

The health benefits of stress relief

Beyond just feeling better and like you can get through the day a little easier (two major wins), finding ways to relieve stress and anxiety is also good for your physical health, says Ester Sternberg, professor of medicine in the University of Arizona College of Medicine, Tucson, and research director of the Andrew Weil Center for Integrative Medicine.

To understand why, you have to understand what happens in your body when you experience stress.

When we feel uncertainty, fear, or like we can’t control a situation, our body’s stress response activates. “All living organisms have a stress response, because it’s essential for life,” Dr. Sternberg says. This response, known as “fight-or-flight,” causes a cascade of hormones (like cortisol and adrenaline) and brain chemicals to be released in the body.

Stress is a reaction to something specific like a worldwide pandemic, deadline, or problem at your job; anxiety is a reaction to stress, characterized by ongoing (and sometimes excessive) worrying, even in the absence of an obvious stressor.

Stress can also be ongoing, or chronic, if the stressor hangs around for a long period of time. At a certain point, it can be difficult to distinguish if youre feeling stress or anxietyand they can both happen simultaneously. At the end of the day, either chronic stress or anxiety is going to make you feel a similar way.

“When you’re stressed, you’re bathed in this soup of stress hormones and nerve chemicals, all of which are causing every cell and nerve in the body to react and stand at attention to be ready to react,” Dr. Sternberg explains.

This response makes you feel sweaty, anxious, and like your heart is beating fast.

This reaction can be a good thing in the momentlike when you have to make a split-second decision about whether to hit the brake on your car.

But, it’s not good if you’re flooded with these stress hormones and chemicals for months on end, like we all have been throughout the Covid-19 pandemic, Dr. Sternberg says. “If the stress response goes on too long or in the absence of immediate threats, that’s when you get sick.”

Dr. Sternberg points out that chronic stress has been proven to have a whole host of effects on the body. It can tune down the body’s ability to fight disease, decrease the effectiveness of vaccines, slow wound healing, speed up cellular aging, and possibly even promote the growth of cancers.

“Stress does not cause these diseases, but it impairs your immune system’s ability to fight infection and repair wounds and protect against cancer and slow aging,” Dr. Sternberg says.

It can also increase your risk of heart conditions like high blood pressure and heart disease, in combination with heart disease risk factors, she adds.

(Related: Bad Stress vs. Good Stress: 9 Ways to Know the Difference)

How breathing exercises can help anxiety

It’s important to be in tune with yourself and be able to recognize when you need to stop and take some steps to actively relieve stressto salvage both mental and physical health.

“Try to look out for feelings of irritability, [being] overwhelmed, nervousness, and anxiousness,” says Regine Muradian, licensed clinical psychologist, speaker, author, and mental health advocate in California who specializes in stress and anxiety. “Notice if you are feeling stretched too thin or are overthinking. When you are feeling any of these things, it is your body telling you that it is time to destress and relax.”

Luckily, doing simple breathing exercises can help. “Deep breathing helps us relax our body naturally, calming our mind and body,” Muradian explains.

The exact way breathing calms the body isn’t fully understood, but one of the leading beliefs is that controlled, deep breathing activates the vagal nerve, which Dr. Sternberg explains is the main nerve responsible for activating the body’s relaxation response.

A 2018 research review published in Frontiers in Human Neuroscience suggests that slow breathing techniques reduce anxiety through multiple mechanisms in the body, including stimulating the relaxation response and sparking activity in the brain that sends messages throughout the body to calm down.

“The immediate way to put the brake on the stress response is deep breathing,” says Dr. Sternberg.

Next time you’re feeling overwhelmed, stressed, and anxious, try one of the breathing techniques below to find your calm. Try them all to find out which you like best, and then use it as a tool whenever you need some help calming your mind.

(Related: What Is Doomscrolling? What Psychologists Need You to Know)

Diaphragmatic breathing

Also referred to as belly breathing, this is your classic deep breath. Dr. Sternberg says that this is the type of breath you want to focus on when doing any breathing exercise to stimulate the relaxation response.

Nailing this type of breathing in its basic form will help you benefit more from the specific breathing patterns below. The key is to think about breathing deeply into your belly and not just taking shallow breaths in your chest.

• Sit, stand, or lie down comfortably.

• Place one hand on your chest and one hand on your stomach.

• Breathe in through your nose for 3-5 seconds, feeling your stomach rise. The hand on your chest should stay relatively still.

• Breathe out through your mouth if you can for 3-5 seconds, feeling your stomach fall.

• Continue this breathing pattern until you feel relaxed. Or use it with one of the more intricate breathing techniques below.

(Related: How to Know If Your Worries Are a Deeper Problem)

4-7-8 Breathing

4-7-8 breathing is a technique that was developed by integrative medicine expert Andrew Weil. Dr. Sternberg explains it as a form of breathing that’s related to yoga breathing. The goal here is to breathe consciously, slowly, and deeply. The numbers tell you what to do: Inhale for 4 seconds, hold your breath for 7 seconds, and exhale for 8 seconds.

• Sit up comfortably with your spine straight.

• Place the tip of your tongue just behind your upper front teeth gums.

• Exhale completely through your mouth, making a whoosh sound.

• Close your mouth and inhale quietly through your nose for four seconds.

• Hold your breath for seven seconds.

• Exhale completely through your mouth, making a whoosh sound, for eight seconds.

• Repeat this pattern three more times for a total of four breaths.

(Related: 19 Therapist Tips for Finding Hope in Dark Times)

Joshin Kokyu Ho

Reiki practitioner and energy healer Parita Shah suggests this fundamental practice in the Reiki tradition, which is thought to help build vitality and concentration. It’ll get you focused on your breath and help you feel grounded.

Like other forms of meditation, this works best if you do it daily. Shah suggests approximately 15 minutes each day to help you feel connected to your body and reduce the impacts of stress.

• Sit comfortably, bring your palms to prayer position, and set any intention you have for the practice.

• Let your palms rest on your thighs, and keep your spine straight and chest open.

• Inhale through your nose and mentally follow your breath as it travels through your nose, chest, and down to the Hara (known as the body’s centre of energy) just below the belly button.

• Hold the breath as you observe your body and mind.

• Exhale, as you think about this energy of life expanding in your entire body and sending it out into your surroundings.

• Continue this for about 15 minutes.

(Related: 11 Foods that Make Anxiety Worse)

Quieting Response

The American Institute of Stress recommends this visualization and deep breathing technique to counter a powerful stress response. The whole thing only takes six seconds and is more of an on-demand stress relief tactic versus something you should practice every day.

• Start by “smiling inwardly” with your eyes and mouth and releasing the tension in your shoulders.

• Imagine holes in the soles of your feet. Take a deep breath in and visualize hot air flowing through these holes moving slowly up your legs, through your abdomen, and filling your lungs.

• Relax each muscle as the hot air moves through them up your body.

• Exhale and reverse the visualization, so the air goes back and comes out through your feet.

• Repeat this whenever you need to instantly feel relaxed.

(Related: The Surprising Health Benefits of Stress-Baking)

Nadi Shodhana

There are many different types of yogic breathing techniques, but Shah recommends this oneoften called “nostril breathing”because it is traditionally used to oxygenate the body and rejuvenate the nervous system. She says you can reap benefits with as little as one to three minutes each day. Again, practicing it regularly is always best, so that you’re constantly working on finding your calm.

Important note: “You should feel relaxed and balanced at the end of the practice,” Shah says. “If you feel out of breath or anxious, you may have forced the breath. Aim to find a balance between effort and ease.”

• Sit comfortably with your spine lengthened and your left palm resting on your left thigh.

• Close your right nostril with your right thumb and inhale through your left nostril for 4 seconds.

• Close both nostrils and hold your breath for 4 seconds.

• Open your left nostril and exhale for 4 seconds.

• Close your left nostril with your ring finger and inhale through your right nostril for 4 seconds.

• Close both nostrils and hold your breath for 4 seconds.

• Open your right nostril and exhale for 4 seconds.

• Repeat this cycle three or more times until you feel calm.

(Related: How Wellness Experts Cope With Coronavirus-Related Stress)

Tactical Breathing or Box Breathing

This type of diaphragmatic breathing is used by the military to help members calm down in very stressful situations. It’s is also a great tactic to help stop a panic attack. You’ll take those deep belly breaths, and follow the pattern described below, visualizing each second as you count.

• Breathe in for 4 seconds.

• Stop and hold your breath for 4 seconds.

• Exhale for 4 seconds.

• Repeat this pattern three to five times.

Next: How to Know If Your Anxiety Is Normal

The post 6 Breathing Exercises for Anxiety That Can Help You Feel Calmer appeared first on Best Health.

What is a mental health day?

You’ve been going and going and going like the Energizer bunny. Think of a mental health day as a time to recharge your batteries in a healthy way before you grind to a halt. The goal of a mental health day is to step away from work and give your brain a break. It’s a way to take care of your mental health and improve your energy, motivation, and even boost your productivity when you return to work.Your mental health day should include specific activities, including self-care, to achieve these goals. These can be reading/journaling, sleeping in or sleeping late, nature walks, and a hobby you enjoy. Going to lunch with a friend is good, says Condon, provided you set ground rules so the conversation stays light and pleasant (no politics or work talk allowed). Some activities to avoid during your mental health day include scrolling through any form of social media, wallowing in negative emotions, bingeing on junk food or alcohol and controlled substances.(Related:The Awesome Health Benefits of Awe Walking)

But what about work?

You may be thinking a mental health day sounds good right about now, but there’s no way your company will agree to it. After all, your gain is your boss’ loss … right? Not exactly. You’re not the only one who reaps the benefits of a mental health day. Your employer can too. A study by the World Health Organization estimated that for every $1 spent on support for mental health, which includes mental health days, there is a $4 return in work productivity.

Signs you need a mental health day

It can be challenging to figure out when you need to give your brain a break, but there are some obvious signs that your body and mind need to decompress. Here are some common signs of mental, physical, and emotional fatigue, according to our panel of mental health experts.

Your go-to coping mechanisms are not working

Yoga, meditation, breathing exercises, or a quick walk around the block are all ways people manage routine stressors. But when these typical tricks and tactics aren’t working, it’s time to take an extended break. A daylong commitment to mental health is needed, says Sam Bernard, executive director of a Tennessee-based firm specializing in disaster psychology and crisis response, advisor to the Federal Emergency Management Agency (FEMA), and fellow of the American Academy of Experts in Traumatic Stress.(Related:8 Women Share the Impact the Pandemic Has Had on Their Mental Health)

Your emotions are getting in the way

When emotional reactions are out of sync with the situation, it’s time for a reality check. Short tempers, angry outbursts, apathy, and disinterest may be a sign your perception is distorted. Blame it on stress, says Condon. And left unchecked, this lack of awareness leads to damaged relationships and disruptive workplaces.

You have difficulty staying focused

Stress creates a mental fog that makes it difficult to concentrate, make decisions, or see the big picture, says Bernard. If you find yourself fixated on small details that don’t matter, or flailing about with no goals or direction, a day away from stressors can help clear the brain fog.

You’ve been working long stretches with few breaks

As working hours increase, so do stress levels. Lisandro Irizarry, MD, a physician in New York City, has witnessed firsthand the emotional toll overwork can take on staff during the pandemic. “They had feelings of inadequacy because they could not control the situation,” he says. Some coped by simply shutting down. Take a mental health day away from the workplace instead of mentally detaching from the situation.

You are a different person at work and at home

When your behavior changes significantly, and noticeably, between work and home, pay attention. “People are good at putting on a game face at work, [but] when they come home, they take off the mask,” says Condon, who works with first responders on mental health issues. Involve those closest to you as you deal with stress because they likely see your full picture.(Related:6 Happiness Books that Mental Health Experts Trust)

You begin resenting your colleagues or work situation

As stress begins to build, you may see challenges or threats where they don’t exist, such as when a coworker questions or disagrees with you, says Dr. Irizarry. Those internal frustrations can lead to misplaced anger directed at colleagues, creating an unpleasant workplace. If that sounds like you, it’s time to improve your mental health.

Your emotional issues are leading to physical problems

If your emotional distress is manifesting physically, this is a sign you need a rest day to catch your breath. Some physical problems associated with emotional issues include:

• Increased headaches, backaches, gastrointestinal distress
• Dizziness, nausea, tightness in the chest
• Frequent colds
• Irregular sleep

Physical symptoms are your body’s response to internal stress, says Bernard. As stress levels rise, your immune system starts breaking down.

You feel frustrated, helpless, or hopeless

It may sound simplistic, but positive thinking helps people out of a funk. In a 2020 review paper published in Cureus, researchers recommend focusing on positive thinking, taking a mental health day, and reminding yourself thatfeelings of fear, panic, and anxiety will fade. Doing so, they say, can help people get through the Covid-19 pandemic. The bottom line is if you think you’re broken, you’ll probably stay broken. So focus on where you want to be, and kick-start that plan on your mental health day.

When to seek help

If you feel a mental health day may not be enough to help restore your energy, mood, productivity, and so on, it may be time to seek out a mental health professional. Mental health conditions like clinical anxiety and depression can linger well past a mental health day or a few days off. It’s best to speak with a doctor for a diagnosis and to find out whether you need treatment to help you deal with the day-to-day challenges. If you’re stuck in a bad job, it may be time to quitfor the sake of your health.Now that you know about mental health days, here are four ways to improve your mental health during COVID-19.

The post 8 Signs You Desperately Need a Mental Health Day appeared first on Best Health.

(Related:Can Anxiety Cause High Blood Pressure?)

The science on dehydration and anxiety

Not drinking enough water or being dehydrated may make you feel depressed and anxious. This is true even when controlling for other variables that may influence mood, according to a 2018 study published in the World Journal of Psychiatry. Researchers questioned 3,327 adults about their water intake and then had them rate their mood on a depression and anxiety scale. They found that the people who drank two cups or less of plain water per day reported significantly higher levels of depression than people who drank five cups or more each day. Even people in the middle, who drank three to four cups per day, rated their moods as better than the dehydrated group.

Water and mood are so connected that even very mild dehydrationlosing just 1 percent of your body’s watercan make you feel depressed, according to an earlier study published in The Journal of Nutrition. The researchers had 25 healthy young women do the same workout on three separate days. On the first day, they did a “moderate” sweaty workout and didn’t replace their sweat loss by drinking water, allowing them to become mildly dehydrated. In the second workout, they not only sweated out water but were also given a diuretic, a drug to draw extra water out of their system, making them quite dehydrated. The third workout they performed fully hydrated.

After each workout, the women answered questions about their mood and cognition. When they were dehydrated, they reported “significant adverse effects” on their moodduring the workout, after it, and when resting. They felt more depressed when dehydrated and reported other negative feelings, perceiving the workout to be harder than it was, getting frustrated, and wanting to give up.

(Related:How Rumination and Obsessive Thoughts Are Linked to Anxiety and Depression)

Your brain and water

These findings are not surprising, as the brain cannot function properly in states of dehydration, says David A. Merrill, MD, psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California. The effects start from even a small amount of dehydration and can range from subtle to severe. To understand why, first you have to understand why water is so important to your brain.

The brain doesn’t “use” water to function, but it is affected by changes in your overall blood volume. Your blood is mostly water, so when you become dehydrated, the amount of blood circulating in your body is reduced. It is this reduced supply of blood that affects brain function, says Xuan Kang, MD, a neurologist with UCHealth Neurology Clinic and assistant professor of neurology at University of Colorado Medicine.

Dehydration’s effect on the brain manifests in three ways:

(Related:Does Coffee Dehydrate You?)

Concentrated electrolytes

Your body and brain run on a fine-tuned system regulated by nutrients, and dehydration throws that balance off. When nutrients like salt get too concentrated in your blood, you can experience “altered mental states,” says Dr. Kang. If dehydration continues, it will cause seizures.

Less blood to the brain

Your blood transports glucose to your brain as a source of energy. When your brain doesn’t get enough blood, it’s not getting adequate fuel. That can lead to brain dysfunction, says Dr. Kang. This shows up as cognitive impairmentsit feels harder to thinkand mood disturbances.

Shrinking brain tissue

A little dehydration is not a huge deal, and your body will be able to regulate itself. But severe and/or chronic dehydration can actually decrease the size of your brain, says Dr. Kang. Reduced brain volume is linked to mood disorders, according to a study published in JAMA Psychiatry.

The mind-body connection

The physiology explains just part of the link between mood and hydration levels. You also need to consider how the physical impairments of dehydration impact mood, says Kristin Orlowski, a licensed psychologist with UCHealth Family Medicine in Littleton, Colorado. “The mind-body connection is significant, so if dehydration stresses the body, then it can also have a negative effect on a person’s behavioral health functioning,” she explains.

Dehydration can worsen short-term memory, perception of task difficulty, alertness, and working memory, all of which can cause you to feel worse, she says. That, in turn, increases depression and anxiety. Essentially, dehydration causes you to do poorly, which then causes you to feel poorly as well. These negative effects can be compounded for people who are chronically dehydrated, says Orlowski. For instance, if chronic dehydration has worsened other physical health conditions, or if it’s caused you to miss out on pleasurable and meaningful activities, it could indirectly lead to longer-term mood disorders, like depression, she explains.

(Related:Walking This Number of Minutes Will Boost Your Mood)

Mental symptoms of dehydration

You may feel the mental effects of dehydration before you feel the physical ones, although they can be subtle, says Dr. Merrill, a professor emeritus of psychiatry at the University of California-Berkeley. It’s not uncommon for people to feel their mood and productivity nosedive in the middle of the day. Often they don’t even know why. It’s only later, after drinking water and feeling clarity return, that they make the connection.

Here are some of the mental symptoms of dehydration to look out for:

• Confusion
• A feeling of mental slowness
• Fatigue
• Headache
• Inability to concentrate
• Ruminating
• Unexplained sadness
• Anxious thoughts
• Frustration or having a “short fuse”

There are other possible explanations for these symptoms, but if you haven’t had a big drink of water, guzzling a glass is the first thing you should try. It’s a quick and often a nearly immediate fix.

(Related:9 Hydrating Foods to Maximize Your Water Intake)

How to boost your mood with water

This is one health issue that is easily remedied: drink more water and stay hydrated. That may be easier said than done, considering how easy it is to forget to drink during a busy day. In addition to water, you can also eat more hydrating foods, like watermelon, to make sure you’re body receives enough fluids. To boost hydration, start by focusing on the positive, like these surprising benefits of drinking more water. Next, try our experts’ suggestions for ways you can make drinking water a healthy habit:

Give yourself visual reminders

Remembering to drink is half the battle, so give yourself visual cues. One way is to place a brightly colored water bottle on your desk and take a sip every time you notice it.

Schedule drink breaks

Set an alarm for every two hours on your phone to remind you to drink a glass of water. While you’re at it, take a quick five-minute stretch, or walk aroundexercise is also a proven mood-booster.

Add some flavour

While plain water is the healthiest option, many people find it boring and bland. To inspire yourself to drink more, try adding a squeeze of lemon or lime, drinking an unsweetened flavored water, or down a sparkling variety.

Log it

A proven way to build healthy habits is to hold yourself accountable. One way to do that: keep track of your intake. You could log each glass of water into your fitness app or on your smartwatch, make check marks on a calendar, text a friend, try a habit-tracking app, or move rubber bands up your water bottle with each drink.

Make it part of a healthy lifestyle

Hydration is just one part of managing depression and anxiety. To really boost your mental health, make sure you’re also eating a healthy diet, getting enough sleep, exercising daily, and reducing your stress. If you are still struggling with depression or anxiety, talk to your doctor or a therapist for more help, says Dr. Merrill.

a

The Best Way to Deal with Anxiety

nd director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California

Now that you know about dehydration and anxiety, this is what you should know about drinking water left out overnight.

The post Dehydration and Anxiety: How to Boost Your Mood with Water appeared first on Best Health.

Entering a new “new normal”

The idea that we are returning to normal is not exactly accurate, according to Jane Greer, a marriage and family therapist in New York City and author of What About Me? Stop Selfishness From Ruining Your Relationship. “The numbers are still up, people are still encouraged to wear masks, social distancing is still important,” she says. “So the safety measures and protocols are still in place, and by virtue of that, that in and of itself means things are not normal.” Instead, we’re creating a new normal. We’re not returning to our pre-pandemic lives; nor are we continuing with the restricted living we’ve been doing for more than a year. The new norm allows for more activity and the ability to be out in the world more. “But it’s not one’s old life, so that’s the first thing,” Greer says.Paul Hokemeyer, a clinical and consulting psychotherapist in New York and author of Fragile Power: Why Having Everything Is Never Enough, agrees. He says it’s perfectly normal to feel anxiety as the world returns to normal because we know the notion of returning to normal is a lie. “It’s a fiction that we tell ourselves to remain hopeful,” he says. “Deep in our hearts, we know that the world we left when Covid-19 hit did not remain stagnant. It was radically changed, just as we and our lives were changed.” This split between what we want to believe and what we know to be true causes discomfort that manifests as anxiousness or anxiety.(Related: How to Move Ahead When the Tank Feels Empty)

Why are people anxious about the post-pandemic world?

It’s hard to quantify the many different reasons people might feel anxious about the world opening back up, but an obvious reason is that there is still a world health crisis going on. Sanam Hafeez, MD, a neuropsychologist and faculty member at Columbia University in New York City, says some may feel anxiety about the vaccine’s efficacy against new variants, for example. “For over a year, people are so used to checking themselves for symptoms of Covid-19 that it’s possible that some people have developed varying forms of health anxiety,” she says.(Related: How to Talk to Your Loved Ones About the COVID-19 Vaccines)

Fear of the unknown

At first, there was fear around the change that came with the pandemic. Now, that fear is the change that comes with the post-pandemic limbo. You can’t go back to the routine you held before the coronavirus hit because Covid-19 is still a global issue. But you don’t need to keep the same pandemic routine either. “Anxiety comes from not knowing, and when we’re doing the same thing daily, we know what we’re doing, where we’re going, and we’re comfortable in our routine,” Greer says.(Related: 8 Women Share the Impact the Pandemic Has Had on Their Mental Health)

Anxiety accompanies change

To an extent, people adapted to pandemic life and now need to adapt yet again. That’s a lot of change and unknowns for anyone to handle. Our rhythms and routines of daily living are comforting. When your regular schedule is disrupted, you’ll feel anxiouseven if it means moving beyond a pandemic. “This is extraordinarily true with Covid-19 because people have taken a break on so many levels,” Greer says. People have been on a break from the ordinary activities of life, like school and in-office work. They’re also taken a break from life’s joys, such as parties, travel, sports, and close contact. There’s also the fact that some people are returning to old routines that now might feel brand new. “One person, after she was vaccinated, saw her grandchildren and was absolutely crying,” Greer says. “She said, ‘I can’t believe what it was like just to put my arms around them.'”(Related: How Covid Has Remapped Friendships)

Abandoning the comforts of home

In addition to the unknown, some people are also anxious about losing some of the pandemic’s silver liningsthings they enjoyed or appreciated about the past year. Maybe you discovered a new hobby, spent more time with your partner or pet, or started cooking more. Or maybe you’re one of the many office workers who shifted to a work-from-home arrangement and are dreading the day you have to give that up.Living through a pandemic puts many things into perspective, and you may value things like social or solo time in a different way. According to Dr. Hafeez, shy people, introverts, or those who experience social anxiety, are especially susceptible to anxiety about the world reopening. “This group of people may have found some relief that the restrictions of Covid-19 afforded,” she says. “As the world moves from virtual to real-life or in-person situations, this places more stress on those who either like their alone time or have anxiety in business or social situations.”People who were happy to skip in-person socializing during the pandemic may experience anxiety from the pressure to participate in social engagements once again. After all, during Covid-19, they could avoid socializing without worrying about external pressure to show up. “Now, as many have settled into that routine, we are about to go back to a semblance of our former routines, and that reentry can cause anxiety for many, as we are out of practice with ‘normal’ things in life, like dating in person, going to cocktail parties, and meeting friends for happy hour,” Dr. Hafeez says. Getting accustomed to this social interaction is going to take some time.(Related: Could Your Chest Tightness Be Due to Anxiety? Why It Happens)

Existential dread

Anxiety, in moderation and properly managed, provides people with important data and information. “It tells us the status quo in which we are currently living needs to be altered because it’s too chaotic and uncomfortable,” Hokemeyer says. “As this relates to the anxiety we are feeling about reentering our post-Covid-19 world, the anxiety we are feeling individually and collectively is telling us we have work to do to repair ourselves, our relationship, and the world we live in.”The bigger issue is anxiety of an existential nature: Your life may have undergone dramatic alterations during-Covid-19 and you’re wondering what kind of world you’ll be re-entering. “Covid-19 and its attendant stresses and strains changed us,” Hokemeyer says. “It brought into sharp relief the thin and very tenuous line that separates chaos and order, health and illness, life and death. While this heightened awareness and deeper consciousness present an exceptional opportunity for repair, it can also be overwhelming,” Hokemeyer says.(Related: 6 Breathing Exercises for Anxiety That Can Help You Feel Calmer)

Who is most at risk?

Some people might not feel as anxious as others about this coming change. Hokemeyer says that people who are conscious of and thinking about the way they are in the world are susceptible to these feelings of “emergent anxiety.””My patients who want desperately to make meaning and manifest change from this experience are the ones who are suffering from the most anxiety,” Hokemeyer says. “This is because at this nascent stage of reemergence, they haven’t quite figured out how to concretely manifest the change they want to see.” Of course, anyone with existing anxiety disorders is also more prone to feeling anxious about the changes coming with post-pandemic life.

How to manage post-pandemic anxiety

Plan what you can

Anxiety stems from feeling a loss of control, so the more people can exercise control, take control, and put controls in place, the calmer they will be, according to Greer. That means being very mindful, thoughtful, and intentional about the activities and plans you participate in post-pandemic. “Do it in a structured way that you plan for it and you look forward to it, like a vacation,” Greer says. “That way, you know what you’re doing, who you’re going be doing it with, and where you’re going be going.” All of that gives you something exciting to look forward to, and it gives you some sense of control over the events and happenings in your life. Plus, it gives you time to mentally prepare. “You can make a plan, look forward to it, and actually do it,” Greer says.Hokemeyer says one of the best treatments for anxiety is structure. Create and keep a daily routine and be sure to set goals. “Make sure you are sticking with a daily routine that includes time for exercise and social engagement,” he says. “Get up and go to bed at the same time every day. Eat three healthy meals. Take a daily walk.”

Find your support staff

Another way to manage anxiety is to talk to friends and family. Share your concerns because others probably feel the same way. “Learn about anxiety in general and what tools can be used to master it, such as belly breathing and meditation,” Dr. Hafeez says. If these thoughts are really interfering with your quality of life, seek help from a mental health professional.(Related: How to Find the Best Therapy App for You, According to Experts)

Practice self-care

Hokemeyer highly recommends starting a journal, particularly when it includes positive affirmations. These are short statements meant to inspire you, like “I am full of energy and ready to take on the day” or “I am worthy of love.” You may also want to do some bullet journaling. Fill one page in a notebook with your random thoughts in the morning. “Then fill up another page of one to three affirmations that you want to manifest as you reemerge into our post-Covid-19 world,” he says. These can be simple and broad or really specific to your desires. The main point, Hokemeyer says, is to be an active participant in your healing journey. Consider jotting down these phrases that calm anxiety.

Don’t say “goodbye” to the good stuff

If you’re anxious about leaving behind the silver linings of pandemic life, Greer suggests taking inventory of what has worked for you during the pandemic. “Once you know what it is, then you put the controls in place by planning those activities into your life so that you’re not losing them; you’re just not going to be able to have them the same amount of time,” Greer says. “So you find they become your takeaway lesson from the pandemic, and you learn now how to integrate them into your life to have a more meaningful experience.”Be aware of what’s important to you, what you gained, and what you don’t want to give up. Then really structure your life and figure out how to include those aspects in it. Will you be able to add those elements of your life into every single day? Maybe not. But consider doing so on a weekly or monthly basis. According to Greer, that will give you a sense of control and will let you keep having these positive experiences.(Related: How Rumination and Obsessive Thoughts Are Linked to Anxiety and Depression)

When will the anxiety ease?

As more time goes by, Covid-19 cases and deaths will decline more and more, and people will see that they remain Covid-19-free. At that point, most people should feel better about returning to the world, says Dr. Hafeez. But change takes time. Dr. Hafeez recommends taking baby steps when returning to a “normal” life. “For example, if you are traveling for the first time since the pandemic, don’t take an overseas flight,” she says. “Take a short, domestic flight to build your confidence.”If you are dining out at a restaurant for the first time, don’t go with a larger group during the Saturday night rush. Try a Monday night with one friend. According to Dr. Hafeez, this baby-steps process goes by a more sophisticated term: exposure therapy. With this technique, you expose yourself to the thing you fear, little by little, until the fear subsides. “Yes, as a whole, we will go back to normal, but it will take some time after the collective trauma this country and the world have been through,” she says.Hokemeyer is optimistic that post-pandemic life anxiety may start to subside around 90 days into the complete reemergence and reopening of the world. “Ninety days is an important period neurologically,” he says. “It’s the amount of time required by our central nervous system to integrate new information and recalibrate to a new reality.”(Related: How to Build A Self-Care Plan, According to Experts)

Keep tabs on your feelings

The essence of anxiety comes from change, not knowing what will happen, and a certain sense of helplessness. Be aware of how you feel as you make plans for yourself, Greer says. Look for ways you can control or take charge of your post-pandemic life. The more controls you have in place, the calmer you’ll be.Next: This Unexpected Technique Can Help Control Anxiety

The post Post-Pandemic: Coping With the Anxiety of a Changed World appeared first on Best Health.

Before long, she’d developed body dysmorphic disorder (BDD), along with an eating disorder. The condition strikes over 350 000 Canadians, and not just athletes and bodybuilders.

(Related: Do You Have a Healthy Body Image?)

BDD diagnostic criteria

Some people don’t like part (or all) of their body, but BDD goes beyond dissatisfaction. According to the psychiatric manual DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), this is the criteria used to indicate a patient has BDD:

• Preoccupation with nonexistent or slight defects and flaws in appearance

• Repetitive or compulsive behaviours, such as mirror checking or changing clothes many times

• Clinical significance, meaning the obsession must cause significant distress or must inhibit everyday functioning, such as a person’s social life

• Differentiation from an eating disorder, which ensures that the clinician shouldn’t actually be diagnosing the person with an eating disorder

• There are two additional further distinctions to the diagnosis:

  • Muscle dysmorphia: A person is particularly worried about their body build (muscles) being too small or insufficient. This specific type has been linked to higher suicide rates and poorer quality of life than other types.

  • Insight specifier: How accurate or inaccurate a patient’s perception of themself is.

Beth Rosenbaum is a Philadelphia-based licensed clinical social worker and therapist with over 30 years working with eating disorders and BDD. She says that there can either be an infatuation with reaching a certain size or weight, or people can have a preoccupation with how a certain body part looks. She typically sees women obsessing over their breasts, stomachs, and thighs, trying to fit the “societal perfection expectations for women.”

For men, often it’s the stomach, chest and muscles, abs, biceps, and a concern they aren’t meeting a standard as well. She’s also careful to differentiate between BDD and body dissatisfaction, which many Canadians struggle with.

The emotional toll can be severe, with people thinking about the body part(s) they hate many times per hour, disrupting their daily lives and ability to concentrate.

(Related: These Proven Ways Can Help Boost Your Body Image)

What causes BDD?

There isn’t one cause, but a variety of triggers in conjunction with past or current traumas in the patient’s life. Rosenbaum says it’s often a result of underlying emotional issues that need to be addressed. She also sees most people with eating disorders also suffering from BDD as well.

Societal standards, social media scrolling, and the inaccurate idea that our lives would be better if we were a smaller size, are all to blame, Rosenbaum explains. Mixed messages about society’s expectations don’t help either.

She describes women’s magazines which she says traditionally have told women in particular conflicting messages: “On one side of the cover, it’s the miracle diet next to how to bake the perfect cake. I did a research project on conflicting messages…what do we do with that?”

BDD can also be associated with transgender patients who are transitioning.

“People who were born with a female gender [and now identify as male] may have a hard time with breast development and hips and stomach, and that too can lead to eating disordered behaviour,” Rosenbaum says. She also sees other major bodily transitions, such as pregnancy and postpartum life, being a trigger for BDD. “You could lose all the ‘baby’ weight but your body proportions have changed,” she says.

(Related: On the Pursuit of PerfectionAre Our Social Media Habits Harming Our Self-Worth?)

Signs of BDD

Your idea of a “flaw” isn’t realistic

The Diagnostic Manual differentiates between people who are actually obese and are worried or struggling with that, and BDD. With BDD you are concentrating on minute imperfections that are normal aspects of being human, rather than actual body issues that are visible to others.

Samantha DeCaro, an assistant clinical director at The Renfrew Center of Philadelphia, says BDD is a fixation on “perceived” flaws.

“These flaws are not detectable, or they are barely noticeable, to anyone else,” she says. “People with BDD commonly become obsessed with real or imagined imperfections on their face, their hair, or the size and shape of a particular body part.”

You avoid social situations

Ever canceled an event because you can’t find something that makes you look skinny enough to go out? This is a concerning sign that can indicate BDD. Psychotherapist Haley Neidich, a licensed social worker with an online private practice, says those with BDD may “isolate themselves and avoid social situations.”

Rosenbaum says the major distinction that helps her diagnose BDD is identifying “how much does this interfere with [a patient’s] life?” “How much of my thinking time does this take? Does my focus on my body keep me from doing things I enjoy, like going out with my friends?” All of these can indicate that you are moving from body dissatisfaction to a more concerning, obsessive disorder.

(Related: 15 Things About Social Anxiety Disorder Psychologists Wish You Knew)

You spend a lot of time staring in the mirror

When bodybuilder Greeley finally reached her lowest point and reached out to a therapist, she was diagnosed with BDD, as well as bulimia. “When you are in that world staring in the mirror taking thousands of [progression] photos for coaches, I’d say ‘I can’t see my abs, Oh God,'” she says. Greeley would spend hours “stalking” other people’s Instagram accounts, comparing her body to theirs. “I felt not skinny enough. It became sick and obsessive,” she says.

You can’t stand your own face

Rosenbaum says the pandemic has worsened BDD for many people who are sitting on Zoom calls for hours, staring at their own reflection. She jokes that even she has never “checked her hair” this much.

“People are staring at their distorted image all day. For most of us, we are bodies from the chest up. We don’t even have bodies,” Rosenbaum explains. This unreasonable amount of time we can now spend staring at our own features is exacerbating the problem. It’s being called the “Zoom Boom” as plastic surgeons see more patients considering plastic surgery in 2020. Recent research from the American Society of Plastic Surgeons reveals telemedicine calls for plastic surgery are up 64 percent.

DeCaro says we are living in a society obsessed with “fatphobia and ageism,” which causes everyone to be critical of their bodies from time to time, but those with BDD can be constantly concerned with “real or imagined imperfections on their face” or other body parts.

You see your body as parts, not a whole healthy being

Finding yourself hating a specific body part? This can be one of the difficulties of BDD, as piecing out the body causes us to hyper analyze the flaws of each part, rather than looking at the body as a whole being, Rosenbaum explains. One of the strategies she’s found helpful with patients is helping them to see their bodies as a whole being that serves a function, and to focus on what your body can do.

“Appreciate what your body does for you. Every aspect of your body. Learn to appreciate what it does and how it serves you so well… so we need to feed our bodies with fuel to give us energy so our brains work. So we can walk and love and engage in everything our bodies do. Often [people with BDD] only focus on the surface,” Rosenbaum says. That deep dive into our perspective on our bodies, and focus on the importance of certain parts being perfect, is what BDD patients work on in therapy.

(Related: Body-Positive Quotes to Remind You All Bodies Are Beautiful)

What to do if you think you have BDD

First, determine the severity of the symptoms. Often BDD happens in conjunction with an eating disorder, which can be more dangerous than BDD by itself.

Neidich says individuals with BDD are known to pursue or complete medical procedures in order to change their bodies in an effort to rid themselves of the obsession, which can be dangerous. “Given the high prevalence of disordered eating among individuals with BDD, it is important to point out that eating disorders are the most deadly mental health disorder,” she says.

Behaviours Rosenbaum says can be more severe including binging and purging, restricting calories, overexercising, and other typical eating disorder symptoms. Seeking therapy is an important step towards overcoming BDD, and is a great place to start.

Next steps

Neidich suggests the following steps, noting that BDD often occurs along with another condition (comorbidity):

• People with co-morbid personality disorders may be referred to dialectical behaviour therapy (DBT) treatment, a type of cognitive behaviour therapy that helps teach skills to handle negative emotions.

• Those with co-morbid post-traumatic stress disorder (PTSD) may be referred to a trauma therapist.

• Anyone with obsessive-compulsive disorder (OCD) may be referred to a specialist for cognitive behaviour therapy (CBT) combined with Exposure and Response Prevention, a type of therapy that exposes people to their fears.

• Those with co-morbid substance use disorders will be encouraged to attend 12-step programs and focus on sobriety.

• Individuals with eating disorders should have a multidisciplinary treatment team.

“Just like other mental health conditions, it is possible for people to reach a place in their recovery where they are no longer symptomatic (or minimally so),” Neidich says. “However, individuals with a history of BDD are at a high risk for a recurrence of the symptoms or other mental health conditions in the future, particularly around a time of transition or intense stress in their lives,” she explains.

Greeley is finally able to manage, after years of therapy. She says you don’t just wake up and not have BDD anymore, and that sometimes she still has to check herself: “It’s OK to have one Oreo. You can have a cheeseburger and it won’t be the end of the world,” she says. She credits her care team’s support with helping her “learn to love herself all over again.”

Next: 5 Happy Hormones and How Boost Them Naturally

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Chest tightness and other symptoms of anxiety

Chest tightness is just one of many possible ways anxiety can manifest. “The classic anxiety symptoms are thoughts or fear of death, inability to sleep, inability to concentrate,” says Pedro Cazabon, system medical director of primary care at Ochsner Health. You may also experience muscle aches, body aches, not being able to relax, shortness of breath, feeling tired and irritable, trouble sleeping, rapid breathing, sweating or trembling, even gastrointestinal upset.”There’s a real physiological change when we have a stress response,” says Brittany LeMonda, senior neuropsychologist at Lenox Hill Hospital in New York City. “It’s really not necessarily an emotion experience, it’s [also] a physical experience.”(Related: Can Anxiety Cause High Blood Pressure?)

Why does anxiety lead to chest tightness?

Several processes act together to create different symptoms of anxiety, including chest tightness (which is also often accompanied by chest pain or pressure). One involves hormones.”If you sense a threat or fear, that triggers a release of adrenaline hormone,” explains Dr. Cazabon. “Your heart rate goes up, blood pressure can go up. Your vascular [blood] vessels can tighten a little bit. The chest muscles can also tighten and can give you the feeling of something squeezing,” he says. The stress hormone cortisol also plays a role.

Muscle tension

“The rib cage and the diaphragm are all made of muscle and bones,” says Bradley Gaynes, professor of psychiatry and epidemiology at the University of North Carolina School of Medicine, in Chapel Hill. “You can get tension there, too. And that’s why you might feel chest [tightness] and pain, and shortness of breath.” It’s not too different from having stress-related pain and tightness in your neck or shoulders.

Oxygen intake

When you’re feeling anxious, you take fast, shallow breaths which means you’re not bringing in enough oxygen. Your body reacts by taking even more short breaths which results in a vicious circle. This can also contribute to chest tightness, says Dr. Gaynes.(Related: 6 Breathing Exercises for Anxiety That Can Help You Feel Calmer)

What else can cause your chest to feel tight?

Causes of chest tightness run the gamut from the relatively benign like indigestion to a gallbladder attack to a potentially life-threatening heart attack or a pulmonary embolism (clot in your lung), says Dr. Cazabon. That’s why it’s such a tricky diagnosis to make.Why is chest tightness associated with so many ailments? “The chest and upper abdomen are integrated from one nerve,” explains Dr. Cazabon. “The vagus nerve [the 10th cranial nerve that supplies the heart, chest, and other organs] travels from the brain all the way to the gastrointestinal tract, but it just registers nonspecific pain.” You need to know more of the story to zero in on a reason.

Is it anxiety or something else?

Because so many things can cause chest tightness, it’s one of the trickiest symptoms to diagnose, says Dr. Cazabon.One way to suspect it’s anxiety is to think about what’s going on in your life at the moment. “Is there any kind of clear stressor that’s happening that might explain why you’re more anxious?” says Dr. Gaynes. Trouble at work or in a relationship may help explain the symptom. So may feelings of fear.(Related: Why Is It So Hard to Find a Therapist Who Gets Me?)

Other clues

Think about possible physical causes for your symptoms. Chest tightness is less likely to be from anxiety if you have a personal or family history of medical problems like heart attacks or blood clots, says Dr. Gaynes.If you can reproduce the feeling of tightness by pushing down on your chest, it’s less likely to be a heart attack and more likely to be a musculoskeletal problem possibly from anxiety, says Dr. Gaynes.Chest tightness that comes after physical exertion is more likely to be related to your heart, says LeMonda. Pain that lasts only about five to 10 seconds is more likely to be anxiety, she adds.

Assessing the cause

If you have any doubt at all about the cause of your tightening chest, you need to get input from a medical professional. That’s much easier today than it once was. In the past, you had to make an actual appointment with a doctor or trek to the emergency room. These days, there are less onerous options, says Dr. Cazabon. Many health systems have telemedicine capabilities, like calling a hotline and talking to a nurse or doing a video visit.”You don’t necessarily have to run to the emergency room or go to the doctor to get help,” says Dr. Cazabon. “There are plenty of places where you can get advice. They will determine the cause with you and determine the next step.”(Related: How to Know If Your Anxiety Is Normal)

How to relieve chest tightness and anxiety

But if you’re certain your symptoms are from anxiety, the remedy can be deceptively simple. At the top of the list: Shifting your breathing from short, shallow breaths to longer, deeper ones, perhaps through mindfulness or meditation. “That can help you get more oxygen which can calm your lungs and help your chest not feel as tight,” says Dr. Gaynes.If something specific is stressing you out, “talk” to yourself using some cognitive-behavioral techniques (CBT) to relax. For instance, how likely is a doomsday scenario you’re imagining likely to happen? Would it be the end of the world if it did? CBT can also help you unlearn anxiousness that has an outside trigger.

Exercise

For our ancestors, the fight-or-flight response was supposed to get you physically away from a threat or confront it. You’re unlikely to face the same kind of threat today (a lunging tiger, for instance). But you can still use exercise to wear out the response, so to speak. “This can help reset your anxiety center,” explains Dr. Cazabon. Try walking, running, climbing stairs, or punching a bag.

Medication

Drugs to treat anxiety are usually a last resort. “I always think it’s better to find a way to manage anxiety without medication because the medication is putting a Band-Aid on things,” says LeMonda.But if absolutely nothing else works, there are medications, including certain SSRIs (selective serotonin reuptake inhibitors), which are believed to help regulate mood and anxiety, says Dr. Cazabon.Next: 6 Ways to Fight Anxiety and Depression During Covid-19

The post Could Your Chest Tightness Be Due to Anxiety? Why It Happens appeared first on Best Health.

Can anxiety cause high blood pressure?

In-the-moment anxiety affects blood pressure in the same way stress does, explains Vijay Nambi, associate professor of medicine at Baylor College of Medicine in Houston. It kick-starts your sympathetic nervous system, which releases the stress hormones adrenaline and cortisol that can increase heart rate and blood pressure.A prime example of this: white coat hypertension. That’s when your blood pressure readings at your doctor’s office are higher than normal, likely because you are anxious about the visit.Sometimes this reaction can be helpful and serve as a warning against impending doom. But when anxiety is chronic, it can lead to a higher risk for heart attack, stroke, and kidney disease, Dr. Nambi explains. For one, anxiety affects your ability to engage in a healthy lifestyle, like getting enough sleep, exercise, and healthy food.”When we are anxious, we tend to overeat or overindulge,” he says. “Your sleep hygiene is lost, and your blood pressure will go up.” An unhealthy diet, lack of exercise, and sleep loss can increase blood pressure. Anxiety may also get in the way of taking your blood pressure medications, he notes.There are other theories about how anxiety directly affects blood pressure. For example, anxiety may increase levels of angiotensin II, which in turn can raise blood pressure, according to research published in Neuropsychiatric Disease and Treatment. Certain blood pressure-lowering drugs block angiotensin II. Over the long term, anxiety may also more easily activate the sympathetic nervous system.Depression and anxiety may travel together, says Salim Virani, professor of medicine at Baylor College of Medicine. “We know depression and Type D personality is more significantly associated with future risk of heart disease,” Dr. Virani says. Type D people are distressed and tend to see the glass as half empty. By contrast, optimistic personality types may have a lower risk of heart disease or stroke, he says.(Related: 3 Tips to Help You Cope With Covid-19 Anxiety)

Treating anxiety and high blood pressure

“If you are anxious because of something that is explainable such as job loss, it is a normal response, but if these feelings persist or if there is no reason for them, start by seeking help from your primary care physician,” Dr. Nambi suggests.You can treat anxiety with talk therapy, medication, and cognitive behavioral therapy (CBT), a type of therapy that works to change how you react and respond to triggers.Engaging in mindfulness meditation may also help reduce anxiety, and these benefits can be seen after your first session, according to research presented at the 2018 annual meeting of the American Physiological Society. The results were even more pronounced one week after the meditation session. Study participants also showed less mechanical stress on their arteries an hour after the session. (Mechanical stress on the arteries can set the stage for heart attack and strokes.) “Treatment will allow you to have a better outlook toward life and take better care of yourself,” adds Dr. Virani.Treating and preventing high blood pressure is also important, says Guy L. Mintz, director of Cardiovascular Health & Lipidology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, New York.(Related: This Unexpected Technique Can Help Control Anxiety)This includes:

• monitoring your blood pressure at home
• exercising for 150 minutes each week
• eating a heart-healthy diet with no added salt
• maintaining an ideal weight

“Hypertension is referred to as the silent killer because it has no symptoms,” Dr. Mintz says. “Hypertension is a major risk factor for heart attack and stroke and needs to be addressed early and effectively.”

The last word

Anxiety can cause blood pressure to rise. Over time, that can increase the risk for more serious consequences of high blood pressure, including heart attack and stroke. High blood pressure can also cause anxiety when you worry about these complications. Getting help for anxiety and high blood pressure is the best way to take back your health.Next: Can Stress Cause High Blood Pressure? What Heart Doctors Need You to Know

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Anxiety is a normal response to certain threats. But “irrational” fear and worry that interferes with daily life may indicate an anxiety disorder.

Eighty-eight percent of respondents to a Statistics Canada survey reported experiencing at least one symptom of anxiety in the two weeks prior to completing the survey, which was conducted during Canada’s first lockdown period. Youth (age 15 – 24) were also more likely to report worsening mental health. And though Canada doesn’t collect race-based data on Covid-19, the CDC found that certain groups were especially hard hit, Black people, Latinx people, essential workers, unpaid caregivers for adults, and people who were already being treated for anxiety, depression, or post-traumatic stress disorder (PTSD).(Related: 14 Virtual Care Services in Canada You Need to Know About)

Can CBD help with anxiety?

Meanwhile, cannabidiol (or CBD) is being touted as a treatment for a number of health issues, including anxiety. Most of the evidence is from studies in animals and not humans. However, some research suggests CBD could be helpful for certain types of anxiety in healthy people who haven’t been diagnosed with mental illness, and for anxiety in people with certain psychiatric conditions.”There appears to be great interestand increasing useamong people taking CBD to assist in managing mental health issues like anxiety, stress, and insomnia,” says Jerome Sarris, a professor of integrative mental health and head of the Healthy Minds Research Program at Western Sydney University’s NICM Health Research Institute in New South Wales, Australia. “Clinical trials are needed, however, to be able to more firmly conclude about whether the use of CBD in those with generally good mental health is beneficial beyond a placebo-effect,””What hasn’t been studied is anxiety as its own condition versus as a symptom of a disease,” notes Jahan Marcu, PhD, founding partner of cannabis consultancy Marcu & Arora and editor-in-chief of the American Journal of Endocannabinoid Medicine.

What’s the evidence?

“What CBD is probably best studied for is acute stress related to public speaking challenges,” says Marcu.A small studyof healthy men, published in 2019 in Brazil Journal of Psychiatry,found that a 300-mg dose relieved anxiety during a public speaking test. Another study, in people at high risk of psychosis, found that those who were taking 600 milligrams of CBD per day had a lower cortisol response to social stress.The two studies to date of inhaled CBD have found it was effective at much lower doses, notes Marcu, in the 16 mg to 32 mg range. “It does seem like in healthy volunteers that CBD might be helpful,” he says.A small study published in the Journal of Psychopharmacology found that 400 mg of CBD was linked to a decrease in anxiety for people who had generalized socialized anxiety disorder (SAD). In a study published in a 2019 issue ofThe Permanente Journal, participants with anxiety and/or sleep problems took 25 to 175 mg of CBD daily. Although sleep issues didn’t change dramatically over the three-month testing period, anxiety levels decreased, according to the report.”There is some emerging evidence supporting the use of CBD in various psychiatric disorders such as schizophrenia, while potentially also being of use for social anxiety,” says Sarris, adding that researchers around the world are studying CBD. “There are lots of clinical trials going on at the moment. We will have a better idea in coming years.”(Related: 15 Things About Social Anxiety Disorder Psychologists Wish You Knew)

How CBD may work for anxiety

Researchers aren’t totally clear how CBD affects the brain.”The main brain pathway being modulated by CBD which may affect mood and anxiety involves the ‘endocannabinoid’ system,” Sarris says. “This is involved in regulating mood and pain. And it appears that CBD interacts beneficially with this biological pathway.”The endocannabinoid system (ECS) consists of cannabinoid-like compounds in the body known as endocannabinoids; the cell surface receptors that bind to them; and the enzymes that make endocannabinoids and break them down. Things that are good for yougetting enough sleep, exercisinghelp keep the ECS in shape. You can even get a boost of endocannabinoids from singing in a choir, notes Greg Gerdeman, a cannabis neuroscientist and educator.On the other hand, lack of sleep and unrelieved stress and anxiety can weaken the ECS. So it’s less effective in helping us to manage stress.”People having different levels of activation in their endocannabinoid system may be more or less resilient to stress, and may differ in their abilities to recover from the stress of psychological trauma,” Gerdeman says. “The challenge of this is knowing to what extent it’s actually happening in humans, and what dose of CBD is required to accomplish this.”CBD could also ease anxiety by affecting levels of the “feel good” brain chemical serotonin, Marcu notes. It acts on the same receptor targeted by selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft, which are first-line treatments for anxiety as well as depression.(Related:Can You Use Melatonin for Anxiety?)

Best forms of CBD for anxiety

Inhaling CBD by vaping or smoking CBD-rich hemp is the quickest way to feel its effects, but these consumption methods come with their own health risks. They can cause potential lung damage. There are possible harmful ingredients in vape oil, including legal additives like propylene glycol, that can be dangerous when heated and inhaled.If you’re considering using CBD vape oilor any CBD oil or CBD edible, for that matterexperts agree you should only use products sold at legal dispensaries licensed by your province.CBD oil, CBD tinctures, CBD pills, CBD capsules, and other CBD edibles take longer to workpeople may start feeling the effects from a half hour to two hours after consuming thembut their effects are longer-lasting, says Martin A. Lee, co-founder and director of Project CBD, a California nonprofit that promotes CBD research, and author of Smoke Signals: A Social History of MarijuanaMedical, Recreational, and Scientific.CBD edibles can be more effective for chronic, long-lasting anxiety, Lee notes.You can get CBD into your system faster by holding a CBD tincture or CBD oil under your tongue for at least two minutes, which allows it to be absorbed into the bloodstream more readily, notes Bonni Goldstein, MD, medical director and owner of Cannacenters, a medical practice in Los Angeles, and author of Cannabis is Medicine: How Medical Cannabis and CBD are Healing Everything from Anxiety to Chronic Pain.

Side effects

CBD’s effects vary from person to person and CBD can interact with many commonly used drugs. Otherwise it’s generally considered safe. Potential side effects include sleepiness, fatigue, irritability, changes in appetite, nausea, and diarrhea.

Can it cause anxiety? Or make it worse?

Low doses of CBD can make some people feel more alert, while larger doses can lead to sleepiness, Dr. Goldstein notes. But for the great majority of people, taking CBD doesn’t cause anxiety or worsen it.

(Related: How to Know If Your Worries Are a Deeper Problem)

Consult your health care provider

If you’re interested in trying CBD for anxiety, experts have two key pieces of advice: Tell your health care provider about it. And make sure you are getting a safe product that contains what the label says it does, which is often easier said than done.

Dr. Goldstein and other experts recommend using only CBD products sold in licensed dispensaries, where marijuana is regulated by the government.

How much CBD oil to use for anxiety

Investigators are still figuring out the best CBD doses for various indications, including anxiety, Sarris and other experts say.”We need further research on what the ideal dose of CBD is for the individual,” Sarris says. “Commonly, people are consuming between 10 mg to 70 mg for general mental health usage. However, for other more serious psychiatric disorders, clinical trials are using 400 mg to 800 mg. This can be expensive, and people’s responses to CBD do vary. So it’s important to work in concert with a health professional to work out what dose is appropriate.”

What CBD formulation is best for anxiety?

CBD oil, CBD edibles, and other products come in three forms:

• Full spectrum, meaning they contain all of the other compounds found in the plant, including THC and terpenes
• Broad spectrum, with all of these compounds except THC
• CBD isolate, which contains only CBD

If you’re concerned about failing a drug test for marijuana due to trace levels of THC in a CBD product, your best bet is to stick with broad spectrum products or isolates without THC, which is what drug tests look for. But keep in mind: With regular use, it is possible for even small amounts of THC to build up in the body, raising the possibility of a positive drug test.If this isn’t an issue, it may be worth trying a full-spectrum product, experts say.”Other compounds from full-spectrum cannabis extracts, such as certain terpenes, may also be of benefit,” says Sarris. That’s because of “additionalanxiety-reducing, muscle-relaxing, and sleep-assisting properties.”(Related: What You Need to Know About Cannabis Edibles)

The bottom line

If you’re considering CBD for anxiety, discuss it with your doctor, and from legal dispensaries where products are regulated.Next: How to Know If Your Anxiety Is Normal

The post Everything You Need to Know About CBD Oil for Anxiety appeared first on Best Health.

Distraction can be used for short-term issues

“For generalized anxiety disorder, we often ask people if they worry when theyre busy at work. They’ll often say no, it’s when I come home, or when everything is quiet and I’m trying to fall asleep, says Korol. So, busying the mind can definitely keep anxious thoughts at bay.This tends to work best for short-term issues. For example, if youre having a medical procedure done, have a job interview, or awaiting results from a testin other words, anxious about something that has an end datedistraction can be effective at helping you shift your attention so you can sleep and carry on with your day, says Korol. You can use distraction to give yourself a little vacation from thinking about it, she says.

Choose the right type of distraction

The best type of distraction is something you can do with your hands. Visual, spatial activities use sort of nonverbal areas of the brain and keep you a little bit more occupied [than reading or watching TV], says Korol. Think drawing, painting, organizing, baking, and one of the most relaxing hobbies you can take up, knitting. If you choose TV or a podcast, Korol warns: It should be something that calms the nervous system and not be too exciting. Think The Queens Gambit over The Undoing.Alternatively, you could try playing a game. A recent study looked at people who experienced a traumatic event and, instead of retelling the story afterwards, were encouraged to play Tetris. The game was effective at preventing the images of the event from replaying in their minds and was able to ward off post-traumatic stress disorder. Tetris is kind of interesting because it’s a puzzle game that you do under the pressure of time, says Korol, so your brain can’t do very much else when you’re engaged in it.(Related: Can You Use Melatonin for Anxiety?)

Distraction can be harmful when using it to cope with long-term issues

For longer-term anxieties distraction isnt the best way to cope, because it doesn’t get at the core issue. “[Therapists] tend to teach other strategies, says Korol. She helps her clients learn how not to believe their thoughts, and plays the worst-case-scenario game, in which they both brainstorm a coping plan for how to manage such scenarios. When you start avoiding things [like flying, for example] that aren’t really dangerous, then your world becomes very small. So, with recurring anxieties, you want to address them head-on.

Anxiety around loneliness is a different issue altogether

I’ve been working with more people who are single right now and trying to come up with creative ways for them to find connections with people, says Korol. She doesn’t recommend coping with loneliness by flooding the mind with TV shows, music, and podcasts. You have to find some ways to have some social contact, says Korol. Listen to podcasts in between social occasions when getting lost in anxious thoughts, she says, but make it a priority to develop social connections.

Ask for help if the problem persists

For persistent anxieties, a therapist can help. Anxiety disorders are really treatable and there’s a lot we can do to help people feel better, says Korol. But therapy isnt the only option. There are videos on dealing with worry and rumination that can help (like Korol’s own), as can courses (for example, the University of Regina has an online therapy unit available for everyone in the province), and self-help resources (such as one from Australias Centre for Clinical Interventions, which offers free workbooks on panic, worry, rumination, and anxiety). For more resources visit CMHA.ca.Next: 6 Breathing Exercises for Anxiety That Can Help You Feel Calmer

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Im not alone in this experience. A recent study conducted in China found people had higher rates of insomnia, acute stress, anxiety, and depression in the wake of the pandemic. Notably, the data showed a 37 percent increase in the rates of clinical insomnia since the beginning of the pandemic.

(Related: Do You Have Morning Anxiety?)

When I was asked to test drive Toronto-based Gravids 3.0 weighted blanket with cooling technology, I was a bit skeptical. Previously, I had tried a weighted blanket but didn’t like it because of how hot I got and how unevenly distributed the weight was. And to be honest, pre-pandemic, I didnt think of myself as someone with serious enough sleep issues to need a weighted blanket. But now, the possibility of more sleepless nights, without overheating, was incentive enough to at least try a different product that might help.

Weighted blankets are therapeutic blankets that weigh anywhere between 5 to 30 pounds. The weight, which is distributed throughout the blanket using glass beads, grains, or plastic pellets, provides deep pressure stimulation all over your body. This is thought to trigger your parasympathetic nervous system and help you relax by slowing down your heart rate.

(Related: How to Tell If Your Anxiety is “Normal”)

Its the general feeling of calm, similar to the sensation of being hugged or swaddled, that helps users fall asleep. So, theyve long been recommended for patients with anxiety or sleep disorders. One study, published recently in the Journal of Clinical Sleep Medicine, found that weighted blanket use resulted in better sleep, more daytime activity, and reduced daytime symptoms of fatigue, depression, and anxiety. Plus, in the 12-month follow-up period, study participants who continued to use weighted blankets maintained the positive effect on sleep.

The blanket I tried weighs 15 pounds, about 10 percent of my total weight, which is how heavy experts suggest the blanket be. The first time I tried it, I was hooked. The comfort was instantaneousit felt like I had just wrapped someones arms around me. I was still a little apprehensive about how it would fare at night, but after a few weeks of sleeping with my weighted blanket, I now sleep through the night, fall asleep quicker, and wake up feeling a lot more rested.

(Related: What Your Sleep Problems May Be Telling You)

The EcoBreeze Cooling Coveralso does its job. The cover is made from Tencel Lyocell, which is made from tiny eucalyptus tree fibres that are hydrophilic (meaning they attract water). This makes the fabric better at absorbing water and keeping users dry than other materials like cotton or polyester. I stayed cool all night.

The price-point is a little steep ($169 for the 15-pound twin-sized blanket), especially if you add the cooling cover ($79). But, the higher price point was worth it for me to regain some normalcy to my sleep cycle especially when compared to my bad experience with a weighted blanket at a lower price point. And, as a bonus, Im free from damp, sweaty nights.

Next: 10 Science-Backed Ways to Get More Shut-Eye

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What is rumination?

Rumination is a mind that spinsand often into catastrophic thinking.”Rumination isn’t just thinking a lot about something,” says Stephanie Parmely, a behavioural health psychologist with Dignity Health in Folsom, California. “It’s akin to a cow chewing cud. You’re wrestling over and over again with a thought that tends to be negative.”Getting lost in this sort of negative brain swirl is related to low levels of the neurotransmitter GABA. The presence of GABA in the hippocampus in your brain inhibits unwanted obsessive thoughts, says Parmely.Of course, we all have intrusive thoughts on occasion, but pay attention to how often they’re hijacking your thinking patterns and how much mental space they’re taking up. “I don’t think healthy people ruminate a lot,” she adds. “If it happens continually, that’s possibly a symptom of a mental health problem.”(Related: How to Know If Your Anxiety Is Normal)

5 situations in which rumination may take hold

1. You can’t let go of something trivial

It doesn’t matter what it is, but it’s really not that important. And yet, you can’t let it go.”This is a function of some stress in your brain that’s making it hard to inhibit thoughts,” says Parmely. This, in turn, feeds anxiety.”When you entertain thoughts, it reinforces the connections in your brain that allows those thoughts to happen,” she adds.

2. Did you turn off the stove?

Intrusive thoughts about whether you did or didn’t turn off the stove (and then continually worrying or checking that you did) falls under an obsession that’s identified with obsessive compulsive disorder (OCD), says Thea Gallagher, assistant professor with the Center for the Treatment and Study of Anxiety in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.Once in a while if you fret about turning off the stove (or locking your front door or closing your garage), that’s normal. But obsessions are problems when they interfere with your life and activities you like to do, according to the International OCD Foundation.

3. You said something offensive

Maybe you were an insensitive jerk to your friend. But maybe you weren’t. Rumination might mean continually replaying that conversation in your head, thinking about what you should or shouldn’t have said, and how that would have changed the outcomeand scolding yourself for it.Face the source of these thoughts and you’ll quiet them down, says Gallagher, who uses exposure therapy as one way to deal with anxiety.”If you feel like you did something wrong, go to the source and ask,” she advises. If someone says that what you said did not bother them, then consider that your interpretation of the situation may be unduly harsh.These thoughts may stem from social anxiety disorder.A type of anxiety that arises during social situations, it’s characterized by fears of humiliation, judgment, or rejection, according to the National Institute of Mental Health. In this situation, it’s important to challenge your beliefs.”Even though you may think people are thinking about you in a negative way, that’s not the case,” says Gallagher.

4. You wake up worried

Morning anxietyis real. Rumination may actually be a bid for productivity or a tool to help you figure something out, says Gallagher. “But ruminating is a spiralyou don’t get anywhere except down.”Often this involves worrying about things you can’t control (or expecting the worst) either in the day ahead or far in the future, which only worsens anxiety or depression.

5. Someone said something rude to you

If you’re triggered by a rude comment from your boss, a family member, friend, or someone on social media, stop to think about the deeper reason behind the mental replay, suggests Gallagher. For instance: Do you feel taken advantage of by people?Once you’ve identified that, you can think about what, if anything, you want to do about it. Do you want to confront your sister but are normally conflict-avoidant?”Either push yourself to do something about it or radically accept the situation for what it is and move onto something else,” she says.Again, this takes practice and perhaps a professional to help you develop the skills to tackle problems head-on, or move on.(Related: How to Stop Worrying and Have a Happier Life)

Strategies for managing rumination and obsessive thoughts

When you find yourself overcome by obsessive thoughts or caught in a pattern of rumination, here’s what you can do:

Focus on what you can control

Is there something that you can do to take action? Doing that will help reduce your anxiety because it may help resolve the situation. If it’s completely out of your control, try accepting the uncertainty. This is far harder than it sounds, and so connecting with a therapist can help give you the tools to do this.

Maintain perspective

Depression is about the past, while anxiety is rooted in what can happen in the future, says Gallagher. If you’re ruminating over what could be in the future or stewing in the uncertainty of the unknown, she recommends thinking about the worst-case scenario, the best-case scenario, and the middle ground.

Try mindful meditation

A stronger prefrontal cortex will help you tune out things you don’t want to think about, says Parmely. Mindfulness meditation exercises your brain to help buffer it against obtrusive, distracting thoughts, as well as foster acceptance.

Distract yourself

Start thinking with a different part of your brain. Mindfulness will help with this, but so will other activities like colouring, knitting, crocheting, ortaking a walk, says Parmely.

Start a math problem

Crunching numbers in your head will get you out of the emotional part of your brain, says Parmely. And the math problems don’t have to be complicated. Add 2 plus 2, 4 plus 4 (and so on). Or try a series of subtractions such as 100 minus 7, 93 minus 7 (and so on).

Stand on one leg

The cerebellum is the part of your brain that senses balance and it can get you out of the running thoughts in your head, says Parmely. Stand on one leg or try a yoga pose. A 10-minute yoga routine every morning can help you start off the day in a more mentally balanced mindset.

When to seek help

If you feel like you can’t control your thoughts and the coping skills above aren’t helping with rumination or obsession, consider talking to a therapist, suggests Parmely. Treatment may include cognitive behavioural therapy, support groups, anxiety medication, or antidepressants.Next: 3 Tips to Help You Cope With Covid-19 Anxiety

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Causes of sleep anxiety

Sleep dread may not be an official term, but you can think of it as an offspring of insomnia, says Virginia Runko, PhD, a behavioural sleep medicine specialist and psychologist in Washington, D.C.”People who have problems falling asleep see how that affects them during the day, and so there’s this anxiety around how the night will go. Sleepless nights are a terrible experience, and no one wants to go through that,” she says.However, it’s important to note that because sleep anxiety is a phobia, or an irrational fear, this usually causes disruption in day-to-day activities and can have a serious toll on mental health.(Related: What Your Sleep Problems May Be Telling You)

Is it anxiety, insomnia, a phobia, or something else?

Knowing the proper way to treat your somniphobia depends on the root issue at play, says Martin Seif, PhD, a clinical psychologist specializing in anxiety in Greenwich, Connecticut. Here are a few possibilities:Anxiety or generalized anxiety disorder: Your mind spirals into worry when you’re alone. Or, you have worries that are out of proportion to reality such as fear of a home invasion when you live in a safe community or a fear of dying in your sleep when you are a healthy person.Anticipatory anxiety: You dread going to bed because you think about everything you need to do at work the next day, explains Seif.Relationship issues: You dont want to go to bed because you dont want to have sex with your partner.Insomnia: Youre preoccupied with the amount of sleep youre getting because you feel as if you have to sleep to perform well the next day. Sleep is an ironic process, says Seif. Focusing on falling asleep makes it harder to sleep.A phobia: Research shows that somniphobia can stem from recurrent sleep paralysis, a condition where you are awake but temporarily cannot move. You may also have hallucinations at the same time, which can be extremely disturbing, according to a 2016 study in Current Sleep Medicine Reports. (One 2019 case report in the Brazilian journal, Revista Paulista de Pediatria, recounted that these sleep paralysis episodes were so frightening that it impacted the patients sleep and school performance.) Severe nightmares may also be behind somniphobia.(Related: How to Find the Best Sleep Aid for You)

Signs and symptoms of sleep anxiety

Sleep problems and anxiety tend to go hand in hand. Someone with anxiety tends to have difficulty sleeping; having problems sleeping can lead to anxiety. According to the Anxiety and Depression Association of America, sleep problems tend to be common in most psychiatric disorders.Symptoms of sleep anxiety can manifest themselves both mentally and physically. If your fear of sleep is due to a phobia (rather than, say an anticipatory anxiety or insomnia-related), you may experience the following as it relates to approaching sleep, says the Anxiety and Depression Association of America: a feeling of imminent danger or doom, heart palpitations, sweating, trembling, a fear of dying, feeling faint or light-headed, chest pains, or a fear of losing control.(Related: 3 Tips to Help You Cope With Covid-19 Anxiety)

Risk factors for sleep anxiety

Experiencing post-traumatic stress disorder (PTSD) and having nightmares also may make you more vulnerable to somniphobia. Some estimates say that up to 96 percent of people with PTSD have nightmares and they may happen several times per week, according to the U.S. Department of Veterans Affairs. It’s not hard to imagine that people may experience sleep dread due to fear of having nightmares. (Related: Magic Mushrooms for PTSDHere’s Why Psychedelics May Help Heal Trauma)Other reasons for an uptick in nightmares right now: Covid-19, the upcoming election, and the social justice movement. “Many people are having triggering and very negative dreams,” says Runko. If that’s you, talking to a therapist can provide the support you need to process your thoughts, experience, and fears.

Treatment for sleep anxiety

Now that youve identified the reason why you may be experiencing anxiety around sleep, you can focus your efforts there. For instance, if you have anxiety about going to bed in an effort to avoid sex with your partner, relationship therapy (together or alone) may be in order.Insomnia can benefit from strategies like sleep hygiene or psychoeducation about sleep, says Seif. (People can perform very well on less sleep than they think, he says, which can help you put the night in perspective.) If its anxiety or a phobia, then cognitive behavioural therapy (CBT) or exposure therapy is often recommended. Here’s what you need to know about each treatment option.

Therapy vs. medication

The first line of treatment for somniphobia caused by insomnia is cognitive behavioural therapy for insomnia, or CBT-I, says Runko. You might first be asked to set up a specific sleep schedule. You’ll also be given tools that help you feel more confident going to bed, including relaxation exercises or reframing negative thoughts surrounding bedtime.Sleep dread is often magnified by spiraling thoughts, like “I’ll never be able to sleep and then I won’t be able to function, and I’ll lose my job”“Reining those thoughts in and addressing those directly can be helpful,” says Runko. A therapist can help you develop these skills.The American College of Physicians recommends using CBT-I as the initial treatment for the sleep disorder before prescribing medication. If CBT-I isn’t enough, doctors are then advised to consider adding a short-term course of medication (around four to five weeks) that treats insomnia, which may include benzodiazepines, nonbenzodiazepines (commonly known as “Z” drugs), or certain antidepressants.Some people have also found melatonin helpful in treating sleep anxiety.(Related: Can You Use Melatonin for Anxiety?)

Home treatments

Plan a transition period between awake time and going to bed. “Your brain needs to slow down to shift gears, and too many people try to be super productive to the last minute,” says Alex Dimitriu, MD, a dual-board certified doctor in psychiatry and sleep medicine in Menlo Park, California.If worries tend to spiral before bed, Dr. Dimitriu recommends journalling. “It’s common to be flooded with thoughts at bedtime, but if you sit and work through them [rather than avoiding them by filling the space with scrolling on your phone], these thoughts tend to get better in 20 or 30 minutes,” he says.The trick with journaling, though, is that you have to write in an honest, real, and vulnerable way. Get deep: Write down your fears and detail the dark stuff hijacking your brain.(Related: Treatment for Anxiety Disorders Isnt Just About MedicationIts About Tackling the Root Cause)

When to see a professional

A professional can help you focus your sleep efforts in a way that helps, not hinders, your sleep. Runko suggests searching to see if you can find a nearby provider who is board-certified in behavioural sleep medicine, which is designated as CBSM or DBSM.Runko also recommends the self-help book: Quiet Your Mind and Get to Sleep.Next: Do You Have Morning Anxiety?

The post What Is Somniphobia? What to Do If You Have Sleep Anxiety appeared first on Best Health.

Causes and risk factors

Your body was built to deal with anxiety as soon as you open your eyes in bed, says Alex Dimitriu, MD, a dual-board certified doctor in psychiatry and sleep medicine in Menlo Park, California.”In the morning, [the stress hormone] cortisol is elevated, and you have more adrenaline and an elevated heart rate. That’s what wakes people up,” he explains. But for some people with anxiety, that physiological response becomes psychological and symptoms are far worse in the morning than any other time of day.

Lack of sleep or going to bed late the night before tends to make morning anxiety worse, says Dr. Dimitriu. The circumstances of the day can also accentuate symptoms. “Lateness can really make people anxious,” he says. It can make you feel scattered as you scramble to make up for lost time all day. (Here are a few sleep hacks to make sure you get your vitamin Zzz.)

Your diet can impact anxiety too. What you eat and drink first thing in the morning can impact how you feel all day. Too much caffeine or not enough water can make you feel anxious. Low blood sugar from not having enough to eat can also trigger symptoms of anxiety. (Here’s how to maintain healthy blood sugar levels.)

Managing morning anxiety

If you have morning anxiety, it can help to tackle the anxious thoughts as quickly as possible, says Virginia Runko, PhD, a behavioral sleep medicine specialist and psychologist in Washington, D.C.She recommends a few minutes of meditation as soon as you wake up. If you have anxiety, this may seem like an impossible ask, as sitting with your thoughts can be uncomfortable. (Watch out for these meditation mistakes that secretly stress you out.)However, a study in The FASEB Journal in 2018 suggests that a single, extended session of mindfulness meditation may reduce anxiety and can improve cardiovascular function in adults who have mild to moderate anxiety.In addition, medication is also a potential option that can help relieve morning anxiety, says Runko. Tricyclic antidepressants and serotonin reuptake inhibitors (SSRIs) are common drugs used to treat anxiety. Talk to your doctor to decide on the right treatment for you.(Related: Treatment for Anxiety Disorders Isnt Just About MedicationIts About Tackling the Root Cause)

Prevent morning anxiety

These strategies won’t cure anxiety, but they can remove some triggers to give you a more stress-free day:1. Go to bed on time. How much sleep do you need? Losing even small amounts of sleep is associated with increasing anxiety, according to research in Nature Human Behavior in 2019. On the other hand non-rapid eye movement (NREM) sleepwhich accounts for as much as 80 percent of your Zzz’s at nightexerts anti-anxiety effects on the brain, researchers say.2. Wake up earlier. Because lateness can be such a trigger for anxiety, says Dr. Dimitriu, waking up earlier will help you begin your workday or head out the door on time. Additionally, an earlier start will also help you slow down your morning, which promotes a calm mindset. This may require you to shift your bedtime back in order to get sufficient sleep.3. Don’t check your phone immediately. In an ideal world, “your day shouldn’t begin with the phone,” says Dr. Dimitriu. Reading about stressful news events before your day even begins compounds anxiety. “Be mindful of what media you ingest, especially in the morning. I recommend trying to keep your mind blank and your thoughts your own for the first hour of the day,” he says.4. Make dietary changes. Limit alcohol and caffeine. Eat a healthy well-rounded, healthy diet. Don’t skip meals so that your blood sugar doesn’t drop. Drink plenty of water so you stay hydrated.5. Manage stress. Learn some self-help tips to keep your day from getting out of control. Exercise regularly, learn deep breathing, and practise mindfulness, so you live in the moment instead of worrying about things out of your control.(Related: Could Laughter Be the Best Medicine for Stress and Anxiety?)

When to seek help

Look for help when morning anxiety becomes distressful. “There’s a stigma about mental health that you need a reason to go,” says Runko. “Why suffer if there’s help out there?”In this case, in-person therapy (if it’s safe in your area in the current pandemic) or virtual therapy are options. Also consider group therapy or a support group in your area, which will connect you with people who are going through the same things, she recommends. Not only is it helpful to know you’re not alone, but you can share strategies that help you start the day in a more peaceful way.Next: 3 Tips to Help You Cope With Covid-19 Anxiety

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Melatonin may be helpful for sleep-relaxed anxiety

Even though the evidence specifically linking melatonin to anxiety is weak, it could still be a helpful tool, especially if your anxiety is sleep-related. When we think about insomnia, a lot of insomnia can be related to anxiety with racing minds and that kind of thing. says Melinda Ring, executive director of the Osher Center for Integrative Medicine at Northwestern University in Chicago. On the flip side, if you dont get enough sleep, you have the potential to be more anxious the next day.We do know that it tends to be a cycle. People with insomnia, especially chronic insomnia, tend to have worse depression and worse anxiety. And we also know that people with depression and anxiety tend to have worse sleep, says Rafla-Yuan.Alex Dimitriu, MD, double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine, adds that melatonin has been shown to improve sleep quality, which may also help the brain better restore itself at night and be better equipped to handle daily stress and dips in mood.

Should you consider melatonin for anxiety?

If you have generalized anxiety, melatonin is not considered a go-to treatment. It’s actually not something that would be a first-line recommendation from me, in terms of anxiety, unless it’s sleep-related anxiety issues, says Ring, adding that other supplements, like lemon balm, lavender, or chamomile, could be more beneficial.Ring recommends always talking to a health-care provider before trying any new supplements.

When you should avoid melatonin

Ring cautions you shouldnt take melatonin alongside other sedatives without doctor supervision and that if you have a history of seizures you should also work with a doctor to see if melatonin is appropriate for you. Melatonin can also interact with other medications like blood thinners.Rafla-Yuan notes that melatonin has not been as well-studied in infants and children, and so people in those age groups should not take it without a doctors support. People who are pregnant or breastfeeding should also avoid melatonin, adds Ring.

Side effects of melatonin

If sleep issues are contributing to your anxiety, and you want to try melatonin, theres likely no harm, says Rafla-Yuan. Melatonin has really low side effects, especially when compared to other sleeping medications. So it is always a medication I recommend folks try if they think they would be helped by sleep medication.General side effects of melatonin include headache or dizziness, nausea, drowsiness, depression, or exacerbation of depression. In fact, some people even have anxiety or irritability, says Ring. All of those are a possibility, but generally it’s well tolerated.(Related: Simple Ways Therapists Ward Off Depression)

If you want to try melatonin for anxiety

Melatonin is most commonly purchased over-the-counter in pill, gummy, or liquid form. A range of doses are available from 0.3 mg to 10 mg and higher but larger doses arent necessarily more effective.If youre generally healthy and not taking other medications, Ring says it would likely be safe to try melatonin without talking to a doctor first. Its important to note though, that the timing and dose can influence its effectiveness, so you may want to work with a doctor regardless.Remember though, melatonin on its own is not considered a treatment for anxiety and should only be used in conjunction with a number of different measures. It would fall under lifestyle modifications, says Rafla-Yuan. We know that sleep, diet, and exercise are all important parts of a comprehensive anxiety treatment plan. There are other medications for anxiety specifically that we would also consider. Psychotherapy can also be an important part of the treatment plan as well.Next: 13 Sneaky Things In Your Home That Trigger Anxiety

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“When the body feels attacked by stress, it activates the ‘fight-or-flight’ reaction, releasing adrenaline and increasing cortisol levels. Excessive exposure to these hormones can affect just about every system in the body,” says Dr. Charles Parks Richardson, physician and founder of Cleveland Diabetes Care. Deep relaxation can help you shift from “fight-or-flight” mode so that your body can rest and recharge from the inside out.

So what can you do to release the tension? Recent research identified the most relaxing hobby of them all: knitting.

A search for the most relaxing hobby

Researchers at diys.com set out to find which hobby is most likely to reduce stress by lowering heart rate. A survey of 2,379 people revealed 20 common activities that people use to reduce stress. These hobbies included everything from gardening and cooking to hiking and tai chi.(Related: The Secret to Stress-Free Cooking Through a Pandemic)Then, researchers asked 357 men and women ages 20 to 30 to complete 20 popular hobbies for several weeks while wearing aFitbit activity tracker with a heart rate monitor. The data revealed which activities calmed participant’s heart rates the most, leading to relaxation.The results found that those participants wielding knitting needles lowered their heart rate by an average of nearly 19 percent.

The link between relaxation and your heart rate

“When we are in the fight or flight response (our body’s way of preparing us to survive), we have a fast heartbeat, high blood pressure, slower digestion,” Dr. Richardson says.This link between stress and a rapid heartbeat is the reason why the study’s researchers based their entire definition of relaxation on a lowered heart rate. Medical experts have also linked clinical anxiety with a risk of heart disease. (Stress and anxiety aren’t the same thing. Stress is the response to a demanding or threatening situation. Anxiety is where you have excessive worrying, even sometimes without a stressor.)Since your heartbeat is likely to speed up when you’re stressed or panicky, the study highlighted activities that do the opposite slowing and soothing your heart rate.

Is knitting really the best way to unwind?

The answer probably depends on your personal preference. While knitting lowered heart rates the most on average, you might prefer activities such as fishing (which landed second place for “most relaxing”) or calligraphy (a tie with blogging for third place).There’s a second reason to second-guess knitting as the epitome of stress relief: Heart rate is not the only indicator of low stress or tension release. “It is important to have … ‘healthy’ stress such as excitement from social events (and) daily exercise,” Richardson says. The National Institute of Mental Health backs this up by suggesting exercise which raises your heart rate a s a way to cope with stress.(Related: How Wellness Experts Cope With Coronavirus-Related Stress)

Three more relaxing hobbies to try

Whether you want to try something new or resurrect a pre-pandemic hobby, you can choose from a variety of relaxing and heart rate-lowering activities. Consider these relaxing hobbies from the study.

Enjoy a day of fishing

The study’s research indicated that fishing is the second most relaxing hobby. While knitting decreased participants’ heart rates by about 18.75 percent, fishing slowed them by 10 percent.Spending the day out on the lake, river, or pond can be truly meditative. A 2011 review of the research on the benefits of nature suggested that even the sounds and smells in the great outdoors have the power to boost your health and mood.

Blog about your life

Many avid writers notice how journaling reduces stress. But what about blogging? Perhaps it’s the practice of letting feelings flow freely or simply the realization that you’re being heard, but this online form of journaling received a third-place tie for “most relaxing hobby.” The study indicated that blogging can decrease your resting heart rate by 7.5 percent on average.Dr. Richardson noted that activities that include involvement with others perhaps even over the internet does make a difference in stress reduction. “Being around other people in a safe capacity is really important to avoid anxiety brought on by isolation,” he says.(Related: 3 Tips to Help You Cope With Covid-19-Related Anxiety)

Paint a picture

The study revealed that painting can lower your heart rate by about 3.75 percent on average. While it’s clear that grabbing your brushes and easel won’t ease your heartbeat in the same way that knitting might, painting could have other tension-relieving benefits.A 2018 research review of art therapy found that over 80 percent of the trials resulted in stress relief for the participants. In other words, art soothes. Even colouring books for adults can be good for your health.

When it comes to relaxation, consistency is key

Dr. Richardson emphasized the importance of a release valve for the stress that builds up in daily life especially in the middle of a pandemic. “The circulatory system is heavily affected by stress and anxiety. . . It is very important for patients to control their blood pressure and continue to work out during the pandemic,” he cautioned, adding, “When our body remains in a state of chronic stress, it can cause health conditions like high blood pressure, stomach ulcers, and cardiovascular diseases.

In these stressful times, you must find ways to unwind. Whether you’re a knitting fiend or an avid runner a hobby that did not fare well in the study because it raises your heart rate the important thing is to release tension in a way that feels good for you. When you love your relaxing hobby, you’re more likely to spend time doing it.

Next: What Happens to Your Body When You Actually Relax

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1. Stop scrolling

If you notice anxious thoughts spike following a Twitter or Instagram sesh, or after watching the news, its time to tune out. Even pre-pandemic research published in 2010 in Current Psychiatry Reports showed that health anxiety can be high following exposure to disease-related media and there is no shortage of virus-dominated stories at the moment. Many psychologists, myself included, are recommending that clients limit media exposure as one way to help manage excessive anxiety, says Dr. Melanie Badali, a psychologist and board director of Anxiety Canada. Cut back to checking your social channels just once a day, or every few days, to give yourself a break from the pandemic news cycle.(Related: How to Know If Your Level of Health Anxiety Is “Normal”)

2. Balance the probabilities

If youre following the governments health advice, taking reasonable precautions and otherwise in good health, its important to factor all that in before you freak out on your way into the grocery store. I always tell my clients to think about the probabilities, says Dr. Kristen Kaploun, a clinical psychologist in Burlington, Ont.

3. Call out your anxious thoughts

If youve balanced the probabilities (whether its the danger of shopping in-store, your child going to school or attending a distanced birthday party, for example) and you know the likely outcome is probably fine, but youre still starting to panic, its time to call a duck a duck, as Kaploun puts it. In other words, concede that its your anxiety talking. If were able to acknowledge that anxious thought, its much easier to dismiss it, she says.Next: The Impact of Social Distancing on Seniors Living at Home

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What is health anxiety?

Since the start of COVID-19, youve likely heard friends talk and seen lots of online chatter both serious Facebook posts and flippant Instagram memes about escalating anxiety around health. But feeling a pandemic-induced health panic isnt the same as having a diagnosed health anxiety disorder.Essentially, health anxiety is when a person has an irrational and obsessive worry about having a serious medical condition or illness, says Dr. Kristen Kaploun, a clinical psychologist in Burlington, Ont. In the extreme, its what people used to refer to as hypochondria (now an outdated term).A hallmark feature of health anxiety is that it really goes above and beyond what would be considered a normal concern for your health, says Kaploun. For a person with high health anxiety, a headache can be interpreted as evidence of a brain tumour, for example. And in the context of a coronavirus, a person with high health anxiety is likely to misinterpret basic bodily sensations and changes, like mild shortness of breath, a dry throat or muscle aches, as proof of infection.For people with health anxiety, Is this normal? is a near-constant refrain, says Kaploun. While many of us may find ourselves asking this question more these days, people with true health anxiety are calling their doctors for referrals to specialists on a daily basis, sometimes again and again, and even showing up at the ER several times a week. No amount of reassurance or proof of health is really enough, she says. It may be clear to the health professionals working with them, as well as their family and friends, that their symptoms are imagined, but to a person with high health anxiety, the possibility of illness is real.

When should I worry about my health worries?

We know from research conducted prior to the COVID-19 pandemic that almost everyone experiences health anxiety to some degree, says Dr. Melanie Badali, a psychologist and board director of Anxiety Canada. Like most types of anxiety, health anxiety is evaluated on a continuum. In theory, low-level health anxiety is beneficial because it spurs us to pay attention to potential problems, seek diagnosis and treatment, and take proactive care to prevent illness and disease. However, excessive health anxiety can be detrimental and cause a lot of suffering, says Badali.Figuring out if youve crossed that line can be tricky these days. It seems that so many of us are on health high alert, partly because the stakes are so high. Jenn Dunstan is a 34-year-old single mom with irritable bowel syndrome whos been experiencing serious (and likely stress-induced) flare-ups since the start of COVID-19. Im solely responsible for my rent and bills, she says. Im constantly afraid of becoming ill and unable to work or provide for my two kids.Then there are women like Lauren Mugford, 28, whos not too anxious about actually contracting COVID-19 but is feeling the mental health effects of an isolated and unsettled pandemic life. Ive tried to be strong mentally and keep my nerves at bay, but over time I am noticing the long-term effects on my body, she says. Mugford adds that she didnt have her period for four months, which has never happened before.The health worries and the ripple effect of that anxiety are serious issues. Some experts predict there will be a mental illness pandemic that follows or coincides with the COVID-19 pandemic, says Badali.Many people with diagnosed health anxiety rely on cognitive behavioural therapy (CBT) to manage the disorder, in which they learn about thoughts and behaviours that influence anxiety and how to change them. While CBT and the help of a therapist are useful for many people, there are general anxiety management strategies that can help too. At the core, dealing with health anxiety is about learning more about anxiety in general and connecting to what youre feeling, says Badali. Knowledge is power, she says. Learning new things helps us build resilience.Now that you know you have normal anxiety, learn how to stop worrying and have a happier life.

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Foods that can cause anxiety

According to the Canadian Mental Health Association, 50 percent of the population will have or have had a mental illness by the time they reach the age or 40. What’s more, anxiety disorders affect 5 percent of Canadian households.Medications, therapy, mindfulness, and exercise can all be good options for treating actual disorders or coping with everyday anxiety (and there’s plenty of coronavirus-related anxiety). However, there’s another remedy that’s closer to home: avoiding certain foods and beverages.”We have all felt high or low after eating or drinking,” says Sharon Zarabi, RD, bariatric program director at Lenox Hill Hospital in New York City. “Behaviour and mood can be controlled by the ingredients we put in our bodies.” Stress can affect your eating but eating can also affect your stress levels.Here are the foods that can cause anxiety.

Coffee

The connection between coffee and anxiety may not seem that surprising, but it bears repeating, especially because so many other foods and drinks contain caffeine. You may be piling on this anxiety-provoking compound without realizing it, says Su-Nui Escobar, PhD, RDN, a national spokesperson for the Academy of Nutrition and Dietetics. You may be drinking “only” two cups of coffee a day but if you add an energy drink, some soda (even orange soda), and a slab of chocolate, your intake is sky-high.Caffeine affects your body in much the same way as a scary event wouldby churning out adrenaline, says Escobar. It can also release the stress hormone cortisol which spikes heart rate and blood pressure. Those hormones promote anxiety and also make it harder to sleep, which just worsens the anxiety. Some non-caffeinated but perky alternatives: herbal (not black) tea, decaf coffee, or sparkling water with a lime or fruit undertone. “That gives you the sensation of a bubbly drink with flavor and zero caffeine,” Escobar says.(Related: What Happens to Your Body When You Drink Tea Every Day)

Energy drinks

Speaking of caffeine and energy drinks, these popular products can contain pure, concentrated caffeine. A two-ounce shot of five-hour energy, for instance, contains 200 milligrams of caffeine, about the same as a Starbucks Cold Brew. Published in the Journal of Caffeine Research, a 2016 review of studies looking at energy drinks noted that most of the research found associations between consuming energy drinks and symptoms of mental health problems such as anxiety, stress, and depression.And energy drinks may do more than make you feel jittery. They’ve been linked with increased heart rate and blood pressure as well as changes in the electrical activity of the heart, even strokes and seizures, not to mention anxiety and even psychosis, according to the American College of Cardiology. While many of these effects may not cause serious health problems, the concerns did prompt the U.S. Food and Drug Administration (FDA) to issue a warning.(Related: What Happens to Your Body When You Have an Energy Drink)

White bread

Or white rice or white pasta. All these items are processed and contain refined sugars which, in general, are a no-no for a healthy diet and can affect your mood. “The sugar spikes blood sugar followed by a quick drop-off of sugar which is associated with anxiety,” says Escobar. Sugar tickles the same pleasure centres as cocaine, an addictive stimulant drug, which may feel good for a moment but when you crash you won’t feel nearly as good.Go for complex carbohydrates in whole grains like oats, brown rice, and sweet potatoes. Whole grains are one of the pillars of healthy eating plans, such as the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet.(Related: 10 Sneaky Foods That Can Increase Your Blood Sugar)

Regular soda

Sodas give you a double whammy of caffeine and sugar, hence why it’s one of the top foods to avoid if you have anxiety. Caffeine can leave you shaking while sugar, says Zarabi, “is like a drug and hijacks our brain. It elevates our mood at first but in the long term, it worsens our emotional well being, and causes inflammation and excess body fat.” According to the 2015-2020 Dietary Guidelines, close to half of the added sugars in Americans’ diets from beverages like soda and fruit drinks. And don’t necessarily reach for the diet soda as a substitute as that may cause depression.(Related: 23 Flavoured Water Recipes That Are Beyond Refreshing)

Chocolate

Oddly enough, though chocolate has been hailed as a stress buster (in moderation), it may also have a darker side because it, also, contains sugar and caffeine. When you have that drop off, you can get anxious, says Escobar.”If you really want to have something sweet, pair it with protein and a little bit of fat,” says Escobar. Suggestions include Greek yogurt with a little sugar and blueberries or peanut butter and fruit. “This will give you physiological satisfaction that will prevent you from having cravings,” she explains. (Dark chocolate, btw, has fewer added sugars than light chocolate.)(Related: This Is What Happens to Your Body When You Eat Chocolate)

Fried foods

Fried foods (think French fries, fried chicken, fried onion rings, and doughnuts) may lead not just to anxiety, but also depression. And nearly half of people with depression also have anxiety, says the Anxiety and Depression Association of America.And this should be anxiety-provoking: Fried foods are also linked with heart disease which is the number one killer of Americans. Many studies over the decades have confirmed the link, with a 2015 review study, published in the journal Nutrients, finding that eating fried foods four or more times a week is linked with a higher risk of type 2 diabetes, heart failure, obesity, and hypertension. Obesity, diabetes, and hypertension or high blood pressure are all major risk factors for heart disease. This is likely because foods are often fried in oils high in saturated fatty acids and partially hydrogenated oils, both of which can clog your arteries. Better choices are monounsaturated and polyunsaturated fat.(Related: 9 Superfoods You Can Turn Into Scrumptious Comfort Food)

Fruit juice

Many of the fruit juices that you buy in the supermarket are 10 percent fruit and 90 percent sugar, points out Escobar. Things aren’t much better even if you squeeze the juice yourself, she says. Think about it: when you eat a piece of fruit, let’s say an orange, you only eat one or two at a time. Not only does it have less sugar than juice, but it’s also packed with fibre, which is digested more slowly, keeps your blood sugar stable, and makes you feel full longer. If you make fresh-squeezed juice, you’re going to need, easily, five or six oranges. That’s pretty much all sugar and no fibre, setting you up for a spike in blood sugar and the jitters.The American Academy of Pediatrics recommends that children under one year don’t get fruit juice at all; that kids aged one to three have no more than three ounces a day; children four through six no more than four to six ounces daily; and a maximum of eight ounces for children seven years and older. Dried fruit, with such concentrated sugar, poses much the same problem.(Related: 12 Easy Food Swaps to Reduce Your Sugar Intake)

Alcohol

Drink too much alcohol and you may feel relaxed for a while, but it can backfire, causing you to lose sleep which is a sure recipe for anxiety, says Escobar. And not unlike ice cream and other high-sugar foods, alcohol leads to the highs and lows of blood sugar that lead to anxiety and depression. It can also result in dehydration, yet another reason you may feel edgy.The updated Dietary Guidelines recommend that women have no more than one drink a day and men no more than two and only if you’re of legal age. What constitutes one drink? Usually 12 fluid ounces of regular beer containing five percent alcohol, five ounces of wine or 1.5 ounces of distilled spirits. If you do drink alcohol, you can minimize dehydration by drinking plenty of water.(Related: Trying to Drink Less? These Tasty Mocktails Make it Easy)

Light salad dressings

Many of these so-called “lite” products make up for reduced fat with high levels of hidden sugars, says Escobar, making them one of the foods you should avoid. Light salad dressings are a major culprit. When Harvard University researchers looked at one ready-made tomato basil sauce in the supermarket, they found that half a cup (less than most people would eat) contained three teaspoons of sugar. A cup and a half for dinner, which seems more realistic, would be nine teaspoons. Try our sugar-free Tahini-Lemon Dressing.

Ketchup

Ketchup may be the poster child for hidden sugar with one tablespoon containing 12 calories of added sugar, according to the most recent Dietary Guidelines. “Sugar is found in almost everything we eat,” says Zarabi. “Don’t be fooled to think that something needs to taste sweet to contain sugar, since sugar is concealed in the ingredient list with other forms of molasses, high fructose corn syrup, rice, syrup, brown syrup, invert sugar, granulated, table, and anything ending in -ose.” Even some over-the-counter painkillers are sugar-coated, says the National Library of Medicine.”If you’re going to have a tablespoon of ketchup go ahead,” says Escobar. But if you’re going to dump half the bottle on your burger, reach for mustard, which typically doesn’t have any sugar.(Related: 10 Things That Happen to Your Body When You Stop Eating Sugar)

Artificial sweeteners

You would think that artificial sweeteners, which technically aren’t sugar and don’t add calories to your day, would eliminate the high-low trap of added sugar. In fact, no. These additives can cause the same crash you might experience with sugar or caffeine, along with feeling tired, changes in mood, trouble concentrating, and heart palpitations. Aspartame, one of several high-intensity sweeteners approved by the FDA, actually blocks the production of serotonin (the “feel-good” chemical) in the brain. A 2014 study in the journal PLOS One, found that both adding artificial sweeteners to coffee or tea was associated with a higher risk of depression than drinking them black.Next, learn a 10-minute science-tested anxiety trick that really works.

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• Vancouver TheatreSports, Vancouver
• Montreal lmprov, Montreal
• Neptune Theatre, Halifax

Next, learn how busying the mind can help with anxiety.

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How to calm anxiety

If you have anxiety, it can be difficult to keep your mind at ease daily. Add a global pandemic, like Covid-19, and you feel even more helpless or on edge. (Follow these tips to cope with coronavirus-related anxiety and stress.) However, when your mind is racing with your stressors and fears, it helps to take a deep breath and repeat a mantra, according to mental health experts.Whether you have been diagnosed with anxiety, or if youre deeply worried about a particular situation, these magic phrases can help calm your anxiety and feel more in control.

Take a cue from Nike

Get past your current state and start calming anxiety by being proactive. (You can also try to busy the mindto keep anxiety at bay.) Even if it doesnt have the perfect outcome, at least youre moving away from the anxiety of trying to figure out your next step. Theres no wrong decision, as long as you do something to move out of deliberation mode, says Debra Kissen, clinical director of Light on Anxiety Treatment Center in Chicago. Stop trying to find the perfect solution and just take some movement forward, even if its an imperfect step forward.

Give yourself a reality check

Remind yourself that although anxiety is unpleasant, youre in no physical danger when your emotions are taking over. In a moment of anxiety, especially with panic disorder, people feel like Im not going to survive this. This is not OK to feel this way, Kissen says. Its not fun, but its not dangerous. (Learn how one woman deals with her anxiety disorder.)

Go for gratitude

Take a moment to appreciate your good health, loving family, or stable job. Your brain cant experience stress and gratitude at the same time, so its an effective way to change your mindset, says Heidi Hanna, PhD, author of Stressaholic: 5 Steps to Transform Your Relationship with Stress. When you feel stressed or brain fog, if you can shift to a place of expressing gratitude for something in life, that immediately starts to shift into a more restorative state, she says. If your mind wanders, go back to feeling grateful. (Here are some insightful prompts for your gratitude journal.)

Practice mindfulness

Calming anxiety in this way can help you stay in the moment, rather than stressing out about all your worries and regrets. Notice your thoughts and sensations as they come, and shift them back to whats happening in the present moment. Focusing on watching your kids or washing the dishes will keep your thoughts in a more bearable state. Its having the ability to redirect themrather than getting totally caught up in ruminationand putting your attention to whatever the current moment has, says Kissen.

Give in

When you feel overwhelmed by things you cant control in the momentlike politics or global warmingcalming anxiety isn’t always easy. Accept that bad things happen and give yourself up to the course of the day. Its the nicest thing because youre not trying to manage anything anymore, says Kathleen Hall, founder and CEO of Mindful Living Network and The Stress Institute. Its like hitting the delete button. (Try this 10-minute anxiety fix.)

It will go away

When youre feeling completely overwhelmed, remind yourself that anxiety is fleeting. When you are chronically stressed, it can feel like you are drowning in problems and are barely staying afloat, says Aarti Gupta, PsyD, clinical director of anxiety and family therapy center TherapyNest in Palo Alto, California. Reminding yourself that the stressor is not permanent can provide peace of mind and grant the energy required to tackle the problem and explore viable solutions. (Learn other ways therapists ward off anxiety.)

Give yourself a pep talk

By referring to yourself in the second person, its like youre calling in a team of family members, mentors, and other loved ones to remind you that youre not alone and that calming anxiety is possible. When you say I can do it, it stresses you out a little bit because youre alone, Hall says. Second-person works because youre calling yourself to action. (Here are other tricks for dealing with anxiety.)

Focus on “enough”

Say the first part while taking in a big gulp of air, and follow with the second one as you exhale. The stress response often starts when people feel like they dont have the resources to deal with the demands being put on them, says Hanna. People are constantly told theyre not enough. We need to buy more or do more to be enough, to have enough, she says. Its letting go and relaxing in the moment, saying Im exactly where Im supposed to be in this moment. (Here’s how to know if your worries are a deeper problem.)

Recognize your panic

By definition, anxiety means youre feeling overwhelmed by a stressor, even when youre in no immediate danger. Its like being in a building with a fire alarm going off, but theres no fire, says Kissen. Calm yourself down by recognizing that theres no need to panic. Here’s how to reduce your risk of a panic attack.

Fact-check yourself

Say youre walking up to a party and dont think you can handle a crowd, or are about to make a speech when youre prone to stage fright. Empower yourself with a reminder that your fears dont define you. If you explore your history, chances are you had that feeling a million times, and that situation ended up being OK, says Dr. Kissen. Here are more tricks for calming social anxiety.

Go for positivity

Sub out loving for any word that you feel describes you when youre being your best self. Now close your eyes and think about how it feels when youre embodying that trait, says Hanna. Use those values and feelings to guide you before you start your day so that you can react in a way youre proud of. We get so focused on needing to do stuff all the time that we forget how we want to be, says Hanna. If youre having trouble thinking of a word, consider the compliments youd like to hear from others. That mindset will help you figure out what matters most to you, she says. (Also, it may be helpful to know how to get rid of negative energy.)

Think about the upside

Every obstacle is an opportunity, says Hall. Try to see your problems as a chance for you to learn and grow, rather than focusing on the potential negative outcomes. (Check out the things in your home that can trigger anxiety.)

Embrace your emotions

Dont let anxiety debilitate you. Attend a football game or go on a date, even if you have to take a bit of anxiety along with the ride. As Im waiting to not feel uncomfortable or out of danger, Im not living life to its fullest, says Kissen. You dont need to be anxiety-free to live. (Here’s what else can trigger anxiety.)

Be defiant

When anxiety is keeping you away from a social activity or important presentation, put yourself back in control by doing the opposite of what your mind is trying to convince you. Youll win, and anxiety will lose, says Kissen.

Next, learn about the treatments for anxiety, aside from medication.

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A world of worry

Jim Folks mental health odyssey began in 1974 with an upset stomach. Next came muscle tension, dizziness and heart palpitations. At the time, Folk was 21 years old and working in his familys auto-repair shop in Regina. When his symptoms didnt go away, he grew worried. Whenever I had an ache or pain, Id freak out, says Folk, now in his sixties.After a few months, he saw his doctor, who told him it was just stress and to go home and rest. But I didnt feel stressed, Folk says. And I couldnt figure out why every time I tried to relax, my symptoms went full tilt.At first, Folk was convinced he had multiple sclerosis, or maybe cancer, even when doctors reassured him that he didnt. He began experiencing non-stop nausea coupled with debilitating panic attacks. Id start trembling all over, feel dizzy and have hot flashes, he says. I was in the bathroom countless times, heaving with intense stomach upset. My symptoms were robbing me of more and more of my life.

Years passed, but his health failed to improve.

Folk saw several doctors and mental health professionals and tried an array of pills and herbal remedies. Nothing worked. My whole life revolved around a few blocksto work and back home again. I could barely drive, couldnt visit friends, couldnt enjoy my family. Eventually his wife at the time told him he needed to get better or their marriage was over. Folk booked an appointment with a psychologist. Two weeks laterand 10 years after the onset of his symptomshe was finally diagnosed with generalized anxiety disorder and panic disorder.Generalized anxiety disorder, or GAD, is a condition characterized by persistent, excessive worryeven when theres nothing concrete to worry about. People with GAD try to plan for every eventuality, all the time, says Dr. Melisa Robichaud, a psychologist in Vancouver. Its cognitively exhausting. It can be physically taxing, too, with symptoms ranging from fatigue and irritability to difficulty maintaining concentration to restlessness or agitation.At its core, Robichaud says, anxiety is the bodys most basic survival mechanism, the fight-or-flight response you get when you feel threatened. Anxiety is like the bodys smoke alarm: whether theres smoke or fire, it makes the same noise. It can be triggered by real danger but also by anything we perceive as dangerous.People with GAD think through what-if scenarios excessively, and this cycle of worries can end up provoking even more anxiety. The thought of an unpaid bill can quickly escalate to worrying about what theyll do if they wind up homeless. Theyre constantly in their heads and they cant stop their worrying once it begins, Robichaud says.

Who is affected?

While scientists arent entirely sure why some people are more prone to GAD than others, part of the risk is genetic, says Simon Sherry, an associate professor of psychology and neuroscience at Dalhousie University in Halifax. The condition also often coincides with other illnesses, such as depression, and women are twice as likely as men to be affected, according to Sherry.As anxiety disorders go, GAD is one of the most common, especially in older adults. Studies suggest it affects somewhere between three and 10 percent of people, says Julie Wetherell, a psychologist at VA San Diego Healthcare System and professor of psychiatry at the University of California, San Diego who focuses much of her research on psychological treatments for GAD in elderly patients. GAD is more common in seniors than social anxiety disorder, panic disorder, post-traumatic stress disorder and major depression.It also manifests a little differently in people who are 55 and older. Wetherell says they tend to worry less about work and more about personal health and family.

Tricky diagnosis

Anxiety symptoms are associated with several health issues, which can make diagnosis difficult. Conditions that can causeor mimicanxiety include coronary artery disease, chronic obstructive pulmonary disease, dehydration and hyperthyroidism. Its possible to have both a medical condition and anxiety, so when a medical condition is diagnosed, anxiety may remain untreated, Wetherell says. Anxiety-like symptoms can be caused by medications, including blood pressure pills, hormones, steroids, anti-depressants and over-the-counter drugs that contain caffeine, like some cough syrups and decongestants.GAD sufferers rarely turn to psychologists and will instead often see a medical doctor about their physical symptoms. In some cases, professionals brush off both physical and psychological concerns. Many people think that worry isnt a legitimate mental health complaint since everybody frets, Robichaud says.Shes seen patients who endured symptoms for 15 years before seeking help. Older adults tend to downplay problems with anxiety. GAD sufferers often get accustomed to their extreme patterns of thinking, Sherry says. If worry is your normal, you may not appreciate the extent to which youre living in distress, he says. But while GAD is common, costly and impairing, its also highly treatable, which is why its important to seek help. (Plus, here’swhat psychologists wish you knew about happiness.)

Medication vs. therapy

It took two years of treatment before Folk was symptom-free. While I had reasonable moments during the 12 years I was ill, most of the time was horrible, he says. My anxiety disorder felt like a nightmare I couldnt wake up from.Folks psychologist taught him that he could react physically, even when he wasnt aware that he was anxious, and explained why he wasnt able to calm himself down. It was helpful for me to know what was going on in my body, Folk says. Then it took a year of stress reduction and daily self-reflection strategies to help me learn not to react to life with fear.His success in overcoming GAD eventually led him to found Anxiety Centre, a site that offers information and counselling by mental health professionals to those grappling with the condition. The guidance provided on the site is based on cognitive behavioural therapy, which is the gold standard in treating anxiety disorders. CBT teaches patients to change their unhealthy patterns of thinking and behaviour in order to help them function normally. I worked hard at overcoming my fear of anxiety and panic attacks and, over time, my symptoms subsided, Folk says. Hes been symptom-free since 1985.While some medications can help treat anxiety, they come with serious side effects, such as sedation, cognitive impairment (over long-term use) and even the development of a tolerance, which can lead to addiction. Wetherell often recommends a non-pharmaceutical approach rooted in relaxation and meditation. Our research team is currently using Mindfulness-Based Stress Reduction, which has no side effects, she says. (MBSR techniques include mindful breathing and mental body scans to increase awareness of physical sensations.) We found that MBSR reduces cortisol, a stress hormone that damages the hippocampus and frontal lobe of the brain, so it may have beneficial effects on memory and thinking, as well as on anxiety.Wetherell says there are videos on YouTube that lead people through body scans (which coach participants in bringing awareness to each part of the body sequentially) and other mindfulness techniques. I encourage people to practise daily so they can use relaxation techniques when theyre anxious, she says.Other studies support Wetherells findings. A few years ago, researchers from the Georgetown University Medical Center in Washington, D.C., published a study showing that GAD patients had fewer hormonal and immunological stress markers in their blood after taking an MBSR class for eight weeks. An important aspect of mindfulness is to learn to zero in on present-moment experience, says Robichaud. For GAD patients, worries involve thoughts about negative events that might occur in the future, so being able to focus on the present can be beneficial.To remain present, Christine Purdon, professor in the department of psychology at the University of Waterloo, suggests patients be aware of the tenses theyre thinking in. I ask them, Is your mind in the future? Does it need to be there? Purdon shows people how to recognize that whatever theyre worrying about is neither imminent nor realistic. The goal, she says, is also to help people realize when theyre underestimating their ability to cope and overestimating the demands of their environment.

How to manage GAD

For mild cases of GAD, lifestyle changes may help. One of the most important is exercise. Researchers at Princeton University found that physical activity reorganizes the brain in a way that reduces the organs response to stress so that anxiety is less likely to interfere with normal brain function. Exercise can also tire you out, so you sleep betterand sleep is key. Lack of shut-eye can contribute to excessive worrying.So can too much time spent on social media. Last year, a study published online by the journal Computers in Human Behavior showed that using multiple social media platforms increases the risk of anxiety and depression (multi-tasking and switching from one thing to another are associated with poorer attention, cognition and mood).Theres also some evidence that what you eat may play a role in your ability to calm your mind. A 2015 study in the journal Psychiatry Research found that eating foods high in probiotics (pickles, kefir, sauerkraut) may protect against symptoms of social anxiety.And a 2011 U.S. study found that fare high in omega 3s (such as fatty fish) has been linked to lower anxiety.

Staying the course

Although you can reduceor even overcomeGAD, maintaining solid mental health remains a lifelong process. Mark Virgin, a 54-year-old lawyer in Vancouver, was diagnosed two years ago and sees his psychologist twice a year for checkups. I still suffer from anxiety, but now Im equipped with coping mechanisms, he says. Virgin tries to meditate daily. (Keep in mind, these meditation mistakes can stress you out.) Hes also reduced his coffee and alcohol consumption and stays committed to an exercise regimen.Afraid of how the stigma associated with mental illness might affect his work and relationships, Virgin initially attempted to mask his symptoms, until they became crippling. He would worry about potential issuesusually work relatedand build up improbable, worst-case scenarios in his head. It got to the point where I was having a hard time leaving my homeand Im a pretty extroverted person, he says.CBT helped Virgin recognize the implausibility of the catastrophic narratives he had been constructing. One of the strategies he found to be most useful was writing out the scenarios, then reading them back. I was suddenly struck by how disproportionate what Id constructed was to reality, he says.Virgin now speaks openly with coworkers and friends about his experience, with the goal of encouraging others to address their symptoms. He also serves as the board president of AnxietyBC. I decided to share to try and de stigmatize it, he says. He hopes that dialogue will allow others to speak freely and learn about treatment options. Its exceptionally liberating when you finally have the tools to manage this disorder.Next, check out these mental health tips from therapists.

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