La Coop P.A.- General and Forensic Psychiatry - Boutique-Private Psychiatric and Forensic Practice in Tampa-Clearwater-Florida


November, 2012 - How To Deal With Anxiety Without Meds


This email comes to you courtesy of another awesome patient of mine. She actually wrote to me on the holiday weekend and figured I might not get to it until I got back. WRONG! Of course I got right back to her, and we got her through the anxiety issue. Now, this is a patient that I have known for years and she's such a great person, wants help, and utilizes it. She asked me for some coping skills/tips to quell her anxiety before we see one another again. Something that she can do in the here and now. I thought it would make a great newsletter because around this time of year people are facing more stressors. They are meeting up with relatives and alot of anxiety is stirred up.

So, let's talk about some ways to cope with anxiety, without addition of medication. These coping skills are something that you can do on your own and in a pinch.

Until next time have a wonderful and happy Thanksgiving!

Dr. L


Those of you that know me, know that when I believe that medications are needed, I'm the first to prescribe them. However, many patients don't want to be on meds, and many patients don't need to be on meds. Just because I don't believe that someone needs medication, doesn't mean that I don't believe they have anxiety. It just means that the anxiety the person has may be related to a stressor that will go away, or the physical symptoms of anxiety are tolerable and can be quelled with some behavioral steps.

1-2-3s of ANXIETY...

First, you need to recognize what you are feeling. Is this anxiety or something else? Alot of times, people mistake anxiety with something else. Are you hungry? Do you need to go to the bathroom? Did you just run up a flight of stairs? Did you just get scared by someone that came from behind you to play a joke? Did you get enough sleep last night?

OK, it's anxiety - what now? We have to determine where it is coming from. Is this something that is seemingly coming out of nowhere or can you link it to something? For example, if you have a big presentation or exam coming up, it's normal to have anxiety about this and this is something that we can deal with behaviorally. First, have you done everything that you were supposed to do in this situation to prepare? Is this a rational anxiety where you didn't prepare for something and now you're about to hit the wall of consequence? If that is the case - find your resources. Can you get someone to help with the kids while you focus all of your energy on this task? Can you speak with your boss and move it? If you have to face the music because you've already put it off - here is what you can do.

BREATHE - this is something that typically speeds up when you get nervous. Your throat closes, and it seems that you can't get enough air in your body. You need to slow your breath down. You can do it consciously. Find your breath first and then hold it for a second and take a deep breath in for 7 counts (or as many as you can). Hold it for 7 counts, and then breath out for 7 counts. What this is doing is it's not only regulating your breathing but your heart rate. By expanding your lungs, you are hugging your own heart with your lungs. You feel better when you are given a hug, right? So, your heart does too. Give it a try. Keep doing this until you calm down. It takes practice, but once you got it down you won't believe how helpful it is!!

STRETCH - another thing that happens is your body tenses up because it's getting ready for a fight. Go to another area of the house where things are quiet and literally stretch your muscles. A good one is putting your arms over your head (holding your hands together) and then letting them drop as far back as you can. This expands your lungs. You can also do a back bend or just bend at your waist and try to touch your toes.

PHYSICAL MASTERY - Sometimes there is still tension and this is just a build up of endorphins, etc. You want to get them out! I like to do push ups to get some of that energy out because they are difficult for me to do. Try an exercise that's difficult for you. Keep some dumbbells in the office and hit 20 chest presses before going into the meeting room.

Want more tips to tolerate distress?

My colleague (who has become a dear friend over the years) Amanda Smith founder of the organization Hope for BPD has a newsletter with daily tips that come directly to your email. Hope for BPD is an organization that serves patients and their families who are suffering from Borderline Personality Disorder. One pervasive symptom of this disorder is a difficult time coping with distress. Each day these emails coming is a great reminder that everyone has the ability to tolerate distress with a little help. Check it OUT!

I hope this gives you some basic skills to use when you are in a bind and need something to unwind!

Dr. L

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