Best Health - - ADVICE - EL­IZ­A­BETH WIENER AND LISA BROOKMAN El­iz­a­beth Wiener is an ed­u­ca­tor who lives with de­pres­sion and anx­i­ety. Lisa Brookman is a clin­i­cal psy­chother­a­pist based in Mon­treal. To­gether, they form @wisewomencanada

Nau­sea, cold sweats, shiv­er­ing, heart pal­pi­ta­tions, sleep­less­ness, dizzi­ness. These symp­toms may sound like the flu, but they’re ac­tu­ally the very real and po­ten­tially de­bil­i­tat­ing phys­i­cal signs of anx­i­ety. Stud­ies have long shown that our minds and bodies are in­ti­mately con­nected, and it’s pos­si­ble to feel the phys­i­cal symp­toms of anx­i­ety long be­fore its emo­tional toll kicks in. For­tu­nately, there are ways to man­age the phys­i­cal dis­com­fort that anx­i­ety can bring and re­duce its psy­cho­log­i­cal im­pact.


AWHEN I WAS 24, I VIS­ITED MY FAM­ILY DOC­tor be­cause of chronic nau­sea, dizzi­ness, headaches, in­som­nia and a per­sis­tent feel­ing of im­pend­ing doom. I was di­ag­nosed with gen­er­al­ized anx­i­ety dis­or­der and sought treat­ment from a psy­chol­o­gist who pro­vided me with tools to man­age my rac­ing thoughts. But for me, the phys­i­cal ef­fects I ex­pe­ri­enced were in­tol­er­a­ble, and I was des­per­ate for re­lief. With pro­fes­sional guid­ance and prac­tice, I’ve learned it’s pos­si­ble to con­trol and ease the phys­i­cal dis­com­fort of anx­i­ety.

1. One of my favourite tools is ex­er­cise. A brisk walk, a run, a spin class or a yoga prac­tice will pro­duce en­dor­phins and de­plete cor­ti­sol, both of which tem­per those un­pleas­ant phys­i­cal sen­sa­tions. I’ve made it a habit to move my body at least once a day.

2. When I’m par­tic­u­larly anx­ious, my breath­ing be­comes rapid and shal­low, which only ex­ac­er­bates my pan­icky feel­ings. To deal with this, I in­hale and ex­hale deeply a few times, focusing on my breath. This calms me enough to prac­tice 4-7-8 breath­ing: In­hale deeply for a count of four, hold for a count of seven and slowly ex­hale for a count of eight. Af­ter a few cy­cles, you’ll feel more grounded and pre­pared to use some of your other anx­i­ety-fight­ing tools.

3. One of the worst ef­fects of my anx­i­ety is on my di­ges­tive sys­tem. Nau­sea and di­ar­rhea of­ten oc­cur be­fore I even re­al­ize that my anx­i­ety is getting out of con­trol. To com­bat this, I avoid trig­ger foods, like caf­feine, al­co­hol, sugar, and re­fined car­bo­hy­drates. This also helps pre­vent the rac­ing heart that of­ten ac­com­pa­nies height­ened anx­i­ety.


ACOGNITIVE BE­HAVIOURAL THER­APY HAS long been ac­knowl­edged as the gold stan­dard in treat­ing anx­i­ety. It helps peo­ple to re­frame their neg­a­tive thoughts and pro­vides cop­ing skills for when those thoughts arise. My goal is to help my clients with their anx­ious thoughts and the dif­fi­cult phys­i­cal sen­sa­tions that ac­com­pany anx­i­ety (once they’ve seen their fam­ily doc­tor to rule out any pos­si­ble un­der­ly­ing med­i­cal con­di­tion). Some strate­gies I like to use are:

1. Distress tol­er­ance, which is a com­po­nent of di­alec­ti­cal be­hav­iour ther­apy, com­prises sev­eral help­ful cop­ing tech­niques for deal­ing with the phys­i­cal and emo­tional symp­toms of anx­i­ety. One of these en­cour­ages clients to ac­cept their sen­sa­tions with­out judg­ment (i.e. avoid­ing state­ments such as “I shouldn’t be feel­ing this way”) and to avoid re­sist­ing them. Ac­cept­ing present feel­ings, no mat­ter how un­com­fort­able, is the first step to deal­ing with and man­ag­ing them.

2. Re­lax­ation tech­niques are par­tic­u­larly use­ful in eas­ing the phys­i­cal dis­com­forts of anx­i­ety. One of these, pro­gres­sive mus­cle re­lax­ation, in­volves clench­ing and tens­ing var­i­ous body parts, and then grad­u­ally re­leas­ing the con­stric­tion. Start­ing at the feet and grad­u­ally work­ing up the body, PMR is a very ef­fec­tive tool in man­ag­ing the mus­cle ten­sion, ac­cel­er­ated heart rate and short­ness of breath that of­ten ac­com­pany height­ened anx­i­ety.

3. Dis­trac­tion is an un­der­rated tool for man­ag­ing phys­i­cal anx­i­ety. I ad­vise my clients to en­gage in a calm­ing ac­tiv­ity like read­ing, lis­ten­ing to re­lax­ing mu­sic, or talk­ing to a close friend, when their symp­toms feel over­whelm­ing.

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