During the middle of the winter of 2020, we found ourselves amidst the Covid-19 pandemic. That period of time also happened to be when I was in the middle of the huge undertaking of planning and renovating the building for our new practice. Something that I felt was a calling and dream come true, yet it came with many challenges.

When I started having all kinds of unexplained symptoms that quickly spiraled into something quite debilitating during this time, I knew that something was up, I just had to figure out what. But how to figure something out when you’re feeling completely overwhelmed, anxious, short of breath, wondering if doom and even death is lurking around the corner?

I am not kidding, and not exaggerating. I do feel a little silly writing about it now, though. Yet, it is not yet something that I am completely free of…
That ‘something’ is anxiety and panic attacks… very unwelcome companions that joined me on my life path…
Thankfully they visit less frequently these days.

Through grace, and with the necessary support, I found ways to investigate, understand, and deal with this condition better. And to my surprise, when I started talking about it, I found out that there are more people struggling with it than I ever realized.


That is why I feel compelled to share what I now know, in the hope that others can be helped, and experience less suffering.

Common symptoms of anxiety

(and these are symptoms that I experienced myself):

*Feelings of restlessness, worry, and anxiety, sometimes with good reason, oftentimes without any reason.
*Insomnia and extreme fatigue
*racing/ intrusive thoughts, especially at night
*Emotional instability
*Feeling overwhelmed
*Chest pain, shortness of breath, and rapid heart rate
*Lack of concentration
*Lack of appetite
*Having the urge to avoid things that trigger these feelings (if the triggers can be identified)
*When my symptoms were at their worst, the feeling like I was just plain losing my mind prevailed. Not. Good.

Other common symptoms:

*Trembling
*Sweating
*Gastrointestinal issues (abdominal pain, nausea, diarrhea, or constipation)

What surprised me most about my own experience, were mainly two factors. Firstly, the severity of the physical symptomatology I experienced. I felt physically so unwell, that there were times when I thought whatever was going on with me, was surely going to cause my (premature) death. This was before I knew that anxiety was to blame. And because I did not know what was going on, it was a really scary time, and this in turn of course contributed to more feelings of anxiety.
The other surprising thing was that the worst symptoms often came with no warning and no trigger. This made it difficult to manage because I was frequently caught off guard.

My aim with this article is to give people hope.

Therefore I am going to focus more on what management strategies there are, rather on the etiology (causes), although I will touch on that too.

What is important to realize is that the feeling of being anxious is a symptom of some underlying issue.
Therefore it is important to try to get to the underlying root cause or causes.

The following is a list of things that can contribute:

*Genetic predisposition (family history of anxiety or depression)
*Neurotransmitter (chemical messenger) imbalances. The most well-known neurotransmitter in relation to anxiety and depression is serotonin. Other neurotransmitters are dopamine, GABA, acetylcholine, norepinephrine, and so on.
*Trauma and life events, including adverse childhood events (ACEs)
*Suboptimal time management (too busy/ always rushed, too little pleasure and relaxation)
*Certain personality types have a higher incidence
*Women are much more prone than men
*Sedentary lifestyle
*Unhealthy diet (high in sugar and carbs, high in processed foods). Caffeine and alcohol consumption, even if in moderation, can also contribute to worsening the symptoms of anxiety. This easily becomes a vicious cycle.
*Other food-related aspects, like food allergies or food intolerances. Gluten is a major culprit. Another less well known, but important molecule that can cause inflammation and chronic illness, is oxalates.
*Toxin/ mold exposure
*Intestinal dysbiosis (overgrowth of unwanted gut organisms, with subsequent too little of the good bugs) By the way… this is such an important topic and plays a role in numerous chronic diseases.
*Hormonal issues, whether it is imbalanced sex hormones, thyroid hormones, or adrenal issues.
*Blood sugar related issues
*Other physical diseases like cardiac problems, lung diseases, certain rare tumors.
*Drug or alcohol-related problems can contribute to anxiety symptoms
*Excessive exposure to electronics, and the type of light emitted from these devices, can contribute to anxiety and other psychiatric conditions.

Diagnosis and management

Sometimes the diagnosis can be made by the person experiencing the symptoms.
To get a professional objective opinion is useful. A thorough assessment of the symptoms involved and taking a good history are good starting points.

Depending on the circumstances and history, it might be necessary to rule out some of the medical conditions discussed previously.

But remember that a ‘diagnosis’ of anxiety or panic attacks, is not the end of the road. Ideally, deeper investigation and root cause resolution should be sought.
And since it is a complex issue, there are often multiple contributing factors, therefore working with a professional person who can guide you through the process is very helpful.
Because my condition involved so many physical symptoms, I got a few blood tests and other investigations to rule out some physical problems.

What everyone who suffers from this condition wants to know is, how to just feel better?!
How to escape the whirlpool that is threatening your sanity.

For me, the first glimmer of hope lied in the realization that it made me feel (much) better when I was moving. Because I experienced debilitating fatigue as one of the symptoms of my anxiety condition, at first I did not think I was capable of taking a brisk walk.
Thankfully, one Saturday morning my husband and I managed to go for a walk, something we used to do regularly, and usually, I love doing. (But winter, business, and whatever else got us out of this routine for a while. Retrospectively I know that this contributed to my anxiety condition).

During this first-one-in-a-while walk, I started to feel better, so much so, that I honestly did not want to stop walking!
So I implemented this activity regularly in my life again with good results.

Other helpful things

*Adjusting one’s schedule….scaling down on the to-do lists is very necessary. I realized that I always felt pressed for time, no matter what I was doing, and how fast I was doing it, it seemed that there was something even more important waiting to be done. I was always rushed and never felt that I was doing the right thing at the right time.

*Seeking support. If your spouse or family doesn’t give you the needed support, try to find someone else who does. Isolation is not helpful. Group support from others who experience the same condition can be very helpful. (This rings true for any chronic condition or illness)

Because the sympathetic nervous system goes into overdrive with anxiety, it is important to stimulate the parasympathetic nervous system

*This can be done with regularly deep belly breathing, focusing on prolonged exhalation. It might seem too simple to work, but it really does.

*Combining breath work with stretching exercises, is even better

*Barefoot walking outside, and just being outside in nature

*Anything that causes vibration of the throat, like singing out loud in the shower. Even gargling can give temporary relief.

*Havening techniques. This involves simple touching of the hands, face, and upper arms. This can be applied by a practitioner or by a person to him- or herself. It creates delta waves in the brain which are associated with deep sleep, meditation, and healing.

*self-myofascial release techniques with a foam roller

*Massage therapy stimulates the parasympathetic nervous system effectively. If you have been lucky enough to have been the recipient of a nice massage recently, you will know how relaxing the effect can be!

*Working on better sleep is extremely important. This is a topic on its own, but if you do not get enough, good quality sleep, your body has a very hard time fighting off anything, including anxiety.

*Keeping a journal. This can include triggering and relieving factors or just writing your thoughts down on paper.

*Consciously practicing gratitude, whether it is in a journal, around the dinner table, or with a friend who wants to get into the same habit.

*Working on your thought life, and improving on the way you think and process these thoughts can be very helpful. Dr. Caroline Leaf is an expert in this field, and it is worth checking her work out.

*What ties in with this, is meditation. Numerous studies have proven the benefit of this practice, not only on anxiety but also on general wellbeing.

*Nature offers healing. To be outside, and to see beautiful things in nature can really have a profound impact on a person’s wellbeing.

*Sunlight exposure, especially early morning sunlight can be a wonderful remedy. It helps to wake you up, and aids to reset the circadian rhythm. This, in turn, will improve sleep at night.

*Supplements: Vitamin D, probiotics, calming amino acids like theanine. Adrenal support with Ashwagandha.

*Neurotransmitter support is one of the most useful tools.
Determining which one you are most likely lacking in and then taking a trial with the appropriate supplement.
For low serotonin symptoms, tryptophane, or 5-HTP can be used.
Tryptophane and 5-HTP are both precursors of Serotonin, they can be thought of as building blocks. In the ‘building’ process, zinc and Vitamin B6 are required. Supplementing with these will often give better results.
(5 HTP and Tryptophan must not be taken if you are already on a pharmacological medication that affects serotonin, like fluoxetine, paroxetine, citalopram)
Other neurotransmitters that can have very impactful effects are GABA, and melatonin.

*Aromatherapy. Essential oils like lavender, bergamot, and rosemary are worth the try.

*Psychotherapy or prayer counseling, and dealing with past and present emotional pain or trauma is usually a necessary step.

*Pharmacological therapies can be used short term.
The SSRI class of drugs is commonly used.

*For quick temporary relief of symptoms, a benzodiazepine like Ativan, or Urbanol can be used. This is also just short term management, and it should be used with caution.

Conclusion

The distress that anxiety cause is so great that it interferes with a person’s ability to lead a normal life.  And even though all of these management and treatment methods may seem impossible to do while anxiety gets the better of you, it is important to remember that there is hope, you can get better. 

In my personal experience, I’ve learned that the self-discipline to practice the methods to manage the anxiety gets you a long way.

But, you DO NOT have to go through this journey alone.  For assessment and guidance regarding a management plan, please visit Rachem Wellness.