Helping Anxiety

Written by Dr. Kathy Dooley on Dr. Dooley Noted May 5, 2015

Another gem from Dr. Kathy Dooley. We've now talked about grief, depression, and here's one about their not-too-distant cousin, anxiety (also covered here). Coping strategies have been identified here. This is a conversation that occurs all too often in MD offices everywhere. Think about what you're putting in your body and why. Think about symptoms, and think about causes. Don't always try to take shortcuts.

- Dr. P

At age 21, I let anxiety get the best of me.

I was hospitalized with a panic attack. 

I was quickly offered a copious amount of medication, mostly in the form of anxiolytics (Klonopin) and benzodiazepines (Xanax). 

I’ll never forget the interaction with my doctor. 

Picture me 15 years younger. 

Doc: “Why don’t you take Xanax? It’s wonderful for diminishing anxiety.” 

Dooley: “I’ve read that, sir. But what is creating my anxiety?”

Doc: “It’s hard to say. Probably your intense classes.”

Dooley: “But I LOVE my classes. I love school.”

Doc: “Maybe it’s your boyfriend?”

Dooley: “He’s amazing. These things don’t make me anxious. I just get hit with it, as if out of nowhere.”

Doc: “Listen, I understand. My wife suffers from anxiety. She has taken a Xanax every morning for the past 20 years. Her anxiety is under control.”

Dooley: “If it were under control, she wouldn’t need Xanax.”

Doc: (blank stare) 

So, I walked out. Thank god I can think for myself, because the pressure from family and friends to take drugs was insurmountable. 

Funny how non-anxious people want to tell anxious people what they should do. 

A client of mine recommended chiropractic.

I went – and obtained immediate relief. 

The chiropractor taught me how to breathe with my abdomen, so as not to overuse muscles in the chest and neck that might trigger anxious breathing. 

Like any solid rehabilitative strategy, my anti-anxiety drills became a part of my everyday life. 

A crowded subway train becomes a contest with myself on exhale prolongation. 

If I feel my pulse race or my heart increase in beats, again I turn to the breathing to bring respiration and pulse rate down. 

When I run, I make conscious efforts to maintain my breathing cylinder, avoiding chest breathing, rib flaring, and air gasping. 

These things did not come naturally to me.

Anxiety came naturally to me. 

So, interventions were necessary. 

I chose to not take drugs. 

Breathing drills were challenging at first. I had to set alarms to remind myself to breathe. 

But with time and commitment, I started naturally going to the drills to feel my best. 

Conquering my own anxiety has drawn anxious people to me like a magnet. 

I never knew that conquering my own struggle would have numerous beneficiaries. 

This inspires me to make even more conscious efforts to work on anxiety prevention. 

After all, we anxious people need to train for the event that may happen some day. 

I haven’t had a panic attack in countless years. 

But I’m ready in the event that I do.

If you think you don’t have a choice but to take anxiolytics, you are mistaken. 

Benzodiazepines and anxiolytics are part of a standard care protocol for anxiety. 

That doesn’t mean you have to follow that standard. 

I have standards of my own. 

I don’t want to take a pill to control me. 

I want to do the work to see myself out of discomfort. 

Drugs are easy. Drugs also have consequences. A major consequence of anxiety drugs is that anxiety tends to increase without their usage. 

They aren’t fixing anything in the long run. 

With anxiety, you learn you are in control as much as you chose to be.

I hope you know you have options.  

As always, it’s your call. 

- Dr. Kathy Dooley 

Wake Up Call For Coffee Drinkers

Written by Dr. Prathap Addageethala

Original draft August 30, 2013

Re-jigged March 11, 2015 (facts are still good!)

Today’s facts were based on my favourite morning, mid-afternoon, and early evening beverage – coffee.  There have been many studies both evangelizing and demonizing the effects of coffee drinking, but in recent times coffee has been accepted in the scientific community as a safe and probably even beneficial commodity to the average consumer.

The typical benefits of coffee are depicted in your average TV commercial – a yawning office type awakens. Bleary-eyed he shuffles his way down the stairs towards the kitchen, bathrobe trailing behind. Within moments of tearing off the seal of a new can of Folgers and brewing a fresh cup, he’s smiling widely out an open window, the haze lifted, awake, and alive. In real life, it won’t happen that quickly, but yes, caffeine is a stimulant, it can create alertness, drive away fatigue, and increase your sense of satisfaction with the world in general. In fact coffee enthusiasts who were drinking between 2-4 cups per day were less at risk for depression and suicide. Beware though, more than 9 cups a day actually increases suicide risk.

The real major risk that had been buzzing around research circles was the effect of stimulants on heart patients. Because stimulants cause the heart rate to increase, there were some concerns for people that were predisposed to heart conditions such as arteriosclerosis, and history of heart attack. Indeed for this population, caffeine is not recommended. As a mild stimulant, overuse dependency is a very real thing. Take for example the large numbers of people who simply “cannot function” until they have their cup of coffee in the morning. For these folks, and I’m one of them, removing coffee from their morning routine can create feelings of fatigue, headache, loss of concentration, and even anxiety. These symptoms are usually alleviated by further abstinence from caffeinated products, staying hydrated, and with exercise. If you’re looking to break away from your “coffee addiction” keep in mind that “moderate use” is around 3-4 cups a day, and is still consumption below a level that causes any health risks. We’re talking about black coffee here folks, not a “Large 4×4″ or a supercalifragilisticexpialidocious latte.

The stuff you add to your cup of joe is typically terrible for you – especially if you’re at the higher end of coffee intake. Fatty creams, sugar-packed flavourings, artificial sweeteners, and (obviously) white sugar itself, are some examples of concentrated caloric loads that are often hidden causes of weight gain.

But for the average consumer, coffee can be beneficial for a number of reasons. There have been a lot of connections with weight loss and coffee; the increased heart rate also seemed to have an effect on increasing metabolic rates, burning more calories. The increase in energy provided athletes with ability to be more active during training, and many pre-workout supplements have added caffeine to provide a bit of a boost. Caffeine also has a role in appetite suppression, further pushing its weight loss supplement label.

Coffee’s chemical constitution contains several useful products for our bodies, such as anti-oxidants, chlorogenic acid, and trigonelline (the nature of these molecules are outside the scope of this article!). Due to these molecules, more research shows that coffee intake can reduce your chances of Alzheimers, Parkinsons, dementia, Type II diabetes, and even reduce potential alcoholic cirrhosis of the liver in heavy drinkers. These are all higher order diseases and conditions, so more research must be done in order to verify these early conclusions.

Realize that caffeine is a diuretic, and that it will cause you to urinate at a higher frequency. The body naturally produces a hormone called “Antidiuretic Hormone” or ADH. This hormone helps to conserve water for our body’s normal processes. Caffeine is an ADH-inhibitor, in other words, it counters the effect of ADH, therefore preventing us from retaining water, and as a result we visit the bathroom more frequently. An average person’s water intake should be in the range of 2L per day. But with every 8 oz cup of coffee (about 100 mg of caffeine) an additional 2 cups of water should be taken in.

Stay thirsty hydrated my friends!

via http://www.facebook.com/doctorprathap