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 

The Look of Depression

Written by Dr. Kathy Dooley on Dr. Dooley Noted May 9, 2015

In keeping with the theme of mental health this week, I'd like to share a couple of articles from Dr. Kathy Dooley that sync right in. Her style is simple, eloquent, and almost entirely based on personal experience. Enjoy!

- Dr. P

Depression is stigmatized. 

People don’t tend to want to be around people who are depressed. 

I should know. I’ve suffered from depression. 

There were moments when I opened up about the way I felt to my closest friends. 

Not knowing how to help me, they chose to no longer be my friend.

So, I learned to mask everything I was feeling. I knew depression had a look I wasn’t willing to show. 

The more depressed I felt, the more I would internalize. 

I spent my most struggling moments alone, fearing I would be burdensome or lose more friends. 

In therapy, I learned to be more honest with my feelings. And if I lost friends for it, then so be it. If they aren’t concerned with my well being, then the friendship isn’t real, anyway. 

The current nature of social media makes showing truth to friends very tough. 

I remember attending a seminar last year, and there was a moment that I had visibly showed stress. 

A person I had only known on social media pulled me to the side and said the following:

Person: “You seem edgy.”

Dooley: “Yeah, I had a moment of stress. I try not to hide much.”

Person: “I just assumed you never got stressed.”

That shook me. 

Of course I experience stress! It’s the only way to change and experience growth. 

But this woman had an idea she had formed about me from social media. 

I’m fairly upfront about embracing struggle in my writing. 

But that night, I looked at my pictures. 

I couldn’t find a single one that showed me struggling. 

I had cherry-picked the photos of my life, showing me almost always smiling, without an ounce of stress nor edge. 

I had given a visual image to her of who I was, based on pictures she witnessed. 

And I had set her up to see me a certain way. 

Last night, I read a thread about a college track star that took her own life at 19. 

All of her pictures on social media showed the perfect joy of a perfect life. 

A beautiful girl was suffering from depression – but her social media accounts didn’t reflect that.

She thought something was wrong with her because all of her friends seemed so happy on social media. 

But they even told her they, too, were struggling. 

She didn’t believe them – because of what she saw them post on social media. 

She felt alone. So, she took a nine-story leap off a parking garage. 

People with depression need to know that other people are struggling, too. 

We all need to hide less. 

I write about my struggles, but I need to do more about showing more struggles. 

We don’t need to constantly lament. 

But we could all stand to show more honesty, so that others know they aren’t alone in their struggles. 

As always, it’s your call. 

- Dr. Kathy Dooley 

When the Doctor Says, "Don't Do That"

Here's another golden nugget from Dr. Kathy Dooley. The golden rule when it comes to degenerating joints and restricted motion is "if you don't use it, you lose it." 

- Dr. P

Dooley Noted: 4/21/15

An old joke persists: If you tell your doctor it hurts when you do something, the doctor will likely tell you, "Don't do that."

I truly believe this has pervaded our culture so much that certain movements and exercises have been avoided out of injury fears.

People hurt some knees when squatting, so squatting became bad for the knees.

Basketball and soccer had high incidents of ACL injury, therefore one shouldn't play those sports.

Running is probably the most bastardized activity of them all. If it hurts when running, then running must not be for you, right?

What bull.

I'm a doctor, and yes - I have placed patients on restriction from certain activities.

But it's only temporary until they do something important.

It's not that they shouldn't squat or run.

They must learn to squat or run the way that protects them from injuries.

It's not, "Don't do that."

It's more like, "Don't do that the way you did it when you got hurt."

With movement re-education, you can return patients safely to many activities.

But I give these patients fair warning.

If they want to safely do what they love, they may have to do some things they don't love.

If they lose stability in a squat below parallel, they may have to come above parallel for a little while to build some strength there.

(Don't gasp. Earn the right to go below parallel.)

If they lose stability or mobility in their runs at 2 miles, then they may have to be restricted to 1.5 miles with a stopping point for correctives.

(Running isn't bad for you. The way you run may not be right for you.)

Gait re-training may be necessary for someone with pain with walking or with running.

I would never tell someone who loves their activity that the activity is to blame. If the activity were at fault, everyone would have the same injuries.

They don't.

Educate, don't eliminate.

As always, it's your call.

- Dr. Kathy Dooley