9 Ways to Reduce Anxiety Right Here, Right Now

-Margarita Tartakovsky, M.S.

When you’re feeling anxious, you might feel stuck and unsure of how to feel better. You might even do things that unwittingly fuel your anxiety. You might hyperfocus on the future, and get carried away by a slew of what-ifs.

What if I start to feel worse? What if they hate my presentation? What if she sees me sweating? What if I bomb the exam? What if I don’t get the house?

You might judge and bash yourself for your anxiety. You might believe your negative, worst-case scenario thoughts are indisputable facts.

Thankfully, there are many tools and techniques you can use to manage anxiety effectively. Below, experts shared healthy ways to cope with anxiety right here, right now.

1. Take a deep breath.

“The first thing to do when you get anxious is to breathe,” said Tom Corboy, MFT, the founder and executive director of the OCD Center of Los Angeles, and co-author of the upcoming book The Mindfulness Workbook for OCD.

Deep diaphragmatic breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. It helps the body go from the fight-or-flight response of the sympathetic nervous system to the relaxed response of the parasympathetic nervous system, said Marla W. Deibler, PsyD, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC.

She suggested this practice: “Try slowly inhaling to a count of 4, filling your belly first and then your chest, gently holding your breath to a count of 4, and slowly exhaling to a count of 4 and repeat several times.”

2. Accept that you’re anxious.

Remember that “anxiety is just a feeling, like any other feeling,” said Deibler, also author of the Psych Central blog “Therapy That Works.” By reminding yourself that anxiety is simply an emotional reaction, you can start to accept it, Corboy said.

Acceptance is critical because trying to wrangle or eliminate anxiety often worsens it. It just perpetuates the idea that your anxiety is intolerable, he said.

But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence.

“It just means you would benefit by accepting reality as it is – and in that moment, reality includes anxiety. The bottom line is that the feeling of anxiety is less than ideal, but it is not intolerable.”

3. Realize that your brain is playing tricks on you.

Psychiatrist Kelli Hyland, M.D., has seen first-hand how a person’s brain can make them believe they’re dying of a heart attack when they’re actually having a panic attack. She recalled an experience she had as a medical student.

“I had seen people having heart attacks and look this ill on the medical floors for medical reasons and it looked exactly the same. A wise, kind and experienced psychiatrist came over to [the patient] and gently, calmly reminded him that he is not dying, that it will pass and his brain is playing tricks on him. It calmed me too and we both just stayed with him until [the panic attack] was over.”

Today, Dr. Hyland, who has a private practice in Salt Lake City, Utah, tells her patients the same thing. “It helps remove the shame, guilt, pressure and responsibility for fixing yourself or judging yourself in the midst of needing nurturing more than ever.”

4. Question your thoughts.

“When people are anxious, their brains start coming up with all sorts of outlandish ideas, many of which are highly unrealistic and unlikely to occur,” Corboy said. And these thoughts only heighten an individual’s already anxious state.

For instance, say you’re about to give a wedding toast. Thoughts like “Oh my God, I can’t do this. It will kill me” may be running through your brain.

Remind yourself, however, that this isn’t a catastrophe, and in reality, no one has died giving a toast, Corboy said.

“Yes, you may be anxious, and you may even flub your toast. But the worst thing that will happen is that some people, many of whom will never see you again, will get a few chuckles, and that by tomorrow they will have completely forgotten about it.”

Deibler also suggested asking yourself these questions when challenging your thoughts:

  • “Is this worry realistic?
  • Is this really likely to happen?
  • If the worst possible outcome happens, what would be so bad about that?
  • Could I handle that?
  • What might I do?
  • If something bad happens, what might that mean about me?
  • Is this really true or does it just seem that way?
  • What might I do to prepare for whatever may happen?”

5. Use a calming visualization.

Hyland suggested practicing the following meditation regularly, which will make it easier to access when you’re anxious in the moment.

“Picture yourself on a river bank or outside in a favorite park, field or beach. Watch leaves pass by on the river or clouds pass by in the sky. Assign [your] emotions, thoughts [and] sensations to the clouds and leaves, and just watch them float by.”

This is very different from what people typically do. Typically, we assign emotions, thoughts and physical sensations certain qualities and judgments, such as good or bad, right or wrong, Hyland said. And this often amplifies anxiety. Remember that “it is all just information.”

6. Be an observer — without judgment.

Hyland gives her new patients a 3×5 index card with the following written on it: “Practice observing (thoughts, feelings, emotions, sensations, judgment) with compassion, or without judgment.”

“I have had patients come back after months or years and say that they still have that card on their mirror or up on their car dash, and it helps them.”

7. Use positive self-talk.

Anxiety can produce a lot of negative chatter. Tell yourself “positive coping statements,” Deibler said. For instance, you might say, “this anxiety feels bad, but I can use strategies to manage it.”

8. Focus on right now.

“When people are anxious, they are usually obsessing about something that might occur in the future,” Corboy said. Instead, pause, breathe and pay attention to what’s happening right now, he said. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation, he added.

9. Focus on meaningful activities.

When you’re feeling anxious, it’s also helpful to focus your attention on a “meaningful, goal-directed activity,” Corboy said. He suggested asking yourself what you’d be doing if you weren’t anxious.

If you were going to see a movie, still go. If you were going to do the laundry, still do it.

“The worst thing you can do when anxious is to passively sit around obsessing about how you feel.” Doing what needs to get done teaches you key lessons, he said: getting out of your head feels better; you’re able to live your life even though you’re anxious; and you’ll get things done.

“The bottom line is, get busy with the business of life. Don’t sit around focusing on being anxious – nothing good will come of that.”

My Struggle to Stop Expecting the Worst Outcomes

-Sarah Burleton

I would bet that anyone reading this blog has a “what if” thought run through their head at least once or twice a day.

“What if there is an accident on the way to school? What road will I take so I’m not late?”

“What if my car won’t start?”

“What if I have to work late and I can’t get to the daycare on time?”

We “what if” little scenarios in our head all day so we can have a plan A, B, and sometimes plan C to fall back on just in case something in our day goes wrong. We want to have a sense of comfort that not only our needs are taken care of, but the needs of those we love as well. Many of us don’t like surprises and we like to be prepared for anything that comes our way.

So most of you keep your plan A, B, and C in the back of your heads and go about your day. You don’t expect any surprises, but you feel confident that if anything out of the ordinary does arise, you can easily handle whatever is thrown your way.

The difference between you and me is that I not only prepare plans in my head for the little surprises; I truly believe that the worst is going to happen, so I protect myself accordingly. Here are a few examples of what runs through my head when I “what if” a situation:

“What if my relationship fails? Well, it’s going to anyway; everyone walks out on me eventually.”

“What if no one likes me at my new job? Doesn’t matter, no one ever gets to know me or involves me in anything at any job I’ve ever held.”

“What if my new book bombs when it is released? I don’t expect it to do well; no one cares to read about my life.”

Complete self-defeating thoughts.

What do thoughts like these do to me personally and professionally? I push people who love me away because I’ve already planned in my head that they are going to leave anyway. I have a hard time engaging myself with co-workers because I assume that they aren’t going to like me and will just end up making fun of me or talking about me behind my back. And I am having a hell of a time finishing my next book because I don’t believe that anyone cares enough to read about my life and I feel dumb for sharing parts of it.

I’m still carrying my past into my present. My fear of being bullied the same way I was in high school pushes me away from my co-workers. Spending my childhood hiding what was going on in my house and being told I was a liar when I shared my story with DCFS (Division of Children and Family Services) makes me scared to publish my next book. And growing up unloved and eventually abandoned by my mother showed me how cold-hearted people who are supposed to love you can be.

I protect myself now the same way I protected myself in the past: I push people away and I find comfort behind the giant walls I have put around myself. Walls that I put up early in my childhood to protect myself from Mom, the bullies, and the truth about my life. I expect the worst in my adult life because that is all I was used to and that’s all I knew.

But that isn’t fair to me or anyone around me. Just because there was a mean group of kids in high school that enjoyed watching me cry doesn’t mean that co-workers at a new job are going to do the same. My stories aren’t dumb and are important to so many people; regardless of what a DCFS worker thought. And the people who love me aren’t going to leave me and hurt me like Mom did; they are in my life because they want to be in my life.

It’s very difficult to cut those self-defeating thoughts out of my head and not create “what if” scenarios to avoid getting hurt; but like anyone else, I’m trying. I take deep breaths, remember that I’m not a child anymore, and I try to look in the mirror and smile at myself. I cautiously let down my walls, and nine times out of ten I am surprised at how honest and good so many people are.

If you spend your life preparing for the worst and expecting the worst to happen, the only person you are hurting is yourself. You are denying yourself the opportunity to experience love and happiness, and denying others the opportunity to see you for the awesome person that you are.

Couples Who Flay Together Stay Together.

-Gerald Schoenewolf, PhD

What started out as an experiment in somebody’s garage has turned into a growing business where people pay anywhere from $20 to $500 (and more) for the privilege of smashing furniture, demolishing dishes, shredding mannequins or at times even destroying custom-made rooms designed to be replicas of a real room. Some people think this is a good trend, some think it is harmful.

The trend was started by Donna Alexander in Dallas. The first group to come to her garage and break things was comprised of friends and co-workers. Then, in 2011, she quit her job and opened a 1000-square-foot room in downtown Dallas—called simply the “Anger Room.” Soon other versions of the Anger Room opened around the world, including in Houston, Australia, Niagara Falls and Toronto.

Business increased, according to Alexander, during the recent U.S. Presidential Election, when mannequins of Donald Trump and Hillary Clinton were often requested for venting and destruction sessions. Customers in Dallas demolished two Clinton mannequins, requiring replacements. Trump’s mannequins took a bigger beating. “We’ve gone through at least three of the male mannequins that we have to dress up as Donald Trump,” Ms. Alexander reported.

Customers can customize their anger-room settings. Customers of the Anger Room have paid to re-enact a scene from the 1999 movie “Office Space,” in which the main characters, three angry computer programmers, beat a printer to death with a baseball bat. The company can customize the space any way customers want it, and charges according to how much it costs to arrange the space.

Typically, staff members make runs through neighborhoods in Dallas and pick up furniture and other items that people throw out for garbage pickup. There is no shortage of chairs, tables, desks, beds, mirrors and kitchenware. Customers use various weapons in their venting sessions—bats, metal bars, two-by-fours or golf clubs. Knives, guns, and other weapons using projectiles are not allowed. Customers are also provided with protective gear such as helmets, pads and gloves.

Alexander notes that quite often couples come in for mutual destruction sessions, at times customizing a room to replicate their bedroom. It appears that destroying things as a team brings the couple closer together. The theme of such sessions seems to be that “a couple that flays together stays together.”

However, one psychologist interviewed in an article about this phenomenon expressed the opinion that such venting might be harmful. “Although it’s appealing to think that expressing anger can reduce stress, there is not much evidence of that,” says George M. Slavich, a clinical psychologist and director of the Laboratory for Stress Assessment and Research at the University of California, “On the contrary, the types of physiological and immune responses that occur during anger can actually be harmful for health.”

Slavish has a point. Anger, especially chronic anger, can be harmful to the immune response, as the continual arousal of stress hormones in the body takes its toll on our physiology and weakens the immune system. Also, venting in and of itself does not lead to resolution or cure. It may make you feel better for a while, but eventually the anger and other negative feelings will return. It is the same for running or weight lifting or boxing; they can relieve your stress temporarily but unless it is done regularly the stress will return.

However, historically the psychotherapy community has devised various methods of helping clients release their stress, whether it is related to anger, fear, jealousy or some other feeling. The work of Wilhelm Reich and Alexander Lowen led to the creation of a school of therapy called, “Bioenergetics,” in which clients at times beat mattresses or pillows with tennis rackets. However, the object of such exercises in therapy is not just venting. Bioenergetics is an ongoing process of releasing stress and negative energy that, over time, is intended to lead to resolution.

When one hits a pillow or screams at it, using it as a surrogate for someone toward whom one has animosity, the goal is to start with the anger that lies at the surface, and then to reach the hurt and sadness that lies underneath. In addition to physical exercises, Bioenergetics also uses breathing exercises combined with sounds to release pent-up angst. During the course of the sessions the therapist attempts to guide the clients towards re-experiencing traumatic events in their lives and releasing them.

When such an exercise vents anger in order not just to release it but to get to the root of the problem, which sometimes harks back to traumatic events in early childhood, the anger, fear, jealousy, or rage dissolve and the wound is soothed if not healed. One gets in touch with deeper feelings of hurt and sadness and has transformative experiences (sometimes called catharses) that enable much-need self-objectivity as well as forgiveness of both others and yourself.

When people reach this state and can let go of their needless cares and woes, they will have a true release, as opposed to temporary venting, and their immune system and physiological processes will be helped, not hindered.

Why we constantly think: “What if …?”

-Jennifer Delgado

What would have happened if I woke up before and didn’t miss the bus? What would have happened if I’d had the courage to talk to that very interesting person that I met? What would have happened if I had not broken up with my partner? And if I’d said to my boss what I really think?

These are some of the questions we constantly ask ourselves. What if, instead of taking this direction, we had made another choice? The possibilities are endless. In fact, we are perfectly aware that it is a kind of mental game, fantasy, yet we can not help but wonder “what if …?”

The situations that trigger these thoughts

1. “Almost” situation. It is a feeling you probably know well: everything seemed to be going well until a certain point, when something went wrong. Then you can not help but wonder what would have happened if you had done something different at some point of the journey.

For example, if you miss a flight because you arrived very late it is obvious that you can not help it. In this case you’ll be worry only about solving the problem. However, if you arrive just a minute late and the boarding gates close in front of you, you can not help but wonder what would have happened if you had woken up only five minutes before, if you had not met the traffic jam on the road or if you had not stopped to take that coffee.

This is a very painful feeling, since you were on the verge of achieving what you wanted, but you missed the opportunity for a bit. Therefore, you can not help but wonder where you went wrong and what you could do for this not to happen.

2. Abnormal situation. It is a fairly unlikely or rare feeling, something that usually does not happen. In this case, we can not help but wonder what would have happened if things had gone normally.

For example, imagine that one day you’re forced to take a different path to get to work and just in front of you is an accident that leaves you stuck for an hour, so you lose a meeting at work very important for your career. The chances that the road that you normally use to get to work was closed and that on the one you just taken there was an accident are few, but it went this way.

When you live unusual situations it will be difficult for you to stop thinking what would have happened if things had gone normally, if you had not met all the mishaps of the case. Who knows, probably you think also that it was a “sign of destiny”.

Why we tend to imagine routes that we don’t follow?

We constantly wonder what would have happened if we had taken a different direction to give meaning to our lives, to what is happening. Interestingly, imagining other possible scenarios helps us better understand our reality.

In this regard, a study conducted at Ohio University found that we tend to use this way of thinking according to the situation we’re living. We can imagine that things could have gone better or worse depending on the context.

These psychologists have found that when people know that they will not have a second chance to do things, they try to encourage themselves thinking that everything could have been worse, it is a form of consolation to help us accept what happened. But if we have a second chance we tend to think that things could have been much better, so we motivate ourselves to try once again and improve our performance.

The dark side of imagining fictitious scenarios

However, we must pay attention to this mechanism, because we can not always use it to cheer us up. In fact, if we ask us continuously “what if …?” we risk to begin living in a fantasy world and we’ll feel deeply dissatisfied with our lives. Returning to reality, we may feel frustrated and feel guilt, and this won’t help.

The tendency to keep thinking about what might have happened may reflect a deep dissatisfaction with the reality or past decisions that have not yet fully accepted. In fact, we will be more likely to think like this if in the past we have made decisions influenced by others or by circumstances, decisions that were not born within us and of which we feel uncertain.

Thinking of all possible scenarios may seem a harmless mental exercise, but at some point of our journey, we must learn to let go some things, otherwise those thoughts will turn into resentment, guilt and regret. And this won’t be of any help.

Mouse Study Provides New Understanding of OCD

-Rick Nauert, PhD

New research on genetically altered mice suggests the overactivity of a brain transmitter may be the source of neurodevelopmental diseases and behavioral and thought disorders.

Duke University researchers discovered a single type of receptor for the neurotransmitter glutamate in the brain is responsible for a range of symptoms in mice that are reminiscent of obsessive-compulsive disorder (OCD).

The findings provide a new mechanistic understanding of OCD and other psychiatric disorders and suggest that they are highly amenable to treatment using a class of drugs that has already been investigated in clinical trials.

“These new findings are enormously hopeful for considering how to approach neurodevelopmental diseases and behavioral and thought disorders,” said the study’s senior investigator, Nicole Calakos, M.D., Ph.D., an associate professor of neurology and neurobiology at the Duke University Medical Center.

The study appears online in the journal Biological Psychiatry.

OCD, which affects 3.3 million people in the United States, is an anxiety disorder characterized by intrusive, obsessive thoughts, and repeated compulsive behaviors that collectively interfere with a person’s ability to function in daily life.

In 2007, Duke researchers created a new mouse model of OCD by deleting a gene that codes for Sapap3, a protein that helps organize the connections between neurons so that the cells can communicate. Similar to the way some people with OCD wash their hands excessively, the Sapap3-lacking mouse grooms itself excessively and shows signs of anxiety.

Although researchers praised the new model for its remarkable similarity to a human psychiatric disorder, and have begun using it to study OCD, questions remain about how the loss of the Sapap3 gene leads to the grooming behaviors.

In the new study, Calakos’s team found that overactivity of a single type of receptor for neurotransmitters — mGluR5, found in a brain region involved in compulsive behaviors — was the major driver for the abnormal behaviors.

When researchers gave Sapap3-lacking mice a chemical that blocks mGluR5, the grooming and anxiety behaviors abated.

“The reversibility of the symptoms was immediate, on a minute time frame,” Calakos said. In contrast, the original study describing Sapap3-lacking mice found that antidepressants could help treat symptoms but on the time scale of weeks, as is typical with these drugs in patients.

The immediate effects seen in the new study were also surprising, given that the brains of these mice appear developmentally immature and neurodevelopmental diseases are not typically thought of as being easily reversible, Calakos said.

Intriguingly, by taking normal laboratory mice and giving them a drug that boosted mGluR5 activity, Calakos’s team could instantaneously recreate the same excessive grooming and anxiety behaviors they saw in the Sapap3-lacking mice.

The researchers found that without a functioning Sapap3 protein, the mGluR5 receptor is always on. That, in turn, makes the brain regions involved in compulsion overactive.

In particular, a group of neurons that give the “green light” for an action, like face-washing, is working overtime. (These same neurons can promote a habit, such as eating sweets, according to a study published by Calakos’s team earlier this year.)

Calakos said that mGluR5 should be considered for the treatment of compulsive behaviors. “But which people and which compulsive behaviors? We don’t know yet,” she added.

Other lines of research have explored targeting mGluR5 with drugs to move its activity up or down in the brain. For example, mGluR5-blockers are being considered for the treatment of Parkinson’s disease. But because mGluR5 inhibitors have not always panned out in clinical trials, it may make sense to target different parts of the mGluR5 pathway or identify specific patient subsets, Calakos said.

Source: Duke University/EurekAlert

These 5 Foods and Substances Can Cause Anxiety and Insomnia

Before you reach for the medicine cabinet, take a look at your dinner plate.

Do you suffer from panic attacks or have trouble sleeping? If so, you may have tried stress reduction techniques or even medications, but has anyone ever asked you what you eat? It may surprise you to learn that certain everyday foods, some of which are considered healthy, have the capacity to overstimulate your nervous system just as powerfully as a stressful life event.

Medications may be helpful in managing your symptoms in the short term, but what if you could get to the root cause of the problem once and for all? If you identify which ingredients in your menu are working against you, you can gain control over your symptoms, avoid co-pays and side effects, and most importantly, protect your health from the damaging effects of internal biological stress.

When it comes to anxiety and insomnia, the foods listed below can be chemical triggers for anyone. Those at highest risk include women, people over 40, individuals with multiple chemical/medication sensitivities or allergies, and anyone with conditions affecting the digestive or immune system such as IBS, inflammatory bowel disease, or chemotherapy treatment.

Which foods are most likely to press your panic button?

1. Caffeine

Caffeine is a notorious nemesis in sleep and anxiety disorders. In a recent study of people with panic disorder, caffeine increased stress hormone levels in all participants and triggered panic attacks in about half of them. Caffeine keeps you awake by blocking sleep-promoting adenosine receptors in the brain. Even five hours after drinking caffeine, 50% of it remains in your bloodstream and has been shown to impair sleep. In fact, it takes a staggering 16 to 24 hours for caffeine to completely leave your system. This means that even a single morning cup of coffee may affect your sleep quality at night. To see if caffeine is your culprit, gradually cut back a little each day rather than going cold turkey to minimize withdrawal headaches, fatigue, and concentration problems.

2. Nightshades (potatoes, tomatoes, eggplant, peppers, and goji berries)

Plants in the nightshade family produce natural pesticides called glycoalkaloids, which are designed to kill predators like insects and worms, but are also toxic to human cells. These cunning chemical weapons block the enzyme acetylcholinesterase, resulting in overstimulation of the nervous system in sensitive individuals. Anxiety is just one of many neuropsychiatric side effects documented in humans. Common nightshade ingredients in prepared foods include potato starch, chilies, bell peppers, tomato paste, paprika, red pepper flakes and cayenne. Most people eat nightshades in some form every day, so glycoalkaloids may accumulate in your system over time. It takes at least five days for glycoalkaloids to clear your system, so you’ll need to remove these foods completely for a week or longer to see if they are bothering you. Cooking doesn’t destroy glycoalkaloids, but there are other simple ways to minimize your exposure.

3. Alcohol

Alcohol can be very effective in relaxing you and helping you fall asleep. However, as alcohol starts to wear off in the middle of the night, sleep quality suffers significantly. Metabolism varies depending on age, gender, genetic background and other factors, but the primary predictor of how long alcohol remains in your bloodstream is quantity. On average, each “drink” (1.5-oz shot, 12-oz beer, or 5-oz wine) takes two hours to clear your system: two drinks—four hours, three drinks—six hours, etc. As alcohol wears off, “mini-withdrawal” effects can range from restless sleep to bad dreams to full-blown panic attacks. If you’re in the habit of drinking every evening, cut back gradually to minimize potential for withdrawal, which can temporarily worsen sleep and anxiety problems.

4. Aged, fermented, cured, smoked, and cultured foods (salami, cheese, sauerkraut, red wine, etc.).

The way to turn a fresh whole food like beef, milk, grapes, or cabbage into a gourmet food like aged steak, brie, merlot, or kimchi is to add bacteria to it and let it ferment. During fermentation, bacteria break down food proteins into tiny molecules called biogenic amines, which accumulate as the food ages. The most important biogenic amine found lurking within aged foods is histamine, a powerful neurotransmitter that can aggravate our digestive, hormonal, cardiovascular, and nervous systems. Histamine causes anxiety and insomnia in susceptible individuals, partly through its ability to increase levels of adrenaline, our “fight-or-flight” hormone. Histamine is indestructible, so cooking and freezing don’t help. This article contains more detailed information, including meat, seafood, and beverage tables as well as food preparation tips to keep your histamine levels low.

5. Sugar, Flour, and other Refined Carbohydrates

All sugars and starches, except those that come in the form of a natural whole food like a piece of fruit or a sweet potato, are considered refined carbohydrates.

Popular breakfast foods like orange juice, sweet yogurts, and most cereals are rich in refined carbohydrates that start your day with a blood sugar spike, setting into motion a hormonal chain reaction that can affect your mood, energy, concentration, and appetite for hours. After insulin surges to bring your blood sugar down, the stress hormones cortisol and adrenaline rush in to prevent your blood sugar from crashing. Since most people eat refined carbohydrates like bread, chips, or noodles during lunch and dinner as well, they are essentially riding this invisible roller coaster 24 hours a day.

In this study, a single serving of a glucose-sweetened beverage caused adrenaline levels to double in adults and quadruple in children, not peaking until four hours after the drink was consumed.

Adrenaline causes panic symptoms like sweating, lightheadedness, and palpitations in sensitive people. These sensations are often mistaken for “hypoglycemia” (low blood glucose) even though in most cases, blood glucose doesn’t fall below normal.

The standard advice to people who feel panicky between meals is to eat carbohydrates every three hours to prevent blood sugar from dropping. However, that approach can actually worsen the problem over time by increasing your body’s dependence on sugar as well as your risk for insulin resistance.

It is much wiser to remove refined carbohydrates from the diet to prevent blood sugar from spiking in the first place. I recommend eliminating them for at least two weeks to see how you feel. It is best for all of us to permanently avoid these processed sugar sources anyway, so in taking this one small step toward identifying your dietary demons, you’ll be taking a giant leap toward overall good health.

Bottom Line

The most powerful way to change your brain chemistry is by changing how you eat. Keep a food and symptom journal to see if you notice any patterns, keeping in mind that some foods may not trigger symptoms until many hours later. What you discover may be the key to your peace of mind and a good night’s sleep.

Victims Of Bullying At Increased Risk Of Anxiety Disorders And Depression Later On

Children who are bullied are at an increased risk of developing anxiety disorders and depression when they become adults, according to a new study published in JAMA Psychiatry.

The study identified that bullying is not simply a ‘harmless rite of passage’, as it can also cause serious adverse health outcomes in the victims and perpetrators, in the form of depression, physical health problems and behavior and emotional problems, psychotic symptoms, and loss of motivation.

The researchers, led by William E. Copeland, Ph.D., of Duke University Medical Center, evaluated the impact that childhood bullying can have on both the victim and the perpetrator in later life. They wanted to determine whether it can be predictor of psychiatric problems in adulthood.

A total of 1,420 people participated in the study, they were assessed regularly from the age of 9 until they turned 16. They were categorized as either bullies, victims, a combination of both, or neither.

The authors said:

“Bullying is not just a harmless rite of passage or an inevitable part of growing up. Victims of bullying are at increased risk for emotional disorders in adulthood. Bullies/victims are at highest risk and are most likely to think about or plan suicide. These problems are associated with great emotional and financial costs to society.”

The results showed that victims, as well as bullies/victims, were more likely to have psychiatric disorders in adulthood and experience family hardship and childhood psychiatric problems.

Factoring in family hardship and childhood psychiatric problems, the researchers found that victims of bullying had a high rate of agoraphobia, generalized anxiety, and panic disorder. In addition, they found that bullies/victims were at high risk of depression, panic disorder and suicidality. Bullies were only at risk for antisocial personality disorder.

The authors concluded:

“Bullying can be easily assessed and monitored by health professionals and school personnel, and effective interventions that reduce victimization are available. Such interventions are likely to reduce human suffering and long-term health costs and provide a safer environment for children to grow up in.”

It should be noted that teens suffering from depression tend to be more at risk of being bullied because of difficulties making friends. This could suggest that the victims themselves are more prone to being bullied because of pre-existing psychiatric problems.

How Pokémon Go Can Help with Anxiety, Depression

Pokemon GoI have to admit it. I’m 31. Officially out of the “youthful” age group, according to some of my favorite students. “Mrs. Meg, no one uses Facebook anymore. That’s for old people.” Fair enough.  So I must venture further to confirm that I am not all too shot down with playing the new Pokémon Go. I certainly cannot speak for all my contemporaries, though, nor those in older age brackets. This app, released a mere 7 days ago, has already surpassed total number of downloads and user than the Tinder app and has been projected by a number of people in the know to exceed the number of Twitter users soon. Which means, this app is currently spanning a number of age ranges and demographics and providing a number of positive benefits to the masses.

Apart from the joy of beating your friends in chasing down imaginary figures, this game actually has some mental health implications. Think about it. In order to gain the most points, you have to go the most places, right? One must get off the couch in order to catch (I’m going to keep calling them all “Pokémon”, because we’ve already established I’m not hip enough to know all the names of the characters). Your phone alerts you to the Pokémon in your area, so you have to get up off the couch and go get them if you want the points. They don’t just come to you.

I recently read a post on the old folks’ (remember, that’s Facebook) of a dad who admitted to the benefits of the game in relation to his own daughter. After dinner, it was his daughter’s idea to leash up the pup and go for a walk with the parents in order to catch two Pokémon out in their neighborhood. A young teen actually asked her parents to go on a walk with her! Granted, she still had her phone in hand, but I say, progress. While on the hunt for these two mythical creatures, the aforementioned girl walked 1.5 miles (exercise is linked to decreasing symptoms of depression and anxiety), and also stopped and talked to a brother and sister, 10 and 13 years old, respectively (having a common introductory topic can be helpful in decreasing social anxiety) who were chasing a Golding – oh look, I found out an actual name – while the dogs played (and who doesn’t love to watch lovable pups having fun in the park?).

Even if you don’t run into someone also on the hunt for a Pokéspot, having the motivation to get up and get outside (free Vitamin D and Serotonin, along with fresh air and additional steps) can be beneficial to those who have found themselves often couch-side due to negative emotional states. It can be possible for individuals to utilize the game to get on the move for health benefits, to achieve instant gratification, to enjoy playing a game with clearly defined boundaries and goals, and allows those participating to tap into our imagination and creativity.


-MegAnne Duke, LCSW, LCDCi

Whatever You Do, Don’t Run: Your Panic Attack Survival Guide

Your heart was racing. You were dizzy and felt detached. You thought you were about to die. So, understandably, you tried to escape the last situation that caused you to panic.

I get it!

It is natural to try to flee when faced with an anxiety-provoking situation or object. Every part of our being instructs us to do so. But while this could be helpful if we’re faced with a predatory animal, it is the opposite of what we should be doing during a panic attack.

Our bodies are equipped with fight-or-flight responses that, when we’re faced with what feels like danger, help us decide whether to stay and fight or to run as quickly as our legs can carry us. These are absolutely phenomenal responses that our minds and bodies produce in an effort to protect us, so kudos to you, biology, for this life-saving mechanism you have equipped each of us with.

Here is the thing, though. Although this is a fantastic response to have when we are actually faced with a threatening stimulus, panic attacks in and of themselves are not physically harmful—even though they can make us feel as if we can’t breathe. Panic attacks, which are based on a spiral of fear, confuse the brain into thinking there is real danger. The more we run, the more our minds would have us believe there is something to be running from.

So, what to do about it?

Here is your panic attack survival kit, in a series of steps:

  1. Accept, accept, accept! Acceptance is a key ingredient in mitigating and disabling these frightening responses and faulty alarm systems. The more you accept and understand, the less you fear. Try greeting your panic attack with a one-liner such as, “Hello, anxiety!” Actually picture yourself opening the door and welcoming this unpleasant visitor inside your mind’s home.
  2. Stay absolutely still! Wherever you are, stay put—do not flee. While escaping may seem like a helpful short-term solution, it only creates more problems. Running deepens the fear-processing circuits in the brain. Therefore, you may be more likely to experience the same reactions and bodily sensations the next time you find yourself in a similar situation.
  3. Breathe from your belly! Diaphragmatic breathing activates your parasympathetic nervous system or calming response as quickly as a light switch, which disables your fight-or-flight response. Try this reverse breathing technique, or breathing in through your mouth while expanding your belly, and turning your tummy inward as you exhale.
  4. Your mantra: this, too, shall pass! Assuming you received a clean bill of health from your physician, just remind yourself that despite how frightening these symptoms can seem, they CANNOT harm you in any way, shape, or form.
  5. Self-empowerment and praise! Once you have successfully made it through the aforementioned steps, you have learned how to deactivate your fear response whenever you need to. So, congratulate yourself on this victory and start treating panic attacks as empowering experiences that give you an additional opportunity to master your reactions. With each step, you are rewiring your brain and training the way it responds to panic.

In addition to the aforementioned suggestions, if you or someone you care about is experiencing panic attacks, consider seeking therapy from a trained cognitive behavioral therapist who can help you start living and stop running.

-Masha Shapiro-Berkovich, MSEd, LMHC

When Your Anxious Child Rejects Your Help, Try This

be the calm
The worry begins as a trickle in his mind. It develops momentum and drops into his body causing his palms to sweat, heart to race, and tummy to ache. Finally, your child’s worry erupts:

“Mommy, what if I have a new teacher in school?”

“Daddy, what if I can’t find someone to play with?”

The words hit you. You, too, begin to worry both vicariously for him and about your ability to quell the worry. No matter what your past experience, you give it your best shot.

You try reassurance: “Honey, everything is going to be OK, I promise.”

You invoke logic: “It wasn’t so bad last time, remember? That means this time it will be even easier.”

You lend strength: “You’re strong and brave. You have it in you to do this. I believe in you.”

You teach coping skills: “Take some deep breaths. Deep breathing will really help.”

The result? Your child still worries.

And you? You begin to feel exasperated, exhausted, helpless, and perhaps even hopeless.

If this is how you feel as the parent or caretaker of an anxious child, you are not alone. Do not give up hope, do not give up trying–you can and will find a way to reach your child.

Instead of focusing on the end goal of reducing the anxiety, begin with a powerful baby step. Build an empathetic connection with your child.

Note: If you’re feeling tired or even angry as a result of your recent experiences trying to help an anxious child, please do this before using any of the techniques below. Take out a sheet of paper and write down three of your child’s greatest strengths. Think of three examples where your child recently used his or her strengths. Keep this paper with you.

Next time your child comes to you feeling anxious, adopt one of these strategies:

  1. Use the Fast-Food Rule.

This simple rule was developed by author Harvey Karp. Karp reminds us that when we go to a fast food restaurant and order something through the drive through (e.g., “Can I have a burger and fries please?”) they always repeat back the order (e.g., “So you’d like a burger and fries, correct?”). Repeating back to someone what they are saying makes them feel heard and respected. What’s more is it builds an immediate connection.

Before you kick into problem-solving mode with an anxious child, repeat back to them with complete sincerity what they are expressing to you. Master this technique to validate their feelings and help them feel understood.

  1. Tell a story about yourself.

When your child comes to you with a worry (however irrational it may seem), close your eyes and draw out a past experience or feeling of your own that resembles what they are going through. When you open your eyes, say these three words: “I get it.” Then tell them your story and why you understand what they are feeling.

  1. Be the calm you want to see in your child.

Make a decision that you are going to respond to your child instead of reacting to them. A powerful way to respond is by listening intently and silently. After they are done explaining their worry (even if the explanation comes in the form of screaming), maintain your silence.

When the time is right, you can say, “I hear you and I’m here for you.” You can then invite them into your silence by holding hands, hugging, or leaning in. Children are very intuitive and can mimic the energy you exude. Do not underestimate the ripple effect these micromoments of calm can have on your child’s well-being. In silence, you can deliberately cultivate a contagion of peace.

  1. Remix the coping skill.

When you feel your child is receptive to learning a coping skill, remix the ordinary into something fun. Instead of deep breathing, for example, maybe your child wants to try breathing like Darth Vader. If your child is young, perhaps they want to take in a deep breath and blow out birthday candles.

-Renee Jain, MAPP