This article is written by guest author Dr. Carlo Carandang of AnxietyBoss.com
If you’re one of the 5% of Americans who suffer from anxiety, chances are your doctor will be quick to prescribe you medication to help treat your disorder. However while prescription drugs can help in dampening your feelings of excessive worry and apprehension, they can be greatly inhibiting to a more sustainable approach to treating anxiety and achieving a better quality of life.
Medications can cause users to develop dependency on their chemical effects, effectively rendering anxiety sufferers useless without their drugs. Additionally, medications tend to provide temporary relief – a bandaid over an open wound – a quick fix to your problems that doesn’t fully address the chemical imbalances in your body and mind.
A sustainable approach to treating anxiety requires more effort – yes, but the results are more long term and effective than any medication could ever be. A treatment plan that takes into account your diet, level of activity, and alternative therapy options can help immensely in stabilizing your mental health and leave you feeling more in control and able to live a better quality of life.
A Recipe for Happiness: The Whole Foods & Healthy Mind Connection
The term “brain foods” may have been something you’ve heard since you were a kid, but just how much of an influence can your diet have on how your brain functions? Your diet can have a significant influence on many of your bodily systems and your brain is no exception to this.
Consuming certain foods can trigger chemical reactions and neurological responses that can stimulate or heighten feelings of extreme stress or even mimic the experience of a panic or anxiety attack.
“Brain-Approved Foods” help maintain and support the health of your thinking muscle, ensuring that all the connecting parts are in place and that fuel is being supplied to support everyday thought and function.
There are a number of reasons why clinical experts have a long list of ‘junk foods’ and ‘good foods’ when it comes to your overall health. A cross-sectional study conducted on 5,731 men and women found that those with higher quality diets were less likely to be depressed, whereas those who had a higher intake of processed and unhealthy foods experienced increased episodes of stress and anxiety. Other research has shown that even a week’s worth of poor eating can result in an impaired memory and lack of mental focus.
Basically, it’s the old saying: you are what you eat. In the case of foods for mental wellness, this also takes into consideration how much you eat. Your brain’s overall function is offset by a set of chemical reactions and what you put into your mouth is akin to a chemical dosage that travels straight to your brain. Many of the foods we eat interact with the brain and supply us with different types of chemicals and nutrients that support our brain health and function.
Research has identified five chemicals and nutrients that are critical to optimal brain function and health. These are as follows:
Hydration is the primary benefit of water, it provides the proper amount of liquid to your cells so that they can function adequately. Surely during periods of dehydration you can recall your brain being foggy, or your thought process being slower. Water is essential for the brain, it enhances circulation and moderates waste removal. Water also regulates the temperature in the brain, preventing cognitive decline or damage. It is important to maintain hydration throughout the day by keeping a bottle or glass of water near you at all times during the day.
Otherwise known as the fuel for the brain, glucose or sugar provide the much needed energy your brain needs to perform all of its tasks. If you consume a diet that is significantly low in healthy fats and sugars it can lead to brain fatigue and decreased functionality.
Not all fats are created equal and in the case of your brain’s preference, omega-3 and omega-6 are highly favorited. Fatty acids help to strengthen the synapses in your brain allowing for better memory recall and focus.
Considered the building blocks of life, amino acids are responsible for maintaining the connections between neurotransmitters. These neurotransmitters are critical for daily function and include: dopamine for immune and nervous system function, and norepinephrine for focus and alertness. And more specifically, serotonin for mood, learning, sleep, and memory. A lack of amino acids can result in a poor function of neurotransmitters, in the case of individuals with anxiety it could influence poor serotonin levels that fluctuate mood and increase feelings of nervousness.
When your body converts glucose to energy for the brain, extra oxygen is created as well, resulting in ‘free radicals’. Free radicals destroy brain cells that can inhibit brain function. Antioxidants can be found in abundance in fruits, vegetables, and green tea, and help protect your body from free radicals and the destruction it can cause.
Harmful and Helpful Foods for Anxiety
Knowing the nutrients and chemicals you need to maintain a healthy and happy brain is only half the story when it comes to treating your anxiety. It is also important to know the specific food groups that can help or harm your cause. The distinction between the two is very clear and you’ve probably seen them mentioned in about every dietary related article available. In fact, you’ll even notice that the ‘good’ and the ‘bad’ food lists are pretty much the same across the board. But similarities aside, what food groups apply to you when it comes to relieving your anxiety symptoms and kicking your anxiety to the curb?
Foods to Avoid:
It shouldn’t be surprising to see alcohol at the top of this list. Alcohol can cause a number of negative side effects to your body including: dehydration, muscle contractions, and hormonal imbalances. More importantly, the metabolic wastes of alcohol can cause brain damage, dampen cognitive abilities, and inhibit mental clarity and focus. Alcohol is also a powerful depressant that can significantly alter the way you feel, move, see and hear, and can increase feelings of anxiety and stress.
Caffeine is a stimulant that can exacerbate your anxiety symptoms. The unmoderated consumption of caffeine can stimulate an increased heart rate, shallow breathing, and other actions that can imitate or even cause a panic attack.
Dairy products are another food group that if not moderated, or avoided altogether, can worsen symptoms of anxiety. Dairy products can contribute to the increase in adrenaline levels and cause adrenal fatigue, this can often cause a constant state of anxiety or decrease mood levels.
Fried Foods & Processed Foods
When foods are fried or go through extensive processing, their original chemical structures are effectively destroyed making the end product more harmful. In particular, fats become the most damaged during processing and frying, and are very difficult for the body to break down. The increased amount of work the body needs to break down these foods can lead to stressing out other bodily systems including the brain. Additionally, fried and processed foods can directly impact chemical activity and hormonal responses, often throwing your brain chemistry out of whack.
Refined sugars that are found in candy, white breads, and other processed foods are just empty carbohydrates, meaning they have no nutritional value whatsoever. Ingesting refined sugars can lead to adrenal fatigue and increase your adrenaline, contributing to feelings of anxiety, stress, and panic attacks.
Foods to Enjoy
Fruits are full of antioxidants, micronutrients, and wholesome sugars that are important not only for your brain, but your general health as well. Fruits like blueberries, strawberries, cherries, oranges, bananas, and apples supply a healthy amount of glucose to provide the brain with a steady energy source while producing antioxidants that protect the brain from the damage of free radicals.
Dark, leafy green vegetables such as kale, Swiss chard, spinach and collard greens (to list a few) are full of vitamins, minerals, and disease-fighting phytochemicals. They’re an excellent source of folate, a vitamin that contributes to the production of serotonin, a neurotransmitter responsible for moderating mood.
Nuts, seeds, leafy greens, beans, legumes, and certain fruits, including avocado, are rich in magnesium, a natural mineral that supports bone health, energy production, and optimal maintenance of the nervous system. More specifically, magnesium has active properties that allow it to stimulate feelings of calm and serenity by regulating the brain-adrenal axis.
Omega-3 Fat-Rich Foods
In addition to the benefits mentioned above, omega-3 fatty acids play a significant role in controlling overactive inflammation. Excessive inflammation can increase your risk of developing heart disease, obesity, and can contribute to poor brain function and the development of depression and anxiety. Omega-3 fats also help protect and heal the brain, which is especially helpful for sufferers of depression and anxiety who can experience brain damage due to the stress the aforementioned mental conditions can put on the brain. Foods rich in omega-3 fatty acids include seeds like flax, chia, and hemp, as well as some vegetables, walnuts, algae, and fish.
Tryptophan is an essential amino acid that has been shown to help produce serotonin, the neurotransmitter responsible for healthy sleep and mood stabilization. A deficiency in serotonin has also been linked to an increased development of depression and anxiety, and in most cases, serotonin lack is due to a low consumption or intake of tryptophan. Some foods that are high in tryptophan include seeds and nuts like pumpkin and squash, soybeans, oats, beans, as well as some fish and meats.
Whole grains should not be confused with whole wheat; they are an essential part of a healthy diet. They are good sources of complex carbohydrates and some key vitamins and minerals. This healthy combination helps to control inflammation, and provides energy and nutrients for the brain. Healthy whole grains include oats, quinoa, buckwheat, brown rice, and millet.
Get Low to Get High: The Exercise and Mental Wellness Connection
The benefits of exercise are long standing when it comes to your physical health, but how your body functions and feels after exercise doesn’t just end there. Research has evidenced that aerobic exercise is an effective and cost-efficient therapy alternative for anxiety and mood disorders, as well as panic attacks and depression. (Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clinical Psychology Review, 21, 33–61) Aerobic exercise is effective in decreasing overall levels of tension, elevating and stabilizing mood, improving sleep and improving self-esteem. In addition, regular exercise has been recognized to provide anti-anxiety and anti-depression effects.
Some of the anti-anxiety benefits of regular aerobic exercise include:
Cortisol is a hormone released during times of stress and anxiety, and exercise can help reduce your cortisol levels by producing counteracting hormones that help elevate your mood. Intense activity can also help release muscle tension and tightness that would otherwise contribute to feelings of anxiety and stress.
Exercise helps to regulate bodily systems, also it tires your body and mind out. Many anxiety sufferers struggle with sleep but find that when engaged in exercise, they are able to get a good night’s rest and improve their overall sleep, and thus wellbeing.
Many different types of aerobic exercise can be done with friends or in a group. This opportunity to partake in social interactions has been linked to decreased levels of anxiety and depression, since most people end up in more social situations than they would normally be in. Connecting and working with other people also helps to elevate mood and improve self-esteem.
Aerobic exercise helps to produce positive physical changes in the body that can contribute to improved feelings of self. Self-esteem can play a huge role in anxiety, and when improved upon can help individuals become more confident and certain about their actions and choices.
During exercise, the muscles begin working and fat molecules are broken down. When this happens, the fatty acids promote the increase of tryptophan transportation, resulting in the boost of serotonin levels which can help instill calming effects and enhance our sense of safety and security.
Improved Heart Rate
Anxiety is often associated with an increased heart rate. During aerobic exercise, your heart rate increases and overtime as your fitness level improves your heart subsequently works more efficiently. Improved heart and lung function allows anxiety sufferers to have a better control over their heart rate and breathing, thereby offsetting feelings of anxiety.
Exercise in general can be extremely helpful as an alternative treatment for anxiety, however aerobic exercise is touted specially for its ability to get a maximum amount of work in a little bit of time. What’s most important however is finding an exercise program that works for you and that you can keep up with and maintain. Some popular options for aerobic exercise include:
- Brisk Walking
When it comes to the amount of time you should spend exercising, recent research has found that 30 minutes of exercise a day is more than enough to provide a plethora of benefits. In fact, even short bursts of exercise – about 10 to 15 minutes – can be enough to improve both your fitness level and your mood.
If the mentioned exercise options don’t seem like a good fit for you, or you’d like to jump into something more challenging, explore HIIT style workouts, which can be great exercise options. HIIT or High Intense Interval Training is a training technique that requires you to give 100% effort in quick, intensive bursts, followed by short, sometimes active, rest periods. HIIT workouts are designed to keep your heart rate up, while following simple moves that mostly only require your body weight. A quick and easy to follow HIIT workout routine that I like to perform when I’m short on time or need to put in a little more effort is as follows:
This HIIT routine is repeated three times (or for three rounds) with 20 seconds of work and 10 seconds of active rest. You are allowed 45 seconds of rest between each round.
- High Knees - 20 seconds
- Jog in Place - 10 seconds
- Mountain Climbers - 20 seconds
- Jog in Place - 10 seconds
- Burpees - 20 seconds
- Jog in place - 10 seconds
- Skaters - 20 seconds
- Jog in Place - 10 seconds
- Squat with Knee Raise (alternating leg) - 20 seconds
- Jog in Place - 10 seconds
- End of Round: Rest - 45 seconds
Perform 3 Rounds
Talk it Out: Understanding the Value of Talk Therapy
I know a person, Natalie (name changed to protect identity), who lost her mother to a car accident when she was only 12 years old. After the death of her mother, Natalie’s father took her in to live with him and his wife. She spent her subsequent adolescent years immersed in multiple activities at school and in the community, and did not spend much time with her father and her new step-mother. Attempts were made to connect her with a therapist, to address her grieving with the passing of her mother. Natalie adamantly refused therapy each time, saying she will deal with her mother’s death in her own way, and that nobody else can help her with that. In fact, she highly doubted how therapy would help her, and thought therapy was ‘bogus.’ Alas, when she turned 18 years old and right after she graduated from high school, she ran away from home. Her father eventually found her through Facebook, but to this day, he does not know where his daughter is located.
This is a case where talk therapy would have been helpful. Talk therapy would have helped Natalie to dissect and analyze her thoughts about the situation (her mother dying and her alienation from her father), and how these thoughts relate to emotions (sadness about her mother and anger towards her father), and how her resultant behaviors were inevitable (she ran away as she has an avoidant attachment to her father, whom she blames for her mother’s demise). Had Natalie been engaged with a therapist in talk therapy, she would have seen that her attempts to join every activity available at school and in the community only served to distract her from her sadness over the loss of her mother, and also served as a way to avoid her father and her new step-mother. Had Natalie been engaged in talk therapy, she could have processed and analyzed her anger towards her father, and how she resents him for leaving the family. Had Natalie been engaged in talk therapy, she would have had insight that running away was not the answer, and that there was still the possibility of rebuilding bridges and repairing her damaged relationship with her father.
This is why talk therapy can be life altering; it can help you to identify your disappointments, resentments, worries, fears, and distortions, then help you to resolve them in healthy ways, rather than acting out in destructive ways. If you don’t talk out your problems, you bottle it in, and the anger, depression, anxiety, and resentment build up, like a ticking time bomb. And the only way you relieve a ticking time bomb is to explode. It is better to talk, than to explode and self-destruct.
It is human nature to share and express feelings, thoughts, and emotions. We are social creatures, we like to talk about our stories and narratives to one another, and gain insight from others who have heard our story. A specific form of therapy which helps to connect your feelings, thoughts, and behaviors is cognitive behavioral therapy (CBT).
CBT seeks to assess the linkages between events in the world, the thoughts we have about those events, the feelings that the thoughts evoke, and the behaviors we act out to address those feelings. With CBT, it is assumed that you are acting like a scientist, trying to make sense of the facts of the world. However, many of your ‘scientific’ interpretations are faulty, and the feelings and emotions triggered by those faulty interpretations may lead to maladaptive (and even destructive) behaviors. This then initiates the negative cycle:
CBT focuses on disrupting this negative cycle by changing your thoughts, which help to have less distressing emotions, and promote more effective behavior. So let’s look at how anxiety develops, and how CBT is deployed to decrease your anxiety. Below is the negative cycle of anxiety:
So when you are confronted with a fearful stimulus in the environment, you might have irrational thoughts, such as: “I can’t cope,” or “I feel bad, so it must be bad,” or “something terrible is going to happen.”
As an anxious person, you underestimate your ability to cope with the danger, overestimate the actual danger, and overestimate the negative outcome that may occur despite you being able to cope with it.
These irrational thoughts then induce feelings of anxiety, where you have both psychological anxiety (fears, worries) and physical effects of anxiety (increased heart rate, palpitations, sweating, butterflies in the stomach, muscle tension, knees trembling, and face turns red from flushing). The physical effects of anxiety come from the activation of the fight or flight response, which come from the activation of the sympathetic nervous system and the release of adrenaline into the bloodstream. But because the anxiety symptoms are uncomfortable and distressing, you decide to either avoid the feared situation entirely, or you resort to safety behaviors which help you feel better or keep you safe. Safety behaviors in a social situation where you have social anxiety may be that you drink more, don’t make eye contact, fiddle with personal items in your pockets, fiddle with your smartphone, or stand in the corner, just to name a few.
But if you avoid your feared situation, or if you resort to safety behaviors, you never get to find out that the anxiety will go away naturally, on its own, if you just expose yourself to your feared situation. So your avoidant behaviors and safety behaviors only serve to maintain your belief that something terrible is going to happen, so when you are exposed to your feared stimulus again in the future, you cycle through this same negative cycle of anxiety as described in the previous paragraph.
So CBT helps to break the negative cycle of anxiety by changing how we think and what we do. Subsequently, CBT helps us feel better because we engage in thinking less distressing thoughts (not irrational ones), and engage in more optimal behaviors (not maladaptive ones). Ultimately, CBT helps you become self-reliant, as the CBT therapist has the ultimate goal of having you manage this positive cycle of improvement on your own.
To achieve this end, individuals must learn to use self-help methods, of which the community of CBT practitioners has developed many. These self-help methods may not work for all individuals. In cases of more entrenched dysfunctional behavior-thought-feeling cycles, it may be necessary to tailor the methods to a particular individual’s situation with a live therapist. However, for the majority of individuals who face such problems, general self-help methods are likely to prove helpful. The general self-help methods developed are broadly applicable across a range of emotional problems, including anxiety.
To summarize, CBT can help you improve your mood and mindset overall. It can help you think less distressing thoughts and engage in more optimal behaviors. Fortunately, for Natalie, it is not too late to engage with a CBT therapist to address her irrational thoughts and maladaptive behaviors, so that she can adequately grieve the death of her mother, make peace with her father, and quit acting out her unresolved resentments and distortions. She can choose to live happily rather than reactively, as can you, when you learn to work with and transform your anxiety in effective ways.
Dr. Carlo Carandang, MD is a psychiatrist and researcher in the fields of stress, anxiety and depression. His work has been featured in many scientific journals and magazines. To read his blog or for more info, visit AnxietyBoss.com