Coping with anxiety

It’s been too long since my last post, and the reason makes an interesting topic for an article: anxiety.

A couple of weeks ago I started having heart palpitations – rapid and/or pounding heartbeats that would go on for an hour or more. My resting heart rate would stay elevated for as much as 16 hours at a time. And then the symptoms would just go away… until next time.

My doctor was able to rule out that it was a problem with my heart within one office visit. With a few more tests, he ruled out another couple of dangerous possibilities, and determined that it’s probably anxiety. Now, I’m often quite calm when my heart rate suddenly spikes, but apparently it’s not that simple. It’s a vicious cycle that goes something like this: you have a perfectly normal elevated heart rate due to something like a large meal or exertion or strong emotions, but because you’re anxious, you notice the elevated heart rate (when normally you wouldn’t), and then you get oversensitized to any little weird thing your heart does (all of which is perfectly normal and healthy), and that makes you more anxious, and then your heart really does start doing more and more weird stuff.

The good news is, it can’t hurt you or shorten your lifespan. If your doctor rules out all the dangerous causes, then you are safe from harm, no matter how annoying this problem is. The main problem for me is that it tends to happen at night and prevent me getting enough rest.

Anxiety is really common, and having it doesn’t mean you’re crazy. Our bodies and brains evolved to handle immediate stresses, such as tigers coming to eat us – our response to these stresses was to run or fight. But in our insulated modern world where the tigers can’t get us, all our stresses are abstract and intangible: financial security, the state of the nation, the health of our relationships. We feel the anxiety, but instead of running or fighting, we think and worry. That’s not what our bodies are designed to do, so it’s no wonder some of our bodies get confused and start having symptoms like heart palpitations.

Doctors can prescribe medications to help you with your anxiety. There are several sedative/anti-depressant type medications that will calm you down, as well as beta-blockers, which have a similar effect and are particularly good for people with “performance anxiety.” The lists of side effects on these meds are scary, of course; but most people will experience few if any of these effects, and a good doctor will monitor you and let you know what to watch out for. And you may not need these medicines for more than a few weeks to break a cycle like the one I’m in.

I’m currently not using medication, though I will if other options don’t take care of the problem. Instead, I’m trying:

Yoga. I bought a DVD a couple of years ago called Yoga Conditioning for Weight Loss. I started working out with it a few days ago, and I’m loving the results. I imagine any yoga DVD will be helpful for anxiety, as long as you’re comfortable with the routine. This one seems to be right at the level of challenge I need.
Deep breathing exercises. This brought my heartrate down from above 90 to my normal 78 just a few minutes ago: exhale completely, squeezing your abs to get all the air out of your body, then inhale deeply, until your lungs almost hurt. Then exhale slowly, again squeezing out all the air. Do this three times. Yoga also does this for you, but the beauty of this exercise is that you can do it anytime, anywhere that you start noticing your heart or signs of anxiety.
Herbs. Herbs should be regarded as just like medicines: they do tend to have less adverse effects, but there are limits to how often you should take them, what dosage you should use, and whether you (with your medical history and/or other medications) should be taking a particular herb at all. Therefore, I won’t recommend any specifics, but encourage you to do your own research. Google “anxiety herbs” or “anxiety natural treatments” to get started (here’s a good link). Always, always, always let your doctor know what you’re taking. Ideally you should only take herbs with doctor supervision, but I know some doctors pooh-pooh them and you’re on your own. Just be careful and use common sense.
Ignore my heart. Once your doctor has ruled out anything dangerous, you really must make an effort to ignore your heart, especially if the problem is just that you’re overly tuned into it. I try to distract myself with reading something, having an interesting conversation, or playing a game that really absorbs my attention.
Getting plenty of rest. I’ve not always been careful about getting my eight hours, and I still find it really hard to go to bed on time. But I feel better on the days when I do.
Remove stressful things from my life. This is not easy – for most of us, the big stress comes from work, which we can’t survive without. If you can eliminate any stressful situations – or people! – from your life, do it.
Changing my thinking. Oh, boy, if it was that simple – presto, change-o! – we’d all be perfect, wouldn’t we? But there’s nothing like thinking you’re going to die of a heart attack to help you make a major lifestyle change, so even though I now know I was never in serious danger, I’m letting that “near-death experience” motivate me to change my life in a big way. I’m letting go of a few things permanently and allowing myself temporary breaks (like the one I took from this site) without guilt or the feeling I’m not performing up to standard. I’m realizing there are things that stress me out, but don’t stress out most people, which means the problem is in how I respond. It’s really hard to change the responses you learned in your formative years; but once you become aware of what they are, you can often catch yourself responding in an unhealthy way and remind yourself not to do that.