How to Conquer Anxiety
Anxiety is an exhausting life-stealer. It can feel like a wall between you, the people you love, and the life you want to live. It doesn’t have to be that way. In this article, I’ll explain the science of anxiety and what’s happening in your brain when you feel that rush of tension in your body. I will teach you simple, actionable, practical tools to shift both body and mind using the science-based cognitive-behavioral thought work that helped me change my life.
Anxiety used to dominate my life and is a very common concern for my clients and patients. When it comes up for me now, which it inevitably does, I now have the tools to assess it, address it, and release it.
What is anxiety?
Anxiety is a feeling of tension in your body and a thought in your mind that manifests into physical symptoms. It’s a normal evolutionary response to things we believe in our bodies are dangerous. As a nerdy scientist, I think about evolution and know that anxiety played a central role in human survival. Anxiety is the tool our bodies developed to try to keep us alive while we were being hunted by lions. Anxiety can also be a coping mechanism we’ve developed in response to real dangers from our past. Experiences of violence, physical insecurity, or emotional trauma. At one point in our lives our anxiety may have helped shield us from those real dangers, whether thousands of years ago or 20 years ago or two weeks ago. For most of us though, our ongoing experiences of acute and chronic anxiety no longer serve us and are no longer rooted in the reality of our everyday lives. Our anxiety is attempting to protect us from dangers that are not real.
So what do we do?
How do we generously thank our anxiety for bringing our ancestors through the dangers they faced so many years ago, and us through dangers we may have faced at various points in our lives? Well, by kindly asking that anxiety not to intervene when it isn’t needed. We do it by getting clear on our thoughts, clear on our anxiety triggers, and clear on how we can create enough space to take back control. And while I believe deeply in a cognitive-behavioral framework, in which our thoughts create our feelings, there may be more to it than that for many of us. So let’s back up. Let’s start with some science. What happens to your body when you experience anxiety? Because of the way our minds and bodies work together, anxiety can have a physiologic and or emotional root cause.
There’s a bidirectional superhighway between the gut and the brain.
That is to say, the brain sends signals to the gut, something’s not right here, and the brain responds, “oh my god, panic now.” Gut health can be one of the real root causes of chronic, ongoing anxiety and I’m obsessed with the gut, so that’s where I’m always going to start. Some other things that come to mind are low iron levels, low B12 levels, low thyroid function (also known as hypothyroid) or eating inflammatory or neuroexcitatory foods like gluten, dairy, sugar, caffeine or alcohol. Not sleeping or exercising enough, or having too much inflammation overall can also be factors. Going back to the gut — leaky gut, which is when the gut membrane isn’t tight and lets little tiny particles loose into the bloodstream (which is creepy and amazing), and infections like Candida, SIBO or Lyme parasites can send signals throughout the body that the body understands as anxiety. A lion attacking you, a reason to freak out.
Where do we start?
The first step in uncovering what your physical drivers may be is to see a functional medicine practitioner. Someone who can help you learn what’s going on for you physically. Get the right blood work, get the right diagnosis. Figure the body part out. It’s really important. Try moving your nutrition away from processed, packaged, and fast foods, towards a whole, real food diet. I start everyone I work with with a 30-day elimination diet to see what foods and beverages may be perpetuating their anxiety and other symptoms. Some folks do well on B12 supplements and probiotics. These things all help to calm inflammation and can help regulate that gut-brain panic signaling, which can help reduce anxiety.
Another bodily driver of anxiety is the vagus nerve.
It’s one of the cranial nerves. It comes out of your brain, along your jaw, and goes right down the middle of you, all the way to your tail. And it sends nerve signals from your brain to your stomach, your heart, your lungs, your diaphragm, your digestion, and your reproductive organs, and sends signals from all of those parts back to your brain. For more information on the vagus nerve and how to support yours, check out this article. So, of course, the vagus nerve plays a huge role in emotional regulation and anxiety management. It sends signals to your body telling you it’s time for fight, flight and freeze, which is known as sympathetic nervous system activation. When that happens, a rush of excitatory chemicals floods your body, and your body, in turn, assumes you now need to run from the aforementioned lion. The opposite of this state is parasympathetic activation, also known as rest and digest, and we’ll come back to that very soon.
All of this: gut health, supporting your vagus nerve, eating the right foods, getting your B12, iron, thyroid, all of this is vital and it’s only one piece of addressing anxiety. Addressing anxiety holistically demands that we develop different behaviors and different emotional responses too. Here are some concrete actionable tools you can use when anxiety comes up. Let’s talk first about how to notice anxiety and name it as such.
Many of us have lived for so long with anxiety, it can come to feel like our normal steady state. Whether you’re experiencing chronic daily anxiety or acute anxiety when something comes up, the symptoms are often the same. You may experience symptoms of tension, like increased heart rate, sweaty palms, clenched jaws, or your shoulders creeping up around your ears.
You might notice that your brain doesn’t work quite the way it normally does.
Or you could feel unresponsive or foggy or like your mind is racing, or it feels like the world is speeding up around you. Chronic anxiety feels similar to acute anxiety. Less intense, but more constant. Folks with chronic anxiety can have bouts of acute anxiety and vice versa. Over the long term, chronic anxiety and frequent acute anxiety can lead to insomnia, chronic pain, digestive symptoms, fatigue, and hormone imbalances.
These symptoms are no fun but they can be really useful as little flags to let us know we’re experiencing anxiety. And it’s useful to know that anxiety and stress can be a root cause of these symptoms. Now that we know some of the nerdy science around anxiety, let’s talk about how to manage it. In a previous blog post, I talked about becoming your own watcher, increasing awareness and mindfulness. You can check it out here, as daily mindfulness and meditation practices are the first step in anxiety management, and there are some great tools in that article for you.
The kitten is dead
I want to share a story I read recently that really highlights the power of our minds and our habitual thoughts to create anxiety. The story is by Anne Lamott, and it’s called The Kitten is Dead. It goes like this: “the kitten has slept with you every night since you got her five weeks ago and is always asleep against your legs when you first wake. But this morning when you woke, the kitten was gone. Therefore, the kitten was dead. You must have left the front door open at dawn when you let the dog out to pee. The kitten has been out for two hours and has frozen to death or has been killed by coyotes and it is your fault. Neil will not be able to love you quite as much since you killed the kitten. The wedding will be ruined, if you even go through with it, what with the new underlying thrum of pain, resentment and bitterness, with your having killed the kitten, the tiny, five-pound, Christmas stocking kitten. This all unfolds in under 10 seconds, beginning with the realization that the kitten is not snuggled up against you.”
So of course, at the end of this story we learn that the kitten wasn’t dead.
It was just in the living room playing like kittens do, but a lot of us are killing proverbial kittens with our thoughts every day. Something happens and our brain launches into catastrophic thinking which, of course, produces more anxiety. Here are the steps I recommend and use myself to manage anxiety.
Step one, as soon as you notice that you’re thinking those the-kitten-is-dead thoughts is to center yourself, regain control over your breath, and for some, use a touchstone to help do that.
Two, name the feeling.
Three, don’t resist, fight or cover up the feeling. Accept the discomfort. And four, write it down and change your thoughts.
Let’s get into each of those.
The first step is to calm your physical body by using your breath to relax your vagus nerve and reduce your cortisol stress hormone response and help you get grounded in the present moment. Remember that anxiety takes us out of the present moment and into this other place in which we’re spinning around in the past or worrying about the future. When we take the time to pause and breathe, we reset ourselves in this moment.
I’m going to walk you through an exercise I love called the four seven eight breath. I’ll explain how to do it and will then talk about the science behind it.
Breathe in deeply and blow the air out through pursed lips, and the pursed lips part is important. Make a little puckered face and breathe out for longer than you breathed in. So take a long, slow breath in through your nose, count to four, hold your breath to the count of seven, exhale slowly for a count of eight through pursed lips while you relax the muscles in your face, jaw, shoulders and stomach.
Through this kind of breathing, the vagus nerve starts to send the signal throughout your body that you’re okay, you’re safe. Physiologically speaking, this breath work reduces your oxygen need. As your breathing slows, your heart rate slows, which decreases your blood pressure. That feeling that your heart is beating out of control, which for the record, is my least favorite part of anxiety, dissipates, relaxing your muscles, releasing tension, and allowing better blood flow through your body. This increased circulation alone can help reduce anxiety and panic as new, fresh oxygen-filled blood floods your entire body.
Touch can also help us feel safe in our bodies and can help reconnect the mind and body.
When I feel anxiety stirring, I put my hand on my chest and breathe into it, or I put both hands on top of my thighs and breathe in deeply. We know from a whole range of scientific studies that this physical interruption, this self-soothing through touch really works to interrupt our anxiety and that vagus nerve response. Carrying a literal touchstone like a crystal, a ring, or a coin in your pocket can also help. What the object is doesn’t matter. It’s the intention you put behind it. When you feel yourself getting worked up, when you feel anxiety beginning, you can put your hand on your centering object, touch it, take a deep breath, and say to yourself, “I’m just experiencing anxiety.” I’m safe. Everything is okay. And you can remind yourself to keep breathing.
Name the experience
You could simply say, “I am experiencing anxiety.” Naming the experience is important. It makes you the actor in the situation and not just the subject of your brain and body’s whims. You are not anxious. You’re experiencing anxiety in this moment. Stating what is happening simply and without judgment creates just enough cognitive space between yourself, your body, and the experience so you can begin to do something about it.
Often, when you experience anxiety and panic, your minds take us out of the present moment and into those old stories and experiences that were either legitimately dangerous or felt dangerous to you in a primal place in your body.
Trauma, stress, and fear get coded into the body, and grounding ourselves physically deep into our human forms in the present moment by breathing and naming the experience allows you to remember that, in that moment of anxiety, nothing’s usually wrong.
You are safe.
You’re an adult now. And the danger that you may have experienced, either in your own lives or that has been coded into our DNA from your parent’s trauma or their parent’s trauma, is not present in this moment right here right now.
There is no lion.
The kitten is not dead.
And if there were a lion at your door or the kitten truly was dead, being anxious would do nothing to help you get through it.
Don’t resist the feeling of anxiety
Don’t pretend it isn’t happening, as though you could will it to go away. When you try to fight anxiety or get mad at yourself for having it, it just creates more tension inside your body. The way to move through a sensation you don’t like is not to scream, “Go away, feeling, I hate you,” at it. Your body will think something even more terrible is happening. And it will try to protect you with, you guessed it, more tension and tightening of the muscles, leading to more anxiety.
What we resist persists.
And this is certainly true for anxiety. An important part of dealing with anxiety is knowing that it’s okay to feel uncomfortable. It’s one of the central tenets of Buddhism; suffering and discomfort are a normal, natural part of life. I get why you might not want to feel uncomfortable. I don’t like to either. Discomfort can connect us back to old experiences, old traumas, other root issues that we haven’t dealt with and, often, don’t even fully understand.
And while, at some point, really addressing those deeper issues may be a goal, in the meantime, we can practice by getting uncomfortable on purpose, like we do in meditation, and in doing so can feel empowered by realizing that we are fully capable of doing it, of surviving it, and letting that discomfort pass over us without fighting it. Once you’ve paused to calm your physical body down, consider downloading your thoughts onto paper so they aren’t swimming around in your brain like an unmonitored toddler in a china shop. Get them out of your head where you can see them and do something about them.
Give yourself space between anxiety
For so many people, writing it down is crucial because it gives you that space between you and your anxiety; the anxiety that’s producing thoughts like, the kitten is dead, my boss is about to fire me at any and every given moment, she’s going to break up with me because she asked me to talk tonight. This kind of awareness of our thoughts is deeply healing in and of itself. Sometimes, when I write down my anxious thoughts, I can see that they’re just absurd.
They make no sense or they’re just not based in reality.
Those thoughts are just my mind doing what minds love to do, which is attempting to keep me alive by any means possible by worrying about a past I can’t change or a future that hasn’t happened yet.
I can totally appreciate where these thoughts are coming from, but it doesn’t mean that these thoughts serve me right now or that they’re true.
The thoughts we think and the stories we tell get neurochemically coded into our brains. The most classic example of this is one many of us learned in Psych 101. A scientist named Pavlov studied a group of dogs. He rang a bell, gave them a treat, rang a bell, gave them a treat. And he noticed that over time, he would ring the bell and they would begin to salivate. Their vagus nerves would start that process whether or not he gave them a treat.
Their brains had come to associate the sound of the bell and the treat and they had a physiologic response.
This happens in us when we see our ex’s name on our Instagram feed or caller ID, when our boss calls us into their office. We start to feel the physiological signs of tension; tightness in our shoulder blades or jaw, heart rate increase, our thoughts might speed up or we might start to get into a spin about something. The sensation in our bodies is the bell being rung and we respond the way we’ve trained ourselves to, with anxiety. And we can change our response to that bell through the power of neuroplasticity.
The concept of neuroplasticity comes to us from neuroscience and gives us an understanding that, much like Pavlov’s dogs, we can train and retrain our brain to associate new thoughts and new feelings. We can actually change the chemistry and composition of our brains by choosing new thoughts, and we can train our brains to believe these new thoughts, which is amazing.
Let’s go back to Lamott’s story and apply the concept of neuroplasticity to it.
So, you’re Anne, you wake up. The kitten is dead. You get to decide, in that moment, if you want to keep thinking that dead kitten thought, which plunges you into the abyss of anxiety, or if you want to think a new thought that brings you into a place of control over your own mind. That is to say, the kitten and its presence in her bed or not were not causing Anne’s anxious feelings. Her thoughts about the kitten were. Had she been able to pause and to ask herself the question, “does this thought serve me?“, she may have been able to step back and to choose a new thought at that moment.
So, this is always my central guiding question: “Does this thought serve me?”
It doesn’t matter what the situation is or what I’ve got going on. I always get to choose if the thought I’m thinking actually serves me and if I want to keep thinking it. Does this thought help me to take action in this situation, or does it just keep me spinning in anxiety? The cognitive-behavioral framework I teach and use is predicated on this understanding of neuroplasticity and our ability as the actor, not the subject of our brains, to change the thoughts our brains choose.
This concept has been validated by countless researchers. You feel anxious not just because of your physiology, but because of your thoughts about a given situation, which can elevate cortisol and keep your body and your mind spinning in upset. And you can choose to not get on that rollercoaster ride into tension, stress, and freak-out. I get how hard this is. It takes a lot of patience and a lot of practice. But when we begin to realize that our only two choices are to continue to feel stuck in anxiety or overwhelm or to change our thinking, I’m always going to choose to change my thoughts about the situation.
Choose your thoughts on purpose
These tools are so useful to practice in the moment of feeling anxious. Although. it is just as important to choose your thoughts on purpose and ahead of time. That is thinking now in a calm place about what you want your future self to think and feel in a moment of anxiety. For example, if you’re Anne Lamott, you can practice before bed, “the kitten likes to go play early in the morning,” as a thought to replace, “the kitten is dead.” If you get anxious about presentations or meetings, you can choose the thoughts, “I’m going to do my best during this presentation,”. You can visualize yourself doing well before you even step into that boardroom. Professional athletes do this all the time. They visualize the game and being successful on the field before the big day. And there are studies that show that planning now for how your future self will think, feel and act, leads to more success and less anxiety in the long run. When you do these kinds of exercises, you are retraining your brain, thanks to the power of neuroplasticity.
To be clear, we don’t want to change our story just for the sake of changing our story. We want to change the story so that neurochemically, our physical lived experiences in our body will be different. You’re teaching your brain to respond differently to the physical sensations of tension and anxiety. That’s when you can start to affect real and lasting change.
One of the primary tools I use is what I refer to as thought work. It’s central to the work I do to help folks to heal the mind-body connection and to help you stop salivating, as it were, in response to life being lifey. You get to practice thinking, “it’s unlikely the kitten is dead, and if she is, we’ll deal with that,” instead of jumping to the worst-case scenario. To tell your brain what to think in that situation ahead of time before the situation happens. You get to choose your present and future thoughts and feelings on purpose ahead of time. We know that when we’re feeling anxiety, we’re often disconnected from our human bodies. And one of my favorite ways to get back in touch with my body takes just a few minutes. It’s called a body scan meditation. You can find mine here. I hope you enjoy it as much as I do and I hope that it’s really helpful. Whether you’re riding on the subway, at work or whenever you’re feeling anxious. Take a moment to walk through this meditation and ground yourself in your perfect human body.
I’ve gone through a lot of nerdy science and nerdy psychology here. Please don’t expect your anxiety to stop overnight. It takes daily practice to recognize our reactive thoughts and to begin to be able to control them. Practice noticing the feelings in your body and recognizing the thoughts in your mind. Work in a few minutes of active mindfulness or meditation each day.
You can conquer anxiety.
If I did it, anyone can.
Thank you for taking the time to read Feminist Wellness. I’m excited to be here and to help you take back your health!
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Victoria Albina, NP, MPH is a licensed and board certified Family Nurse Practitioner, herbalist and life coach, with 20 years experience in health and wellness. She trained at the University of California, San Francisco, and holds a Masters in Public Health from Boston University and a bachelors from Oberlin College. She comes to this work having been a patient herself, and having healed from a lifetime of IBS, GERD, SIBO, fatigue, depression and anxiety.
She is passionate about her work, and loves supporting patients in a truly holistic way - body, mind, heart and spirit. A native of Mar del Plata, Argentina, she grew up in the great state of Rhode Island, and lives in NYC with her partner. A brown dog named Frankie Bacon has her heart, and she lives for steak and a good dark chocolate.
Change Your Thinking, Reclaim Your Health