Wellness

8 Ways to Reduce Anxiety

8 Ways to Reduce Anxiety

When it comes to anxiety, we all have a different baseline, says holistic psychiatrist Ellen Vora, MD. Some of us naturally feel steady under stress. Most of us fall somewhere in the middle. And while we can all make certain lifestyle changes to keep anxiety in check, some of us may never be totally free from gut flutters and nagging worries. If you’re one of those, Vora says, that’s not necessarily a bad thing. In fact, with the right mind-set, it could be a strength.

We asked Vora for her best tips for minimizing anxiety, wherever your baseline falls.

(You can also listen to Vora in a conversation on The goop Podcast, “What Our Anxiety Is Telling Us.”)

A Q&A with Ellen Vora, MD

Q
What does it mean to look at anxiety through an ancestral lens?
A

The body, while imperfect, is actually pretty well designed. It’s designed to carry out the basic requirements and goals of a living being, which are more or less to stay healthy, reproduce, and have successful offspring. For that to happen, your body wants you to have a healthy fear of things that are risky so that you don’t make stupid choices and get yourself killed. But it doesn’t want you to be so gripped by and paralyzed with anxiety that you can’t function in your life.

The ancestral perspective of biology says that if something’s not functioning in the body, there’s probably some way that our biology is mismatched with our environment. It makes a lot of sense: There’s so much about our modern environment that does not resemble the environments our bodies evolved in. When you’re extremely anxious, it’s an indication that some wiring has gotten stripped.


Q
From an ancestral perspective, what might be throwing us out of whack?
A

On the proverbial savanna, we would be acutely stressed when something was a matter of life and death. You can see this pattern in other animals: Imagine you’re watching a bunch of antelope, say, eating grass. They’re all calm and happy until a leopard comes around, and then the antelope all freak out and run for their lives. But once the threat has disappeared, they shake it off and go back to eating grass in peace.

In our modern (and human) lives, the script is flipped. Most of us are never really life-or-death scared. But we are living with constant, low-grade stressors: our work-work-work culture, long commutes, technology that demands our constant attention. Unrelenting low-grade stress, especially without any outlet for discharging it, is the opposite of what our nervous systems evolved to deal with.

And that can take a toll. Amelia and Emily Nagoski’s definition of burnout notes that stress gets stuck in the body if we don’t process it. We absorb stress into our system on a daily basis, and we never discharge or metabolize it. It just builds up and builds up.


Q
Why are some people more prone to anxiety than others?
A

I don’t like to pathologize anxiety. We’re all on a spectrum. Humans are diverse, and some people are built to be more vigilant than others. This can be due to genetic or epigenetic factors, it can be a learned behavior that was modeled by primary caregivers, and sometimes it can be a manifestation of a life lived out of alignment with purpose.

Some of us are more anxiety-prone, and I think we should celebrate those people. In so many cases, people who are sensitive in one way are sensitive in every sense of the word. You may be more sensitive to food intolerances. You may be more sensitive to chemicals. You might feel your feelings more deeply. You may feel a greater sense of empathy. You may have a stronger connection to your intuition. And your nervous system might be sensitively tuned to stimuli—in other words, you may be more prone to anxiety.

“I don’t like to pathologize anxiety. We’re all on a spectrum.”

As a society, we need some people who aren’t sensitive. We need some people to be our surgeons and our marathon runners, right? They’re naturally unfazed, or they’re good at acclimating to tough experiences. But we also need our sensitive souls. They’re viscerally affected by what’s off before the rest of us recognize anything’s wrong at all. They’re the ones who teach the rest of us how to change course.


Q
What are the best ways to manage anxiety when things spiral a little out of control?
A

BLOOD SUGAR

Healing anxiety starts with blood sugar. If you haven’t eaten and your blood sugar crashes, your body pulls the alarm that makes it secrete cortisol, the stress hormone, as well as adrenaline. That tells the liver to break down the stored energy we keep there in the form of glycogen, and that releases glucose (sugar) back into the bloodstream. That process saves the day: Our organs don’t fail, and we live to see another day. Fabulous! What’s not great about that is that the body goes through an all-out stress response, which feels synonymous with anxiety or even panic. And it’s completely preventable.

So how do you avoid it? There’s the definitive solution, which is to completely switch to a whole-foods diet with plentiful healthy fats, well-sourced proteins, veggies, and carbohydrates from starchy vegetables like sweet potatoes and plantains rather than from refined sugars and grains. A lot of people do better anxiety-wise when they’re consuming animal products and red meat—even if it’s just occasional additions to your meals.

If you’re not about to overhaul your diet, there’s also a hack, which is to take a spoonful of coconut oil or almond butter at regular intervals. Everyone has their own sweet spot. Some people take a spoonful upon waking and before they go to bed, others take theirs every three hours throughout the day.

SLEEP

Sleep is the best—and least expensive—anxiety medicine. But these days, many people struggle with sleep for reasons that are completely manageable.

Our circadian rhythm, which is our sleep-wake cycle, is cued by light. For our human ancestors, this was a little more foolproof. If it was light out, it was daytime. They would feel awake. If it was nighttime, it was dark out, and this made them feel sleepy.

“Sleep is the best—and least expensive—anxiety medicine.”

In our lives now, light is topsy-turvy: Maybe you work in a dim, fluorescent-lit cubicle during the day and then watch Netflix on a tablet in bed at night. One of the best things you can do for sleep is get strategic about light and make sure that you are getting authentic darkness at night.

That can be hard to do, but there are some hacks, like blue-light-blocking glasses. I encourage everybody to get the goddamn phone out of the bedroom at night. Get an actual alarm clock, and set your phone up to charge somewhere outside of the bedroom. This helps with sleep on so many levels. But for starters, you won’t be looking at a blue screen right before bed, and you won’t be disrupted by little dings and pings when you’re trying to fall and stay asleep.

CAFFEINE

You know where this is going. We have to talk about the relationship between caffeine and anxiety. Coffee is everybody’s favorite ritual. Sometimes it feels as if coffee is your only friend in the world on those days when it hurts to wake up.

What we don’t always realize is that caffeine is an anxiogenic drug, meaning it generates anxiety. For anybody who’s struggling with anxiety and especially for those taking medications for anxiety or insomnia, it’s important to know that you’re taking an anxiogenic drug in the morning to wake up, and then another drug to treat the anxiety, and perhaps still another drug to treat the insomnia. It’s better to just avoid the drug that makes you feel anxious and artificially awake in the first place.

“Sometimes it feels as if coffee is your only friend in the world on those days when it hurts to wake up. What we don’t always realize is that caffeine is an anxiogenic drug, meaning it generates anxiety.”

If you’re a coffee drinker and you struggle with anxiety, it’s worth the attempt to gradually decrease your consumption.

MAGNESIUM

There is evidence that magnesium helps with anxiety and panic, as well as migraines, headaches, insomnia, cardiovascular health, and constipation, and it may help some people with muscle tension and cramps. Pretty compelling! I usually want people with anxiety to take about 400 to 600 milligrams of magnesium glycinate at bedtime.

SELF-COMPASSION

There’s a real crisis among women. It’s hard for so many of us to sit with the idea that we are okay, that we are enough. We are just as worthy as everybody else—no more, no less.

I work to support women in opening their eyes to the really wack pressures that we’re under. No wonder we so often feel like we’re falling short. I want women to recognize: Here’s what reasonable expectations feel like. I want them to feel strong enough to set healthy boundaries in the name of self-love. Most importantly, I want people to embrace the following idea: I did my best, and that’s all I can do. That’s enough.

MEDITATION

Meditation: Do it. And lower your standards for it. Demystify it. It doesn’t matter if you can’t clear your mind. Nobody can. That’s not the goal. You simply show up for any amount of time, and then you give yourself a gold star and a pat on the back no matter what went down.

“Meditation: Do it. And lower your standards for it.”

Mindfulness meditation is just about practicing present-moment awareness on purpose. When your mind wanders—and it will—that’s not failure. It’s an opportunity. Gently bring your mind back to the present moment. Each time you do that, it’s like a little bicep curl for the muscle of present-moment awareness. You strengthen it little by little.

EXERCISE

Exercise is one of our most amazing medicines for anxiety. But some kinds of exercise, for some people, can be somewhat anxiety-generating. You have to figure out for yourself what makes you feel less anxious and what’s actually so intense for you that it triggers anxious feelings.

Let go of all the ideas about which exercise is best and just listen to what your body is drawn to. Sometimes you want to do HIIT, and sometimes you want to do yoga. That’s fine.

REFRAME THE CONVERSATION

Finally, we need to reframe our understanding of anxiety as a nuisance or something that simply needs to be eradicated. Anxiety is our body communicating to us that something is out of balance. Get still, get quiet, and listen to whatever tiny voice is inside you. Journal, meditate, daydream, make art, or take a walk in the woods without any distractions.

Ask your body what your anxiety is communicating and what needs to change in your life so that you can live in a state of balance and ease.


Ellen Vora, MD, received her BA in English from Yale University and her MD from Columbia University’s medical school. She’s a board-certified psychiatrist, an acupuncturist, and a yoga teacher based in New York City.


This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.