Managing Anxiety and Panic: Non-Medication Strategies for Relief

Anxiety and Panic

Hello Dr.
Wu, I apologize for bothering you.
I would like to ask about my situation.
I have been experiencing panic and anxiety for about three years.
I took an antidepressant for over a year, and after gradually tapering off, I felt somewhat better.
However, recently, my anxiety has returned.
My symptoms include waking up in the morning worrying about whether I will have an episode that day, which leads to anxiety.
My heart rate increases to 90-120 beats per minute when I walk, and I feel a bit of autonomic nervous system dysregulation.
Additionally, I experience dizziness and a sensation of tightness in my brain, as if my nerves are tense and not relaxed.
Sometimes, when I focus on my breathing, I feel like I can't breathe properly, and my hands and fingers become cold.
Is this due to anxiety? I had a difficult time tapering off the antidepressant before, so I'm hesitant to go back on it.
Currently, I only take one Yung Kang Hsu in the morning to stabilize my autonomic nervous system, which was prescribed by a cardiologist due to a history of benign premature ventricular contractions, though they are infrequent.
The doctor said it’s fine, but I still feel anxious and tense.
This anxiety stems from my panic episodes three years ago.
Given the painful experience of discontinuing medication, I would like to ask if there are non-pharmacological treatment methods, such as dietary changes or cognitive behavioral therapy (CBT).
I really want to feel better; otherwise, I feel like a walking corpse.
When I am well, I enjoy the feeling of physical comfort, but I still worry about feeling unwell, and then it happens, leading to discomfort.
I have been walking and jogging for an hour every afternoon for the past two days, hoping it helps.
How many days of regular exercise does it typically take to feel improvement? Additionally, when I stop running, my heart rate increases, and I feel a bit breathless and panicked.
Is this due to excessive worry? If I push myself to keep running, will it trigger a panic attack and cause me to faint? I am really afraid of that.
My previous exercise stress tests showed normal results, and my heart did not show signs of oxygen deprivation, but I still feel anxious when my heart rate increases, which leads to panic.
Dr.
Wu, I truly want to get better, but I find myself waiting for that feeling every day.
Anxiety causes muscle tension, and I feel tightness in my head and discomfort in my neck.
Could all of this be due to poor circulation? Also, does excessive sleep contribute to anxiety? Please help me! Thank you.

Xiao Yi, 20~29 year old female. Ask Date: 2023/03/19

Dr. Wu Enliang reply Psychiatry

Cold hands and fingers can indeed be a physical symptom of anxiety.
Non-pharmacological treatment methods such as psychotherapy, relaxation training, high-purity DHA fish oil, or devices like CES, as you mentioned, may be helpful.
The time it takes to feel the effects of regular exercise can vary from person to person.
It is normal to experience a rapid heartbeat and a sense of breathlessness when stopping after running, which may cause a bit of panic, but there's no need to worry.
Excessive sleep is not likely to cause anxiety.
Dr.
Wu Enliang

Reply Date: 2023/03/19

More Info

Managing anxiety and panic attacks can be a challenging journey, especially when medication is not the preferred option due to side effects or personal concerns. It’s commendable that you are seeking non-medication strategies to alleviate your symptoms. Based on your description, it seems you are experiencing a range of anxiety symptoms, including heightened heart rate, dizziness, and muscle tension, which can be quite distressing.
First, it's important to understand that anxiety can manifest in various physical symptoms, such as increased heart rate, dizziness, and muscle tension. These symptoms can often lead to a cycle of fear and anxiety, where the fear of experiencing these symptoms can exacerbate them. This is a common experience for many individuals dealing with anxiety and panic disorders.

Non-Medication Strategies for Managing Anxiety and Panic
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective forms of therapy for anxiety disorders. CBT helps you identify and challenge negative thought patterns and beliefs that contribute to your anxiety. By reframing these thoughts, you can reduce the intensity of your anxiety symptoms.

2. Mindfulness and Meditation: Practicing mindfulness can help you stay grounded in the present moment, reducing the tendency to worry about future panic attacks. Techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help calm your mind and body. Apps like Headspace or Calm can provide guided meditations that are beneficial for beginners.

3. Regular Physical Activity: You mentioned that you have started walking or running for an hour each afternoon. Regular exercise is a powerful tool for managing anxiety. It releases endorphins, which are natural mood lifters, and can help reduce stress. Aim for at least 30 minutes of moderate exercise most days of the week. As you continue this routine, you may start to notice improvements in your overall mood and anxiety levels.

4. Breathing Exercises: When you feel your heart racing or experience dizziness, practicing deep breathing can be very effective. Try inhaling deeply through your nose for a count of four, holding for a count of four, and then exhaling slowly through your mouth for a count of four. This can help activate your body’s relaxation response.

5. Healthy Lifestyle Choices: Nutrition plays a significant role in mental health. Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support your overall well-being. Additionally, reducing caffeine and sugar intake may help decrease anxiety symptoms.

6. Sleep Hygiene: Quality sleep is crucial for managing anxiety. Establish a regular sleep schedule, create a calming bedtime routine, and ensure your sleep environment is conducive to rest. While you mentioned sleeping too much, it's important to find a balance that allows you to feel rested without oversleeping, which can sometimes lead to increased feelings of lethargy and anxiety.

7. Support Groups: Connecting with others who are experiencing similar challenges can provide comfort and understanding. Consider joining a support group for individuals with anxiety or panic disorders, either in-person or online.

8. Journaling: Writing down your thoughts and feelings can be a therapeutic way to process your anxiety. It can help you identify triggers and patterns in your anxiety, allowing you to address them more effectively.

Addressing Specific Concerns
Regarding your concern about feeling breathless or anxious after stopping your run, it’s common for individuals with anxiety to hyper-focus on their physical sensations. If you find that stopping during your run increases your anxiety, try to maintain a steady pace and gradually increase your endurance. If you feel overwhelmed, it’s okay to slow down or take a break, but try to avoid stopping completely if it triggers anxiety.

Lastly, if you continue to struggle with anxiety despite implementing these strategies, consider reaching out to a mental health professional. They can provide additional support and may suggest other therapeutic options that align with your preferences.

In summary, managing anxiety and panic attacks without medication is possible through a combination of therapeutic techniques, lifestyle changes, and self-care practices. It may take time to find what works best for you, but with patience and persistence, you can achieve a greater sense of calm and control over your anxiety.

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