Dealing with Anxiety - Part 2

This week we continue our conversation about anxiety. We share several techniques to help you self-regulate stress and deal with milder forms of anxiety, including mindfulness meditation, breathing exercises, and more. Be sure to check out the previous episode to learn more about clinical forms of anxiety. 

NOTE: This podcast is not meant to diagnose or treat anxiety. Please share any concerns you have about your anxiety with your doctor or mental health provider. 

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Transcript

Wende 0:00

All right, last week we talked about anxiety from a clinical point of view. Now we are going to talk about anxiety. Maybe you have some mild stress or you deal with anxiety from time to time. We're going to share some techniques that have worked for us and for many other people on how to deal with the anxiety and stress that you experience day to day.

John 0:26

All right, here we go. Leverage your time, balance your life with Dr. Wonker and my delightful daughter, Wendy Whitus.

Wende 0:36

All right, Dad, we're we got so excited about talking about anxiety that we decided we're gonna do part two. Part two. So last time.

John 0:43

Well, wait a minute. Before we get into part two, well, I wanted to interrupt you because remember, I couldn't think of that acronym. Okay. Remember from part one, yes. It's eye movement desensitation and reprocessing. EMDR. Okay, so tell us what reminds me of what that was. Evidence-based psychotherapy designed to alleviate distress from traumatic memories. So it's a treatment for post-traumatic stress disorder that we talked about earlier in that last podcast.

Wende 1:16

Yes, and this is where they use like rapid eye movements.

John 1:19

Using bilateral stimulation, typically guided eye movements, it helps the brain reprocess traumatic experiences while reducing the emotional stress. So you do this rapid eye movement, you get relaxed, then the doctor takes you through some of the things that are stressing you out, and eventually over time that relieve alleviates some of the stress from the trauma.

Wende 1:47

It's meant to be, I mean, it's uh some people have had miraculous results from just a couple of sessions of that, I've heard. Uh someone that I work with um in the film industry was just said that he he just was cured of his PTSD after like two or three sessions. It's amazing.

John 2:07

It's an excellent good treatment. Yeah. Non-medication-oriented treatment. Now we want to get into what yeah.

Wende 2:14

So last time we talked about, and if you haven't heard it, go back and listen to the first one because the first one talks about kind of clinical anxiety, um, when you need to see a psychiatrist, what kind of psychiatrist to look for, um medication plus treatments. Now we're gonna talk about like if you took this, and we talked about the GAD seven, which was the general anxiety disorder, a little test.

John 2:41

And it has seven questions that you can take to see if you have clinical, medically generalized anxiety disorder.

SPEAKER_02 2:51

Yes.

John 2:51

Now, if you do, some of the techniques that we're gonna talk about will help that. Okay. So what do you want to talk about?

Wende 2:58

So, yeah, so I was going to say I think a lot of us are feeling existential anxiety or general anxiety, but maybe to a milder level, maybe to a moderate level, maybe something that doesn't necessarily require a psychiatrist.

SPEAKER_02 3:13

Right.

Wende 3:13

So we're gonna talk about some ways that we can alleviate stress and deal with our anxiety that are accessible to all. Uh, another thing about just in America, our medical system is most, unfortunately, most uh It goes to medication and treatment and that sort of thing. Well, it's not just that, but most insurance does not cover mental health disorders, which is a travesty. It's just terrible.

John 3:45

Yeah, because it's a real, real illness. It's like the I mean it's heart disease moment.

Wende 3:50

Um and or a lot of those really good psychiatrists and psychologists are not in network. They choose not to take insurance, they choose not to be in.

John 4:02

I'm not out of the network yet because I'm not gonna mess with all these insurance.

Wende 4:07

So that's the catch 22 that we have in America. It's like the ones that are really good say, hey, I've got plenty of patients without being in network and messing with the whole broken system of the insurance company. So I'm just gonna stay out of that and you know, take take my money. Rightfully so, but not everyone can afford that. So we're gonna talk about some treatments that they psychologists might give to help with uh cognitive behavior therapy.

John 4:33

No, you said take my money. That didn't sound good. I'm not into that just to take money. I you know the reason I'm not saying that. Yeah, I'm gonna say something. You know, being in psychiatry for 50 plus years, okay. I've got plenty of money, Landy. I don't really need that money. So when people come to see me, I do charge them. Sure. And I charge them relatively low fee. But I charge them because why? Because if you don't charge them, they don't value that treatment. Exactly.

Wende 5:04

And you should charge. Yeah.

John 5:06

And of course I should, but I don't want people to think I'm a money. No, it's not.

Wende 5:10

I wasn't saying that at all. I'm saying that it's like our system is so broken, and this is a whole nother podcast, but our system is so broken that the doctors that are really good, they don't want to play that game and bog them down in all of the, you know, the paperwork and everything that comes along with collecting insurance payments. They'd rather just have their private practices by with good reason and and keep it simple for themselves so they can focus on treating the patients. Yeah, that's what I'm saying. I'm not saying that they're money grabbing. I'm saying that they're we have a broken system and we can talk about that another time.

John 5:48

So you want to talk about meditation? Talk about that. What is meditation when you so one?

Wende 5:54

Well, let's so let's give a roadmap. We're gonna talk about, I'd like to talk to you about cognitive behavior therapy in a little bit. Um, but we're gonna talk about some ways that I personally deal with stress and anxiety that just comes with life, right? Just the general anxieties of life. How I experience stress is in looping thoughts. So that's where my anxiety comes at. Like I'll get fixated on a thought, like a worry about a family member or about something that's, you know, a job that's coming up that's stressful. And I find that I can't stop thinking about it. It just loops around in my head and ping-pongs around. I think a lot of people can relate to that. So I'll tell you what helps me is meditation and mindfulness practice. Those kind of go hand in hand, but they're two different things. So meditation for me, and you know, the it's very simple, but it's you know, it's a simple thing to do. So men um mindfulness meditation is just sitting quietly in any pose that's you're comfortable but alert, closing your eyes if that feels comfortable, or looking down uh softly down the bridge of your nose at an object, and then just focusing on a point.

John 7:19

It could be your breath, it could be a sound, breathing in relaxation, breathing out tension. If you're driving a car, don't listen to this.

Wende 7:31

If you're driving a car, that's right.

John 7:33

Don't close your eyes, please.

Wende 7:35

Um, but just to uh set a timer for about 10 minutes, maybe five minutes at first, and just focus on your breathing or some other thing.

John 7:48

You can say any word, love, joy, peace, chocolate.

Wende 7:52

Yep, anything that keeps your mind kind of focused on that external thing. So let's say it's your breath. So you you breathe in, you're noticing yourself breathing in, you breathe out, you're noticing yourself breathing out. In and out. Breathe in relaxation, breathe out, attention. And then when your mind wanders, because it will, then the uh what you should do is notice oh, my mind has wandered. You might even label thinking and then bring it back to that point, that breathing technique.

SPEAKER_02 8:27

Right.

Wende 8:28

So it's very easy to do, but you know, people get hung up on like, well, my mind wandered or I couldn't stop. That's okay. That's part of the practice. The more you do it, the better you get about letting that go and realizing that that's just part of it.

John 8:43

Yeah, and generally speaking, from the relaxation response that was written by about Herbert Benson, Harvard psychologist back in the 70s, relaxation response, meditation, sitting quietly, breathing in, relaxation, breathing out tension. Generally speaking, he said that if you did that 20 minutes every day, then that will relax you and all those biochemical changes will eventually dissipate. So we would say you said start out with five minutes. Probably should aim for 20 minutes every day regularly.

Wende 9:22

Yes. And I think it's good to give people a ramp up because 20 minutes seems like a lot to me. To me, even it does. I might try to aim for 20 minutes later. Uh, right now I do about 10 in the morning. Usually a guided meditation where I'll listen to someone on either the Peloton app or the Calm app kind of walk you through a meditation that's guided rather than just sitting alone.

John 9:48

Let's say something about that calm app. Talk about that. Just a little bit calm.

Wende 9:53

I love the calm app. Yeah. So the calm app has a lot of different features, but the main feature that I that I use is the daily calm. And it's this Tamara Levitt. She has the most soothing voice. She really almost puts me to sleep.

John 10:10

Peaceful.

Wende 10:11

Very peaceful voice. And she leads you through a meditation every day that's about 10 minutes in length. And what I love about it is it's a balance of quietness. So you might have some waves in the background or some gentle music where she's allowing you to be quiet, but then she also wraps up with a little story or some helpful tip about meditation. Or yeah, so it's a really great app.

John 10:36

Right.

Wende 10:36

And every day you get a different one every day. So it's good variety.

John 10:40

And there are other apps like that. You can get Peloton apps and other things. Yep. So those guided imageries are very helpful, but you don't have to do that.

Wende 10:50

No, you don't have to do that. All you need is just a a place to sit.

John 10:54

A closet.

Wende 10:55

A closet, a cushion, a bed, a couch, a chair.

John 11:00

I wouldn't recommend a bed because you go to sleep.

Wende 11:04

That's not necessarily a bad thing all the time, but uh sometimes, but yeah, you want to be alert when you meditate. So um what's what's cognitive behavioral therapy?

John 11:15

Okay, cognitive behavior therapy is changing your thoughts so you'll have better feelings. So let's go back to the basics. I call it the A, B, C, D of cognitive behavior therapy. So um let's say you're stressed out. Well, you're stressed out because A, an activating event stresses you out. Okay. Then you go to that consequence, you know, you go to the belief, man, I'm stressed out and so forth.

Wende 11:45

So B as belief.

John 11:46

Yeah, and you go directly to the belief, the feeling, when you really need to go to the way you think, because the thinking really causes the feelings, but we get the feelings ahead of the thinking. Okay, yeah. So you're gonna be able to do that.

Wende 12:03

So for an example, let me see. If I have a a stressful job uh for production and I'm worried about um getting everyone parked in the right place, that's something that that stresses me out quite frequently. Because you'll have like 60 cars and trucks that I have to park. So I get stressed out.

John 12:25

You get stressed out. I guess so.

Wende 12:28

My belief every time is I I'm going to fail. It's not going to work. I'm not going to be able to, people are going to be mad. We're going to be blocking people's drive. That's what I believe, that I'm going to do a poor job.

John 12:42

Yeah. And that belief goes into causing the anxiety, right? So what you do is you change your belief. Okay. Actionating event, be the belief, see the consequences of that belief. Okay. So you change the way that you think or what you believe. Okay.

Wende 13:06

So I could say every time I've done this, it's worked out.

John 13:10

Right.

Wende 13:10

I I change the thought pattern and interrupt, right? That, okay, I'm believing that this is going to fail, but there's really no evidence for that.

John 13:18

Right. And so when you go into therapy, the therapist will say, the activating event, let's change your beliefs about that event. Changing the beliefs will consequently get rid of the feelings. A, B, C. Activating event, belief, consequences of that belief. Okay. If you change that belief, consequently, you won't feel so stressed out. So activating event, you get worried about parking. Belief, well, I've always handled it before, I'll handle it again. Now, that sounds easy, but it's sometimes difficult to do. And a lot of times it'll require therapy. That's why when you're stressed out a lot about a lot of different things in your life, a good cognitive behavior therapist will go in and help you change those beliefs. You can't change that belief overnight. Right. You've got to work on it and work on techniques that will help you think better, think more clearly about what you're dealing with.

Wende 14:24

Good. So what is the difference? I've also heard of DBT, dialectical behavior therapy. Is that right?

John 14:32

Well, dialectical behavioral therapy really was formulated for people with borderline personality disorder. And borderline personality disorder is a whole new topic that I don't want to discuss, but it's very complex. But it was generated by, I forgot who it was, dialectic behavior therapy. And it's essentially cognitive behavior therapy with a few things added to it.

Wende 15:00

So for anxiety, CBT, cognitive behavior therapy would mean.

John 15:20

It adds family stuff and a little bit of other stuff, but it's essentially the same thing. Okay. Okay.

Wende 15:26

But the changing your thought or the thoughts about your okay, cognitive.

SPEAKER_02 15:31

Change your fears, yeah.

Wende 15:33

Changing your thoughts behind about your fears is a good method for alleviating some anxiety.

SPEAKER_02 15:39

Right.

Wende 15:40

Right. Really taking a look at why do I think why am I thinking the worst case scenario? Or maybe it's not why, it's just I am thinking the worst case scenario. Let me retrain my brain to think of a good outcome instead. Right.

John 15:54

Yeah. Maybe. So that's it, cognitive behavior therapy. Great. Okay. Okay. But now you're talking about your deal deal about parking cars and all that. Yeah. That stresses you out, right? Sure. That's a milder form, if you will, of your stress. Some of those stresses can be so overwhelming and so multidetermined that it's not just simple doing that. You've got to see a therapist who will really practice in-depth cognitive behavioral therapy with you. Okay.

Wende 16:24

Yes. So, but if you're experiencing some mild things, one technique might be just to examine the thoughts behind and asking yourself, is this true? Is this something that I'm believing? Um, but is it fact-based, or is this just uh an overreaction, a snowball effect of my worries? So really examining your thoughts is a helpful technique. Right. Good. Um, I also wanted to talk about some breathing techniques that have worked for me that have been aside from meditation, but just breathing techniques out in the real world, right? So when you get stressed out, you tend to breathe shallowly, hyperventilate a bit.

John 17:05

Sound?

Wende 17:06

Yeah, there's a couple of techniques that I've learned that have been taught to me by other people. And one is a box breath where you uh take, and this doesn't work for a lot of people because they don't like the holding. So I I want to encourage people if you if you try this, if the holding makes you anxious, is just to softly hold, not like hold your breath. You're not doing that, but you're just kind of holding that inhale at the top, thinking of leveling it off. So the box breath, you have equal parts inhale, hold, exhale, hold. So that's like a box, right? So you might inhale for four, gently hold that breath for four without grasping, let out your breath for four, and then hold the exhale for four. So that's called a box breath. Yep. One, two, three, four. Well, I'm counting too fast, but yeah. And then uh, if if you do get stressed out by the whole, then equal parts breath um is just as good. So you just breathe in for a count of, let's say, four or six, and then breathe out for a count of four or six.

SPEAKER_02 18:17

Right.

Wende 18:17

Another one that's uh helpful for anxiety is actually extending the exhale. So you want to breathe in for four, but exhale for six.

John 18:28

Okay.

Wende 18:29

Or breathe in for a count of six and exhale more slowly than you inhale.

John 18:34

Okay.

Wende 18:34

That's been proven to help you regulate.

John 18:38

Yeah, because people that are anxious where they do h they hyperventilate, they breathe real fast.

Wende 18:44

Yeah.

John 18:44

And shallow and shallow, and that causes uh you breathe out your carbon dioxide, and that causes tingling in your hands and that sort of thing, and cause you actually to faint.

SPEAKER_02 18:57

Yes.

John 18:57

So what what these uh techniques do is they slow down your breathing, and as it slows down your breathing, you relax and you think peaceful functions. Yes. Okay.

Wende 19:12

All right, one more that I know, and then you can we can talk about any that you, any others that you um know that we can try. This is a very cool thing that you may have heard of about if you're out in the world, you know, you're out in an unfamiliar setting and you're feeling anxious, is the five senses. Okay, right. So you have five senses. So you find five things that you can see and you name them. Okay. So you're out in the world, you're starting to feel panicky. This will kind of trick your brain into not thinking about that scary thing, but you because you're actually focusing on your five senses. So you find five things that you can see. So, mom, what are five things that you can see right now? Cabinet, stove, uh stove, refrigerator, light, fixture, um, windows, um, TV. Yeah, so five things that you can see in your field of vision. And then the next one is five things or four, four things, we're counting down four things that you can hear because you might hear the refrigerator humming. My voice, a clink of a glass, yeah, traffic, birds, whatever. So four things that you can hear, and then three things that you can um touch, right? So, and you feel the surface. So, I feel the surface of this um bar, this cabinet. I, you know, I can touch the surface of my jeans, that's different. My jacket, that's different. So three things that you can touch, then two things that you can smell, and then one thing that you can taste, which is usually something you've just eaten, or the you know, golf if you're chewing it or something.

John 21:03

So you pay attention to these five senses, and that takes your mind off of what you're worried about.

Wende 21:09

Exactly. It's a good technique. It's a great technique. I learned that from a a family member that was having some anxiety that that her um her counselor taught her that technique, and it really works.

John 21:21

Oh, it's pretty good. Okay, anything else? Well, you're an authority, it's pretty good.

Wende 21:29

I'll just hang out my my shingle like peanuts cartoons, five cents for psychiatry. Um, and then there's a similar technique with colors, you know, where it's basically the same trick that you're taking your mind off. You know, you're looking for this was in Better Call Saul, actually. Um, what's his name? Chuck did this that he had learned like he would say, like orange, you know, orange fruit, red carpet, blue sky, you know, and it works and it's pretty good.

John 21:59

That was kind of fun.

Wende 22:02

But it showed that he was probably seeing someone that you know taught him that technique for his anxiety disorder. He had a bad. What did he have in that? What what what did what would Oh man, I don't know.

John 22:15

That's almost a psychotic anxiety. You know, it's a generalized anxiety, it was overwhelming, but he had a psychotic deal. He really did. And it's psychosis. Too complex to get into.

Wende 22:27

But um and definitely some OCD in there, too.

John 22:30

And let me say one other thing real quick about bile feedback. You hear biofeedback? Yeah. And really what that bio feedback is when you get on the scale and you see you weigh 120 pounds, that's biofeedback. Okay. You get on the scale and weigh 125 pounds. Bile feedback. That biofeedback tells you better not eat that dessert. Okay. So it's just a measurement. So biofeedback is you can go into a fancy place and they'll hook you up with all sorts of monitors to monitor your stress and then they'll teach you to relax. And usually you'll have a oscilloscope or a little monitor that will show the the tension of your skin, your pulse rate, and all that going down. And so you just make that little ball or whatever you're seeing go down and you relax more. So it's essentially the relaxation response or meditation under guidance of monitoring your uh bottle signs. Okay.

Wende 23:26

Some of the watches do that now, right? The Apple Watch and everything will give you some biofeedback. Yeah.

John 23:32

So that's what biofeedback is. Okay.

Wende 23:34

Oh, and speaking of the Apple Watch, that reminds me two other really good things to reduce stress, right? One is exercise.

John 23:41

Mm-hmm. Yeah.

Wende 23:42

Yeah. So, you know, the Apple Watch made me think of that because another issue.

John 23:47

Vicky and I have not been exercising lately. It's been, I guess, the well, I we can give all sorts of excuses, but we haven't been. So because we don't exercise regularly, our stress level goes up. So one of the benefits of exercise, it drives down your stress. So it causes, you don't have as much epinephrine, arbinephrine, secreted out. So exercising every day not only helps your heart, but it helps your stress.

Wende 24:19

Sure, sure.

John 24:20

Okay.

Wende 24:21

So exercise, good diet that includes a lot of water and less caffeine.

John 24:28

Oh, yeah. Be sure and stay away from that caffeine, the cokes, and all that. Have people come into my office all the time. I'm so anxious, Doc. Well, how many cups of coffee are you drinking? Well, I drink about 10. So, you know, cut out the caffeine. Yeah. Yeah. Eat right, eat properly.

Wende 24:46

Yeah. Sugar spikes too, right? Exercise.

John 24:49

And what else? Socialization. Getting out with people, talking with people, laughter. You know, I was telling Vicki, but Vicki, I'm not laughing as much as I used to. So getting around people will help you laugh. And laughter is good. Laughter is what? Internal jogging. So laughter is so good for you. So being around people will help you laugh more. Watching certain television shows will help you laugh more. So laughter is so important. Socialization is so important.

Wende 25:29

Yeah, that's great.

John 25:30

And good sleep. And good all of that. Oh, that's a whole new podcast.

Wende 25:35

Yep.

John 25:36

Is uh there are a couple of things that our society is really having problems with. One of them is not eating right, and the other one is poor sleep hygiene. And that is very difficult. You've got to get that sleep. And sometimes sometimes it's difficult to go to sleep. It is. And uh to stay asleep. A lot of times that is biological and might need treatment from a psychiatrist or something, but a lot of it has to do with we're bombarded with so much stimulus.

Wende 26:13

Yeah, all the phone images.

John 26:15

Television and uh not computers and phones and all that stuff bombards our system, so we have a difficult time relaxing. And so we lie down and say, Well, I can't get to sleep. Well, the best way is to get rid of all those phones and all the computer and all that stuff a couple hours before you want to sleep. Turn off all that stuff. Yeah, that's and uh really true.

Wende 26:42

I mean, I've anecdotally I've noticed that myself that if I'm on my phone or my computer, my laptop uh right before bed, it takes me a lot longer to fall asleep than if I'm reading a book.

John 26:54

Right.

Wende 26:54

Yeah.

John 26:55

So get you a dull, dull book. Yeah. And uh don't this is another thing. You can paralyze yourself. You can get in bed and say, oh, I can't sleep. I can't see, I'm never gonna be able to sleep. So get out of bed and read something and then go back to bed. Don't ruminate on inner business. Interrupt those thoughts.

Wende 27:18

And then the last thing I'll say is prayer. Gosh, prayer really helps with anxiety. Um, to me, that is something that I kind of come to last, and it's like an aha moment. It's like, oh yeah, I should pray about this. Yeah. So praying about your worries, and especially at night when those looping thoughts get more catastrophic, for some reason in the middle of the night, something that is small just grows in proportion in your mind.

John 27:46

Let me tell you something that helps with my prayer. You know, you know, a lot of times when we pray, we pray, God, please help get rid of this. All right.

SPEAKER_02 27:58

Yeah.

John 27:58

So we need to think about acts, you know. We need to think about praising God, think about the good things God has given us and that sort of thing, thanking God for all the blessings, instead of going right in and asking, but just being thankful, having gratitude. Oh, say something about gratitude. How can we forget?

Wende 28:21

So wrapped into the prayer. We'll just talk about the gratitude, um, keeping a gratitude journal, keeping a track of all the good things in your life, whether it's writing them down or just mentally reviewing them, that's been shown to decrease stress and anxiety. Yeah, we can increase happiness.

John 28:39

Yeah, that's right. Uh gratitude journal or thinking about the good things, very helpful. And with all the bad things going on in this world, we can focus on the bad, but we need to focus on the little things that are so important.

SPEAKER_02 28:56

Yeah.

John 28:56

Outside the bird singing, whatever.

SPEAKER_02 28:59

Yes.

John 29:00

Uh, just be thankful that you have a nice home. Be thankful that you have a daughter that you love, that you have you have a wife, a woman, a man, whoever that you love and you care for. Those issues, thankful for the bite of the apple or whatever. You know, have a gratitude journal. Focus in on that. So in the prayer time, you can thank God for all those things. And this is the way I like to visualize God. I like to think of the universe and how broad that universe is. Uh, the light years, you know, that's a long, long time. And the light year in our universe is fifty-eight million light years wide, you know. Wow. Just think about the universe, the wideness, the vastness of God's love, and how it permeates through the universe. Focus on the benefits, the blessings of that wide-ranging God that goes on for light years, light years, and light years. How small and insignificant we are compared to the universe, but also how important we are in the universe. That little spark of love. Let the little spark of love in your heart grow and fill up that universe so that your spark of love can be part of that loving universe. So sometimes thinking about that, I mean it's just kind of meditating, but it's also prayer and being thankful for a Lord of the universe that controls all of the little things.

Wende 31:02

That's right. That's all wrapped up together. So thank you. We've I think we've talked about some great ways to deal with anxiety and stress, to really um help people, and that's what we're here to do. So if you found value in this podcast, please share it with your friends and family. We'd love to have you support us in that way.

John 31:22

Yeah, and Wendy, that was uh really good. Very helpful for me that what you talked about, you know, and share this with people. Um, we uh don't make any money off this, we do it because we like to sit and talk with each other and learn from each other and have fun with each other and laugh a little bit so we can do that. It's a selfish thing. It's a selfish thing, but you can share this with other people. It'd be nice if we could help other people instead of just ourselves.

Wende 31:56

All right, everyone. We'll see you next time.