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Ten years ago this month I finished my medical training and started working in the real world. While my formal training ended in 2005, the learning continues and sometimes takes me by surprise. For example, it was only after listening to many guys describe their experience with anxiety that I started to recognize some of the symptoms in myself: the frequent racing heart, stomach cramps and flushing that I’d never paid much attention to before. Suddenly these symptoms organized themselves into a recognizable pattern. And only then did I see that I had started to avoid things that triggered these intense and unpleasant feelings.

I was lucky. My work helped me discover my own hidden anxiety, but it also showed me that I wasn’t alone.

Anxiety is entirely normal and can sometimes be helpful. Fear can assist us in performing during difficult situations by preparing the body for stress.  Anxiety becomes an issue when these primitive adaptive responses are exaggerated or occur at inappropriate times.

Many people suffer from intense anxiety that interferes with the ability to work or maintain meaningful relationships. If you think you might be among them, you should speak to your doctor or consider completing the generalized anxiety disorder questionnaire (GAD-7).

For severe anxiety, medications are available that are generally well tolerated and effective. However, medication, as always, is only part of the solution. There are many potent therapies that can be used alone or in combination with medication to help control chronic worry. Oftentimes, though, patients have already come up with their own solutions for dealing with anxiety—even before they’re fully aware of the problem.

The first strategy I often prescribe for anxiety is to become a “self-scientist.” It’s important to acquaint yourself with all of the ways anxiety presents itself in your body. Distress signals are not always clear. Sometimes our bodies use pain or shortness of breath as a way of identifying an issue, and so we need to pay attention. One popular tactic for becoming more self-aware is mindfulness meditation. Mindfulness and meditation in general help not only with awareness but also with sleep, mood and anxiety. Certain types of meditation and breathing exercises are also an excellent first defence against escalating panic.

A second strategy should be to gather social supports. Open up to a partner, family member or trusted friend about how you’re feeling. Chances are they have all felt the same way at some point, and it’s incredible how talking out loud with someone can suddenly make your feelings less overwhelming. Also consider seeing a counselor trained in cognitive behavioural therapy. This type of therapy can help reframe some of the ingrained maladaptive thoughts that can perpetuate worry.

Exercise is another technique for managing stress and anxiety. Many studies have demonstrated a positive effect of aerobic and resistance exercise on mental well-being. If it has been a while since you were last active, start slowly, with simple walking or a beginner yoga class. Frequently people with anxiety issues have already begun an exercise program—they recognize intuitively that it helps with how they feel.

Unfortunately, some other self-help strategies are less effective.  Drugs and alcohol are often used to self-treat anxiety but they provide only temporary relief. I also find that people often tend to underestimate the degree to which marijuana and caffeine can precipitate anxiety. Even one cup of coffee can mimic panic in those who are extra sensitive, and it’s surprising how much caffeine is hidden in things like workout supplements.

My most important piece of advice is not to fall into the trap of feeling ashamed of anxiety. Worry is a natural part of life; it is a problem only if it starts to interfere with work and relationships. Think about some of these strategies the next time you feel anxiety escalate. Remember that worry is an automatic reflex—but you can choose how you
react to it.