Feel the tight grip of anxiety loosening as Dr. Angela Downey, your guide on the Codependent Doctor, unveils the intricacies of our inner alarm system. Discover the paradox of anxiety—it's a natural part of being human, yet often it steers us into irrational territory, as exemplified by a patient's undue panic over undercooked chicken. We dissect this primal fight or flight response, honed for physical threats, now firing in the face of modern psychological stresses. Dr. Downey expertly demonstrates how anxiety, when misunderstood, can lead us astray, causing undue stress and the importance of acknowledging it as a crucial, protective signal from our bodies. By staying grounded in the present, we can ease the burden of ruminating on the past or future, and find solace in the now.
Embark on a journey of mastering calm with actionable cognitive strategies designed to combat the chaos of anxious thoughts. Dr. Downey introduces techniques such as the body scan, deep breathing, and meditation, alongside insights into lifestyle choices that influence mental wellbeing. The transformative power of therapy, especially Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT), is highlighted, providing a blueprint for challenging negative thought patterns and fostering resilience. This episode is more than a trove of wisdom—it's a call to embrace self-care through affirmations and thought management, setting the stage for next week's deep exploration into codependency. Stay engaged and empowered; subscribe for a journey with the Codependent Doctor, where mental health takes center stage.
Feel the tight grip of anxiety loosening as Dr. Angela Downey, your guide on the Codependent Doctor, unveils the intricacies of our inner alarm system. Discover the paradox of anxiety—it's a natural part of being human, yet often it steers us into irrational territory, as exemplified by a patient's undue panic over undercooked chicken. We dissect this primal fight or flight response, honed for physical threats, now firing in the face of modern psychological stresses. Dr. Downey expertly demonstrates how anxiety, when misunderstood, can lead us astray, causing undue stress and the importance of acknowledging it as a crucial, protective signal from our bodies. By staying grounded in the present, we can ease the burden of ruminating on the past or future, and find solace in the now.
Embark on a journey of mastering calm with actionable cognitive strategies designed to combat the chaos of anxious thoughts. Dr. Downey introduces techniques such as the body scan, deep breathing, and meditation, alongside insights into lifestyle choices that influence mental wellbeing. The transformative power of therapy, especially Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT), is highlighted, providing a blueprint for challenging negative thought patterns and fostering resilience. This episode is more than a trove of wisdom—it's a call to embrace self-care through affirmations and thought management, setting the stage for next week's deep exploration into codependency. Stay engaged and empowered; subscribe for a journey with the Codependent Doctor, where mental health takes center stage.
Welcome to the Codependent Doctor, a weekly podcast focusing on all things codependency. Are you struggling to love yourself, feeling burnt out or having trouble forming loving and meaningful relationships? I can help you heal from the past and move forward with healthier selves, healthier relationships and healthier, more fulfilling lives. Join me as we reclaim your authentic self. I'm your host, a family doctor and fellow codependent Dr, angela Downey. We can do this together. Hello to all you wonderful podcast listeners and thank you for joining me for the fourth episode of the Codependent Doctor. I want to start by thanking everyone out there who is supporting me in my podcast. I've had so many wonderful comments and I really appreciate all the feedback that I've gotten. A few of you have asked why I started this podcast and the reason for it is for the last, you know year and a half two years I've been obsessed about self-help and recovery from codependency. This podcast really just helps me stay focused and continuing on my path to recovery and I've learned a lot in the last year and a half and I figured if I can help somebody out there with their codependency or some of their mental health issues, then I figured I was doing a good job and I'm willing to put my story out there if it's going to help someone else.
Speaker 1:
So today we're going to be talking about anxiety. This is something that I see in the family doctor's office almost on a daily basis. Anxiety is very common and all of us have experienced anxiety at some point in our lives. So what is anxiety? I started by taking a definition from the Cambridge Online Dictionary, which says that anxiety is an uncomfortable feeling of nervousness or worry about something that is happening or might happen in the future. I want to start by saying that anxiety is normal and everybody has anxiety. Anxiety is a very important feeling. It's there to tell us that something is wrong with our environment. It's important that we listen to our bodies when it's trying to tell us something. If you're walking down the street late at night and a burly man is coming towards you, it's normal to feel anxious. It doesn't always have to be a burly man. It could be anything that you're perceiving as a threat coming towards you. As you're walking down the street at night, your body lets you know that something's up and it gives you the option to make a change. It's telling you that it wants you to modify your environment somehow so that you're going to feel safer. So in this case, you might change to the other side of the street. Over time, we've learned that certain situations are dangerous and it's our ability to spot these dangers that is what's keeping us alive. But what happens when your brain is convincing you that there's a threat, but it isn't real when the threat is irrational?
Speaker 1:
I had a patient who ate some chicken in a restaurant. When she cut into the chicken, she noticed that the middle was a little pink. She had already had a patient who ate some chicken in a restaurant. When she cut into the chicken, she noticed that the middle was a little pink. She had already had a couple of bites and was only now learning that there was some uncooked chicken. She became very afraid that she was going to develop food poisoning and that she might die. Can people die of salmonella poisoning? Sure, maybe If you have a weakened immune system, if you don't have access to a hospital or clean drinking water. The Center for Disease Control estimates that there's approximately 1.35 million episodes of salmonella infections per year, and not all of these are caused by chicken, mind you. And of those 1.3 million infections there are approximately 420 deaths. So deaths can occur, but they occur very rarely.
Speaker 1:
Anyway, when she saw this pink chicken, she began hyperventilating and crying in the restaurant. She went to full blown panic mode. She ended up leaving the restaurant and going to the emergency room. She was upset that she had to wait several hours before being seen and she continued to cry and panic while she waited, worrying that she might get food poisoning. At no point did she actually kind of sit with herself and recognize that right at that moment that she was safe and that she wasn't having any symptoms. She didn't have a sore stomach. She didn't have any diarrhea. She was fine, other than the fact that she was worrying about what could happen in the future and this was giving her a panic attack. It was the anticipation that something terrible might happen that was crippling her. She ended up not getting any symptoms and felt fine afterwards. She didn't end up getting any nausea or vomiting or diarrhea from the chicken. Everything ended up being fine.
Speaker 1:
I once heard someone say that worrying about the past is what causes depression and worrying about the future is what causes anxiety, and that what was most important was living today, in the moment. I thought that was interesting. Anyways, I'm going to come back to this story a little bit later on when we talk about how to manage anxiety. What happens with anxiety? So, when we perceive a threat, our body releases hormones like adrenaline and cortisol. So adrenaline is going to make your heartbeat faster, causes your blood pressure to go up and gives you more energy. Cortisol increases your blood sugar, which helps feed the brain and gives energy to your muscles. Cortisol also slows down other body functions that aren't needed for the flight or fight response, like the digestive system. The increased adrenaline and cortisol is really important for the fight or flight response. We need this in order to be able to run away from the threat or to face it head on. It's going to prepare us for battle. It's going to give us all this energy to be able to fight or to run or to defend ourselves.
Speaker 1:
The problem is that we're no longer running away from things like wild animals, and we're not always running away from some perpetrator holding a knife running at us on the sidewalk. We're actually just sitting in our office chairs and we're feeling some kind of threat coming towards us. All this pent up energy has nowhere to go, so it just stews within us and starts causing us to have these horrible feelings. So some of the signs and symptoms of anxiety can be things like a really uneasy feeling in your stomach, having some nausea, diarrhea. You might feel lightheaded or dizzy. Some people get like pins and needle feelings in their hands or fingers. You might start breathing faster and your chest might feel very heavy or tight. It might be hard for you to get a big breath in. Some people start sweating, getting hot flushes. Some people just have trouble sleeping. While you're sleeping you might end up grinding your teeth or you start clenching your teeth, and these can lead to full-blown panic attacks where you just that might end up grinding your teeth or you start clenching your teeth and these can lead to full blown panic attacks where you just that anxiety builds up so much you're hyperventilating and you're not really able to function anymore.
Speaker 1:
It's really important that you see your doctor if you're having any of these symptoms. We want to make sure that it's not something else that's causing some of your physical symptoms. Things like chest tightness, racing heart and dizziness shouldn't be ignored. Could there be some kind of other hormonal imbalance? Could you be having a heart attack? But after you've had a thorough workup and everything is normal, then it's time to start working on your anxiety. So I can't say this enough, but anxiety is a normal reaction to a threat. Everybody gets anxiety and it's important that we have some level anxiety in order for us to remain safe. So everybody gets anxiety, but some people are just better at managing it than other people.
Speaker 1:
Sometimes it can be difficult to recognize what is a threat and what's not. So some people see or anticipate very few threats, while other people might see a threat around every corner. In fact, some of the same circumstances can cause an anxious response in one person and nothing in the other person. The difference is what that person's thoughts are about the circumstance. So, as an example, let's say you get an email from your boss asking you to speak with them. One person might think really positive thoughts about it. He's thinking, wow, maybe I might get a promotion or maybe I'm being asked to be part of that big project that's upcoming. Another person might be completely neutral and not think anything. I'm just going to show up and wait and see what happens. Whereas another person might get very anxious. They're thinking to themselves I'm probably being fired, or I knew they never liked me. How am I going to pay the rent this month if I lose my job, my partner is going to lose all respect for me or I'm going to end up alone and destitute, trying don't know what this meeting is about. But all you're doing is you're anticipating the worst case scenario and that worst case scenario becomes a really big threat to you and your anxiety might get the best of you. So your anxiety is a normal reaction to a threat and only you can determine what is or isn't a threat.
Speaker 1:
From an evolutionary standpoint, anxiety was critical to survival. Our caveman relatives or I guess our cave person relatives needed that anxiety to survive. If they didn't get that jolt, adrenaline or cortisol to outrun or fight some wild beast, then they wouldn't survive. So that relative with anxiety that's who we're related to. That's whose genes we have. That person who never felt anxiety. He's long gone. He didn't survive long enough to pass on any of his genes. So we're related to the person who is able to feel anxiety and to save himself. They were able to recognize threats. So we still need anxiety to survive, but most of the time we're not faced with threats that require a shot of adrenaline. We have papers and projects that are due, or sometimes we see threats that aren't actually there. These threats don't necessarily require a shot of adrenaline or cortisol, but when we do perceive that threat, that adrenaline, that cortisol builds up within us and it gives us that feeling of tight chest or shortness of breath and we don't feel very good. Anxiety becomes a problem when these threats that you're perceiving are not rational. So when there's not really a threat and most people wouldn't see a threat but that person does see a threat and it's very real to them.
Speaker 1:
Children aren't immune to anxiety either. If you take a child who's scared of the monster under his bed, his parents know that there's no monster and yet it's very difficult to convince that child that there's no monster, and yet it's very difficult to convince that child that there's no monster. It's these types of perceived threats that can be most damaging to people, and when someone is feeling anxious about something, it's very difficult to convince them that they are safe. And sometimes it's hard for someone to be supportive of another person when they're having anxiety, especially if you don't see that there's a threat and somebody else is seeing that there is, and it is hard to convince people that there is no threat. Just like that monster under the bed, that monster is very real to that child and he's terrified, but you and I know that there's no threat, so sometimes it's very difficult to you know you want to be supportive of the person in front of you who's having a panic attack, but sometimes it is difficult to be supportive, especially if you don't see that threat.
Speaker 1:
If you are a person who suffers from anxiety, it's up to you to take responsibility for your feelings and to not rely on others to fix your issues. There are different ways of managing your anxiety, but it's going to take a lot of work. If you're being chased by a person with a knife, I give you permission to be anxious. That's allowed. Take advantage of that adrenaline and fusion and hightail it out of there. But most of the time we're not being chased by anyone with a knife and there is no real threat. It's possible to take control of and manage your anxiety, but it takes a lot of work and self-reflection.
Speaker 1:
There are medications that can help with anxiety, medications that you can take daily that will help you cope a little bit better while you do the work necessary to manage and overcome your anxiety. So please see your doctor to see if any of these medications will be helpful for you. There are also sedatives that can very quickly relax you. I don't personally like these medications because they aren't a good long-term fix and they can be habit forming. It's just a way to quiet your brain temporarily.
Speaker 1:
Let's say you have a wasp's nest in your shed. Taking a sedative would be the equivalent of just closing the door to the shed. Just because you close the door and you can't see or hear them anymore doesn't mean they're not there and it's going to be a problem every time you think about that shed. The thoughts of taking out a shovel or lawnmower are going to be really scary because you know that those wasps are in there and that wasp's nest is going to get bigger and bigger and become more of a problem as time goes on. Now you have the choice to just keep closing that door or to ask for help. You can either look up a bunch of YouTube videos on how to get rid of wasps' nests so this would be the equivalent of doing workbooks or listening to podcasts on managing your anxiety or you could hire a professional for help. These sedatives might make you feel better temporarily, but unless you're doing the work to manage your thoughts, you're likely going to live with anxiety for the rest of your life.
Speaker 1:
Medications have their place when it comes to managing anxiety, and I'm going to ask that you speak to your doctor about them, but today I'm going to focus on other things that you can do to manage your anxiety. Please keep in mind that these are things that you can try once you have been seen by your doctor and they have told you that you're physically fit. When you start feeling anxious, I want you to take a deep breath and ask yourself am I safe at this very moment? Don't worry about what might happen four hours or four days from now. Are you safe right now? And if you are, then you've got some time to figure this out.
Speaker 1:
Instead of fighting the anxiety, I want you to do a body scan and describe what you're feeling. I'm feeling short of breath, my chest is feeling heavy, my fingers are tingling, I feel hot and sweaty. I feel a lump in my throat. Really, take a moment and see what's physically happening in your body when you feel this anxiety. This is going to help distract your brain and give it something to do. Also, it's going to remind you that you've had these physical sensations before and that you ended up being okay the last time that this happened. Next, I want you to put your hand over your heart, take a big, deep breath in and tell yourself that you are safe in this moment. Repeat to yourself that you are safe in this moment.
Speaker 1:
Continue to take some deep breaths in, fill your lungs and then exhale. You want a longer exhale than inhale. Exhaling activates your parasympathetic system, which promotes calmness and relaxation. This exercise is probably not going to feel very good at first. When you're having severe anxiety or panic attack, your body wants to take in more air and even cause hyperventilation. This is going to be easier if you practice deep breathing when you're not feeling anxious. So if you practice beforehand, it will get easier to do when you are feeling anxious. Meditation on a daily basis can be very helpful for this, but most important is reminding yourself that you are okay in this moment. Whatever happens in the future, you have time to deal with that. You're going to take some deep breaths and you're going to exhale longer than you inhale and, like I said, this is going to help promote calmness and tell your body that it's okay and that it can relax.
Speaker 1:
Exercise is a really great way to manage your anxiety. So anxiety causes a vibration or an energy that you can use when you're trying to escape a threat. It's that jolt of adrenaline that you get. If you're not running away from a threat, then that energy has nowhere to go but to settle in your tissues. It's why your muscles get so tense and your breathing increases. Your chest gets tight. If you do activities that dispense this energy ahead of time, the anxiety won't be as difficult to manage. Initially, exercising might not feel that great. In fact, I've had some patients tell me that it feels terrible. That might be because when you're exercising, your heart rate goes up. You become short of breath. These are all symptoms that might mimic your anxiety or your panic attacks. So you can reassure yourself that this is going to pass, or potentially, you might want to start more slowly if that's the case and just start with walking to expend some of that energy.
Speaker 1:
Minimizing caffeine is also really important. Caffeine is going to make you hyper aware and can make your anxiety worse. This includes coffee and the thousands of different ways that you can prepare fancy coffees these days. It's also going to include all the energy drinks that are on the market now. I've never had an energy drink. I've never actually had a cup of coffee before. Even if you've never had coffee or energy drinks, it is possible to still have anxiety. I also strongly recommend that, if anxiety is something that's controlling your life, that you call a therapist to help manage your anxiety. They're likely going to use one of two techniques, so one of them being CBT and the other one REBT.
Speaker 1:
Cbt stands for cognitive behavioral therapy. It's going to provide you with a toolkit of strategies to manage your anxiety. It's going to help you understand the connection between your thoughts, your feelings and your behaviors. It's typically a more structured and goal-oriented approach and it focuses on developing practical coping strategies and problem-solving skills when it comes to managing anxiety. So here's a few things that you might learn if you're going for cognitive behavioral therapy. It's going to help identify and challenge any negative or irrational thoughts that you might have. So, let's say, if you're having social anxiety and your thought is you know everyone is judging me, cbt would help challenge this thought by asking questions like what proof do you have that this is true? Is this true in all circumstances? Are there people out there who might not be judging you? So those are examples of different ways that you might want to challenge some of those negative or irrational thoughts. There might be some behavioral experiments, and by that I mean CBT is going to help you experiment with different scenarios.
Speaker 1:
So, let's say, if somebody has generalized anxiety disorder, they might have the belief that they must always be prepared for the worst case scenario. A therapist might encourage you to deliberately not prepare for a minor event and to observe what happens, and this might help you realize that your anxiety is unfounded. Exposure therapy is another tool that they might have. This is a technique that's used to help people confront feared situations or objects in a gradual or controlled manner. So, for example, someone who might have a phobia of spiders might gradually expose themselves to images of spiders. Then they might move on to seeing spiders from a distance and eventually they're going to be able to be in the same room as a spider. Over time, this repeated exposure is going to help desensitize you to your fears. It will also help you develop some coping strategies. So it's going to give you practical skills to be able to manage your anxiety symptoms. This can include relaxation techniques, deep breathing or progressive muscle relaxation. It might teach you how to meditate. It's also going to help you challenge catastrophizing thought patterns and to develop problem-solving skills to address the sources of stress. It's going to help you become more aware of your thoughts and feelings, without having any judgments. It helps to foster a more compassionate and accepting relationship with your inner experiences.
Speaker 1:
Another form of therapy is REBT. This stands for Rational Emotive Behavior Therapy. It was developed by psychologist Albert Ellis in the 1950s. It's similar to CBT. It's based on the premise that our thoughts, emotions and behaviors are all interconnected, in that irrational beliefs and thought patterns contribute to our emotional distress. It's based on the premise that our thoughts, emotions and behaviors are all interconnected and that irrational beliefs and thought patterns contribute to our emotional distress. Rebt aims to help you develop greater emotional resilience, flexibility and self-acceptance by challenging and replacing your irrational beliefs with more rational or adaptive ones. So Ellis developed the ABC model to explain how events might trigger beliefs, which then can lead to an emotional or behavioral consequence. So A stands for activating event, b stands for beliefs about the event and C stands for consequences. The basic idea behind the ABC model is that the external events, which would be A, do not cause our emotions, which would be C, the consequences, but rather it's the beliefs. So B that in particular, being irrational beliefs, cause the consequences. So A does not cause C, but rather it's B that's causing C. So this model is telling us that our emotions and behaviors are not directly determined by our life events, but rather it's the way that these events are cognitively processed and evaluated.
Speaker 1:
As an example, let's go back to the beginning, when we talked about the food poisoning. So in the ABC model, in that first example that we used, with that lady who had the chicken that was undercooked, a would be I ate undercooked chicken. B. Your belief about this would be undercooked chicken can cause food poisoning, c. The consequence would be I would get very, very sick and potentially die. So you can see that A does not necessarily mean C. So eating undercooked chicken does not mean that you're going to die, but it's your belief about that undercooked chicken that is going to cause you to think that you might die. With this model, the goal is to change your belief, because it's your belief that's going to cause you to feel anxious. So let's say you have A, you're eating the undercooked chicken, and your thought about that is occasionally people get sick when they eat undercooked chicken and if this happens I could always get some help. If that was your thought, then your consequence would likely be significantly less anxiety than if you were thinking you were going to die. So by changing the thoughts around the circumstance, you're able to control your C-line, your anxiety level, a little bit more than you would have had you been jumping to that other conclusion that you might die.
Speaker 1:
As another example of REBT and using the ABC model, I have a patient who when COVID hit she followed public health rules and did not leave her home. But unfortunately, when public health rules got lifted she has still not left her home. So she has not left her home in three years and now gets her you know, all of her groceries delivered and packages delivered by Amazon. So she's no longer leaving her home. So for a activating event we would put something like the COVID virus is a transmittable infection. Her belief became the world is a dangerous place. So the consequence of that was she couldn't leave her home anymore because the world was a dangerous place. Reframing your thoughts might look something like COVID is a virus with symptoms of cough and cold, and I've had these before and I have recovered. So instead of, you know, thinking the world is a dangerous place, she could be thinking something like I might get a cold. I've had these before and I've recovered and I've been fine.
Speaker 1:
I'm not going to focus too much on REBT because in my practice we use CBT a little bit more often. It's something I'm more familiar with, but REBT is something that your psychologist or psychiatrist might help you with. So your homework for the week is to think about your anxiety. So the next time you're feeling anxious, try to do a body scan. How do you feel when you're anxious and recognize that you've had these feelings before. You felt the racing heart feeling before. You felt the chest tightness before and it was okay. You survived. Your doctor has told you that you're healthy.
Speaker 1:
What are some irrational fears that you might have? It might be helpful to talk to a relative or somebody who knows you very well to determine what fears you have that might be irrational Anxiety can control your entire life and it can affect your relationships. If this is happening to you, it's going to take some time and a lot of really hard work to overcome the ingrained beliefs that you have about the threats in your environment. So when you're ready, I would challenge you to get some help from a therapist. The therapist is going to help challenge you to reframe some of these thoughts that you have about your beliefs.
Speaker 1:
Some mantras for the week are at this moment, I am safe. I am able to control my thoughts, which can help lessen my anxiety. I can access tools that help manage my anxiety. Thank you for joining me for another week of the Codependent Doctor. Next week, the podcast is going to be on controlling others and just a heads up. You cannot control others, so enjoy your week and I will talk to you later. Thank you for joining me and I hope today's podcast resonated with you. Click, like and subscribe so you don't miss any future episodes and to help others who might benefit. This podcast is not meant to provide medical advice and should not replace seeing your doctor for mental health concerns. If you're having a mental health crisis, please present to a hospital, call 911 or your local crisis helpline. I'll talk to you next week with another edition of the Codependent Doctor. We can do this together.