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This Is You On Stress

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I was late to work. What if I lose my job? How will I find time to grocery shop? My family is going to starve. Could this headache mean I have cancer?

Even if your head doesn’t spin with these exact worries when it hits the pillow at night, there’s probably something similar whirring through your brain, keeping you up just when you should be powering down. As a psychiatrist and contributor to the Today show, I see many women who battle with anxieties, and not just at night. They obsess about their children, their marriage, their finances, their job, their parents; about sickness, accidents, disappointments and assorted other upsets that come under the heading Bad Things That Could Happen. This is the nature of anxiety—an unpleasant emotional experience caused by the unpredictability and uncontrollability of the future and the ways that it could hurt you.

We all experience anxiety. It’s the mental part of fear, which is a biological response to a threat or danger. From an evolutionary perspective, fear is what has helped us humans survive for so long: It impels us to run away or hide if we see, say, a bear approaching. And if you are in a park known to have many bears, it’s totally normal and logical to feel anxious even if you don’t see one, because this makes you cautious and keeps you from leaving food out at your campsite. But what if you are at work and you start thinking about a camping trip you might take with your family and grow very worried that you could encounter a bear that might maul you or your kids, resulting in utter tragedy? This is when anxiety no longer serves a useful function and becomes a real problem—when you can’t stop obsessing about the possibility of something terrible happening, no matter how small or remote it is.

Trying to have it all just adds to the anxiety many women feel. I hear frequently from Today watchers and my New York City-area patients that the burden of balancing a healthy relationship and turning out great kids while remaining financially afloat (and looking young and staying fit, of course) leaves them fried and fretting. A patient I’ll call S.W. came in reporting that she was exhausted from waking up in the middle of the night concerned that she wouldn’t get the next big project at work, her son wouldn’t make the basketball team, her husband wouldn’t get that raise and they wouldn’t be able to afford a down payment on the house she wanted. Then, when she was awake, she felt little jolts of stress all over again. S.W. did not have an anxiety disorder per se but rather a normal, albeit hefty, dose of worry.

It is possible, though, to retrain an anxious brain. I helped S.W. learn how to lower both the frequency and the amplitude of her worry so she could sleep better and be much more productive during the day as a result—and you can learn how, too.

Why we worry
S.W.’s story isn’t unique, nor is the fact that her husband doesn’t tend to fret about this stuff: Believe it or not, it’s partly because of the way women’s brains are wired. A woman’s limbic cortex—the area responsible for emotional processing—is larger on average than a man’s, leaving more potential space for worry to live. Guys’ brains also tend to produce more of the soothing neurotransmitter serotonin. Then there’s the psychological impact of society’s expectations for women. While, over the years, husbands have certainly stepped up the domestic duties they perform, women often still feel that they’re responsible for the household. And while men may consider it a job well done if they’ve made an effort, we often stress out if we don’t do every little thing flawlessly—from getting a balanced meal on the table to making sure our kids’ hair is combed—even though perfection isn’t always under our control. One group of worriers I see growing, in fact, is the smart and successful woman. She’s juggling a lot, and she understands not only how many balls she has in the air but how many can drop. She may also worry about worrying so much, which makes her feel worse.

Think yourself oh-so-calm
This kind of stressing is normal, but it’s not inevitable: There are things you can do to take the wind out of worry’s sails. First, note that anxiety tends to be future-oriented (What if something happens?) and quickly escalates to the most dire of consequences (Then I’ll be broke, divorced, homeless, dead). But is there really any evidence for these outcomes? Challenging your fears before they get very far prevents them from blowing out of proportion and keeps new ones from cropping up. Ask yourself, “Is this something that’s about to happen or something that might happen in a faraway, imaginary future? Do I have any control over the outcome?” Try to take steps to manage what you can—finally setting up your 401(k) so you don’t go broke, spending more one-on-one time with your spouse to remind yourself of your solid relationship. When thoughts pop up about things that you can’t control, whether it’s being laid off or widowed, say to yourself, “That’s just my mind doing its worry shtick again.” Then move on.

You should also take advantage of the mind-body connection. When you perceive danger, adrenaline surges through your body, which causes you to breathe faster and sweat harder. This reaction in the body feeds back to your mind, making you nervous and often leading your brain to invent dire outcomes that are unlikely to occur. Breaking that cycle can interrupt the worrisome thoughts. To do that, try slow, deep breathing for a few minutes each day or whenever you’re freaking out. Put your hand over your abdomen and breathe in for a count of five, then out for five. Muscle relaxation also calms the body. Sitting in a quiet place, tighten each muscle group in your body—starting with your feet and working your way up to your head—for a count of five, then release. Or use visual imagery: Picture a beautiful and relaxing place you’ve been to or seen.

The truth is, life will never be worry-free. But if you learn how to wrangle your fears, you’ll feel happier in the here and now, instead of spending your energy trying to detect a bear far, far down the road.

Is it just nerves—or an anxiety disorder?
Everyone gets stressed. So how do you know if it’s everyday anxiety or a sign you need help? If worry has been interfering with your work (you can’t focus on the task at hand), affecting your relationships (you need constant reassurance or don’t trust your partner) or limiting your ability to go about your life day to day (maybe you’re afraid to drive on a highway or you avoid stressful situations by staying home) for several months, then you may have an anxiety disorder. Though very common—in a given year, 40 million American adults have one—a disorder can wreak havoc on your life if left unchecked; many undiagnosed sufferers turn to drugs or alcohol to self-medicate. So make an appointment with a psychologist or psychiatrist who specializes in anxiety and can determine whether you need treatment. Anxiety sufferers often respond well to cognitive-behavioral therapy (CBT), which teaches you to reframe your anxious thoughts, or acceptance and commitment therapy (ACT), which focuses on defusing the fear your anxieties evoke. If anxiety is high, medication may be prescribed to ease symptoms. The good news is that anxiety disorders are very treatable, so you don’t have to suffer in silence.
Stop stress this second
In panic mode? These four tips will work right away.1. WRITE DOWN YOUR FEARS.
Make a list of what’s worrying you at the moment, then put it away. This simple act stops the obsessive cycle of anxiety so you can move on.2. AMP UP YOUR ACTIVITY.
Vigorous exercise diminishes stress, and with it, worry. Get your heart rate up for 20 to 30 minutes. Even walking briskly around your neighborhood after work counts.

When your mind starts to spiral out of control, say to yourself, “It’s all right—I’m a worrier. That’s what I do. But everything always works out.” Some accepting self-talk can help lower the number and intensity of your fret sessions.

Listening to music can distract you from stress, research shows. The same goes for any activity that engages your senses, like reading, cooking or watching a movie.

Gail Saltz, MD

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