WELLNESS RX SPECIAL REPORT: 

“STRESS AND ANXIETY”

By Edward Ullmann and the Wellness Rx Team

“Replace the fear of the unknown with curiosity.”  - Anonymous

In today’s troubling times, the handling of stress and anxiety has become the number one challenge for most Americans. Our experiential evidence at Wellness Rx is reflective of what is happening here in the Northeast.  Our patients are dealing with levels of the unknown, never before experienced around the globe, and it is hitting home now. In an attempt to support our community, we offer this comprehensive report to offer ways to identify and offer paths to living and managing how we can interact with stress and stress filled situations.

According to the National Alliance on Mental Illness, one in five adults (20%) experience some form of mental illness each year, but less than half of those people will get help. Anxiety is by far the most common of all mental disorders. 

Before COVID, ages 30 to 44 had the highest rate of anxiety (23%) and age 50 and older the lowest rate (13.8%). Females experienced 30% more anxiety than men and anxiety is impacted by many factors such as genetics, income, culture, race, religion, unresolved trauma, and social pressures. 

Post-COVID, 53% of adults are reporting that their mental health is worse. Young adults 18-25 are now experiencing the highest rate of anxiety (25.8%). Major factors for this increase include loss of support services, loss of income, isolation, and loneliness from COVID restrictions, and fear for oneself, one's family, friends, and country.

Stress is a normal emotional response to adversity and anxiety is the body’s natural reaction to this additional tension experienced by the nervous system. Stress triggers the release of hormones from the adrenal gland (cortisol, adrenaline/epinephrine and norepinephrine) into the bloodstream. This release increases energy levels, muscle tension, and blood pressure and reduces sensitivity to pain and the normal operation of the digestive system. 

Good stress can produce euphoria, motivation, love, and push us along in competitive environments to do our best work. In these moments, the body perceives a stressor as a positive emotion. Unfortunately, most stressors such as work, finances, family dynamics, relationships, school, internal perceptions of oneself, unresolved trauma, COVID restrictions, fear, loss of control, and fear of the unknown produce bad stress. It’s not long before the hormones released to manage stress become depleted and anxiety occurs. 

In simple terms, anxiety occurs when a demand vastly exceeds a person’s capabilities to handle it and the body perceives a stressor as a negative emotion. 

Signs of anxiety can vary, but in general, one worries and becomes anxious, thoughts are racing, one becomes frustrated, angry, irritable, overstimulated, or highly excited, or makes bad decisions. Extended periods of anxiety also produce physical ailments such as high blood pressure, gastric/GI disorders, sleep deprivation, headaches, and muscle tension. We all hold stress in the body differently (stomach, back, shoulders, etc.) so physical ailments experienced by one individual can be different than another. Short-term anxiety or episodic anxiety such as a death in the family, taking an examination, divorce, business or job loss, or dealing with an epidemic is a normal response to one’s body and mind being pushed beyond their limits. Extended periods of anxiety, however, when one simply cannot take action to move forward with their lives or reach peace within themselves, often leads to chronic health conditions or secondary mental health challenges such as depression or addictions. Depression can also be accelerated with the depletion of neurotransmitters in the brain especially serotonin.

Extended periods of anxiety (stress can become cumulative) can take over one’s life and lead to serious mental health challenges or full-blown personality disorders. Generalized anxiety disorder is the most common challenge that is usually diagnosed when one has been worried or deeply anxious for more than six months. During this period the anxiety could also lead to panic attacks or simply dominate one’s personality which could lead to a propensity towards negativism, obsessional thoughts, compulsive acts, or physical complaints that are not there. It is at this time that one should seek professional help or at least have a support network to help guide them.  

Other serious anxiety triggered mental health challenges include:

Neurotic behavior which is when mental, emotional, or physical reactions to the anxiety become drastic and irrational. Neurotic behavior is often seen as an automatic, unconscious effort to manage deep anxiety. The opposite of neurosis is self-actualization.

Panic attacks are sudden episodes of intense fear or anxiety and physical symptoms especially tachycardia or a racing feeling of the heart. Panic attacks are primarily based on a perceived threat rather than imminent danger.

Social Anxiety Disorder is when everyday social interactions cause irrational anxiety, fear, self-consciousness and embarrassment. An individual with this disorder may experience excess fear in which they may be judged, criticized, humiliated, or may express concerns about offending someone.

Obsessive-Compulsive Disorder (OCD) is associated with excessive or unwanted thoughts (obsessions) and fears that cause anxiety. An individual with OCD will often try to relieve their anxiety by carrying out certain repetitive or habitual behaviors or rituals (compulsions). Examples of OCD behavior would be fear of germs or trying to arrange things in a specific order. While OCD symptoms might present themselves at an early age, symptoms usually worsen with age. OCD patients can also experience secondary personality disorders.

Post-Traumatic Stress Disorder (PTSD) is a condition that results in a series of emotional and physical reactions in individuals who have ever witnessed or experienced a traumatic event. While it’s common to associate PTSD with soldiers returning from war or individuals who have been sexually assaulted, PTSD can also be triggered by events such as a car accident, death of a loved one, a natural disaster, torture, long term abuse, or the fear of losing a business again. 

Symptoms of PTSD include physical pain especially chronic pain (up to 35% of people who suffer from chronic pain also have PTSD), nightmares or flashbacks, depression or anxiety, especially mental phobias, physical and emotional withdrawal, avoidance, repression, or the intentional blockage of memories, “on edge” or “jumpy” personality and irritability.

Narcissistic Personality Disorder relates to a person who has an inflated sense of self-importance. While the disorder is more common in men, it can also impact women. Symptoms include an excessive need for admiration, a disregard for others’ feelings or a lack of compassion or empathy, an inability to handle criticism, a refusal to apologize, and a sense of entitlement. Individuals with this disorder tend to deny flaws in themselves and blame others for their shortcomings, mistakes and misfortunes (projection). They are also subject to outbursts of intense anger or silence.   

Finally, individuals can also suffer with impulse control issues, hysteria, perfectionism and aggressiveness and can have more than one anxiety disorder to deal with (dual diagnosis).

TRADITIONAL TREATMENT FOR ANXIETY

In traditional medicine, treatment often centers around cognitive or talk therapy and/or drug therapy. Approximately 70% of all prescription medications for anxiety are written today by a primary care physician or mid-level provider (Nurse Practitioner, Physician Assistant, or Psychiatric Nurse). The most commonly prescribed prescription medication for anxiety are the benzodiazepines or “benzos”. The benzodiazepines have smooth muscle relaxant and sedative properties, are anticonvulsant and can be hypnotics (sleep-inducing). They are categorized as short-acting (triazolam), intermittent acting (alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), temazepam) or long-acting (diazepam (Valium)). Benzodiazepines generally take about 45 minutes to become effective and are best used on a short-term basis. Long term use can lead to physical dependence and abrupt withdrawal can be dangerous. Benzodiazepines have an additive effect when taken with alcohol. Buspirone, hydroxyzine (antihistamine), and Clonidine (to help prevent a racing heart) are also commonly used medications for anxiety. 

For patients dealing with more serious anxiety conditions, antidepressant and antipsychotic medications may be added to the patient’s drug regimen. For some, antidepressant medications can also help improve confidence and improve one’s ability to interact with others.

NON-TRADITIONAL AND NATURAL TREATMENT FOR ANXIETY

There is no one way to treat anxiety. Each individual is unique with different genetic make-up, different environmental backgrounds, different life experiences, and different expectations of life. There are, however, many ways, tools, and techniques for one to reduce stress on their own or in partnership with their health professional. 

HERE’S OUR OVERVIEW:

First drinking plenty of good clean water helps so many issues as does taking full deep cleansing and energy altering breaths. When we are stressed, we forget these very simple yet important ways to reduce stress and improve our mood. Further down, we provide a breath practice that is therapeutic for all.

Also, when you get regular exercise it becomes hard to hold onto stress.  Just a good brisk walk for 20-30 minutes will really help you. So many individuals have found great help with their anxiety by making yoga part of their life.

A walk in the great outdoors is most relaxing, especially when enjoyed with friends or loved ones. As we age, we begin to more fully understand the powerful relationship we can have with our natural environment and the natural world. Just like when we observe the wonderment of a young child, the natural world brings us joy, happiness, love, and relaxation. It’s free!

Take some time to find ways to relax and even meditate.  Most folks feel they cannot meditate.  With just a little practice you will find this is a great way for you to alleviate the effects of stress and anxiety.  There are many online videos to help you find your way, and many wonderful free meditation apps, like Insight Timer. Remember that reaching a meditative state is often also reached when one is immersed in a peaceful activity such as art, becoming part of nature, fishing, skiing, music, or a hobby that you are passionate about.

Other great tips are to manage your time well, ask for others to help you, and be a problem solver. Often if the issue that is causing the stress is resolved the stress will subside. Letting things hang over you will only raise your anxiety levels greatly. Most importantly, try not to be ruled by your emotions, there’s no upside, but plenty of downsides. Remember, you are the director of your life and you alone will determine the amount of stress that will accumulate in your energy field.    

Experts suggest that if you are trying to help a loved one or friend deal with their anxiety it is important to help ground them and to be completely non-judgmental. And please do not criticize them or tell them “I told you so …”. They are already beating-up on themselves. You can try to explain that the situation is not life or death and that taking a time-out to think things through could be a healthy decision. Most importantly, be positive, supportive and if appropriate, share your stories of times that you have been challenged by anxiety or depression. If they are open to listening, you could suggest they get help. 

NUTRITIONAL AND SUPPLEMENTAL SUPPORT

*Check with your doctor, pharmacist, or herbal specialist 

for potential drug interactions.

Researchers from throughout the world are clearly showing a link between nutritional deficiency and the body’s physical responses to what we feel as stress or anxiety. We suggest starting with a daily multivitamin from a high-quality source and then adding:

*B-Complex supplement especially high doses of Vitamin B6 (Pyridoxine)

*Vitamin C (500 mg. three times a day)

*Vitamin D (at least a total of 1,000 IU’s a day)

*Iron sulfate or gluconate daily supplement if any level of deficiency has been found

*Omega 3 Fatty Acids (1,000 mg. twice a day)

*Mineral supplementation especially magnesium if not adequate in multi-vitamin

*Quercetin is an excellent supplement that strengthens the immune system and has anti-inflammatory and antioxidant properties to protect against stress-induced anxiety

*L-Tryptophan is an essential amino acid supplement that is a serotonin precursor that helps emotional wellbeing and restful sleep. Tryptophan is found in beef, poultry, fish, nuts, seeds, and legumes

*L-Theanine is an amino acid supplement contained in green tea that promotes relaxation and stress reduction

HERBAL SUPPORT 

*CBD Oil has become one of the most interesting natural products to become mainstream in many years. Working with high-quality CBD products, we have found it to be very safe.

*Ashwagandha has been called the King of Ayurvedic herbs and has proven to be successful in reducing stress and anxiety. The herb also appears to calm the brain which leads to enhanced mental energy and better concentration. The daily dosage is related to the degree of anxiety disorder.

*Valerian Root is an herb used for centuries to treat insomnia and anxiety. The herb can produce drowsiness so daytime use should be monitored and be dose-related.

*Lemon Balm Extract is an herb used once a day to increase calmness and alertness in adults under mental stress 

*Skullcap is an herb that has been found to impact mood and reduce anxiety by stimulating the neurotransmitter GABA

*Chamomile and Peppermint Teas are herbs that offer a peaceful experience for reducing stress and anxiety

*Life Extension offers a blend of herbs (magnolia bark) and Phellodendron (bark) extracts, lychee (fruit), and green tea extract intended to balance the body’s cortisol response to stress

OTHER SUPPORT OPTIONS

*Lavender, Vanilla, Black musk, and Orange Essential OIls have all been proven to provide relaxation applied to the body, in a bath, used during a massage, via a diffuser, or inhaled. This is the field of aromatherapy.

*Homeopathic products are provided by Hyland’s (Nerve Tonic, Calms Forte), Similasan (Stress and Tension Relief), Bach’s series of Rescue Remedy products, and Boron’s Gelsemium sempervirens, Argentum nitricum, Ignatia Amara.

*Massage Therapy or other hands-on modalities is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. 

*Movement Therapies like Yoga, aerobic exercise, Tai Chi or Qi Gong

*Acupressure and Acupuncture Acupuncture is a form of alternative medicine and a key component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body.  Acupressure is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. 

*Emotional Freedom Technique (EFT) is an interesting alternative acupressure therapy treatment used to restore balance to a disrupted energy field and to help release unresolved trauma. 

*BioPhoton Light Therapy (Biontology.com) is the next generation of Acupuncture that uses the body's meridian system to rest the body so it can heal itself as originally intended.  A Biontologist neutralizes these energetic blockages (Chi) thus increasing the communication between organ systems and their cells to restore authentic wellness to every system in the body both physically and emotionally.

*Biofeedback is a mind-body technique that teaches awareness, profound relaxation skills, and ways to manage an anxiety attack, as well as ways to recognize, reduce and control stress responses

*Reiki is a form of energy healing from Japan that helps to reduce stress and anxiety by balancing the “life energy force” around us and with our bodies. 

Equal Breathing Practice

This breathing technique focuses on making your inhales and exhales the same length. 

Making your breath smooth and steady can help bring about balance and equanimity. 

Find a breath length that is not too easy and not too difficult. You also want it to be too fast so that you’re able to maintain it throughout the practice. Usually, this is between 3 and 5 counts.

Once you get used to equal breathing while seated you can do it during your yoga practice or other daily activities.

How to:

Sit in a comfortable seat, with your feet flat on the floor. Inhale and exhale through your nose. 

• Count (in your heart and mind) during each inhale/exhale so they are even in duration. Ideally count to 3, 4 or 5.  Inhale (1-2-3-4-5), Exhale (1-2-3-4-5), Inhale (1-2-3-4-5), and so on...

• Or, choose a word or short phrase to repeat during each inhale and exhale. Relaxing words such as peace, breathe, I am, or love.

• You can add a slight pause or breath retention after each inhale and exhale, if you feel comfortable. (Normal breathing involves a natural pause.)

• Continue practicing this breath for at least 2 minutes and work up to 5 minutes. 

As you practice this you can do this several times a day if you begin feeling flustered, out of balance, triggered by someone else’s mood or activity. 

WELLNESS Rx CLOSING COMMENTS and SUMMARY

Times of great change can be a pathway and the fuel we need to help us create a more interesting future, for all of us, not just some people. Fear is the root of depression, doubt, worry, hopelessness, and of course stress and anxiety. The antidote is love. For some, living in a state of love is not easy. 

We may not have experienced unconditional love like between a parent and their children or may have unresolved trauma that makes it difficult to connect through love with ourselves and others. How do we find the balm that will help us in these oh so difficult and often hopeless times? 

We may find help through our spiritual or religious practices, by reading or interacting with health and wellness practitioners.  In moments of darkness and despair, when we worry for our future, it is ourselves, our soul who we listen for, and try desperately to reach.  What is your soul telling you? What is your gut telling you? What is stopping you from simply accepting yourself as “who you are, imperfections and all”. 

Take a moment to visualize joy and happiness. Simply bring yourself to pause for a moment and visualize a time in your life that brought you tears of joy and rays of sunshine. For some, it’s a romantic sunset on the beach, for others hiking to the top of the mountain, and for others the birth of a child. Whatever the event, feel the energy that you felt at that moment. Smile and return to that visualized moment whenever stress is taking over.

Many in the growing field of Mindfulness suggest that you start taking five minutes in the morning (as early as possible) to connect with gratitude. Keep this in your own head and heart, it may not come easily at first. Have fun with this. It can be messy and humorous. Say to yourself, I am grateful for quiet time, or funny jokes my loved one shares. Grateful for the smiling clerk who gave me coffee. How grateful I am that I am right here, right now (even if you are having a hard day/week/month). I’m grateful for the sun rays, for the tree standing tall and providing shade. How grateful I am for cloudy days, and rain showers to bring us water for plants and for our use. Repeat the phrase over and over, “I appreciate this moment” even if the mind is saying otherwise. 

Finally, as we celebrate America’s 244th birthday, we are a land of confusion. Irritable, stressed, worn out, and simply being hit, over and over, by invisible forces. Only 12% of Americans reported in a recent poll that they are satisfied with the way things are going in their country. Not a pleasant cloud to be under, but it’s reality. It’s our reality. 

In times like these, it’s simple acts of kindness that make us feel better and healthier. Kindness, like love, is universal. A universal truth. Oftentimes, like forgiveness, the act of kindness brings more joy to the giver than to the receiver. According to a recent survey, we humans choose kindness over any other value. Over creativity, ambition, security, seeking power, self-interest (ego), or social justice.  Kindness is an innate emotion in all of us. 

We all benefit from acts of kindness. When we give from the heart and commit to being of service to others, we personally find joy, our family grows, our community grows, our nation grows and our world grows. 

So, our challenge to win back our country and ourselves may just start with random acts of kindness. After a while, random acts of kindness can become contagious, new seeds of hope can be planted and new models of community can begin to reveal themselves. Most important, random acts of kindness can help us feel better about ourselves, better about where our country is heading, better about our future, and hopefully, help us better manage our daily stress and anxiety.

❉  ❉  ❉  ❉  ❉  ❉

Edward Ullmann is the owner and managing Pharmacist of Wellness Rx Pharmacy located in the Catskill Mountains at 5980 Main Street Tannersville, NY 12485 (518) 589-9500 www.WellnessRxLLC.com

About Wellness Rx:  Wellness Rx Pharmacy blends Traditional Pharmacy with Natural Medicine and is located on Main Street in Tannersville, NY.  Wellness Rx looks at the person's entire scope of health of the whole person with this unique combined wellness approach.  Wellness Rx also has several alternative wellness practitioners available by appointment and listed on their website.