"Do I have anxiety?"

“I’m just pissed off all the time!”

“My stomach hurts all the time!”

“I can’t sleep at night!”

“I just feel scared, and I don’t know why!” 

“I worry about everything!”

“I am having trouble breathing!” 

“My heart is always racing!”

“My arms and legs are always tingling!”

“I feel dizzy!”

“I’m sooo stressed out!”

The above expressions are just some of the chief complaints that we at City Care Family Practice encounter that can also be common indicators of anxiety.  Unfortunately, many of us will experience these feelings and thoughts, and not even grasp that these are feelings of anxiety.  Even more regrettably, among those who do realize, many do not want to talk about it and get help.  May it be due to the stigma of mental health, lack of social support, or simply facing one’s anxiety begets more anxiety, many people suffer in silence.  Anxiety is more widespread in our society than many of us realize or would like to admit. 

Now, anxiety is not always a bad thing.  A little bit of it can keep us on our toes and allow us to accomplish our busy workdays, take copious notes in our classes, and study for our tests.  Also, feeling anxious may just be a rare occurrence for many people, and when we do feel this way, we are able to effectively manage it and the emotions soon go away.  However, these feelings can also become very frequent and overwhelming, leading to intolerable restlessness, irritability, and sadness, which can soon cause trouble with interpersonal relationships and hardship at one’s job or school. 

There are many triggers to experiencing anxiety.  Something deep-seated, such as growing up in a stressful family environment as a child can lead to having these emotions bubbling to the surface as an adult.  Or something more obvious and in your face, such as a toxic working environment, living in a new city (like trying to acclimate to the hustle and bustle of New York City), transitioning from school life to the “real world”, an abusive relationship, a bad break-up, financial concerns, and substance abuse can lead to having anxiety.

Fortunately, there is an effective treatment for anxiety, and our team at City Care Family Practice is here to help.  You can schedule a visit with us anytime to discuss your symptoms, or at the very least, bring it up during your yearly physical.  To put it simply, we look to attack and conquer anxiety in three different ways, with treatment being best attained when all three ways are used:

Healthy diet and lifestyle

Healthy lifestyle habits are very effective at managing and ultimately eliminating anxiety.  A diet rich with fruits, vegetables, and proteins; and avoiding fried foods, alcohol, coffee, dairy products, acidic foods, and refined sugars can help decrease anxiety symptoms.   Current physical activity guidelines recommend 150 minutes of exercise per week (generally 30 minutes a day for 5 days a week or 50 minutes a day for 3 days a week).  Exercise allows for a healthy way to release stress.  Yoga and meditation are also great ways of releasing nervous energy and relaxing the mind.  Deep breathing, focused breathing, and alternate nostril breathing exercises can be employed during the actual stressful moment to help alleviate anxiety.

Talk therapy

Engaging in “talk therapy” with a licensed psychologist/therapist is also very effective at managing and eliminating anxiety.  Some may feel uncomfortable speaking with a stranger about their personal life, but for others, it may be easier to talk about what is troubling them with a stranger rather than a friend or family member.  Therapists can help unravel underlying issues in your past or review stress management techniques to help address what is presently causing anxiety.  City Care Family Practice can recommend therapists in the area for our patients.

Medications

Ultimately, as medical doctors, we can offer medication to help treat anxiety.  Common medications that are effective include SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro) that can help with long term management of anxiety.  Another class of medication called benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin) can help manage anxiety right when it is happening.  During our visit, the medication will be fully explained, and side effects will be reviewed before prescribing.  Regular follow up visits will always be scheduled to make sure the medication is working for you, and dosage changes can be made when needed.  Many people are able to wean off and stop taking medication once the anxiety is controlled.  If needed, a referral to a psychiatrist can also be given to our patients who need or prefer to see one.

As primary care physicians, we always fully investigate all medical causes of these symptoms along with the emotional causes.  With patience in finding the treatment that works for you, we can help you overcome the hurdles that anxiety brings in your daily life.