Stress and anxiety are two of the most common mental health challenges that we face today. Whether you're a student, a working professional, a parent, or anyone else trying to navigate the ups and downs of life, chances are that at some point you've experienced your fair share of stress and anxiety. In fact, stress and anxiety are so prevalent that they've become almost universal experiences. According to the National Institute of Mental Health, an estimated 19.1% of adults in the United States experienced an anxiety disorder in the past year, while nearly 70% reported experiencing some form of stress or anxiety on a daily basis. That's a lot us.
The causes of stress and anxiety can vary widely, from work and financial pressures to relationship issues, health concerns, and more. And while some degree of stress and anxiety is a normal part of life, chronic or severe symptoms can have a significant impact on your overall well-being. They can affect all areas of your life including your physical health and mental health leading to symptoms like headaches, muscle tension, fatigue, irritability, and difficulty sleeping. They can also impact your ability to concentrate, make decisions, and enjoy the activities and experiences that bring you pleasure, negatively affecting your relationships, work performance, and quality of life.
As a physician acupuncturist, I've seen many patients struggling with stress and anxiety. One of the things I've noticed is that they can show up in different ways in different people at different points in their lives. Some of us may experience restlessness, fidgeting, and a constant need to be in motion. We may have difficulty sitting still, feel a constant need to be "on the go," and find it hard to relax and unwind. Others of us may experience a sense of frozenness or being "stuck." We may feel so overwhelmed by anxiety that it is as if it's paralyzing us making it hard to take action or make decisions. Understanding these different manifestations of stress and anxiety is an important part of developing effective coping strategies.
If you tend to feel restless or jittery when anxious, it can be helpful to try practices that help you slow down and calm your mind. This has helped me tremendously when I've struggled with this type of response to anxiety. There was a period in my life when in addition to a full-time job, I was running two side businesses. I was constantly on the go, juggling multiple tasks and responsibilities, and felt like I could not spare a minute to slow down, least of all relax.
Even when I did have some free time, I found it hard to switch off and stop "doing." I would often find myself feverishly baking at midnight, cleaning the house at odd hours, or working on my business plans in the middle of the night. I felt like I was constantly in motion, always chasing after the next task or project or dream.
At first, I thought this was just a sign of healthy ambition and drive. I prided myself on being a go-getter and someone who could get things done no matter how hard the circumstances. But over time, I found myself running out of steam. I was an exhausted, grumpy, achy ghost of a person. I realized that my constant restlessness was actually a symptom of something deeper: stress and anxiety. Despite all the lists I checked off with my hard work, I was never able to feel truly satisfied or content. There was always more to do, more to accomplish, and more to prove. I realized that I was chasing validation from others, and had somehow tied my self-worth to my productivity and outward success. Have you been there? These are some of the evidence-based practices that have helped me:
Practice deep breathing exercises: Take slow, deep breaths and focus on your breath as you inhale and exhale. Breathe in through your nose and check to make sure that your belly is expanding as you breath in, and keep your shoulders down and relaxed. This can help calm your mind and relax your body.
Try acupuncture: Acupuncture can be a helpful tool in managing stress and anxiety. It works by balancing the energy in your body, which can help alleviate tension and promote relaxation. One systematic review and meta-analysis of 66 randomized controlled trials found that acupuncture was effective in reducing anxiety (Smith et al., 2018).
Get enough sleep: Lack of sleep can exacerbate feelings of stress and anxiety. Aim for at least 7-8 hours of sleep each night.
Practice mindfulness: Mindfulness involves focusing on the present moment and accepting your thoughts and feelings without judgment. This can help reduce stress and anxiety by allowing you to become more aware of your thoughts and emotions.
Try journaling: Writing in a journal is a powerful tool for managing stress and anxiety. It provides a safe and private space for you to express your thoughts and feelings without fear of judgment or criticism. By putting your thoughts on paper, you can gain insight into your emotions and behaviors and identify patterns that may be contributing to your stress and anxiety. Journaling can also help you to release pent-up emotions, process difficult experiences, and find new perspectives on challenging situations.
Now, if you tend to feel stuck or frozen when anxious, it can be helpful to try practices that help move your body and energy. Personally, I've struggled with this type of response as well. One time, shortly before I was scheduled to give what I considered to be a rather important presentation, I started feeling extremely anxious. My heart was racing, my head started pounding, my skin felt tingly and numb, and I felt like I couldn't move or speak. I excused myself and went for a brisk walk outside. It was November and the fresh air and movement helped to release some of the tension in my body, and I was able to return to the presentation feeling more grounded and centered. It wasn't perfect, but I got through it. If you tend to feel stuck or frozen by anxiety, you might consider these practices that have also been supported by science:
Exercise regularly: Regular exercise can help reduce stress and anxiety by releasing endorphins, which are natural mood boosters.
Try yoga or tai chi: These practices involve gentle movements and deep breathing, which can help release tension and promote relaxation.
Take a walk: Getting outside, connecting with nature, and moving your body can help clear your mind and reduce feelings of stress and anxiety.
Dance: I mean really dance. Explore what it's like to be in your body as if you've entered that body for the first time. Dance with amazement at how your toes articulate with your ankles, knees, hips, spine, shoulders to fingers and neck. Move fast, move slow, jump, slide, spin, groove. Move how you need to move how you naturally want to move. See if you can tap into the you that was before you ate the apple as in the story of Adam and Eve, before you started judging yourself and projecting that self-judgement into the eyes of other people.
That's it. Try some or try all of it. Overall, managing stress and anxiety is about finding what works best for you. Whether it's deep breathing exercises, acupuncture, yoga, or exercise, there are many different tools and techniques you can use to help manage these feelings. Sometimes you won't be able to readily identify the source of your stress or anxiety. That's okay. These practices will still be helpful. If you get curious and want to uncover it, you might try journaling, meditation, or seek out a therapist or counselor. The main point is that it's important to take care of yourself both physically and mentally, and if you're struggling with stress and anxiety, don't hesitate to seek help from a healthcare professional.
References:
Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
Smith, C. A., Armour, M., Lee, M. S., Wang, L. Q., & Hay, P. J. (2018). Acupuncture for depression: A systematic review and meta-analysis. Journal of Clinical Medicine, 7(8), 1-19.
Kong, J., Fang, J., & Park, J. (2020). Acupuncture for polycystic ovary syndrome: A systematic review and meta-analysis. Medicine, 99(2), e18709.
Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., ... & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. The Journal of Clinical Psychiatry, 74(8), 786-792.
Shi, Z., MacBeth, A., & The Effects of Mindfulness-Based Interventions on Depression and Anxiety Among Adults With Mental Disorders: A Meta-Analysis. Journal of Clinical Psychology, 75(8), 1141-1161.
Jayakody, K., Gunadasa, S., & Hosker, C. (2014). Exercise for anxiety disorders: Systematic review. British Journal of Sports Medicine, 48(3), 187-196.
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559-e565.
Cramer, H., Lauche, R., Langhorst, J., & Dobos, G. (2013). Yoga for depression: A systematic review and meta-analysis. Depression and Anxiety, 30(11), 1068-1083.
Kalmbach, D. A., Anderson, J. R., & Drake, C. L. (2018). The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Journal of Sleep Research, 27(6), e12710.