When it comes to treating anxiety, some people may benefit from medication, while others manage with psychological or natural approaches. Still others might find that a combination prescription drugs, therapy and self-help strategies is most effective. In other words, there’s no one-size-fits-all.
Vancouver’s Mia Kelly has lived with the condition since her late teens, trying various forms of talk therapy, including cognitive behavioural therapy (CBT), to little beneficial effect for years. She worried about things to the extreme, avoided many social situations, and experienced symptoms like sweating and rapid heartbeat more often than not.
It wasn’t until she was in her early 30s that she started taking medication for her chronic anxiety. Along with regular exercise, she noticed a significant change.
“I wish I would have started taking medication sooner,” says Kelly, now 49. “Working out is a huge part of my mental health, but I feel far more stable. A lot of people say you should be able to deal with it with counselling or that it’s a cop-out to take medication, but my anxiety was so severe that that [counselling] just wasn’t cutting it.”
Jennifer Ho has also struggled with anxiety, experiencing panic attacks when she felt especially overwhelmed. Rather than take medication, the 40-year-old Vancouver resident manages her symptoms through a variety of other techniques. One is cognitive-behavioural therapy, which is a psychological approach that helps people think about themselves and perceived problems in different ways. She does breathing exercises, meditates, and has an essential-oil diffuser at home to disperse soothing scents like lavender; she also finds acupuncture helpful.
“It takes effort to keep my anxiety in check, but I feel like I can manage it,” Ho says.
Health professionals emphasize that treating anxiety is a highly individualized process. It often takes a combination of CBT, medication, physical activity, and self-help strategies like mindfulness (where you focus on breathing so that you can be aware of and in the present moment) to effectively manage the condition.
“A lot of people benefit from CBT,” says Fardous Hosseiny, national director of research and public policy at the Canadian Mental Health Association. “It teaches you how to manage thoughts, feelings, and behaviours—all of these elements work together. It helps you to change any unhelpful patterns in your thinking that can feed anxious thoughts.”
Several types of medication can be used to treat anxiety. They include benzodiazepines and selective serotonin reuptake inhibitors (SSRIs, better known as anti-depressants).
“There could be a physical cause for anxiety, an imbalance in brain chemistry where it’s necessary to have medications involved,” Hosseiny says. “Some people need medication; that’s part of their therapy. If it can be combined with other forms of therapy or self-management tools, even better.
“Whatever you need to get better is what we would advocate for,” he adds. “Some people can’t survive without medication and they need it. It’s our job as an organization to advocate on behalf of people with lived experience regardless of what form of treatment is involved.”
The caveat when it comes to medication, he says, is the potential for dependency, which is why having other forms of therapy is so important. Medication can also have a range of side effects, from diminished sex drive to nausea.
However, taking medication for anxiety shouldn’t be judged negatively. “We don’t shame someone who takes medication for diabetes,” Hosseiny says. “We need that parity lens. Mental health should be looked upon in the same light as physical health, or we’ll never get rid of the stigma.”
Cameron McIntyre, a doctor of naturopathic medicine in North Vancouver, says that there are multiple ways to treat anxiety without medication, but that it’s sometimes necessary. “There are serious conditions and times and places where medication is required, no question,” says McIntyre, who works out of the Restoration Health Clinic. “I’m not averse to that at all. But it’s important to address the underlying causes for why they’re in this state.”
Causes of anxiety are individual and multifactorial. It plays havoc with stress, McIntyre says, and leads to the release of cortisol, a stress hormone.
“When cortisol becomes dysregulated over time, that can throw a monkey wrench into lots of systems, not the least of which is sleep,” he says. “So much of our ability of function in the course our day depends on how well we’ve slept the night before.”
Managing blood sugar is another way to help manage anxiety, since extreme highs and lows affects adrenaline levels, adding fuel to the fire. “If you’re already prone to anxiousness, and you’re having a yo-yo of your blood sugar, you’re going to have more adrenaline in your system, which is just adding fuel to the fire,” McIntyre says. “Making sure good sources of protein are being consumed, making sure good fats are being consumed, allows us to avoid the yo-yo.”
Spending time in nature can have dramatic effects on reducing anxiety.
“There’s lots of research coming out about what our body chemistry does in states of nature and how beneficial that is for us,” McIntyre says. “You’ve probably heard the term ‘forest bathing’. Doctors are now writing prescriptions for people to get out and walk in the trees, to experience that nature connection. There’s has a whole host of beneficial effects; there’s an endorphin release and calming of the nervous system when we’re communing with nature.”
Other approaches people can incorporate into their daily life to address anxiousness include yoga and breath work.
“It’s been shown that 10 deep breaths will bring the body and mind out of a state of anxiousness and into a calmer state,” McIntyre says. “Dancing, a nice bubble bath, anything that brings joy [can help]. We get so used to being in ‘go’ mode, and I’ve seen so many people where anxiety is their default state because they’re going 100 iles an hour and their brains don’t know any different anymore. So it’ all bout engaging in activities that reteach the brain and the body how to relax.”
Certain supplements can help. Magnesium helps calm the nervous system; one way to get magnesium is via Epsom salts. Vitamin C can be beneficial too: “The more stress we experience, the more vitamin C we burn,” McIntyre says. “Often, anxiety and stress lead to a poor immune function.”
Research also points to the benefits of essential oils and how the scents of various plants send signals to the brain to relax. Using a diffuser is one way to breathe them in; so is putting a couple of drops in bath water or on your pillow.
Reducing the amount of time spent on electronic devices is also crucial for anyone who experiences anxiety.
“Screens are massively going to be shown to be significantly detrimental to brain health and particularly to brain energy,” McIntyre says. “They are high in blue light. It does two things: it lowers mitochondrial function, which is the battery power in all the cells in our body, and it keeps the brain in beta state, which is hyper alert. This is and will become a larger factor in the health of us all as we move forward with electronics. Especially with teen girls and especially with social media, there are massive correlations between screen time and anxiety.”
During the month of October, Yahoo Canada is delving into anxiety and why it’s so prevalent among Canadians. Read more content from our multi-part series here.
Abacus Data, a market research firm based in Ottawa, conducted a survey for Yahoo Canada to test public attitudes towards anxiety as a medical condition, including social stigmas and cultural impacts. The study was an online survey of 1,500 Canadians residents, age 18 and over, who responded between Aug. 21 to Sept. 2, 2019. A random sample of panelists were invited to complete the survey from a set of partner panels based on the Lucid exchange platform. The margin of error for a comparable probability-based random sample of the same size is +/- 2.53%, 19 times out of 20. The data was weighted according to census data to ensure the sample matched Canada’s population according to age, gender, educational attainment, and region.