Managing Anxiety, Part II: Lifestyle Choices

By Contributing Editor for Health & Wellness Kathy Whelan

In last month’s article, I wrote about mindfulness and developing a new relationship with anxiety. This month, I explore self-help measures in four areas of health – diet, exercise, sleep and relationships – that can support our bodies and minds and help relieve anxiety.

Often when we experience anxiety, we worry about things over which we have little or no control. The beauty of focusing on lifestyle choices is that we are in the driver’s seat, in charge of where we go and how we get there. Not only do we set and achieve goals that are ours alone but we gain confidence in our ability to shape our lives.

Diet: “You Are What You Eat”

Typically, we take this old expression to refer to physical health, but now, thanks to the new field of nutritional psychiatry, we know it applies to mental health as well. There is constant, two-way communication between our minds and bodies and a particularly strong connection between the gut microbiome and the brain. The food-mood connection is real and very powerful.

The Healthy Eating Plate created by Harvard School of Public Health offers a snapshot of a healthy diet. Absent special dietary needs, its emphasis on healthy oils, vegetables, fruit, whole grains and healthy protein (beans, nuts, fish and lean poultry instead of red and processed meats and cheese) represents a high-quality diet suitable for most people.

This is in line with the Mediterranean dietary pattern found in areas of the world known for the longevity and vitality of their populations. In terms of quality, it is far from the so-called Standard American Diet (“SAD”) with its many highly processed, refined and high-sugar foods that are more animal- than plant-based and often lead to obesity, which is linked to increased anxiety.

Specific dietary recommendations for reducing anxiety can be found in the tips offered by nutritional psychiatrist Uma Naidoo, whose new book, This is Your Brain on Food, contains a full chapter on the subject.

Physical Activity: Motion and Emotion

Easing anxiety is one of many benefits of physical exercise, which decreases muscle tension and helps release calming chemicals into the bloodstream. In fact, our bodies are wired to calm down when we move. Mindful exercise, in which we observe our moment-to-moment experience, helps divert attention from the focus of our anxiety. While aerobic exercise is especially helpful for reducing anxiety, any kind of physical activity is beneficial. What’s important is finding a kind of exercise you like enough to do regularly.

The U.S. Government’s Physical Activity Guidelines for Americans recommend that adults get 150 minutes per week of moderate-intensity aerobic activity (or half that much vigorous-intensity activity) plus two sessions per week of strengthening exercises. For older adults, balance exercises are also recommended. The Guidelines include specific recommendations for people of different ages and in different conditions.

Sleep: Less is Not More

Sleep is vitally important to our overall health and wellbeing and is key to supporting mental health. It energizes our cells, clears waste from the brain, supports learning and memory and increases immunity. It also plays an important role in regulating mood. Yet many adults do not get the seven to nine hours of nightly sleep recommended by the National Sleep Foundation (NSF).

Sleep deprivation may occur because we don’t prioritize sleep – even taking pride in “getting by on less” – but sometimes it’s more complicated. Unlike healthy eating or exercise that we can, in effect, make ourselves do, the more we struggle with sleep, the less successful we are. Our cultural challenges with sleep have led to the popularity of helpful “sleep hygiene” tips, such as those from the NSF.

In addition to these tips, other practices can help, such as using meditation apps for sleep, keeping a gratitude journal or writing out lingering worries to tuck away until the next day. Reframing a nagging To-Do list as a Ta-Da! list of accomplishments can put a positive spin on the day and help you relax. If you fall asleep, awaken and are unable to get back to sleep, it’s usually better to get up and do something calming until your body is ready for sleep again.

If you suspect you have a sleep disorder like sleep apnea, insomnia, narcolepsy or restless leg syndrome, you should consult a healthcare provider in addition to practicing self-help.

Relationships: Quality Over Quantity

Social interaction is a biological requirement just like eating, hydration, movement and sleep. It strengthens the immune system, contributes to longevity, and correlates with less anxiety. Solitary time is important, too, for reflection and introspection, but too much solitude, whether forced or by choice, can be harmful.

Feeling connected is the key, but scientists say that not every social interaction serves this purpose. The quality of our relationships matters more than how many friends we have. It’s important to prioritize relationships that make us feel good, involve reciprocity and cooperation, and allow us to be authentic, even vulnerable. If you are unable to see your friend or relative in person, a virtual visit is better, relationally, than a phone call, but either is better than no contact at all. An excellent way to strengthen important relationships is by becoming a more mindful listener.