Anxiety and Stress Resources
Introduction
Everyone has anxiety to varying degrees, and we can all learn to do a better job of managing it.
Fundamentals first: Diet, exercise, and sleep.
Diet is a critical part of overall health, including stress reduction. Eating a diet that is low in sugar (i.e. limiting breads, sodas, candy, etc.) and not skipping meals will help improve your mood by keeping your blood sugar levels consistent.
Exercise is an outstanding stress reliever and is healthy. Everyone (after getting a physical exam by their doctor) should aim to exercise at least 30 minutes five times per week, but even five minutes per day consistently will have noticeable results over time.
Sleep - Most people need about 7-8 hours of sleep per night, and will deal with anxiety better if they get it.
In addition to the above, four key techniques to help manage anxiety include: meditation, guided imagery, progressive muscle relaxation, and breathing exercises. You can put any of these terms into a Google search, type into amazon.com, type into the app store on your phone, or ask/search at your local library to find more resources or information.
There are many great options out there to help with anxiety and stress; below are few to get you started. The key to all of these is you must practice them regularly for the best results. Just like you would gradually build up endurance in running over months before attempting a marathon, you need to gradually build up your skills in these exercises to see the full effect. Don’t be discouraged if you don’t see a dramatic result immediately. With practice, you will start to see subtle but significant changes in how you deal with anxiety.
-The easiest technique to learn with the quickest effect is progressive muscle relaxation, so this is a good skill to start with.
-You should learn diaphragmatic breathing in order to benefit most from meditations.
-In general, CD/Audio Resources or Apps on your phone are a good starting point as someone guides you on what to do - you
just relax and follow along.
Meditation, Guided Imagery, and/or Progressive Muscle Relaxation
UCLA Mindful (phone app)
Excellent step by step introduction to meditation, available in many languages besides English.
Rivka Simmons-Creating Calm in Your Life (CD)
With 2 meditations (approximately 15 min each), a guided imagery exercise, and a progressive muscle relaxation exercise – a good starting point as her CD has three of the key anxiety coping techniques
Calm (phone app)
An excellent starting point for learning to meditate. In this app you can track your daily time progress as you are walked through a variety of meditations step by step. Also has body scan exercises, which are similar to progressive muscle relaxation for helping to quickly calm yourself down in the moment when you are feeling anxious.
Kaiser Permanente Healthy Living Podcasts (website)
Meditations and guided imagery audio files. Focus on the sections of “Emotional Wellness” and “Living Healthier,” although other sections may apply as well
Jon Kabat-Zinn - Mindfulness for Beginners (CD/audiobook)
Nice CD with step by step guided meditations and discussion of why/how meditation works. He also has several books (Example: Full Catastrophe Living) which can be helpful/insightful if you enjoy reading.
HeadSpace (phone app)
Great meditation program what walks you through how to meditate.
Breathe (phone app)
a great meditation app with guided meditations
Progressive Muscle Relaxation
Systematic tensing and relaxing of muscles from head to toe (or toe to head). One of many written scripts can be found here: http://www.mckinley.illinois.edu/units/health_ed/stress_audio/pmr_txt.html Googling can readily find others. Many step by step videos can be found on YouTube, one example is the following: https://www.youtube.com/watch?v=DalxIqYuKYk
Omit any significant backward neck bending exercises, particularly if you have neck problems.
Breathing Exercises
Diaphragmatic Breathing
A core breathing exercise for anxiety reduction can be used by itself or during meditation. Excellent video instruction can be found here:
Breathe2Relax (phone app)
Also teaches diaphragmatic breathing.
4-7-8 Breathing
Breathing exercise that with practice can help you immediately change your mood and calm down in stressful situations. This can also help you to fall asleep at night.
Full Explanation and Demonstration
http://www.drweil.com/drw/u/VDR00112/The-4-7-8-Breath-Benefits-and-Demonstration.html
Shorter video for use on a regular basis when first learning
https://www.youtube.com/watch?v=gz4G31LGyog
The above pattern of breathing can also be done as cycles of 4 (inhale for 4 seconds, hold your breath for 4 seconds, exhale your breath over 4 seconds, then repeat). You can also add a 4 second pause in between your exhalation and inhalation if this is comfortable. Don’t do more than 4 cycles of this breathing at a time.
Books, Websites, and Audio Resources
From Panic to Power by Lucinda Bassett. Excellent book that gives practical, effective approaches to anxiety. She uses an approach related to “cognitive behavioral therapy (CBT),” which has been shown to be one of the most effective approaches to managing anxiety.
Attacking Anxiety & Depression Program by Lucinda Bassett and Philip Fisher, MD. Outstanding step by step audio program (CDs) that walks you through a CBT and meditation/guided imagery related program for anxiety disorders. www.stresscenter.com
The Anxiety & Worry Workbook - The Cognitive Behavioral Solution by David A. Clark and Aaron T. Beck. Nice step by step workbook that walks you through how to create a CBT program for yourself
The Anxiety & Phobia Workbook by Edmund J. Bourne
nice holistic resources when used in conjunction with a dedicated CBT resource (book and/or therapist) for dealing with anxiety, geared towards anxiety disorders but useful for everyone.
Self-Help That Works: Resources to Improve Emotional Health and Strengthen Relationships by John C. Norcross and colleagues.
Excellent resource with recommendations for books, online resources, movies, etc.
Full Catastrophe Living by Jon Kabat-Zinn. Detailed, helpful book that gives a mindfulness approach to anxiety.
The Kelee Meditation. a good, short variation of meditation
Ted Talks:
The Art of Happiness - A Handbook for Living
Book by His Holiness the Dalai Lama and Howard Cutler, MD – an outstanding overview of constructive approaches to stress and life challenges - a balanced scientific and philosophical discussion of how certain attitudes and habits can increase happiness and reduce anxiety
In addition to the above, make sure you take time to do things you enjoy on a regular basis such as spending time with friends or doing a hobby. You must make time for yourself no matter how busy you are. You cannot be as effective working or helping others if you don’t take care of yourself. This includes setting healthy boundaries in your work and relationships with family, friends, and significant others.
In anxiety producing situations, think about the advice you would give a friend if they came to you with the same concerns. You MUST be at least as forgiving and compassionate with yourself as you would be with a friend. For example, if you would tell your friend to say no to extra work that is assigned to them by their boss, you need to be fair to yourself and allow yourself to do the same – you are just as valuable of a person as your friend is.
Although there are certainly things that can trigger us to feel anxious, how we respond with our thoughts to the stressors in our life is responsible for the majority of how we feel. This is why CBT is so effective. Through the above techniques we can learn to react less to any stressor in our life, and thus be less stressed in general.
We care about your health, and anxiety and sadness can sometimes be extreme. If you have any thoughts of hurting yourself or others, please contact your healthcare provider or go to the nearest emergency room immediately.
Many things in our life are out of our control, but one of the things we do have control over is accepting the fact that many things in our life our out of our control.
Supporting Scientific Research
Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006 Jan;26(1):17-31. Epub 2005 Sep 30.
Hopper, SI et al. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports. 17(9): p 1855-1876, Sept. 2019
Pascoe, MC et al. Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. J Psychiatr Res. 2017 95:156-178
Mayo-Wilson E, Montgomery P. Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults. Cochrane Database Syst Rev. 2013 Sep 9;(9):CD005330. doi: 10.1002/14651858.CD005330.pub4. PMID: 24018460.
Finch AE, Lambert MJ, Brown GJ. Attacking anxiety: a naturalistic study of a multimedia self-help program. J Clin Psychol. 2000 Jan;56(1):11-21. doi: 10.1002/(sici)1097-4679(200001)56:1<11::aid-jclp2>3.0.co;2-g. PMID: 10661365.
Huberty, J.L., Green, J., Puzia, M.E., Larkey, L., Laird, B., Vranceanu, A.M., Vlisides-Henry, R., Irwin, M.R., 2021. Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial. PLoS One. 16, e0244717.
Purdie DR, Federman M, Chin A, Winston D, Bursch B, Olmstead R, Bulut Y, Irwin MR. Hybrid Delivery of Mindfulness Meditation and Perceived Stress in Pediatric Resident Physicians: A Randomized Clinical Trial of In-Person and Digital Mindfulness Meditation. J Clin Psychol Med Settings. 2023 Jun;30(2):425-434. doi: 10.1007/s10880-022-09896-3. Epub 2022 Jul 1. PMID: 35778655; PMCID: PMC10078965.