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As a holistic psychiatrist practicing in New York City, I see a lot of anxiety. A lot. And I'm disheartened to see so many of my patients on loads of psychiatric medications that are not necessarily helping and may even be causing harm. Meanwhile, these highly medicated folks are still suffering from anxiety! This is because we're going about it all wrong. Anxiety is not a Xanax-deficiency disorder. The mind, body and spirit are all involved in anxiety, but I think anxiety is first and foremost a physiologic disorder; that is, it's a disorder of the body, not just the mind. The good news is that shifting our body's physiology is relatively easy to do. There is so much we can do with diet and lifestyle to manage anxiety, and much of it is safer and more effective than medication.

Here are 6 tips for managing anxiety naturally:

Maintain Stable Blood Sugar
  1. "It isn't disrespectful to the complexity of existence to point out that despair is, often, just low blood sugar and exhaustion." - Alain de Botton
  2. The American diet promotes a blood sugar roller coaster, and every time we're on the ride down, we can feel anxious.
  3. When our blood sugar crashes, our body responds with a stress response. We secrete stress hormones, cortisol and adrenaline, which tell our liver to make more blood sugar to keep us alive. The good news: We stay alive. The bad news: This hormonal stress response feels identical to anxiety.
  4. By stabilizing blood sugar, you can avoid this stress response and decrease your anxiety.
Here's how to maintain stable blood sugar:
  • Eat more protein and healthy fats (e.g., olive oil, coconut oil, butter and ghee from pasture-raised animals).
  • Avoid sugar and refined carbohydrates.
  • Eat 3 meals and 2 snacks daily; don't skip meals.
  • Take a spoonful of coconut oil upon waking, in the afternoon and right before bed; this will serve as a blood sugar safety net throughout the day.
  • Always have a snack handy (e.g., nuts, hard-boiled egg, dark chocolate, Epic™ jerky, Vital Choice wild salmon jerky, almond butter).
Do a Trial Off Caffeine
  1. Don't underestimate the relationship between caffeine and anxiety.
  2. Think of it like this: When we're caffeinated, our nervous system is ready for a fight. Introduce a stressor, and you have an all out anxiety response.
  3. If you suffer from anxiety, you owe it to yourself to do a trial off caffeine.
  4. I know, I know, the idea of going off caffeine is giving you anxiety right now. If you reduce your intake gradually (coffee -> half-caf -> black tea -> green tea -> herbal tea) over the course of a week or two, you'll avoid withdrawal symptoms. After a few weeks, you may be surprised to see that your anxiety has decreased, your sleep has improved, your energy is stabilized, and you even tolerate stress better.
  5. If you had a successful trial off caffeine, but you want to go back to having that morning ritual, consider making green tea your go-to beverage, rather than a "Venti Skinny Vanilla Latte."
Sleep
  1. Getting adequate good quality sleep is your best protection against anxiety.
  2. There's a 2-way street between anxiety and sleep - anxiety causes insomnia and sleep deprivation makes us vulnerable to anxiety.
  3. The best way to address this is to set ourselves up for better sleep. Conveniently, the way to do this overlaps with the overall approach to anxiety.
  4. Here's how:
    • Reduce or eliminate caffeine
    • Even if you have no trouble falling asleep, caffeine decreases sleep quality.
    • Maintain stable blood sugar
    • Blood sugar fluctuations disrupt your sleep, causing middle of the night awakening.
  5. Be strategic about light:
    • Let your eyes see bright light in the morning and dim light at night.
    • If your room isn't completely dark when you sleep, wear an eye mask or get blackout curtains.
    • Wind down and unplug before bed
Heal the Gut
  1. Perhaps you've seen some of the recent articles about the relationship between gut flora and mood.
  2. The bugs in our digestive tract have a profound impact on how we feel and play an integral role in anxiety disorders.

  3. Comment: How the microbes living in your gut might be making you anxious or depressed

  4. Here's how to promote healthy gut flora and heal the gut:
    • Avoid what irritates the gut:
      • Food: Gluten, sugar, industrial vegetable oils, artificial sweeteners, alcohol.
      • Certain medications: Antacids, antibiotics, oral contraceptives (only make changes under close supervision from your doctor).
    • Add in what soothes the gut:
      • Fermented foods: Sauerkraut, kimchi, beet kvass, miso paste, apple cider vinegar, kombucha, kefir (if you tolerate dairy).
      • Starchy tubers: Sweet potatoes, white potatoes, plantain, taro, yucca.
      • Bone broth:
      • Supplements:
        • Take a probiotic.
        • Consider supplementing with glutamine and collagen.
    • Create the conditions for the gut to heal:
      • Squatty Potty can be life-changing.
      • Get enough sleep.
      • Manage stress with yoga, meditation, breathing exercises, unplugging, acupuncture, being in nature.
      • Treat gut infections. If you suspect you may have a chronic gut infection, get evaluated by an integrative or functional medicine practitioner.
Exercise
  1. Exercise is the best anti-anxiety medicine.
  2. If you struggle to exercise regularly, forget the boot camps and triathlons. Get in the habit of mini workouts. Do small amounts of exercise in your living room or take a brief walk outside. Sustainability is key.
  3. In general, stand more, sit less, walk whenever possible, and lower your standards for exercise.
  4. Yoga and Tai Qi are particularly beneficial for anxiety, but the most important thing is to find something you enjoy.
Magnesium
  1. Magnesium is mother nature's Xanax.
  2. Many of us are deficient in magnesium, since our food is grown in magnesium-depleted soil.
  3. You can supplement with magnesium in a few different ways:



Comment: Got anxiety? You may be deficient in magnesium


Anxiety has a significant impact on quality of life. Maintaining stable blood sugar, reducing caffeine, getting enough sleep, healing the gut, getting some exercise and filling the body with magnesium are safe tactics that go a long way toward reducing anxiety. If your anxiety does not respond to these lifestyle interventions, I recommend having a consultation with a qualified mental health provider.