by Dr. Denise Renye, Licensed Clinical Psychologist and Sex Therapist, PsyD, MA, MEd, in San Francisco, CA

How to Cope with Anxiety If You Can’t Go to Therapy

I spoke with a friend of a friend recently who said he copes with anxiety solely through medication because that’s all he’s been exposed to. It got me thinking about how some people don’t know what else to try for anxiety other than pharmacological interventions because they may not have considered therapy as an option. And even many people who have considered therapy may not be able to afford it. Learning how to cope with anxiety in healthy ways can make such a difference.

This is quite the conundrum because anxiety disorders are the most common mental illness in the US, according to the Anxiety and Depression Association of America (ADAA). Anxiety affects 40 million adults in the U.S. ages 18 and older —  about 18.1% of the population. Also, anxiety disorders are highly treatable, but only 36.9% of people receive treatment.

Therapy and medication are two ways to manage treatment, but they’re not the only ways. What follows are strategies to cope with anxiety without going to therapy or taking drugs.

7 Non-Pharmacological Strategies for Anxiety

1. Exercise

You knew this one was coming, didn’t you? Anxiety is associated with energy; it’s why we have expressions like “fidgeting nervously,” or “a nervous tic.” Exercise is an outlet for that anxious energy. In addition, there are numerous studies that show exercise and regular activity are beneficial for anxiety, meaning exercise reduces it.

2. Change Your Diet

Did you know 95% of your serotonin receptors reside in your gut? It stands to reason then what you feed your gut affects your mood. That’s true and in fact, a 2016 study found healthy eating can alleviate anxiety. Is your diet high in processed foods such as frozen dinners, shelf-stable cookies, and potato chips? If so, those foods could be exacerbating your anxiety. What happens if you try eating differently?

3. Journaling

It’s not uncommon for a person to experience swirling thoughts when they’re anxious. Thinking about the future in a negative way can promote anxiety such as repeating to yourself: “I don’t look good in pictures,” “No one will come to my party,” “Everyone hates me,” or “What if I lose my job?” Writing those thoughts down, letting all your worst fears become expressed, can help release them from your brain and soothe the anxious parts of yourself. This is also helpful if you experience insomnia that may stem from anxiety.

4. Breathing

It seems so simple because we breathe all day long, but conscious breath can go a long way in alleviating anxiety. I’m a proponent of breathing into your belly, alternate nostril breathing, and circular breathing. I also have a free, guided, breathwork meditation. To start, set a timer for 30 seconds (and work up to three minutes) and see how you feel after breathing with intention and awareness. What I love about breathwork is it encourages a pause. Many of us are conditioned to fear a pause, to fear silence. With anxiety, your brain can run off without you, imagining ten steps into the future. Pausing, sitting in silence, brings your brain back to where your feet are, here, in this present moment. Noticing the present moment, being with the pause, the silence, you may notice things aren’t as terrible as they first seemed.

5. Yoga & Meditation

There are numerous kinds of yoga and meditation in the world, but nearly all of them help with anxiety. Experiment with different kinds until you found one that works for you. Yoga and meditation incorporate many of the characteristics I listed above: pausing, breathwork, and focusing the mind.

6. Spirituality

I view a spiritual practice as complementary to therapy and depth coaching because it can help provide access to the internal world. Spirituality can be defined simply as a sense of connection to something greater than yourself and can offer meaning as well as purpose in your life. Cultivating a meaningful connection with something bigger than yourself just may result in emotions such as peace, awe, and contentment. In other words, a spiritual practice — tailor-made for you — can help you cope with anxiety.

7. EFT/Tapping

Emotional Freedom Technique (EFT), also known as tapping, combines cognitive therapies with acupressure for the treatment of psychological distress. A 2016 study found EFT demonstrated a significant decrease in anxiety scores, even when accounting for the effect size of control treatment. More recently, in 2019, researchers found EFT helps physiologically, meaning not only did study participants self-report that they felt better, but their bodies also showed a decrease in resting heart rate and blood pressure and an altering of cortisol levels.

Adult Children of Alcoholics (ACA)

Sometimes it’s really hard to manage anxiety on your own and you just may need support. If money is an issue, Adult Children of Alcoholics (ACA) meetings are a great option. The meeting is open to not only children raised in alcoholic homes, but anyone raised in a dysfunctional environment. The program functions like other 12-step groups in that members share for a limited time and there’s a sponsor or fellow traveler to help a person through the steps. That means there’s a community of people to support you as you learn how to cope with anxiety. However, what’s unique about ACA is that it also addresses post-traumatic stress disorder (PTSD) and has literature devoted to nurturing an inner loving parent. Creating a strong, secure, attachment figure within yourself could help calm anxious parts of yourself, especially if the anxiety is arising from your inner child.

If you’re struggling with anxiety, you don’t have to suffer through it. Anxiety is treatable with a multitude of drugs, therapy, and any of the methods I mentioned above. If one method doesn’t work, try another. And try it for some time as it may take a while. Just know, relief is possible. Start your search for a therapist today.

References

Anderson, Elizabeth; Shivakumar, Geetha. “Effects of Exercise and Physical Activity on Anxiety.” Front Psychiatry. 2013;4:27. doi: 10.3389/fpsyt.2013.00027

Anxiety and Depression Association of America. “Facts and Statistics.” https://adaa.org/understanding-anxiety/facts-statistics, accessed November 18, 2021.

Bach, Donna; Groesbeck, Gary; Stapleton, Peta; et al. Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. J Evid Based Integr Med. 2019;24:2515690X18823691. doi:10.1177/2515690X18823691

Carpenter, Dr. Siri. “That Gut Feeling.” American Psychological Association. September 2012; 43(8): 50. https://www.apa.org/monitor/2012/09/gut-feeling

Clond, Morgan. “Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis.” J Nerv Ment Dis. 2016;204(5):388-395. doi: 10.1097/NMD.0000000000000483.

Null, Gary; Pennesi, Luanne; Feldman, Martin. “Nutrition and Lifestyle Intervention on Mood and Neurological Disorders.” J Evid Based Complementary Altern Med. 2017 Jan;22(1):68-74. doi: 10.1177/2156587216637539.

Most people would agree the media today is inundated with unrealistic portrayals of women’s bodies. Because of practices such as choosing primarily thin, young, white women to sell products and using Photoshop to erase natural “flaws” and “imperfections,” to name a few, we are not exposed to a diverse (one might also say realistic) array of people. Consequently, generations of people grow up believing their appearance is inferior because it is not widely represented or considered to be “ideal.”

In my practice, I frequently work with women who are struggling with anxiety. Concerns related to weight and body image almost always come up as a contributing fact—in no small part, I believe, due to the media messages regarding the “ideal” body. Many people today have a tremendous fear of being judged for weight gain or their size. Fears and insecurities surrounding the body may take many forms. Some may fear being passed up for promotions or being looked down on at work due to weight stigma or sizeist stereotypes. Other individuals might fear never having a romantic relationship because potential love interests consider their size unacceptable.

Fears contributing to general feelings of anxiety may not always be rational, but unfortunately, weight stigma is a real concern in our society. The size-based discrimination and prejudice many people experience is likely to contributes to or exacerbate feelings of anxiety, depression, and other mental health challenges. Thus, these feelings of anxiety in particular may be more difficult to address. Further complications often result when, in an effort to achieve what societal messages suggest to be an “ideal” body, people develop unhealthy relationships with food and their bodies to achieve this ideal. [fat_widget_right]

From one fad diet to the next, the message is often the same: restricting food and ignoring the body’s natural hunger cues will lead to perfection. Instagram and other social media platforms are filled with pictures of plates of vegetables and videos of workouts meant to inspire. Whether a diet is low-fat, low-carb, or sugar-free, it does not often promote the development of a healthy relationship with all foods.

Take the current trend of clean eating as an example. Clean eating moralizes and judges foods by designating some as “clean” (and therefore acceptable to eat) and implying that consuming foods not considered clean results in the ingestion of dirty or toxic substances. Cleanses, or highly restrictive fasts meant to rid the body of perceived impurities, are increasingly popular, and people talk about “cheat days” as if they are committing a crime by eating sweets or processed foods. It is common to see posts in which people apologize for eating “unclean” foods or say they are being “bad” for eating them.

Clean eating has become prevalent enough that the term orthorexia nervosa was developed to help describe it when taken to an extreme. Though orthorexia is not currently listed in the Diagnostic and Statistical Manual, it bears similarities to other eating disorders. People with symptoms of orthorexia are often so fixated on living a “clean life” that they restrict their food intake to certain items and exercise excessively for purported health reasons. This fixation can have a serious impact on a person’s mental and emotional well-being as well as their physical health and social life.

This may seem like a radical idea, but you are perfect just the way you are, regardless of your size. Your worth is not determined by a number on the scale or a size of clothing. Focus on the beauty and strength you find in yourself and build on those aspects.

Of course, there is nothing wrong with wanting to include nutritious foods into our diets or making sure we exercise to keep our heart and bodies healthy. But somewhere along the line, eating became an act that was no longer intuitive. Years of yo-yo dieting, eating on prescribed schedules, or restricting entire food groups has taken its toll on our physical and mental health, to the point where we no longer trust our own bodies to tell us what, when and how to eat. Movement and physical exercise are no longer simply enjoyable activities, but rather the means to a thin end.

So, what is the answer? How can a person combat body anxiety amid internal and external pressures and messages faced on a daily basis?

The following five ways can help you begin to let go of anxiety and become better able to practice self-love.

Start to build trust in yourself.

Instead of constantly fighting your body, learn to trust it. Intuitive Eating is a philosophy that focuses on teaching people to trust their food desires and hunger cues. Many dietitians are teaching the people they work with to listen to the body’s messages, whether they desire “good” food or “bad” food. It is often a long process, but once your body learns you will no longer restrict certain foods or allow it to go hungry, it will tell you exactly what nutrients and type of food it needs.

Embrace yourself as you are today.

So many people put off adventures, shopping, and life events because they are waiting until they reach a certain weight or body shape. Let’s instead learn to love ourselves just as we are today. This may seem like a radical idea, but you are perfect just the way you are, regardless of your size. Your worth is not determined by a number on the scale or a size of clothing. Focus on the beauty and strength you find in yourself and build on those aspects.

Know your triggers.

Just like any other form of anxiety, body anxiety can be triggered by certain words, people, or actions. Become familiar with who or what sends your anxiety about your body skyrocketing, and then develop a plan. Avoid unnecessary triggers and be prepared for those that are unavoidable.

For instance, if you avoid going to the doctor because you become anxious when you are weighed, let the staff know ahead of time that you do not plan on stepping on the scale. If you have family members who make it their business to comment on what you eat or how you look, prepare a response for them and have it ready so you are not flustered or too embarrassed to address their remarks. By taking these actions you can be more proactive in reducing your anxiety.

Change your feed, not your food.

It can feel overwhelming when you are constantly confronted with images of the “ideal” body type or when all you seem to see in your social media feeds are posts about diets and weight loss. But remember, you have the right to remove anything that feels shaming (this includes people who make you feel ashamed!) from your social media feed and replace them with people and messages that inspire you to love yourself just as you are. Consider following body acceptance advocates and people who demonstrate that fitness and self-love do not come in the form of one body shape, size, color, or age. Doing this can help you feel more positive and inspired when you look at Instagram and other social media apps.

Find the right therapist.

If you are seeking help to change the way you perceive your body and reduce body anxiety, the right therapist is essential. It is important to find a therapist who is educated about Health At Every Size (HAES), a movement that encourages people to work on their physical and mental health without focusing on body size. Therapists are people, after all, and they are not immune to the outside messages about what “health” looks like. Mental health professionals may come into sessions with their own implicit biases about weight and food, so finding a therapist who supports your journey to self-love and acceptance without making it about weight loss is instrumental as you work toward these goals.

References:

1. Bates, L. (2014, October 14). Why is women’s body image anxiety at such devastating levels? The Guardian. Retrieved from https://www.theguardian.com/lifeandstyle/2014/oct/14/women-body-image-anxiety-improve-body-confidence
2. Bell, L. (2015, July 1). Body image and social anxiety. Eating Disorder Hope. Retrieved from https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/anxiety/body-image-and-social-anxiety
3. Get the facts on eating disorders. (2016). NEDA. Retrieved from https://www.nationaleatingdisorders.org/get-facts-eating-disorders
4. Kratina, K. (n.d.). Orthorexia nervosa. NEDA. Retrieved from https://www.nationaleatingdisorders.org/orthorexia-nervosa
5. Multiple anxiety disorders share an elevated concern over physical appearance. (2015, November 4). Anxiety.org. Retrieved from https://www.anxiety.org/body-image-a-common-source-of-anxiety
6. Orthorexia symptoms and effects. (n.d.). Timberline Knolls. Retrieved from http://www.timberlineknolls.com/eating-disorder/orthorexia/signs-effects/
7. Puhl, R. (2015, December 11). Stigma and ‘fat shaming’ can fuel depression and increase obesity. WBUR. Retrieved from http://www.wbur.org/hereandnow/2015/12/11/obesity-stigma-fat-shaming