Monday Medical: Strategies for decreasing anxiety

Susan Cunningham
Monday Medical

Editor’s note: This article is Part 2 of a two-part series on anxiety. Part 1 focused on anxiety basics and screenings.

A recent recommendation to screen all adults for anxiety as part of routine health check-ups means that anxiety disorders will likely be diagnosed and treated more regularly.

“It’s an exciting time for the health field to be tackling the mind-body connection in such a deliberate and intentional way by weaving these screening tools into routine visits,” said Amy Goodwin, a licensed professional counselor and behavioral health counselor at UCHealth Behavioral Health Clinic in Steamboat Springs. “We’re acknowledging that if you have issues such as high blood pressure, anxiety may be contributing to that.”

The brain-body connection

Medication can help prevent anxiety, but behavioral health treatments are just as important.

“Anxiety is the brain using the body to communicate perceived threat, so we orient to strategies that engage both the brain and the body,” Goodwin said. “That’s what cognitive behavior does — it’s trying to engage both the brain and body at the same time to have a more thorough impact.”

Learning strategies to address anxiety is empowering.

“It’s less scary if we have some sense of our own personal efficacy,” Goodwin said. “That’s a very important part of managing anxiety, seeing we’re not helpless in this situation.”

Techniques for the body

Various strategies can help decrease anxiety, such as using the senses to be mindful of what’s going on inside your body, or square breathing, in which you breathe in, pause, then breathe out and pause, doing each step for a count of four.

But the top recommendation is as simple as it can be hard: exercise, which natural releases the fight-or-flight stress hormones that are produced with anxiety.

“Exercise is really the No. 1 preventative and management tool for anxiety,” Goodwin said. “It does exactly what we’re designed to do when stressed — to fight or flight so we can get to safety. Our body burns through those stress hormones, which releases us from our stress response, then we can think a little more clearly about what are our problems are or are not, and how we would like to manage them.”

The first 20 minutes of exercise can feel especially hard as your body is working through those stress response, but take heart — once the stress response is cleared, exercise gets easier.

If you’re not sure where to start, Goodwin recommends putting on tennis shoes and walking up a steep hill — that is guaranteed to release the stress response.

Techniques for the mind

A cognitive behavioral therapist can also help patients dispel anxiety by using strategies to discipline their thoughts. One key is to distinguish between problems that are in or out of your control.

“If we’re thinking about problems for which we can’t create solutions, that creates anxiety,” Goodwin said. “We have to orient back to, ‘What are the problems that are mine, versus what are the problems that aren’t mine?'”

Avoid self-medicating

It’s important to tease out whether substances such as alcohol or drugs are being used to quell anxiety.

“If you’re using alcohol as a management tool, it’s like throwing gas on a fire you’re trying to put out,” Goodwin said. “It worsens anxiety, increases insomnia and negates the efficacy of medications like SSRIs, or selective serotonin reuptake inhibitors.”

Take time to build skills

Goodwin reminds her patients that it takes time and effort to build these strategies into their lives.

“We need to practice these skills in order to really become effective and proficient,” Goodwin said.

At first, implementing new strategies can feel difficult, frustrating and even ineffective. But stick with it, and you’ll see results.

“People tell me all the time, ‘I tried deep breathing and it didn’t work.’ But you can’t pick up a violin and immediately play Beethoven,” Goodwin said. “I really encourage people to give themselves a little bit of a learning curve before they start to assess how things are working.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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