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October 9, 2015 / 26 Tishri, 5776
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Anxiety: Can It Be Controlled?

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As a teenager, I suffered from occasional panic attacks, social anxiety, and more than the usual amount of teenage angst. In today’s drug-obsessed society, I would certainly have been given psych meds; thankfully, back then, it was expected that maturity would bring greater resilience and awareness. And so it was.

Over the years, I developed numerous skills to help calm myself. I also learned that all normal people have ups and downs and worry at times about their health, relationships, finances, and major life changes.. This is because the amygdala, a walnut-sized area located deep within the primitive brain, is forever busy alerting us to possible dangers, both internal and external. On the positive side, the amygdala is what tells us to wash our hands to stay healthy, to drink water to stay hydrated, to stay away from dangerous people, to make sure that we lock our doors and to get to a doctor if we suffer from worrisome physical symptoms. On the negative side, it can take control of our minds so that we can do nothing but obsess about everything from whether Iran will attack Israel to petty fears concerning our looks or clothing, to whether we will be rejected for not living up to the impossible standards of various relatives.

No one is born knowing how to manage life’s stresses. We must acquire skills that help us face the failure, criticism, betrayal, frustration and disappointment with faith and fortitude. Until we acquire these skills, our level of anxiety can cause us panic, confusion and despair. Unfortunately, the medical profession has pathologized feelings. While pills can provide temporary relief, they do not teach us how to think. They can create dependence on external substances or cause severe side effects.

In anxiety-ridden people, the amygdala is in a constant state of hyper-alert, causing them to feel stressed. As they continue to entertain fearful thoughts, the amygdala actually grows larger. By contrast, the amygdala in criminals is generally unusually small. Criminals can commit horrific crimes and feel no emotion, no regret or remorse or pity for their victims. Their brains automatically minimize, deny, excuse, justify, defend or trivialize their crimes. So, if you have anxiety, it’s highly likely that you are responsible and conscientious and will not become an exploiter of others!

The second piece of good news is that the brain is “plastic,” i.e., it can be taught new tricks, and the amygdala can be reduced to normal size. When we try to control something not in our control, we feel helpless and anxious.

When we think about things we can change, we feel empowered. Thus, our task is to take control of what is within our control, i.e., our beliefs and behaviors. The more we control what can be controlled, the more we calm down. You can start taking charge today. For example:

1. Get adequate sleep. Except for the one percent of the population who can function on four to six hours of sleep, we need between seven and nine hours to avoid becoming agitated and anxious. Very few people get adequate sleep today. Many think of sleep as unnecessary or even a sinful waste of time. In truth, the nervous system relaxes and is rejuvenated during sleep. The immune system is also strengthened, helping us avoid illness. Anxiety-ridden people need a great deal of energy to “battle” their negative thoughts and stay positive, especially in the beginning of this learning process. So adopt a disciplined sleep regimen, going to sleep and getting up at more or less the same time.2. Eat only nutritious food. Every nerve cell is surrounded by a protective shield called the myelin sheath. It is composed mainly of Vitamin B. You lower your B levels every time you ingest white flour, white sugar, drugs, food additives such as diet sugars and other junk substances. Therefore eat plenty of fruits and vegetables and healthy proteins. It is also essential to check your level of vitamin D and make sure it is over 40 IU.

3. Get busy. Many anxious people are narcissistically obsessed with themselves. To get your mind off yourself, get busy with chesed projects, exercise, work, crafts or other creative projects. Daily exercise is also very important to help you work off the dangerous level of cortisol which accumulates in your bloodstream when you are under stress.

4. Recognize the “toxic ten” thoughts which keep you in a state of fear, shame and guilt. You cannot bear the discomfort of anxiety unless you figure out what tricks it uses to “kidnap” you. Although the brain is only two percent of the body’s weight, it takes about 20 percent of our energy and oxygen – and more in those who suffer from anxiety. At any given moment, some 100 million bits of information impact on the nervous system from organs including our ears, eyes and skin. Most people shift 99 percent of this information to the “junk mail” section of their brain before they are conscious of its existence. But in anxiety-ridden people, this screening apparatus is defective, allowing too much information to flood the mind. This is what causes the person to feel overexcited and overwhelmed. They must make a conscious effort to do this shifting process until it becomes automatic. For example:

Stop looking for perfection: Forget about looking perfect, making perfect food or being the perfect child/parent/teacher/worker, etc. Strive to be “high normal.” It’s not only humbling but also calming for the nerves.

Stop obsessing about what others think: People’s feelings and opinions are not in our control. We cannot attend all the social events, help everyone who asks for our help or win everyone’s approval. We cannot force anyone to give us love, understanding or respect. We cannot get anyone to stop an addiction, to become more/less religious, to be less lazy or more aware. We can do our best to be polite, kind and caring, but no power in the world can get people to change their feelings or beliefs unless they want to do so. We are all limited. People – especially the demanding types – will always be disappointed and frustrated.

Don’t confuse danger with discomfort: Life’s discomforts are not dangerous. We will experience endless physical and emotional discomforts – accidents, spills, messes or missed opportunities. Think, “If there is no true sakana (danger) or real avaira (sin), then it is trivial.” Tell yourself, “I can cope with this and find solutions.” You missed the simcha? It’s a discomfort, not a danger. Your house is not perfectly neat and clean at all times? It’s a discomfort, not a danger. Things break, get lost and get ruined? It is uncomfortable to be hungry; but it is not dangerous unless you are starving. It is uncomfortable for your relatives to dislike you, but it is not dangerous unless they are truly abusive.

Don’t second-guess God: You might think, “I momentarily lost my concentration during prayer and will suffer some terrible punishment.” Can you know that God has not forgiven you? Be responsible and conscientious, but realize that uncontrolled anxiety is an insidious form of self-torture.

Avoid “victim” thoughts: Toss thoughts such as, “I’m a victim of my moods and cravings.” “I have nothing to contribute to the world.” “Hashem is out to get me.” “No one could possibly love me.” “I’m a failure because I’m not ____ (rich, beautiful, always cheerful, good at math, organized, etc.)” “I can’t change, because my parents were….”

Avoid “what if…” scenarios: Since the future is in Hashem’s hands, refuse to torture yourself with questions such as, “What if Iran attacks?” “What if my in-laws/children don’t like me?” “What if I get fired from my job?” “What if I never get married or I get married and my spouse suddenly leaves me or becomes abusive?” “What if I lose my mind and go insane?” “What if I go to shul and no one greets me?” “What if I make a fool of myself in public?” “What if I get caught by the police and get falsely accused and imprisoned for something I never did?” “What if I don’t pass the test?”

There is no end to the possibilities which a fear-mongering amygdala can imagine.

When anxiety arises, do not try to control it. If you feel cold, you cannot will yourself to feel hot. You can only change actions, such as putting on the air conditioning or a sweater, or bear the discomfort until it passes. You cannot force yourself to love everyone, but you can be compassionate or stay away. Trying to force the anxiety away only makes it worse. You can only think “secure thoughts” or take positive actions. You can breathe calmly, clean the house, pray, sing, write, learn, go shopping, or do something else that distracts you from that pesky amygdala.

When you find yourself worrying, ask, “Is there something I can do? If not, I toss it.” Examples of actions one can take include avoiding white flour and sugar and exercising if I’m worried about diabetes and heart disease; avoiding criticizing, hitting and screaming if I’m worried about a child’s mental health; following safety precautions if worried about being in a car accident.

As you learn to avoid hoarding all the junk mail that come into your brain’s in-box, you will gain a sense of detachment from your overly active amygdala and begin to feel calmer. As you go through the day, be proud of your ability to distinguish between truly important and necessary information and junk thoughts. A good therapist will help you identify toxic beliefs and replace them with “secure thoughts.” At first, this might be difficult, as you may be used to thinking, “My thoughts are absolute truths which I must accept.”

Keep a list of your beliefs and figure out which ones you truly want to keep. The next step is to think “SECURE THOUGHTS.” For example:

* When you contemplate the future remind yourself, “Hashem will only give me what I need for my tikkun and whatever he sends me is out of love and is meant to help me discover my inner strengths.” When you contemplate the past, tell yourself, “I trust that the events in my life and the mistakes I made were educational and taught me what not to do in the future. The pain humbled me, gave me strength and made me more aware and sensitive.”

* Hashem created a very tentative and insecure physical world for a reason- to force me to turn to Him and overcome my addictions, obsessions and illusions.

* My self-esteem is not a balloon which others can inflate with praise or deflate with their critical words or eyes. I can create a strong sense of self-worth that is maintained no matter where I am or who I am with. As a child, I didn’t know how to think, but now I am a grown-up; I can choose what to think, and so can you.

Dr. Adahan can be reached at 718-705-8404 or emett@netvision.net.il

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