How To Win Against Anxiety? Advice from a Psychiatrist!

Anxiety -- just like stress, has been experienced by a lot of people, and it was just recently that people have started talking more openly about the anxieties they experience. We have definitely lived through the times that anxiety was reduced to something as simple as overreacting or overthinking a certain situation, but anxiety is here, and it is real.

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We wanted to take this opportunity to talk about something as impactful as this, since we are all living through a world-wide pandemic, and we are sure that being in quarantine for months have not been easy for anyone of us, so this is why this article focuses on the many ways you can do to overcome the big 'A', and we will also be including some tips and tricks on how you can take care of your mental health in quarantine.

Again, this article will be guided by Dr. Ronald Elepano III, MD Adult Psychiatry, Consultation-Liaison Psychiatry and Occupational Medicine. We have published two articles that were also based from our interview with him, if you haven't checked them out, here are the links to both articles:

How Are You Really? A Talk With A Psychiatrist!

Let's Talk About Stress, Guided by a Psychiatrist!

Because of this pandemic, a lot of people claim that they experience anxiety,

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1. Can you tell us about some of the signs that they are indeed experiencing anxiety, and how can one differentiate normal anxiety from anxiety disorder?

First, we have to frame anxiety in the context that anxiety is a normal experience. 

You are allowed to experience this. We all experience different types of emotion, and it is unfair to judge anxiety and say, “Okay, this is a bad thing.”

Remember when I was talking about adaptive ways the body reacts to negative stress -- which are depression and anxiety -- you are allowed to experience these feelings but the only time it becomes a problem is if it interferes with one’s functioning, meaning all dimensions of functioning. If your capacity to become a loving person is affected, or if it affects your schooling, or your work, then it is time we recommend you seek professional help. 

Now in these trying times, we are all entitled to feel anxious because there are a lot of things going on right now, so one of the things that we are advocating is to talk to someone about it. We have to remind ourselves that it is okay to not be okay because the situation demands it. 

2. What can one do to address the anxiety they are feeling?

Just like what I have stated earlier, we have to talk to someone about it.

I would recommend talking to a professional about the feelings you are experiencing, because there is a lot of misguided information about it, and it is better to have some level of guidance.

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Again, similar to stress, anxiety experience is different from person to person, so there is a possibility where your anxiety experience might be different from my anxiety experience. 

Of course, the more common ones would be nervousness, so in terms of having to address this problem, like I said, try to talk to someone about it and maybe they can provide a certain level of perspective. 

Secondly, information is key. I think it is just a matter of balancing the kind of information you have. I get a lot of patients now who tend to overly experience this because of the information overload that they have at their disposal (pertaining to COVID19), so my advice to them is just limit the information that you get from; websites such as the Department of Health or the World Health Organization. 

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We can make it a habit to filter to some extent, but totally not block yourself out in order to protect our mental health.

Thirdly, remember when we were talking about stress reactions that can also be physical, so I would say physical techniques can provide a certain level of relief. I am such a strong advocate for warm ups and stretching. These are certain techniques that I tell my patients to do so they can minimize the stress or modulate the anxiety they are experiencing. 

3. Aligned with anxiety and stress is the fact that we are all suddenly confined in our homes for months. What advice can you give to people who are now overwhelmed with the sudden shift?

First, I want to talk about these reminders that The Philippine Council for Mental Health has set for everyone to practice.

Photo from Philippine Council for Mental Health

First is understanding that this crisis has affected everyone. No one is exempted from this experience, and we are all adapting to it differently, and it is important to acknowledge that it is okay to not be okay. We all encountered a certain level of loss because of this pandemic, and we have to acknowledge that. 

I think one of the more difficult trends in terms of adaptation in this pandemic is the concept of toxic optimism, so every once in a while, it can help if you just tell your friends your honest thoughts, and acknowledge that we are all experiencing some kind of sadness because of the situation we are in.

Second is, engage in healthy activities that we can all enjoy. This can be a little difficult, but it is a matter of adapting to this new normal. There are a lot of things that you can do, even at home, and it is amazing what this technology can provide for us. Once you realize this, we can all utilize it at our disposal.

I think one thing that I realized is that there are a lot of things you have already in order to cope in this quarantine life, and that is why it also helps if you are able to shift to a more realistic type of optimism.

The things we consume during this time also matters, so let us all remember to minimize fear using facts, hence filtering information is essential for us to protect our mental health.

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Another thing is remembering that words matter. We are all going through such a tough time, and one thing that does not take a lot is just to be kind to one another.

Lastly, set boundaries for yourselves. Just because you are all together in a house, does not mean anyone is free to step over your boundaries, so setting rules would really help.

4. As for my personal recommendations on how to protect your mental health during this quarantine:

a.) Begin the day with gratitude.

One Tibetan monk said, “If you start your day with gratitude, then it would have already been a good day.”

And I think it would espouse that our grief from the loss that we had will be there, but it would not be as heavy a burden compared to looking at the gifts that this pandemic has given us.

b.) Find a routine and create structure.

Of course one thing that has changed is the kind of routine that we have. We have to adapt to a new normal, and we need to look at the new routine that we have to start for ourselves. The idea behind your routine is that it takes away a lot of the stress that is going on with our lives.

It provides a certain level of activity to us, so if you wake up not knowing what to do for the day -- trying to figure out something can become stressful, versus if you have already planned it because it creates structure. Remember structure provides a certain level of stress relief for any of us. 

c.) Respect sleep!

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Third, and this is one of the things that I encourage a lot of my patients to get is good sleep. The beauty of this quarantine, initially, is a lot of us have the time to binge Netflix shows, making us stay up until the morning, coupled with the fact that no one predicted that quarantine will extend this long, so nasira na yung sleep schedule ng mga tao.

My advice is to respect sleep, because if you do not, sleep will run away from you. A good night’s rest is restorative, meaning it helps our brains to rest and relax, and our bodies to restore energy from the day to day experiences.

d.) Eat healthy.

Fourth is to eat healthy.

There's a new body of scientific study called psychonutrition. It talks about psychiatric practice in the context of nutrition because there's such a thing called gut to mind connection, so what you eat can affect how you feel.

It's still in its infant stages, but maybe there are some merits to it, so for example you’re eating a lot of food rich in probiotics, it can lift your mood versus if you are eating a lot of processed food.

5. As we are living in a technological age, we also asked Dr. Ronald about smart phone applications that he recommends during this pandemic.

Dr. Ronald suggests applications such as Calm and Mindshift. 

If you are interested in these applications, you can check out our article: 10 Best Mental Health Applications You Can Try!

Dr. Ronald says that when we download these applications, the idea is to practice it religiously and regularly. We cannot expect that the effect or the impact will be dramatic all at once. You will have bumps in the road, but be brave enough to be bad at something, because with regularity, the gift will come out later.

6. Are there any books, shows, or podcasts that you would recommend?

For books, it depends on your interest, but I think an important thing is that you have to make sure that the ones who wrote it are the pioneers in the field of mindfulness like John Kabat-Zinn, but anything that applies to you and you find it effective in the practice, then that is what’s important.

In terms of videos or podcasts, Kristin Neff has a podcast on mindful self compassion, and it is available on Spotify. 

Photo from Spotify

6. To end this, what is one reminder that you want to leave to the people who read this article, in terms of protecting their mental health?

Take breaks. 

The simplest is to set boundaries for yourself. We have to know that in order to help others, you have to help yourself first -- this is what I learned during my practice, it is that if you are not stable, then you will also drown in the sufferings of others, so through setting boundaries for myself, I am able to protect my mental health as well. 

This practice has also translated to the kind of life I am living. I have learned to say no because there is nothing wrong with saying no, especially that our culture is a yes culture, so you should not be afraid to set limits for yourself, this way you can protect your own mental health.

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Once again, we are grateful for Dr. Ronald for the amount of knowledge that he has imparted with us during our interview with him.