The anatomy of our anxiety

Have you ever felt a panic attack? Do you feel anxious daily?

40 million Americans struggle with anxiety in the US, according to Dr. Vora. 

Ellen Vora, MD, is a board-certified psychiatrist, acupuncturist, and yoga teacher, and she is the author of The Anatomy of Anxiety. She takes a functional medicine approach to mental health—considering the whole person and addressing imbalance at the root. 

Anxiety is incredibly common right now; it’s nearly universal to feel appropriately anxious. 

Understandably, we are anxious. We have that stigma about mental health. 

Kristina asks how we can address that anxiety if it is high.

Dr. Vora answers that she works on identifying the root cause of the anxiety, no matter if it’s a clinical type of anxiety or if external factors cause it. 

Identifying the root cause is also a must, whether it’s a low-grade type of anxiety or a high-graded one.

Quality of life improves significantly without anxiety, which is important for Dr. Vora as a doctor.

Kristina then asks about a relevant differentiation:

The difference between false anxiety and true anxiety

Dr. Vora answers that false anxiety is avoidable anxiety. It’s based on the physical body. 

It’s something that has tripped our body into a stress response. And we experience this as anxiety. It doesn’t need to be happening. So, Dr. Vora’s treatment is to identify the root cause of this person’s physical imbalance that’s creating unnecessary anxiety. 

And on the other hand, we have true anxiety, which is purposeful anxiety. 

It’s not something to pathologize, it’s not something to suppress, and it’s really not something that we can gluten-free or decaf coffee our way out of. It’s our inner compass. It’s a true north nudging us, asking us to slow down, get still, and pay attention. 

Usually, it’s an awareness of something we’ve always known, but we steamroll over it in our lives; we ignore it. And there’s usually a call to action baked into our true anxiety. It’s asking us to get back into alignment in some way or course, correct some aspect of our lives. 

And so this has been the most helpful way for me to think about anxiety. And you ask, like, how do you tell the difference? And it can be difficult. But where I always start with patients is with the false anxiety because that’s creating a lot of suffering, doesn’t need to be happening. 

It’s not serving us in any critical way. And you can chip away at it. You can basically identify potential causes of imbalance and stress. And you address that. You get it out of the way, and it kind of clears the air. 

And then, from that place of relative clarity, you can really get still and get familiar with your true anxiety. It gets easier to identify, okay, now that I’m not physiologically being pinballed from this stress response to this state of unnecessary anxiety. When we’re not in that anymore, we can tap in and hear that clarion note of our true anxiety. 

Kristina introduces how, or if, cultural and changes of modern life affect our anxiety in some way!

Dr Vora answers that there have been many changes in modern life. We have much more light, so we can use glasses to dim the blue light at night and stop it from suppressing our melatonin.

It is nice that we don’t have to fight wild animals in modern life; that has been one of the nice changes!

When we get stuck in vicious cycles with our time, with our enoughness… that really hinders a vicious cycle of contribution.

Kristina returns to the influence of culture on our feelings, specifically the hustle culture. How much is it influencing the anxiety? How much is it true of it?

Dr Vora states that the neverending hustle of 24/7 business will go on unless we stop it. When I feel that stress, I go out for a walk because if not, I know it will hinder my patients.

So, she encourages people to play with the stressed mind and say: how much of it is real and how much of it is a mindset?

You can hustle, but for example, my 6-year-old girl would spend all day making art if she could; she’s had no process of going into the world and saying: I don’t like this!

Sometimes, if you are used to hustling, you can’t stand doing anything, for example, waiting on a plane.

When we are resisting reality, we’re suffering. Mental health is about accepting what life brings to you. 

Radically accept those times when we can’t be productive.  

And in a crisis, can we accept ourselves when things are not ok with us and let this transformation be fully complete?

A very important question arises:

How do you prevent a panic attack?

Dr Vora answers that our panic attack is tipped into a stress response. Stressors are going to happen. The blood sugar crash is one of them. Caffeine is another one. Some of us are sensitive to caffeine. When we drink alcohol, we get GABA in our brains. But then converts it to glutamate, which keeps us alive at night. Directly contributes to feeling more anxious the next day. Magnesium supplementation can be very useful in preventing panic.

Sleeping and eating patterns can also help. We are grown-up babies, and if we get to sleep at the sweet spot when the baby’s tired, we get to nap them up. But if you want to get past the baby’s pattern, the baby gets overtired, moves, and whines a lot!

If you get overtired, cortisol starts running because it thinks there is a good reason to stay awake. Glasses that turn off the white light can stop you from suppressing melatonin. Going to the cold helps your body sleep. Also, a ritual that you do before sleeping can help. 

There is this thing called metabolic flexibility. You can take minerals for it. To break patterns, the book Unwinding Anxiety by Judson Brewer can help a lot.

Also, setting boundaries can be great for social anxiety. Meeting needs with things that you really need instead of getting your mind jumping on. 

Episode resources:

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• Ellen Vora, MD | ⁠Website