What Are The Worst Things I Could Do If I Had Anxiety?

0:00What are the worst things I could do if I had anxiety as a double board certified psychiatrist?

0:07I'm going to tell you, I'm Dr. Rodriguez from Healing Sky, I'm also the medical director

0:13of the Delray Center for Healing and today we're going to talk about the worst things

0:17you could do if you had anxiety.

0:21Most people with anxiety have what's called generalized anxiety disorder, that is a condition

0:27that is focused on excessive worry and tension over most things and most aspects of life.

0:36It's different than panic disorder which is a more extreme version of an anxiety disorder

0:42although generalized anxiety disorder can also have panic attacks as a part of it.

0:49So the first thing that is one of the worst things you could do if you have anxiety or

0:55generalized anxiety disorder is to use caffeine in any form.

0:59People don't think much of this because people use caffeine every day, they drink coffee,

1:04they drink green tea, you name it, it's a pretty big part of our life.

1:09However if you have an anxiety disorder, caffeine will make it worse, it is a natural agitator

1:15so one of the first things to do is to get rid of that caffeine.

1:20If you really like the flavor and you really don't want to let it go, you have the option

1:25of decaf.

1:26Decaf will still have a little bit of caffeine but it's much better than straight coffee

1:33and caffeine.

1:34Next thing is the use of stimulants.

1:37Stimulants such as Adderall, Vyvanse, any of those kind of medications, Ritalin which

1:41are used to treat ADD and they're pretty common, these are not good if you have a lot of anxiety.

1:48It can make your anxiety worse.

1:50These are very stimulating, hence the name stimulants, and they can be very arousing

1:56and if you already have heightened arousal from your anxiety disorder, this can make

2:01you feel worse.

2:03You may not think so and you may take it and you may feel more focused and that might calm

2:08you a little bit but if you use these a lot, it can make your anxiety worse.

2:12So until you get your anxiety under control, it is preferable to not use stimulants.

2:20Now worse than using stimulants is skipping your medications if you are medicated for

2:26your anxiety disorder.

2:29Skipping medications with an anxiety disorder is a little worse than skipping medications

2:33with other conditions because it will typically lead to what's called rebound anxiety which

2:40is when your anxiety is worse than when you first started even taking the medications.

2:47The effort of coming off the medications abruptly will provoke an increase in anxiety, it can

2:53even provoke a panic attack.

2:55So you don't want to do that.

2:57It's worse if it is one of the sedating or tranquilizing medications like a benzodiazepine

3:04which is like a Valium or a Clonopin or even worse a Xanax, if you skip one of those, you

3:10rebound anxiety can be pretty profound, it can be rather extreme sometimes and sometimes

3:15can lead even to a withdrawal syndrome which can be dangerous because those kind of medications

3:21create a certain level of physiologic dependence.

3:24You can't just stop taking them abruptly.

3:27So skipping them whether it's accidental or not, it's a bad idea, you have to try not

3:32to do that because that can definitely make your anxiety worse.

3:36If you find yourself skipping them often, every few days, this can lead to a very stressful

3:42existence because you're having rebound anxiety here and there and overall you're going to

3:48be uncomfortable and overall going through these cycles makes the anxiety disorder worse.

3:54It does make it worse so being consistent is key.

4:00Alcohol consumption is even worse than skipping medications because alcohol now is affecting

4:06your GABA receptors and that's going to be calming initially but then you have a steep

4:12price to pay because afterwards you get even worse rebound anxiety and you risk falling

4:19into the trap of the negative reinforcement cycle where you drink alcohol because you

4:25have anxiety.

4:26The alcohol calms the anxiety initially, then when the alcohol wears off, your anxiety comes

4:32back but now you have rebound anxiety so it's even worse.

4:36So it makes you want to drink again, you drink again and temporarily it makes the anxiety

4:40a little better.

4:41Again, that is a negative reinforcement, you were feeling bad, you drink alcohol, you feel

4:47less bad, now that is a negative reinforcement.

4:50So next time that you feel bad, you're going to be more inclined to drink alcohol which

4:55is not good because you do this cycle a few times and you can develop an alcohol problem.

5:02Having an anxiety disorder is one of the more common reasons why people will develop an

5:08addiction especially to alcohol or any kind of sedating medication because they are trying

5:14to self-medicate which is a bad idea because that leads to big problems.

5:20Beyond the alcohol and also as bad is the use of drugs.

5:26One of the worst things you can do if you have an anxiety issue is using drugs on your

5:30own to try and control this.

5:33And by this I mean street drugs or even prescription drugs if you're getting them on your own or

5:39they are not coming with proper guidance from a physician or sometimes even if you're getting

5:45them from a physician but it is not a psychiatrist, it is a general practice physician or somebody

5:50who is not specialized in treating anxiety and they may give you the medication without

5:55proper or sufficient guidance and this can lead to trouble.

6:00Because again, you can develop an addiction issue to these medications which will probably

6:05work initially but as you become tolerant, as you become dependent, they may not work

6:10as well and then you have a problem because then you're stuck with the anxiety disorder

6:16and now you have a substance use disorder as well.

6:19This is not good.

6:20You don't want that.

6:21So you want proper guidance.

6:22If you're going to use this kind of medication, you want it to come from a psychiatrist or

6:25a psychiatric nurse practitioner but somebody who is trained specifically in handling anxiety

6:32disorders so they know how to moderate these medications safely for you.

6:37You definitely don't want to get it from a friend.

6:38You definitely don't want to get it from the street and you definitely don't want to use

6:42illicit substances which those are a massive loose cannon and you can hurt yourself.

6:47Aside from getting addicted, you could die with an accidental overdose.

6:51You definitely, definitely don't want to use street drugs regardless of if you have anxiety

6:55or not.

6:56They're just not good but even worse with anxiety because you're more likely to develop

7:01an addiction problem if you have already a pre-existing anxiety disorder.

7:08Special emphasis on marijuana when talking about drugs.

7:12I separate marijuana because marijuana is extra problematic because marijuana in most

7:18people's view is not a drug although it really is.

7:22Marijuana also has a legal version referred to as medical marijuana.

7:26People have this illusion that because it is medical marijuana, it is perfectly safe

7:31and it is not.

7:32It is the same drug it was before, arguably worse because it is so much stronger now than

7:37it used to be and marijuana, if you have an anxiety disorder, even though the marijuana

7:43doctor prescribed it for your anxiety disorder, it is going to make your anxiety disorder

7:48worse.

7:49This is one of the big conflicts we have in medicine is that medical marijuana is widely

7:54thought of as an effective treatment for anxiety, however, in reality, it makes things

8:01worse.

8:02People who come in with massive anxiety disorders and they're using marijuana, one of the first

8:06things I have to do is get them off the marijuana, otherwise, they're not going to get better.

8:13Now in the immediate short term, using marijuana may numb somebody out, may make them feel

8:19a little better or a little less bad, but really, in time, it makes the problem so much

8:24worse.

8:25It is one of the absolute worst things you can do if you have an anxiety disorder to

8:30use marijuana.

8:31One of the absolute worst things that you can do.

8:35Now with anxiety, there is a psychological tendency to want to stay home and want to

8:41kind of hide from the world, not engage, you will not stress yourself, that's actually

8:45bad, that can reinforce the anxiety.

8:48You don't want to do that.

8:49So you definitely want to kind of push through as much as you can, expose yourself to real

8:54life situations, you know, such as being with family, going to work, going to school, whatever

8:59it is, you got to get out there, hiding at home is not good, it makes your anxiety worse.

9:05In the moment that you give in to the anxiety and you choose to stay home or you choose

9:11to withdraw from a social function, that will actually end up reinforcing the anxiety

9:21severely.

9:22In the moment it feels better, but it is a massive negative reinforcement, you don't

9:27want to do that, so please don't avoid life because of your anxiety.

9:34The probably single worst thing of all though, if you have an anxiety disorder, is not seeking

9:41treatment, that is a mistake.

9:44People may suffer for years, for decades with anxiety by simply not seeking treatment.

9:50If you have an anxiety disorder, more likely than not, almost assuredly, it will persist

9:56and will get worse over time.

9:57As we get older, life gets harder because life is hard, it's hard for everybody, it's

10:04hard for me, it's hard for you, and it will get harder in the future, that's just how

10:08life is.

10:09You don't have to be anxious about it, you don't have to be depressed about it, but you

10:12have to accept it as it is and we have to be prepared to handle life on life's terms.

10:17Now when you have an anxiety disorder and it is not treated, it will get worse over

10:23time, especially as the stressors of life, as getting older, gets worse over time.

10:28Now that sounds gloomy, but it really doesn't have to be gloomy because you can receive

10:33treatment and you can make the anxiety disorder worse, you can get it under control, you can

10:39get into remission and you can live a normal, healthy, happy life, even though life is hard.

10:45And that is the goal, is to be able to live a healthy, happy life, even though life is

10:49hard.

10:50That is the point of seeking wellness, the point of trying to get better, is to endure

10:55life's challenges and supersede and be happy doing so.

11:00So, not seeking treatment, probably the biggest mistake anybody can make with having an anxiety

11:07disorder.

11:08Along those lines, specifically not seeking psychotherapy is a big mistake because that

11:15part of treatment can really help a lot to help you cope better with stressors as they

11:20come.

11:21It can help reduce the impact of a stressor as it comes, it can help reduce the need for

11:25medication.

11:26The combination of psychotherapy with medication is going to be the winning combination to

11:31handle an anxiety disorder.

11:34These conditions are very common, they can be very distressing, but they are very treatable.

11:39But you have to actually ask for the help and receive the help, you have to actually

11:44do that and your life can change for the better if you do.

11:49I hope you find this helpful, if you would like help from me as a psychiatrist, you can

11:53find me at delraycenter.com or even here on Healing Sky, please look out for my podcast,

12:00The Smiling Brain, here on Healing Sky.

12:02Thank you.