Medically reviewed by, Russell Braun RPH
All too often the hustle and pace of modern life leads to stress followed up with anxiety that will drive many people to seek help from their doctor. The idea is just give me a pill so I can stop worrying about worrying. As doctor clearly doesn’t want to disappoint or leave you with a visit where they didn’t offer some solution.
Many times, this medication that was intended for short term use, will end up being used as a long-term crutch that never really solves the underlying problem.
That can cost you in the long run in more ways than one!
The prevalence of generalized anxiety disorder (GAD) is relatively low often cited as 5%. Therefore, that means 95% of people don’t have GAD, but think about how often people say they are stressed or anxious!
While it is true that generalized anxiety disorder and other mental conditions may require medication, that is not the case for stress from everyday life. At least not until other methods have been applied to deal with the problem.
The best ways to avoid the dangers and cost of anxiety medication is to not take medication at all. Let me give some background on your innate primal hardwiring that leads us to having so much stress in the first place.
Humans have two components to our nervous system, one tagged as the sympathetic nervous system and the other the parasympathetic nervous system.
The parasympathetic nervous system on the other hand is in charge of rest and digestion. The neurotransmitter involved is called acetylcholine. It will help lower your heart rate, relax muscles and allow digestion to occur.
Thousands of years ago the sympathetic nervous system was of the utmost importance for basic survival. The sympathetic nervous system can be easily explained as the fight or flight system.
Just like it sounds it prepares you for a fight or to run away in flight after you determine the size of the predator you have encountered.
To prepare us for fight or flight our body releases neurotransmitters such as epinephrine and norepinephrine that trigger several things in our body. So these neurotransmitters cause increases in heart rate, blood pressure to prepare our muscles for the impending situation at hand.
Why is that a problem?
Over long periods this can have negative health effects such as vasoconstriction that can lead to high blood pressure and when coupled with increased heart rate can put a strain on your heart, ultimately leading to heart disease which is the number one preventable cause of death in the U.S. and worldwide.
At the same time our adrenal gland is releasing a hormone known as cortisol. This has been dubbed by experts as the “stress hormone” and as you can imagine also prepares our body for impending stress.
While cortisol is good for our body in the short term in dealing with stress, it is very bad for us over long periods of increased exposure. Cortisol produces many harmful effects, such as release of cytokines which are chemicals that promote inflammation.
Other harmful chemicals cortisol releases from the immune response can disrupt sleep, increase blood pressure, cause mental fog and even promote depression.
The sympathetic nervous system served our ancestors well to survive for thousands of years in a world without all the comforts that we enjoy today. Because our modern life has few life and death events the bodies reaction is harmful.
Today the biggest stressor we have is responding to all the email in our inbox or getting somewhere on time. These are hardly life and death situations like our ancestors were dealing with. As you can see the sympathetic response to stress is less important in typical day to day life, but can occur much more frequently.
As more and more people have the fight or flight response to situations today that should be handled in other ways. The result is continued epinephrine, norepinephrine and cortisol in our system. After a while these stressors morph into feelings of anxiety.
Do any of these sound-like things you say to yourself?
“I have to respond to all my emails before the end of the day.”
“I have to make dinner before running kids to practice.”
“With back to back meetings I don’t have time to eat lunch.”
So how do we get out of this cycle of activating the sympathetic nervous system?
Based on the way our body works and how the situation comes about it seems silly to think that we need a drug to stop this process, right?
Basically, we are just overreacting to a situation that is not going to jeopardize our lives, so can’t we just change the way we respond to that situation? It seems a change in our mindset on how you can lower stress levels
Respond vs React
Webster defines the words in this way:
Respond: an answer or a reply to
React: behave, act or conduct oneself
When you think about one simply being an answer vs the other being a complete change in behavior you can see that reacting is what the sympathetic nervous system prepares our body to do. If we could instead just respond to the stressful event and not change our behavior we would not succumb to the fight or flight feelings.
Therefore, we have to see that stress is a choice.
Top ways to avoid anxiety medication expense and dangers
1. See Stress as a Choice
You can choose to react or you can choose to simply respond. One will bring you stress due to your body reacting in a fight or flight fashion while the other will let you move on and put the event behind you.
There are many great resources that go into the concept of stress being a choice and how to choose not to be stressed. My personal favorite is a classic titled Don’t Sweat the Small Stuff is an excellent resource on this topic and a must read if you feel stressed
Now you understand how you can choose to be stressed or not, but you will need to practice the respond instead of react method. Here are some other great ideas to help you manage stress without medication.
2. Learn to breathe
Learning to breathe properly is vital for any person suffering from stress induced anxiety all the way to someone with a severe anxiety disorder. Deep breathing allows for more oxygen to exchange from the air you breath into your bloodstream. With more oxygen in your blood your heart doesn’t have to beat as hard or as fast to get the vital oxygen to your muscles and your brain.
Thus, less anxiety feelings from a rapid heartbeat. Once your brain has optimal levels of oxygen all areas of the brain can work at maximum capacity. Allowing more reasoning to assess the situation at hand and identify it as non-life threatening.
3. Practice Meditation
Meditation can be a great way for people who feel stressed to relieve this burden. Meditation is a habitual process of redirecting your thoughts by training your mind to focus. Many studies have been published on the positive effects on improving stress.
Many books and resources are available on meditating. The book The Headspace Guide to Meditation and Mindfulness: How Mindfulness Can Change Your Life in Ten Minutes a Dayis my personal recommendation.
Everyone who feels stressed and anxious should keep a journal. Documenting how you feel at different times of day or during times when you are experiencing stress can be great for several reasons.
The first is that taking the time to stop and write down your thoughts and feelings when you sense stress coming on will throw you back out of the sympathetic response as you need more parasympathetic components as you start to write.
Second being able to go back at the end of the day and the week and look at when you were stressed will allow you to identify patterns. Are certain times of the day more stressful for you? Are there triggers that you can identify as causing the stress repeatedly? Having these captured will allow you to devise a plan to better deal with them.
Third, my blog post on Top 5 Reasons to Bullet Journal on Medicationsgoes in depth on journaling before you start medications and after you start them also known as your trial period. If you end up needing to take a medication for stress and anxiety having documentation of what is going on prior to seeing the doctor will be very valuable. This will allow the doctor to get the correct medication for you based on your detailed symptoms.
5. Use your work benefits & talk to a therapist
Many employees have benefits through their employer that will allow them to talk to counselors for a set number of visits about a variety of topics. If you find yourself having chronic stress and anxiety you should use this wonderful benefit. Talking to a person who is trained at dealing with symptoms like yours can be the cure you were looking for. Don’t let this opportunity slip by to maximize your benefits and get some techniques to deal with stress.
Don’t have any counseling options through your employer? Reach out to local colleges and see if they have programs where you can talk to counseling students. This will often be a free resource where you get to talk to someone with training and they are getting experience as they finish up school.
This is not a new recommendation by any means, but it so often is left out of the treatment plan. Exercise is one of the best things you can do for your mind and body no matter what disease you are suffering from.
This doesn’t have to be intense cardio or weight bearing exercise although those are great too. Walking, gardening, or other hobbies where you are active and getting your heartrate up take your mind off the stress producing situation and release endorphins that equate to good feelings and cortisol levels are lowered.
Shoot for at least 30 minutes of activity 5 days per week. If that sounds like a lot shoot for 5 minutes over what you currently do and build up from there. I have never had a patient come to me and say, you know what I exercise too much. Once you start doing it, you will not mind adding on more time to your routine.
7. Medications – they are not all the same
There is a reason why medications are last on my list. As a pharmacist I see drugs overprescribed all the time. There are many consequences, that range from drug interactions, side effects to wasted money. Please make sure you try steps 1-6 before resorting to medication.
Also, keep in mind no medication has long term studies on treating anxiety. They are all approved only for short term use for anxiety.
Over the counter drugs (OTC’s)
The main OTC drugs used to treat anxiety are the antihistamines. Two types of antihistamines are available they are noted as drowsy vs non-drowsy.
Common drowsy antihistamines include: (all available as generics to save money in parenthesis) *All drug lists are not all inclusive lists
Common types of non-drowsy antihistamines include:
If you try to treat with OTC drugs prior to seeing your doctor consult your pharmacist!
The items below have been noted as having efficacy per the National Library of Medicine, don’t fall for all claims of Herbal treatments.
Common types of Herbal treatments include:
Combinations of L-lysine and L-arginine
Non-addictive antianxiety drug Buspirone
This medication is often skipped over or forgotten by many prescribers. Buspirone is available generically and thus is less costly than brand name drugs.
The drug is not addictive and is shorter acting, which is good as the stress and anxiety felt tend to be short term as well.
The brand name is Buspar stay away from the more expensive brand name. Bupsirone is the generic, and it has shown to be effective and has similar efficacy to benzodiazepines
Has the longest safety and efficacy studies for anxiety.
Will not impair memory or disrupt cognitive skills or driving ability like benzodiazepines can!
The only drawback is this drug is dosed three times per day
Drug in this class:
This is often the first class of drugs doctors will choose from to treat anxiety. This class can be addictive in nature along with other side effects.
Longer acting forms tend to be a concern for causing patients to fall and break bones or hips. In fact these drugs are on the High Risk Medicationlist of medications that Centers for Medicare and Medicaid Services (CMS) does not approve of for patients over 65 due to these risk.
Impact on memory, cognitive function and driving ability. Can cause dependence with long term use and abrupt withdrawal can cause seizures especially for shorter acting benzodiazepines
Drugs in this class include:
Antidepressants- Selective Serotonin Reuptake Inhibitors (SSRI’s)
Are best if there is suspected depression along with anxiety. They can take 3 to 4 weeks to see improvements from medication.
Several key sides effects can play a role in the selection of which drug is used.
Drugs in this class with an anxiety indication include:
Beta blockers – typically a non-selective beta blocker is used
More commonly used for phobia or panic disorder, but may also be used for performance anxiety.
Drug in this class typically used include:
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Share your story!
Have you tried these anxiety treatments? If so, did they work for you? Please chime in below with your comments and thoughts below
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