In My Box of Tools

    If you've read my blog for any length of time, I'm sure you've heard of my "box of tools". This is the imaginary place where I keep all of the helpful ways I manage my anxiety. (I've seen other people call it a mental health crisis kit or a mental health self-care kit, but I just like the imagery of a big box of things that I can sort through.) I know I've talked about the coping strategies, meditation, the diet changes, and the exercises (like yoga for anxiety) that are inside my "box of tools", but my box actually has a bit more stuff in it. I thought I'd share the complete list of contents of my "box of tools" in case anyone was wondering how to build their own.

MUSIC:

    Music plays a big part in how I manage my day-to-day anxiety, so I try to make sure I always have access to music whether it's on my laptop, on my phone, or on my iPod. It doesn't have to be the meditation or relaxation music, either. It can be any kind of music that you find comforting or that you find makes you smile. I have a friend that uses ASMR to relax.

    I, on the other hand, prefer listening to All Time Low when I'm anxious. Traditional meditation and relaxation music tends to grate in my ears, and I find that unpleasant. Something about the heavy drums and guitar relaxes me out. It's like I can feel the tension and anxiety melting out of my body, and I feel like I can actually breathe. A lot of the time, just listening to  a couple of All Time Low songs brings my anxiety down to a manageable level so that I don't need to take any supplement to reset my brain.

MOVIES, TV, and YOUTUBE:

    There are a couple of VlogBrothers videos on YouTube in which John Green talks about his mental health, and those videos always give me a renewed sense of hope. (I've made a couple of posts about a couple of the videos in the past.) I find that those videos always make me feel at least a little better. 

     I also keep my favorite TV show and my favorite movies in my "box of tools". Sure, it doesn't really "fix" anything, but sometimes, all your brain needs is a few moments of distraction from the anxiety so it can stop trying to pile more anxiety on top of the existing anxiety. Plus, watching my favorite TV show or my favorite movies gets me out of my head and into the present for at least an hour or so, and it stops me from thinking about how awful the anxiety feels or how loud the intrusive thoughts are on that day. 

COLORING BOOKS:

    When my brain feels like it's going too haywire for me to use mindfulness meditation, I like to color. I learned in a class that, for adults, the brain treats coloring like a sort of meditation, so sometimes I have to substitute. So, if sitting still and focusing on your breathing isn't for you, I recommend coloring. 

THE ROSARY:

    At the point I'm reaching for my rosary, it's been a REALLY rough day. I've been crying. I can't focus on anything. I probably haven't been able to eat much. Nothing else has worked so far. 

    I find praying the rosary peaceful, even if I no longer consider myself Catholic. The clinking the beads make as I move along the decades, the feel of the beads in my hand, the concentration it takes to keep track and say the right prayer on the right bead, the concentration of thinking about the Mysteries...all of it just add up to a peaceful, hands-on meditative experience for me. It's another tool that enables to me to literally feel the anxiety and tension leave my body. (Note: You don't have to be Catholic to pray the rosary. Anyone can do it if they want to.)

SUPPLEMENTS:

    I've never felt like my anxiety was severe enough so that I needed to take an actual anti-anxiety medication every day, and my therapist agreed. I've just needed to take something occasionally to help bring it to a manageable level after a spike or to prevent the (now) occasional panic attacks. So, my therapist worked with me to find some supplements for my "box of tools" that I could take as needed. I typically use these if nothing else I've tried has worked.

1. L-Theanine Capsules: L-Theanine is a compound that occurs naturally in green and black tea. In the concentrated capsule form, this compound works to noticeably increase the brain waves that help us feel calm and focused. I take one of these when I need a "soft brain reset", and I can usually feel the drop in my anxiety within an hour. (This supplement is not recommended for regular use by people with depression as it increases the brain waves that can worsen depression. It can also lower blood pressure so it isn't a good idea if you take blood pressure medication.)

2. CBD Candy: Yes, CBD products are the "new" hemp products that everyone keeps talking about. I was surprised when my therapist suggested I try a CBD product, and I was equally as surprised by how quickly and how well it actually worked when I tried it. I take one of these when I need a "hard brain reset", and within half an hour, I feel a little wonky but fine. These have a much stronger effect than the L-Theanine, and the effect lasts longer. Since I no longer have access to Ativan, I use these instead. (It didn't have to be candy. There is a CBD oil, but I chose candy because I wanted something that tasted good for once, and it looked a bit more fun.)

**Note: I'm not saying anyone should stop taking their prescribed medications in favor of a more natural approach. I'm also not saying that these supplements are a good idea for everyone. If you need medications, please, take them, and if you're thinking about trying supplements, talk to your mental healthcare team first.

SNACKS:

    This might sounds silly, but I keep small snacks around as part of my "box of tools". I keep small squeezable applesauce packets or small packs of crackers in my backpack pretty much all the time. I also keep small snacks in my room. I do this because, when I'm anxious, I don't eat, and if I'm really anxious, I will literally gag on food when I try to eat. So, I keep small snacks like applesauce and crackers because I can always take a few bites and put it away. Then I can take a few more a few minutes later. If I eat something small like that, I'm less likely to gag on it, and I'm still getting something to eat, which is the main idea.

    This idea works for any small snacks, I just like applesauce, and I like Ritz crackers. Some people eat just a piece of sandwich meat or something else small. The idea is just to eat SOMETHING.

    I'll end with this: It's a good idea to have some helpful things tucked away that you can use to cope on those bad mental health days. It doesn't just have to be ONLY things you learned in therapy. It can be anything that brings a sense of comfort or helps you manage symptoms. Each person's "box of tools" is personal, and that means that your "box of tools" doesn't have to look like anyone else's. All that matters is that you find HEALTHY ways to make yourself feel a little bit better on those bad days.

Letting Go of "What If...?"

     What if I really am a terrible person? What if my cat thinks I don't love her because I wouldn't let her sit in my lap that ONE TIME today? What if I die in my sleep because I took my allergy medications AND an Ibuprofen? What if my heart really does just give out during a panic attack? What if I actually get Covid-19, and I die? 
     My brain has always been great at asking "What if?" questions like the ones above, and I've always been super great at sending myself into an anxious frenzy with the questions my brain likes to ask. Honestly, one minute everything is fine. Then my brain tosses out a question like the ones above, and before I know it, I've spiraled. Thinking of one "What if?" scenario leads to thinking of more and more terrifying worst case scenarios. Then, I'm crying while I'm trying and (sometimes still) failing to pull myself back from the edge so I don't tip over into a full-on panic attack.
     Yes, thinking of the future and having an idea of the things you want is a good idea, and being prepared for some mishaps is a good thing. Here's the thing with the "What if?" questions, though. They're never positive, are they? It's always something like, "What if X goes wrong?" And it's never, "What if X goes well?"
     On top of always being a worst case sort of thing, they take us into the future, and the future is always full of uncertainty. An anxious brain doesn't do well with uncertainty. So, of course, my anxiety skyrockets when those types of questions are asked because I can't say for sure that everything will be okay. (I can't say for sure it won't be okay, either, but my brain doesn't pay attention to that idea.) Then, in an effort to cope in a backwards sort of way, my brain gives me more and more worst case scenarios so I can think about how to handle them.
     Then I have to go to my therapist, and I have to tell her that I practically caused myself to panic. She understands. She tells me the same thing she always tells me: that I have to let go of the "What if?" and live in the current reality. Every "What if?" question I bring her, she asks something like, "What evidence do you have?" Then when I can't think of any evidence to support the worst case scenario zipping around in my brain she asks something like, "So, what's the currently reality of the situation?" Then I basically end up telling her that everything is (mostly/sort of) fine, and that I'm just anxious.
     I've been working on this pretty much the entire time I've been in therapy. It isn't easy. I'm a planner. I'm future-oriented. I've been working on it more with the current situation in the world. Every time I start to hear the "What if?" sneaking in, I have to stop myself. I have to stop and say, "Well, currently, X, Y, and Z are fine, and that's all I have to worry about right now." Or, I have to ask myself, "What is the evidence?" When I (usually) can't come up with any, I just take some deep breaths and try to move on. Some days, this is easier to do than others, but at least I'm working on it.
     I'll end with this: Learning to live in the current reality without asking "What if...?" is difficult, especially for those of us with anxious brains. But...those future what if's are dangerous, friends. When we only live in the uncertain future, we can miss all the things in the current reality that actually are okay and that can offer us some sense of certainty and stability, which we all need to thrive. 

The Weight of the World

     I've always wanted to help people, to put good out into the world and maybe make the world a little bit better for at least one other person. I didn't always know how I wanted to put good out into the world and help people, but I was always sure that was something I wanted. I mostly definitely never wanted to cause anyone harm. I was the kind of person that was full of guilt and remorse if I even snapped at somebody, and I'd beat myself up over it for a long time afterward, even after all had been forgiven.
     Then my intrusive thoughts started happening, and they were the worst possible thoughts I could have, at least to me. They were blasphemous in nature. I just knew God was going to be so angry. I just knew I was going to be divinely punished, and that the punishment that I deserved was the worst punishment possible. This idea also lead to the thought that everything bad that happened in the world, (natural disasters, health crises, large-scale traumatic events...literally everything on a grand scale that hurt other people) had to be my fault because of the intrusive thoughts.
     I know that sounds weird, right? Here's how I got there: I wanted to help people so much and to put good out into the world so much that, of course, the best way to punish me for my intrusive thoughts was to do something to hurt other people because that would hurt me the most. So, of course my divine punishment would have to be to cause bad things to happen to people and to cause suffering because that was the exact opposite of what I wanted. (I know that makes no sense, but mental illness never makes sense, does it?) Every time my therapist and I would take about this, she would point out how irrational it was, how impossible it was. She would also remark that I didn't need to carry the weight of the world on my shoulders.
     Then the current health crisis struck, and it quickly turned into a global event. I'm worried about it, of course. I'm worried about the blatant disregard I see from some people for the health and safety of others. I'm worried about becoming ill. I'm worried about my mom becoming ill. It's been the topic of my phone therapy sessions for weeks.
     I was actually in a phone session with my therapist when I realized something unexpected. I didn't think this global health crisis was my fault. The idea that it could be my fault hadn't even occurred to me. Yes, I'm anxious, but I'm anxious in much the same way other people are anxious during this time. For the first time in my adult life since I've had OCD, I hadn't just assumed this terrible thing was my fault. And then to realize that the idea that had lived in my mind for so long was so far gone that it hadn't even occurred to me? I could have cried happy tears.
     At some point over the last three years or so, I had finally stopped carrying the weight of the world, so to speak, and I didn't even realize it. It's the progress that I'm most grateful for right now. I'm also grateful that I was able to take a moment to recognize how far I've come since I started therapy almost five years ago.
     I'll end with this: Our mental health conditions can make us think some cruel and irrational things. I know it's hard, but don't believe everything you think. Also, progress might not come in quickly recognizable moments, but it's still progress. It's okay to take a moment when you do realize you've made progress just to sit with it and feel grateful for it.

Cooking Around My Anxiety

     I know I talk a lot about the lifestyle changes I made to have a better co-existence with my anxiety disorders. One lifestyle change I made that I don't often talk about is the way that I eat. I practically did a diet overhaul. I've learned over the years since my diagnoses to cook around my anxiety. (It happened a little bit on purpose, but also a little bit by accident.)

     That sounds weird, right? Let me explain. When I have been experiencing prolonged low to moderate anxiety or if I am experiencing the spike in my anxiety symptoms that comes with my monthly hormone fluctuations, I tend to eat more of certain foods because they make me feel better, and I find them comforting. I'll have avocado toast for breakfast more often. Then for dinner, I might cook some salmon, lamb chops, or some black beans, or I might make a recipe that includes a turmeric-heavy seasoning blend that I make myself when I feel like I need the extra boost of comfort. (Turmeric makes me feel so relaxed and happy that I could curl up and purr like a cat. That's totally not weird, right?) As a person who loves food, I thought I just had a strange list of comfort foods.

     I had been doing this for a year or so, and I kept taking it to my therapist. She always asks what I do when my anxiety spikes or is up for a prolonged period of time. I'd tell her I cooked something, and how that food made me feel less anxious. So, then she would bring up the whole brain-gut connection, and she would explain that what we eat has the potential to impact how we feel physically and mentally. A local nutritionist also recently repeated the same thing.
     I wanted to know more about this gut-brain connection so I started looking into it. I found a post on the Harvard Health blog by Dr. Uma Naidoo, a nutritional psychiatrist and faculty member at Harvard Medical School (links at the bottom of this post). In her blog post, she talks about nutritional strategies to ease anxiety. She mentioned that foods high in Omega-3's, like Alaskan salmon had been shown to help reduce anxiety, and that zinc from red meat like beef (or lamb), could also help reduce anxiety. She also lists foods high in B Vitamins, like avocado as anxiety-reducing foods. Dr. Naidoo explained that these foods were sort of "feel-good" foods that triggered a release of dopamine and serotonin. Turmeric was also listed as a spice that had anti-anxiety properties.
     Dr. Naidoo also mentions that foods high in antioxidants, like black beans, fruits like blackberries, raspberries, and plums (which are three of my favorite fruits to snack on), and vegetables like broccoli (which I have at least once a week) and spinach might assist in lowering anxiety as well.
     It turns out that pretty much all of my comfort foods were on Dr. Naidoo's list. Without even realizing it, I had been using an anti-anxiety diet to help manage some of my anxiety. I'm not saying that following an anti-anxiety diet "fixed" anything going on in my brain. I'm just saying that certain foods made me feel better and less anxious after I added them into my diet more often, and I later found out that studies had shown those foods were helpful in managing anxiety. I'm also definitely not saying a diet change should replace medications and/or therapy. I'm just saying it wouldn't hurt to have another tool in your tool kit to try out.
     Now, I understand (at least a little bit), and I cook that way intentionally. The diet piece of the puzzle feels like another tool in my imaginary anti-anxiety tool kit that I can use all the time without having to worry if it'll eventually become ineffective. I know it seems like a weird idea to cook "around" a mental health condition, but people do it all the time for other health conditions like acid reflux, diabetes, and autoimmune conditions. Cooking to help your brain chemicals shouldn't be any different.
     I'll end with this: I'm not saying that eating certain foods will cure a mental health condition, but studies have shown that certain foods CAN help manage the day-to-day symptoms of mental health conditions like anxiety and depression. People change diets to help manage all sorts of physical health conditions all the time, and changing a diet to help manage a mental health condition should be taken just as seriously. If you're a person with an anxiety disorder like me, it wouldn't hurt to take a look at the links below and make your own mental health diet (if you can) for a few months just to see if it might help.

Sources:
Nutritional Strategies to Ease Anxiety:
https://www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441

About Dr. Uma Naidoo:
https://www.health.harvard.edu/blog/author/unaidoo