Anxiety

Lifestyle

The effect of lifestyle interventions on mood disorders has been extensively studied, with positive results to show for it. We’re talkin’ everything from meditation to exercise, exposure to nature to improved sleep.

Nutrition & Diet

There is a strong positive correlation between a plant-based Mediterranean diet and a lower risk of anxiety and depression.

The diet is low in saturated fats and animal proteins, rich in antioxidants and fiber, and loaded with B vitamins (which have been clinically proven to impact depression symptoms, anxiety, and stress). It’s anti-inflammatory, veg-heavy, low-carb, low-sugar, and includes brain-healthy fats. And because it kicks most refined and concentrated sugars to the curb and focuses instead on non-starchy veggies, beans, fruits, and whole grains, it’s considered a “low-glycemic index” diet — meaning it won’t dramatically spike our blood sugar. This is what we want!

Holistic Practices

Get out in nature

Routine, frequent exposure to the great outdoors has been shown to reduce anxiety and depression while improving an overall sense of well-being.

Reduce stress

This is so, SO important — although easier said than done when everything and everyone seems to be competing for our attention. Here are our top techniques:

• Cultivate a meditation practice: Over time, you’ll condition yourself to be more present while letting thoughts come and go. We recommend guided meditations on apps such as Headspace, Insight Timer, and Calm. Meditation not your thing? Try Heartmath, a form of biofeedback that can help with anxiety management. It focuses on breathing and heart rate, two physiologic functions that can contribute to that anxious feeling.

• Cultivate a gratitude and/or journaling practice: Studies have linked both practices to decreased anxiety, and they can also help improve general feelings of well-being and facilitate mindfulness. 

• Get high-quality sleep: Sleep disruptions affect neurotransmitter and stress hormone levels which, in turn, impair thinking and emotional regulation. That’s why it’s so important to prioritize those Zzzzsss.

• Prioritize downtime with family & friends: While we may be conditioned with a “go-go-go” mentality, it’s important to step back and prioritize rest and downtime with loved ones (pencil it into your calendar!). After all, human beings are social creatures, and we derive comfort from connection.

• Don’t forget about “me” time: Call it what you want — self care, alone time, R&R — but you deserve it. There’s nothing “selfish” about taking time for yourself, especially when it supports your mental health and overall wellness.

Cognitive Behavioral Therapy (CBT)

CBT involves working with a coach or therapist to recognize and change beliefs — including negative thoughts and worries. That’s the “cognitive” part. And then there’s the “behavioral” part, which helps you develop better habits and mindset. It’s ideal for those looking to address underlying causes of anxiety while working towards long-term management.

Exercise

Scientists have found that regular movement decreases overall levels of tension, elevates and stabilizes your mood, improves sleep, and boosts self-esteem. Not too shabby, right? According to the World Health Organization, 150 minutes per week of moderate intensity movement (a brisk walk counts!) is enough to do the trick and reduce the risk of developing symptoms of anxiety and depression.

Keep things interesting with a mix of different workouts, including strength training, cardio, and yoga. 150 minutes = about 22 minutes per day — for most of us, that’s very doable!

Supplements & Over-the-Counter Solutions

According to some studies, certain supplements and over-the-counter solutions may help reduce symptoms of anxiety…if you choose wisely. We recommend consulting with your healthcare provider first to ensure you’re using something with optimal efficacy and safety (i.e. backed by clinical research) or consulting with Elektra’s providers.

• Calm ASAP for Stress Support: Calm ASAP may provide relief from occasional anxiousness with a blend of passionflower, chamomile, vervain, English lavender, and holy basil, all of which have been shown in studies to help with anxiety.

• Serenol from Bonafide: Serenol is formulated with Swedish flower pollen, an extract made from the pollen and pistils of a certain family of grasses that helps resolve menopausal symptoms (e.g., hot flashes) in addition to emotional effects of PMS.

• True Calm: True Calm contains a combination of amino acids (GABA, glycine, and taurine) that promote a relaxed, calm state of mind.

• Metagenics SeroSyn: SeroSyn features L-theanine, an amino acid commonly found in green and black tea leaves that has been studied for its anxiety and stress-reducing properties. It also contains the amino acid 5-HTP, a precursor for serotonin synthesis. It’s important to note any supplements that contain 5-HTP should not be taken with the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) – because it may increase the risk of serotonin syndrome.

Prescription

Hormonal

Before considering hormonal treatments for menopause-related anxiety, it’s critical to consider sleep, nutrition, and stress management — all of which can have a powerful impact on symptoms. If you do opt for hormonal treatments, they should always be coupled with mind-body interventions. In other words, nothing should exist in a silo, especially for something as complex as anxiety.

Data are mixed about whether HRT helps with anxiety, with smaller studies showing conflicting results or no effect. The relationship is clearer between HRT and depression with more data suggesting a positive effect of hormone (particularly estrogen) therapy on depression especially in perimenopause. Given what we know about progesterone influencing GABA receptors, it might be worthwhile to try progesterone supplementation during the 2nd half of your cycle in early perimenopause to help with anxiety that seems to correlate with your menstrual cycle.

It is worthwhile to also mention the option of low-dose birth control, which may be used early in perimenopause for those with PMDD (premenstrual dysphoric disorder, a condition similar to PMS that leads to severe emotional symptoms like anxiety, irritability and/or depression in the week or two prior to your period), or moderate PMS.

Non-Hormonal

SSRIs and SNRIs remain the first line of pharmacologic defense for anxiety and depression in peri- and menopausal women. SSRIs are selective serotonin reuptake inhibitors and SNRIs are serotonin and norepinephrine reuptake inhibitors — total tongue-twisters! These neurotransmitters are antidepressants that work by regulating serotonin (the “happy hormone” that controls mood) and norepinephrine (plays a key role in the body’s “fight-or-flight” response to stress). It should be noted that common side effects include weight gain and low libido.

A note about antidepressants: There is still stigma around taking these medications but for many of us who experience symptoms, they can be incredibly effective and helpful, and we have decades of research to back this up.

Examples of SSRIs are:

• Escitalopram/Lexapro: associated with less weight gain and sexual side effects (i.e. low libido) than others
• Venlafaxine/Effexor: associated with higher risk of withdrawal symptoms, so proper weaning is important and should be done under the guidance of your provider

If you’re experiencing an emergency and need immediate help, call 911 or go to the nearest emergency room.

Suicide Prevention Lifeline

+ 1-800-273-8255

Crisis Text Line

Text HOME to 741741