7 Tips For Managing Anxiety Without SSRIs, According To A Doctor
Even though I've been prone to anxiety my entire life, I first went on pills for it — Zoloft to be exact — during a sh*tty time four years ago. I was going through a bad breakup and had just lost my job, and it was all too easy to get a prescription for an SSRI from my doctor in New York. In fact, they didn't really even ask me my symptoms. I just said, “I want Zoloft,” and they asked which pharmacy I’d be picking it up at. The process took less time than ordering cake bites at Momofuku Milk Bar.
Zoloft was an awesome bandaid, the helping hand I needed to pull me out of an all-consuming murk. The pills got me to a good place again — but once I was in that good place, I knew I didn't want to be on the meds forever. The side effects of SSRIs can be dismal: My sex drive all but disappeared. The night sweats had me waking up looking like I just got out of the pool. This was not my forever solution.
When I said I wanted to stop taking the anti-depressants, the doctors gave me a program to slowly wean me off of them over six months. No mention was ever made of changing my diet, my exercise routine, introducing meditation, or giving me a toolbox to deal with life without meds.
Luckily, that's when I spoke with Parsley Health founder Dr. Robin Berzin. We went to college together, and reconnected over a dinner party at my house where I told her that I managed low-grade anxiety every day. Right there over garlic shrimp burritos, she asked me everything about my medical history and current lifestyle — did anyone in my family have anxiety? How was my sleep? Did I exercise? How did I exercise? Did I meditate? How often did I poop?
“Can we finish dessert before we talk about my poop?” I said. "Then I'll tell you everything!"
Right then and there, Robin began prescribing me the Parsley Health way of managing anxiety. Within a month, I began to see serious changes in how often I experienced both the mental and physical effects of anxiety. The changes seemed small at first, but the benefits turned out to be way bigger. This is what my prescription looked like. Most of it wasn't easy — but all of it helped.
Tip #1: Cut Out Foods You're Sensitive To
Not sure what those are? Many people are sensitive to foods like gluten and dairy. “The connection between the brain and the gut is so strong,” Dr. Berzin tells Bustle. “Ninety-five percent of the serotonin in your body is in your gut, and the immune system crosses the blood-brain barrier, so if your body is inflamed from eating foods that trigger an immune response, so is your brain. I have so many patients who are gluten sensitive whose primary symptom is brain fog, fatigue, low mood and irritability, not a digestive symptom.”
I tried a 30-day elimination diet cutting out gluten, dairy, and processed foods. The effect on my mood was surprising — I didn’t have my regular mood swings throughout the day. I didn’t wake up with a feeling of dread squatting in my stomach. It didn’t come all at once, but by week four there was a noticeable difference. The hamster wheel in my mind hadn't come to a halt, but it did begin to slow down.
Tip #2: Cut Out Sugar & Caffeine
Look, I didn't say this would be easy. The fact is, many people are caught in a sugar and caffeine-fueled roller coaster that is driving their anxiety. When they stop eating refined carbs, sugar, and caffeine, their anxiety and insomnia begins to fade.
Cutting out coffee gave me major withdrawal headaches for an entire week — it was like the worst hangover I’ve ever had. Actually, worse than the worst hangover I’ve ever had — but then it went away. Cutting out the caffeine radically improved my sleep, which had major effects on my mood.
Tip #3: Take Magnesium
This one was a game-changer, and probably the easiest suggestion on the list. “Magnesium is a gentle calcium channel blocker, meaning it calms the nervous system and can even mildly lower blood pressure. I prescribe 400mg of magnesium glycinate, the best absorbed form, at bedtime daily for people with anxiety and insomnia. It helps them sleep more deeply and helps people relax. They can take it during the day as well,” Dr. Berzin says.
I take the magnesium when I wake up, which is when my anxiety is most present. It seems to really actually help!
Tip#4: Cut Out Alcohol
After sugar, this one was the hardest for me — it forced me to come to terms with my own unhealthy relationship with alcohol, which I’d often used as a crutch to calm social anxiety. The truth is that I love the idea of red wine — but my body hates the reality of red wine. “Alcohol is a depressant and an anxiety trigger. If you are drinking more than two days per week you may be causing your mental health imbalance,” Dr. Berzin says.
While I havn’t eliminated it completely, I’ve made a conscious effort to be intentional about when and how I drink, which has helped to stabilize my moods and anxiety.
Tip #5: Exercise Every Day
You knew this one was coming. "The human body was designed to run, lift, jump and stretch, and yet most of us are using it to sit in a chair 12 hours a day looking at a screen. As I explain to many of my patients, the energy caused by worry irritability and fear needs a place to go. Exercise is a tool to release it,” Dr. Berzin says. It's just that simple.
Tip #6: Get Genetics Testing For The MTHFR Gene & Take B Vitamins
Some people have a variant in their MTHFR gene, which impacts the rate at which their brains produce serotonin, dopamine and norepinephrine. When they take a methylated form of two B-vitamins, B9 (commonly known as folic acid) and B12, they produce more of these mood boosting neurotransmitters. Parsley makes a Rebuild protein shake that has a complete panel of methylated B-vitamins in it, so people get their B’s and boost their mood with a delicious smoothie instead of a pill.
I started replacing my breakfast bagel with the shake and started to see an improvement in my energy by about the second week. I still miss bagels, though.
Tip #7: Develop A Daily Meditation Practice
You've heard this by now, but it's the truth: Research shows that meditation can lower inflammation, lower cortisol, improve mood, and calm anxiety.
“Deep belly breathing which you often do in yoga and meditation stimulates the vagus nerve, which turns on the parasympathetic or ’rest and digest’ side of the nervous system,” Dr. Berzin says. “I have seen a simple practice like a breathing exercise help people retrain their brains to be less anxious.”
This one works. Still, I think of myself as a lazy meditator — I know it’s good for me, but most days I can’t be bothered. I forced myself to start meditating for five minutes in the morning and five minutes at night and I think it’s a major factor to slowing down the crappy chatter my brain tries to levy at me throughout the day.
Is my anxiety gone? Not totally. I don’t know if it ever will be. But I do know that I now have moments when I forget it’s even there, when I don’t think about it, when the edge is just gone and I’m like, “Oh, this is what normal feels like.” And for me, that's pretty damn good.
Images: Pixaby; Jo Piazza