An Interview With Dr. Clark, Author of 'Living Well with Anxiety: What Your Doctor Doesn't Tell You...'
An interview with Carolyn Chambers Clark, EdD, RN, ARNP, author of Living Well with Anxiety: What Your Doctor Doesn't Tell You ...That You Need to Know.
"Overcoming anxiety takes effort, but it can be done."
Carolyn Clark worked as a therapist for over 35 years, working with many people with all levels of anxiety. She understands that each of us has experienced anxiety at some time, and most of us experience healthy anxiety all the time. It is what keeps us alert and aware. It keeps us from jumping into dangerous situations and what motivates us to try harder.
But sometimes, anxiety can be severe. In those cases, extra care is needed to help overcome the debilitating impact anxiety may have.
Levels of anxiety can change based on our current situation. For example, Dr. Clark talked about her days in graduate school, when pressure was high. The students working to become therapists were encouraged to participate in therapy themselves, to better help future patients.
The stress of school and of delving into your own issues was extremely stressful. Many of the students, Dr. Clark included, turned to minor tranquilizers as a way of coping with the stress.
This experience gave Dr. Clark a multi-faceted view of anxiety, as a person trying to cope with the stresses of life, as a person using anxiety medication and as a therapist.
Her book, she believes, has something to offer everyone, from the person dealing with the heavy load of life's stresses to the person with anxiety so debilitating, he or she is afraid to leave their house. Everyone, she believes, has the ability to help themselves, be involved in their care and can work toward a better future.
During her time working with a community program, Dr. Clark had the opportunity to meet with clients in their home. It was during this time, she realized that there were so many factors impacting anxiety and most people have multi-faceted problems.
For example, someone may be eating fast food or other non-healthy foods, in a non-supportive relationship, have substance abuse problems (either themselves or a family member), lead a sedentary lifestyle-spending much of their time watching television without much physical activity and spend hours watching news programs. Working on the anxiety meant working on the entire lifestyle, making healthy choices, adding exercise and improving personal relationships. Because all of these factors could contribute to increased anxiety, all of the factors needed to be addressed. In other words, a holistic approach worked much better than treating the anxiety as a "single, separate illness."
Suggestions for Managing Anxiety
Dr. Clark suggests starting by creating a daily diary. In it you should keep track of:
- What you are eating/drinking
- Any medications (over the counter, supplements, prescriptions)
- What situations you are experiencing, including your environment and your relationship
- Your mood
You should keep the diary for several weeks, at least, in order to start seeing patterns. It may be a certain situation or certain foods that increase your levels of anxiety. For example, you may find you become more anxious after your second cup of coffee.
Your diary can provide clues to not only what is causing your anxiety, but what changes you need to make. You are being a detective; finding out how you can help yourself.
Another important aspect in caring for your anxiety is in being prepared. Dr. Clark recommends practicing relaxation techniques so that when you begin to feel anxiety rising, you can immediately begin relaxing yourself. Breathing properly and relaxing your muscles can stop anxiety from progressing to a full blown anxiety attack.
As Dr. Clark explained, during an anxiety attack, most people will take shallow breaths. Your body will automatically go further into panic mode because it isn't receiving the proper oxygen. If you take deep breaths, your body will feel more relaxed and the anxiety will dissipate.
There have also been studies showing exercise can help to relieve anxiety. Besides exercise being good for every part of your body, it can help to relax you and decrease stress. Dr. Clark suggests a middle-of-the-road approach to exercise. Some people overdo exercise, becoming addicted and therefore increasing stress rather than using it as a relaxation tool.
Although Dr. Clark also suggests herbal supplements, she recommends working with an herbalist as each person has unique needs and circumstances. You may want to talk with your physician or health care provider and let him or her know that you will be working with an herbalist so all of your health care medical professionals are working together to give you the best possible care.
By keeping a diary and making positive changes, you change from reacting to anxiety to being prepared. Knowing yourself, learning techniques and being prepared can help to control anxiety symptoms.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) has been found to be very effective in treating anxiety, as well as other mental illnesses.
Although sometimes it seems that anxiety comes on suddenly, it is actually a process. Thoughts create worry and anxiety, then anxious feelings develop and finally physical symptoms of anxiety occur. CBT works to break this cycle.
Dr. Clark discussed one patient who could not leave her house because of severe anxiety. The first visit, Dr. Clark went to her home. During the first session, the patient was taught to get into a complete relaxed state. This didn't just mean sitting calmly, it involved being able to relax all her muscles and clear her mind.
As the patient was relaxed, Dr. Clark taught her how to use relaxing imagery, self-talk, deep breathing and other relaxation techniques to calm anxiety. The patient then was asked to recall a situation when a panic attack was coming on and used the relaxation techniques to stop the anxiety. Once relaxed, the process started again to help the patient learn to control the anxious thoughts and feelings.
The next session, the patient came to Dr. Clark's office. It took two hours for her to get into the car, stopping each time she became too anxious and using the relaxation techniques. She had written affirmations on 3 x 5 cards and had these taped to her dashboard. She had taped self-talk to listen to as she drove. Each time she stopped the car; she could read the affirmations, practice relaxation and continue to make progress toward the office.
Once there, Dr. Clark worked on additional methods of managing the symptoms she had felt leaving the house and making her way across town.
In this case, CBT lasted for approximately 6 to 8 weeks. About a year later, the patient came back wanting help in coping with the stress of a new job. Dr. Clark worked with her for a few weeks.
This patient has been able to move on with her life. She is now married with children and works outside the home.
Carolyn Chambers Clark is a board-certified advanced holistic nurse practitioner with a master's degree in mental health nursing and a doctorate in education. She is a faculty member in the Health Services Doctoral Program at Walden University.