336: Why Am I So Anxious? (With Tracey Marks)

You’re listening to the Vibrant Happy Women podcast. I’m Dr. Jen Riday. And on this episode we’re talking about why is the world so anxious. Stay tuned.

Hi, I'm Jen Riday. This podcast is for women who want to feel more vibrant, happy, aligned, and alive. You'll gain the emotional, physical, and spiritual tools you need to get your sparkle back and ensure that depression, anxiety, and struggle don't rule your life. Welcome to the Vibrant Happy Women Podcast.

Hey there my friends, welcome back to Vibrant Happy Women, the place where we talk about being happy and vibrant. Well, today we’re talking about anxiety, something that can really block, or prevent, or hold us back from being our happiest selves. You may have anxiety yourself, you may have a child or a partner with anxiety. Whatever it is, anxiety is all around us. And on this episode my guest, Dr. Tracey Marks and I will discuss where anxiety comes from, what’s happening in the brain and some of the holistic tools available to help with it.

We can have a top down approach to anxiety where we talk about our flawed thinking that can cause anxiety. We can talk about, come at things from a bottom up approach where we look at the body and the somatics. We can look at behavior. Dr. Marks is great at all of this because she is a big expert in her field. She is a psychiatrist, psychotherapist, she can prescribe medications, she can do talk therapy. She knows about somatics. And she has written a book called Why Am I So Anxious, to help us discuss this. So, I’m really excited for you to hear and listen.

If you’re like me and you have a child or children, plural, and a partner with anxiety this is important information. You never know when someone’s going to have an anxiety attack or when they’re going to have a social fear, or they’re going to struggle to try something new because that anxiety is taking hold. Having strategies to help can be oh, so important. So, let’s go ahead and dive into this fantastic interview.

Jen: Hey they everyone, I am talking with Dr. Tracey Marks today. We’re going to be talking about a very newsworthy and pervasive topic in today’s world and that is anxiety. So, Dr. Marks broadcasts over a million followers weekly on her YouTube channel and she is a general and forensic psychiatrist of over 20 years. Her mission is to increase mental health awareness and understanding by educating people on the psychiatric disorders, mental wellbeing and self-improvement. Dr. Marks, thank you so much for being here and welcome to Vibrant Happy Women.

Tracey: Thanks for inviting me to talk with you today, I’m excited.

Jen: I am too. So many listeners have said they feel stuck and frozen in anxiety. They want to get back to their lives or maybe they have gotten back to their lives but anxiety happens, right? There’s a lot of things coming at us in the news cycle. Tell us everything about anxiety. I don’t even know where to begin so I’ll let you lead us into this amazing and broad field.

Tracey: Yeah, certainly anxiety whether it be a disorder or whether it be a temporary or a transient experience you’re having is nothing new but certainly we can all agree that for just about anyone it’s ramped up significantly over the past two years. And sadly, it’s still not really going away a whole lot. We may want to believe that things are much better and trying to get back to our lives, which we have to do but there’s still a lot going on that stirs up a lot of uncertainty about things.

And uncertainty is one of the big fears that generates and perpetuates anxiety in people whether you have a disorder or whether you don’t have a disorder but are just reacting to life.

Jen: So, everyone experiences anxiety in one way or another?

Tracey: Yes, everyone experiences it in one way or another, whether it’s persistent or whether it’s just a temporary thing for you.

Jen: So, you wrote a book to kind of address this. Tell us the name of it and why you chose to write a book about anxiety.

Tracey: It’s called Why Am I So Anxious?: Powerful Tools for Recognizing Your Disorders and Restoring Your Peace. And I had it in my mind that I wanted to address anxiety in written form for a little while. But I’d gotten so busy with life and I produce content on YouTube as you mentioned and everything. So, it was kind of on my radar to address. But then when things started, my own experience in 2021 was that it was worse for me than 2020. 2020 was reaction, let’s all hang in there, we’re all in this together. We kept hearing that kind of thing.

And I buckled down and dealt with it like we all had to do. But then by the time 2021 came and maybe we were halfway through it, it just didn’t seem like much was different. And that year was actually worse for me than 2021, I guess because of my expectations that I’m tired of this and I’m ready for something different, and I’m ready to feel safe. It also helped that I was approached about writing something about anxiety. So that was more the catalyst to actually get me going with it.

But one of the things that I wanted to do that I felt was a need because this isn’t the first anxiety book, was talk a little bit more about the origins of anxiety, more than or beyond say panic disorder, or even generalized anxiety disorder, or OCD, kind of the things that most people think about when it comes to anxiety. But it’s so much more than that. It can manifest in different ways than that.

So, I wanted kind of in the spirit of the way I talk about most things with mental health, I wanted people to have a very deep understanding of why they get anxious, what are some of the things that cause anxiety. And then also be equipped with what can you do about it. And on the what can you do about it front, and then I’ll let you jump in. I won’t go too long here. But on the what you can do about it front, one of the frustrations that I have had with natural remedies beyond say medication is patients will say, “Well, I tried that.”

I could talk to them about exercise, and diet, and all that. “Well, I’ve tried all that and it doesn’t work.” And they’re right, I mean I get what they’re saying. But then it kind of dawned on me at one point. It’s not that these things don’t work at all. They don’t work for everything. So, the real approach to anxiety is taking lots of things, tools that you can have at the ready and you layer them to get a complete coverage of your anxiety.

And it’s even the same with medication. We have that same mindset of, prescribe this medication for someone’s anxiety disorder and all their symptoms should go away. But they don’t all go away and they’ve got lingering stuff, so what do we do about that stuff? And so that’s also some of the things I wanted to address in the book and help people understand.

Jen: Sounds amazing and let’s go back then and tell us, where does anxiety come from because that’s one of the things you address in your book? Everyone’s wanting to know because so many people are anxious today.

Tracey: First of all, there’s anxiety disorders and then there’s situational anxiety some of which have, or most of which have a biological basis. We don’t know why someone may develop one over another. But certainly, genetics play a role in it and sometimes it’s just a spontaneous occurrence. So, some of those disorders are things like generalized anxiety disorder, separation anxiety disorder, panic disorder and so forth. There’s a handful of them.

But then there’s also anxious temperaments and anxious personalities. So, something like avoidant personality disorder is not listed under anxiety disorders, it’s listed under, in the diagnostic manual under personalities. But that personality creates a lot of anxiety or people experience a lot of anxiety. Your upbringing can teach you to be anxious.

So, if you came into this world with your hardwiring is to be somewhat laidback and not necessarily that responsive to things, or respond anxiously. You can still grow up in a household where you’re taught to worry about things, to fear the unknown, to have not much tolerance for uncertainty. And then you can then pick up those habits and thought processes from your caregivers.

So, some of it, that would be looked at as more of the whole nature versus nurture argument, that your nurturance or nurturing experience created an anxious personality or temperament in yourself versus it being something you were hardwired to be.

Jen: So, what happens in the body, in the brain, the nervous system when someone is anxious, whether they’re born with it, or have genetics for it, or it’s through environment?

Tracey: I’ll address that because it does kind of touch on one aspect of anxiety. And that is say the anxiety reaction to something. So, you have your limbic system which I know you’ve talked about this on your podcast just recently about the lizard brain. But the part of the brain that reacts instinctively, so for example, I could have never ever come in contact with a tiger, or grew up in an environment where I don’t even know about animals because I’m just so sheltered.

But I walk outside and if a lion runs up to me, instinctively I’m going to feel fear, even though I don’t know intellectually that that lion may harm me. That instinctive reaction comes from the lower brain because it comes without even thought process. It’s all instinct. So, structures like the amygdala, the hippocampus and what not kind of see the threat, process it and then tell you something’s not right. And then you get a physiologic response, your heart rate speeds up, your blood pressure goes up.

And you may even start breathing harder, we call it the fight or flight response, that’s all natural instinctive response. And then a little bit later it’s a delayed response. Your higher level brain, the part where you think, and process, and rationalize, that then kicks in for you to say, “That looks like a very scary animal, it’s got big teeth, it might hurt me, let me run.” So that’s a natural response that everyone should have because it’s self-promoting. I mean it spares your life to run from a threat.

If though, so the person with anxiety though can experience a similar fear response in the absence of a fear. So, the person without an anxiety disorder can have that reaction, let’s say we’re driving in a car and someone stops suddenly, it may take me five minutes to feel like I’ve got to calm down because I thought we were going to get in an accident. Then I’m fine. The person with anxiety can carry that same feeling on even in the absence of there being a near miss. They just feel that way spontaneously and without any kind of threat that’s anywhere in the picture.

Jen: Wow. So, it can really linger. What are the strategies that can help people with that lingering response or really anxiety, if we were to name it. What are those strategies that you were mentioning that can help them let go and come back to the safe and social state, I guess?

Tracey: When someone has, so there’s – I kind of in the book, I talk, I divide up the tools into cognitive or thinking tools, body tools, and behavioral tools. So, if you have an anxiety reaction, or just wake up feeling tense, or you’re just feeling uptight. And you’re not necessarily thinking about anything. Then you look at things to calm your body, or your mind too if you’re actually feeling tense. But let’s say in the absence of worrying say, you could do things like practice deep breathing techniques, mindfulness is very powerful even though it’s so simple.

So, at its most basic form it is paying attention or attending to things in your present experience or present moment without judgment. And I’m very guilty of not doing this. I can go watch my child in some activity and I’m thinking about some things I need to finish at work, a phone call I need to return, that is mindlessness, that’s not a mindful experience, it’s a mindlessness. So, I’m sitting there hardly paying any attention to what’s going on right in front of me.

And we know that, the science supports that that kind of that way of thinking of focusing on things that are not in the present, the future worrying or rumination of the past, generates anxiety and generates just mental distress in people. So even something like practicing mindfulness, trying to bring yourself back to the present, so back to the car situation, I’m in the passenger and someone pulls out in front of us. So, we have to stop suddenly and my heart is in my throat. I could try and force myself to slow my breath because I’m naturally now breathing faster.

If I force myself to calm my breath, slowing my breath will also slow my heart rate. Other things, I’ll give you one more is called grounding exercises. So sometimes people can feel out of sorts, or jarred by some experience, something that makes them very afraid at the moment. And it can even get to the point where you kind of lose touch with where you are at the moment. Your mind can go to, oh no, does this mean this? And now you’re worrying about something else.

Grounding brings you back to the present and it’s similar to mindfulness but one example is, we call it the five senses thing. So, you name five things that you can see in the room. Four things that you can hear. Three things that you can smell and so on. And all that does is take you from worrying about the future or the past and bring you back to the present moment and is very calming.

Jen: That’s really great. I’d be curious with your expert exposure to so much anxiety, I have a daughter who I really feel like she was born anxious. She was born with a scowl. And she seems super sensitive. No, I’m not kidding, I have six kids so there is a comparison factor. By the age of seven we would go to social events and she would hide under the table. And that’s when I knew she needed extra help. So, she is on medication and has been ever since. How well does medication help in these instances?

And I don’t know if you work with children in particular, but what hope would people have in the medication route if they’re seeing something similar in a child or even in themselves?

Tracey: Yeah. So, medication can be very helpful especially in, I would consider it like turning down the dial of the anxiety. I’ll tell you what I mean by that a little bit more in a moment. So, children, no, I don’t treat children but I’m not sure what the cutoff age is. Usually when it comes to medication maybe eight or nine would be the lower end of the spectrum of when you would prescribe medication for anxiety. We use the serotonin enhancing antidepressants even if the person is not depressed, like Prozac, and Zoloft, and Lexapro.

For some issues and I don’t know if they would do this with a child for someone who say has panic disorder. When you have a predominance of physical symptoms you can address the physical symptoms all by themselves, like with a betablocker. A betablocker is normally a blood pressure medicine but in psychiatry we use it to slow your heart rate, slow the physical response. Because some people can be very sensitive to that physical response. If your heart starts beating fast that tells me I’m anxious. Now I really am anxious.

Jen: And it amps up, yeah.

Tracey: Yeah, and it amps up. So, I don’t know if they’re using that with children. I would say probably they’re limiting that kind of treatment to the antidepressants at lower doses. And they can be extremely effective in turning down the dial. The second part of that though is the behavior that’s been established or that the child has gotten into that may need to change. So, they may feel less anxious.

But let’s just say your child or someone’s child in this scenario, as a part of their anxiety, fears people have developed some social anxiety and has thoughts about everybody’s laughing at me. And they have a lot of inhibitions about going to school because of what people would say. The medication would help dampen that down but it’s not going to completely take away that false script. So that script still has to be changed with cognitive therapy.

Jen: Yes, talk therapy for sure. My daughter is still medicated. She’s 12 now. She resists the talk therapy but I’m really trying to convince her to try that because I see that, the medicine it tones it down but the script is still there. “Everyone’s annoying me.” “Everyone’s too loud.” She just has these stories that now feed into everything.

Tracey: Yeah, exactly, so that’s the stuff. And actually, the medication makes it easier for someone to analyze their thoughts and see the error in their thinking. So, there are some people who they’re too anxious really to benefit from therapy. And I’ve had a therapist refer me to medicate someone so it could actually help them be able to process things intellectually because they’re just so anxious that they can’t even think straight.

Jen: Yeah, wow, I love that. So as a psychiatrist you can prescribe medication. And I know, do you work as a psychiatrist or as a psychotherapist?

Tracey: Both. So, I would say predominantly I do more medication management than I do pure therapy. But I do have patients that I do therapy with that I’m not prescribing anything for.

Jen: That’s awesome. Talking is helpful. Do you have a lot of patients who can bring themselves out of anxiety without the medication just through the talk therapy, using the somatic tools, and the thinking tools?

Tracey: So, I usually tell people that anxiety can come and go in waves. So here I’m going back to people who have anxiety disorders where it’s a predominant thing, it’s not just a situational thing. It can come and go in waves. So, you can have times of your life where it’s unmanageable and all the tools and the things that you do, don’t help enough. And so, you can’t sleep very well. You’re not getting your work done because you’re not sleeping well because of the anxiety and so forth.

That may be a season of your life where you should or do need to take medicine. And by the way, it might not necessarily need to be prescription medicine. It may be able to be over the counter remedies. But nonetheless, get some sort of treatment. And then it can just kind of recede and go away for a while, not all the way away. So, I think people who have anxiety disorder should not expect to be anxiety free because no one is anxiety free.

The difference though between the person who has an anxiety disorder than a person who doesn’t, when say there’s a mass shooting. Is that the person without the disorder can have a period of being in distress, bothered, they might lose sleep that night but they get over it. The person with the disorder, their reaction is just a lot more amplified. And it may cause more problems for them.

So, all that, that’s a long answer to yes, that you can go periods of your life without taking medication but understanding that you still have to do some extra things to kind of rein it in and keep it under control. And so, I think when someone does get medication, that’s the time and it tones down your anxiety, that’s the time to learn what works for you. Meditation might not work for you because you just can’t make yourself not get distracted. Natural or supplements, changing your diet, journaling is big, I love journaling, aromatherapy.

That’s when you experiment with these things and learn what works and helps you so that when you do get off medication, now you know what you need to use even more now because you don’t have that support from medication.

Jen: I love that and it’s so healthy. I mean it gets you to a state where you can think about and change your thoughts like you said. I’m curious, I have a number of listeners, and this is also my experience with a male partner or spouse with anxiety struggles, or PTSD, or anything along the lines of anxiety. Where they don’t want to do that work of talk therapy, or touch medication, what advice would you have for those of us struggling to support an adult in that phase of life who doesn’t want to get the help they might need?

Tracey: My spouse, I don’t know that, I wouldn’t say he has an anxiety disorder, but he is quick to catastrophize. So, it is starting to rain and it’s thundering. Oh, my goodness, we’re going to lose our roof and all of the trees that I said we should have cut down are going to fall on our house and all of this stuff. And I’m like, “Stop it.” And so, I can’t, even though I’m a psychiatrist, I don’t want to step into the role of trying to treat him or try and get him to change his thoughts.

So, what do I do? I try and say things, “Well, that probably won’t happen, or it didn’t happen last time, or let’s just pray that it won’t.” And then point out when that’s passed, because in the moment of them feeling distressed is not the time to start picking at, “Stop this”, or, “Look what you’re doing. And don’t you see?”

When it passes, emphasize how, “All of that stuff you were predicting didn’t happen and most of the time it doesn’t. But I just worry about how it makes you feel and how upset it gets you. Maybe you should get some help with this so that you can see how not to get too worked up about these things because they’re going to happen again.” That kind of thing of after the storm is over helping them see how their failure to do anything about their issue disrupts their life. And if they don’t want their life disrupted then do something.

Jen: Yeah, absolutely. Keep nudging gently, gently.

Tracey: Yeah, gentle nudges.

Jen: I love that. Well, you’re doing important work in the world. Everyone grab your copy of Why Am I So Anxious? It’s a really holistic approach to anxiety and I love that. You have the medicine background, you know the somatics, you know the thought processes and all of these can be really important to really getting a grip on anxiety. So, thank you for writing such a great book. We will have a link to your book on our website but also where can people connect with you? You mentioned your YouTube channel. What’s your website, things such as that?

Tracey: Sure. So, the hub of where I can be found is my website, which is markspsychiatry and that’s M-A-R-K-S, S as in Sam, and the word, psychiatry.com. And that has links to all of my social media channels. But I’m predominantly on YouTube under Dr. Tracey Marks. And that’s Tracey with an E-Y. And Instagram and TikTok is the same handle, Dr. Tracey Marks. And that’s D-R Tracey Marks.

Jen: Awesome, okay. Thank you so much for being on the show, Dr. Marks, I appreciate it.

Tracey: Thank you very much, I appreciate being here.

So, whether you struggle with anxiety or a loved one close to you, I’m imagining there are some takeaways from that interview that you can apply in your life. I want you to know you’re not alone with struggles with anxiety or with family that struggles with anxiety. I face the same things. One of my favorite things is to stay regulated, to make sure I’m happy, that I’m in a place of safe and social and not fight or flight, and not in shutdown or freeze.

When I am regulated, when I am happy, mood is contagious. Even if that anxiety attack or anxious moment starts to escalate, if I stay regulated I notice my spouse, my daughter, my son, they can come back down if I provide an emotional anchor. Now, you’re not responsible for how others feel but listening to this podcast, learning the tools, gaining this wisdom and awareness helps so much because you want to feel balanced and happy.

And you live with certain people, the more you feel balanced and happy that you have these tools that can help, the more they will anchor and ground. And it improves the whole situation. We want our homes, our lives to feel peaceful. So, keep learning, keep moving forward, keep showing up. And if you want more help with this, of course join us in the Vibrant Happy Women Club. Come to the Vibrant Happy Women retreat.

All of these settings facilitate your growth, help you integrate this learning and wisdom into your way of living, your way of showing up, your way of interacting so that it’s easier, and easier, and more natural, and more natural. We’re raising our emotional baselines together. So, thank you so much for listening, I will see you next time. Until then make it a vibrant, happy, low anxiety week. Take care.