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A Balanced Approach for Treating Stress-Related Anxiety

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From raising kids to keeping up at work or school, our lives are full of challenges that stress us out. When that stress leads to ongoing anxiety, it can have a debilitating effect on our daily lives. Professional treatment can help, but what type of care is right for you?

When it comes to treating stress-related anxiety, some might see traditional and non-traditional medicine as opposing philosophies that just don’t mix.  But a closer look reveals two collaborative approaches that aren’t as different as they may seem.

Traditional Medicine

Often times, a primary care physician (PCP) can help you take the first step toward getting stress and anxiety in check.  Jennifer Beach, MD, PCP and assistant medical director at HealthCare Associates (HCA), BIDMC’s hospital-based PCP practice, says her top priority is to help patients change their lifestyle to avoid stress triggers – getting more sleep, improving their support structure, exercising.  But sometimes that’s easier said than done.

“There are times when anxiety becomes such a barrier that you can’t work on these things,” Beach says. In these cases, medication can restore patients’ ability to make lifestyle changes.

“My goal for patients is always to have them take the least amount of medication that they need for their health,” she says, adding that starting low can minimize side effects and doses can be adjusted over time as needed.  “Certainly, there are times when medications are critical and can really provide the turning point at which a patient can get their lives back.”

But all drugs carry risks. “Some patients worry about taking medication for something they feel they should be able to control on their own,” Beach says. “Or they worry they’ll have to take it forever.”  And some are potentially addictive.  But Beach says part of her role is to ensure any prescribed medications are used safely and effectively, and to help patients decide on the right time to taper off.

Integrative therapy

Beach sometimes refers patients to BIDMC’s Cheng-Tsui Integrated Health Center for another approach to treatment.  The center teaches patients to manage stress using practices such as meditation, yoga or Tai Chi.

Aditi Nerurkar, MD, medical director of the center, describes these therapies as complementary to traditional medicine. “This is why we’re called ‘integrative medicine,’ not ‘alternative medicine,’” she says.

In fact, there are some similarities used by both approaches to treat stress-related anxiety.  As with medical treatment, integrative therapy starts with understanding the whole patient.

“The first thing I do is zoom out and look at the whole person…their lifestyle in general,” says Nerurkar.  “I ask about sleep, diet, social support, exercise and how they manage stress.” Like the medical approach, Nerurkar’s first priority is to help the patient address any lifestyle issues. Then, she gradually introduces therapies such as meditation, if necessary.

“I prescribe meditation like how I’d prescribe medication – start low and go slow,” she says.

But how does meditation help?

“Meditation is about bringing your attention to your breathing. Research shows breathing is a good tool for allowing us to feel centered and ‘in-the-moment.’ Anxiety is a future emotion – it’s the ‘what-if’ syndrome – so if you bring yourself to the present, you can get out of that future-based thinking.”

Nerurkar says patients can benefit from meditation with as little as five minutes twice a day.  But it’s a skill that takes time to master. Few integrative therapies are covered by insurance, which can also be a barrier for some patients.

Still, many patients seek out non-traditional therapies as a way to improve their health, Nerurkar says.

“Patients are very accepting of integrative medicine,” Nerurkar says. “By and large, the physician community is totally embracing it as well.”

If stress and anxiety are getting the best of you, make sure to discuss your options with your doctor. You may be able to restore your balance with a balanced approach to care.