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Navigating Anxiety: A Roadmap of 9 Actionable Items

By Dr. Alex Armitage, DNP, CNL, APRN, FNP-BC Specialist in Supportive Palliative Care and passionate advocate for holistic well-being.

You have power over anxiety, I would like to show you how. Managing anxiety effectively involves a holistic approach that extends beyond medications. This comprehensive toolkit emphasizes a balanced approach, integrating mind, body, and spirit to gracefully navigate stress and enhance mental well-being. The article offers easy-to-implement strategies, highlighting practical and accessible techniques including square breathing, meditation, supplements, and joyful activities like exercise, socializing, and cooking.

Woman meditating in the sunshine

In our whirlwind world, anxiety often sneaks in uninvited, disrupting our lives like an unwelcome guest at a dinner party. This chronic intruder elevates cortisol levels, our body's natural response to stress, potentially leading to a cascade of health issues over time. Not only does anxiety have the power to sour a perfectly good day, but it can also cast a shadow over our experiences and relationships. While seeking professional medical advice for severe anxiety is essential, there's a growing conversation about alternative methods to manage anxiety effectively. Are there ways of dealing with anxiety other than medications? The answer is YES!

For some, traditional medications might fall short in controlling anxiety, or in certain cases, they might not be advisable. I recall a particularly poignant encounter with a patient this last week, whose existing health conditions precluded the addition of more medications. Faced with unmanaged anxiety, he posed a heartfelt question: "What can I do if I can't take medication for anxiety?" His struggle with anxiety was so profound that it infiltrated his daily life. This led to an in-depth exploration of non-pharmaceutical approaches to anxiety management. Together, we constructed an 'Anxiety Roadmap' – a personalized toolkit for managing anxiety. This toolkit is designed for moments of heightened anxiety, offering immediate, empowering solutions to regain control over one's feelings.

I will not kid you, managing anxiety with these complementary therapies does require effort and active participation. However, the advantage is that they don't leave you feeling sedated or dealing with a slew of side effects. The strategies we discussed are not just empowering, but they are also invigorating, capable of infusing life and energy back into your world. It's important to remember that these methods can complement any ongoing medical treatments for mental health. The approach we devised is a solid starting point for many and can be tailored to individual lifestyles and preferences. Give it a try next time your anxiety starts to rise, I hope this empowers you!

Anxiety Roadmap: 9 Steps to Control

(Keep reading, there is an easy reference checklist at the end of this article.)

Woman seated cross-legged and practicing breathing

Square Breathing

Imagine turning your breath into a powerful tool to tame the anxiety beast. That's exactly what diaphragmatic breathing – or as I like to call it, 'square breathing' – does. It's simple: breathe in for four seconds through your nose, hold for four, exhale for four through your mouth, and hold again for four. This isn't just a relaxing exercise; it's a science-backed technique to slow your heart rate and drop cortisol levels, thereby reducing anxiety. One of the most powerful ways of controlling anxiety is turning down the cortisol response you’re your body has to threatening thoughts. Breathing through anxiety and then practicing this on a daily basis reduced heart rate, and helps your blood vessels relax which in turn tunes down those chemicals in your body that rise up preparing you to fight when you are anxious. By controlling your breathing, you control your heart rate and your cortisol and ultimately your whole anxiety response diffuses. Practice makes perfect, and incorporating this into your daily routine can be a game-changer. I have recorded a short audio guide for diaphragmatic breathing to help you get started. Click here to go to the audio clip and for a written guide for Square Breathing to get you started.

Meditation: Harnessing Inner Peace

Meditation is like giving your mind a spa day. Unwinding at the end of a hectic day with meditation can work wonders. I have spoken about different types of meditation before and we have some audio files that can help guide you through some of these practices. I find that a simple body scan meditation is very grounding and a helpful way to check in with your body and just acknowledge where you are. Just by doing this check-in your mind will relax and be grateful for the recognition of the space that you hold in this world. The idea is not to force a change, but checking in can validate what you are feeling and how you are feeling and reduce the anxiety that comes with these feelings by accepting them for what they are. Another meditation that is very helpful is progressive muscle relaxation (find the PMR audio file here). In this meditation you will be guided to tense and then relax your muscles starting at your toes and moving all the way to your head. It is amazing how much tension we hold in our bodies without even realizing it. This meditation helps us unlock this tension and provides a path for release and acceptance.

And guess what? You don't need to break the bank for this. There are some subscription apps that offer resources to guide you into tranquility, but you do not need to pay for meditation guides. If you're more of an auditory learner, and YouTube are treasure troves of free meditation guides. Just 10 minutes a day can set the stage for a calmer, more centered you.

Supplements for Anxiety

Managing anxiety can often be aided with the help of dietary supplements, which can serve as a complementary approach to traditional treatments. For most people supplements taken in regular dose are safe (please check with your doctor), affordable and effective for managing unwanted stress and boosting the immune system to increase resilience. Here are five supplements that have been found to help with anxiety:

Magnesium supplements in bottles

  1. Magnesium: Known for its calming effects on the nervous system, magnesium can help reduce anxiety symptoms. It regulates neurotransmitters, which send messages throughout the brain and body, and also controls the hypothalamic-pituitary-adrenocortical (HPA) axis, a central part of the body's stress response system. Foods rich in magnesium, such as leafy greens, nuts, and seeds, are great, but supplements can also be beneficial, particularly for those with a magnesium deficiency. About 250-400 mg daily can be your ally in the fight against anxiety. It's like a warm hug for your nervous system. For those who prefer a more sensory approach, a warm foot soak with Epsom salts (which is magnesium) in the evening can be both calming and therapeutic. It's the perfect excuse to pamper yourself while doing something great for your mental health.

  2. Omega-3 Fatty Acids: Found abundantly in fish oil, omega-3 fatty acids have been shown to reduce anxiety. These fats are crucial for brain health and are thought to regulate neurotransmitters like dopamine and serotonin, which can have a calming effect. Research suggests that omega-3 supplements can lower inflammation and prevent brain cell dysfunction that leads to the development of mental health issues like anxiety.

  3. Ashwagandha: This is an adaptogen, a natural substance known to help the body adapt to stress. Ashwagandha has been used in Ayurvedic medicine for centuries to relieve stress, increase energy levels, and improve concentration. Several studies have indicated that it can reduce cortisol levels, the body's stress hormone, thereby helping to reduce anxiety and stress.

  4. L-Theanine: An amino acid found primarily in green tea, L-theanine has been shown to provide a calming effect. It works by increasing the levels of neurotransmitters GABA, serotonin, and dopamine in the brain, which regulate emotions, mood, concentration, alertness, and sleep, as well as appetite, energy, and other cognitive skills. L-Theanine also reduces levels of "excitatory" brain chemicals associated with stress and anxiety.

  5. Probiotics: The gut-brain axis – the communication network linking the gut and brain – plays a key role in anxiety. Probiotics, which are beneficial bacteria found in certain foods and supplements, can have a positive impact on this axis. I have written a blog on the use of fermented foods which contain probiotics (the reason we eat them) and mood regulation called Good Mood Food: Fermented Food and Happiness which you can find here. Some strains of probiotics have been shown to promote the production of natural substances in the gut, like GABA, which can reduce anxiety. The simplest and cheapest way of getting probiotics is by eating fermented foods.

Woman smelling a yellow marigold in a field of marigolds

Distraction: The Art of Joy

In the quest to manage anxiety, the art of distraction emerges as a potent tool, transforming simple activities into powerful remedies. Engaging in social activities, immersing oneself in hobbies, and stimulating the mind with challenges can create a protective buffer against the onslaught of anxious thoughts. These activities are more than mere diversions; they serve as conduits to joy and passion, rekindling the spirit often dimmed by anxiety.

Diving into hobbies offers a respite from anxiety. Activities like painting, gardening, or crafting are not just pastimes; they're gateways to a meditative state, where the focus shifts from worries to the joy of creation. The rhythmic motions of knitting, the focus required in painting, or the tactile pleasure of working with soil in gardening can be incredibly soothing and grounding. There is a joy to be found in being busy, as it not only gets your mind away from anxious thoughts, but also provides a sense of purpose and accomplishment which makes you feel good. Read this blog for more information "Good Busy: Living a Healthy Busy Life)

Challenging the brain is another effective strategy. Engaging in mentally stimulating activities like solving puzzles, playing strategic games, or learning a new language can redirect focus from anxiety to the task at hand. This not only provides a sense of accomplishment but also helps in building cognitive resilience.

Exploring musical avenues, like playing an instrument or singing, can be especially therapeutic. Strumming a guitar or learning to play the piano offers a dual benefit: the joy of music itself and the satisfaction of acquiring a new skill. Similarly, culinary adventures, such as experimenting with new recipes or baking, aren't just about the end product; they're sensory experiences that engage the mind and body in a fulfilling and creative process.

In essence, these activities are not just about distraction; they are pathways to rediscover and nurture the joy and passion that anxiety often obscures. By engaging in these pursuits, one can find a sense of purpose and fulfillment, turning everyday moments into opportunities for happiness and growth.

Movement: Exercise as Therapy

People stretching in an exercise class

Embracing regular exercise as a form of therapy offers a multitude of benefits, akin to a natural antidepressant. Incorporating physical activity, particularly in the morning, sets a positive tone for the entire day. It's not just about the intensity or duration of the exercise; even moderate activities like a brisk walk can have profound effects. This practice goes beyond enhancing physical fitness; it's a powerful tool for mental and emotional well-being. The scientific literature supports the idea of regular exercise (here is one article and another article if you would like to geek out! I also listed the full reference below). Here is the thing that I have found in my patients, even a single session of body movement can make you feel more relaxed and positive. Even a little bit counts!

The beauty of exercise as therapy lies in its versatility. Whether it’s a jog around the neighborhood, a yoga session, or a dance class, each form of movement contributes to improving mood and mental clarity. The endorphins released during exercise act as natural mood lifters, reducing feelings of anxiety and depression. Moreover, morning exercise can provide a sense of accomplishment, boosting self-esteem and confidence as you start your day.

This mood-enhancing effect of exercise is not just a fleeting moment post-workout; it has lasting impacts throughout the day. Engaging in regular physical activity helps in regulating sleep patterns, which is crucial for mental health. Better sleep quality, in turn, leads to improved focus and energy levels, making daily tasks feel more manageable and less overwhelming. By moving to the beat, you not only strengthen your body but also cultivate a more positive, resilient mindset to face the challenges of the day.

The Sleep Connection

The importance of quality sleep for mental health is paramount. It's not just the duration of sleep that matters, but its quality too. Establishing a relaxing bedtime routine, such as reading or gentle stretching, can signal your body to wind down, facilitating easier sleep onset. Creating a sleep-friendly environment is also key – think comfortable bedding, dim lighting, and a quiet, cool room.

Woman sleeping on lovely white sheets

Quality sleep does more than just rest the body; it regulates mood, sharpens focus, and is essential for stress management. During sleep, the body undergoes crucial restorative processes, including memory consolidation and tissue repair, which are vital for mental well-being. In short, prioritizing a healthy sleep routine is an integral part of maintaining both physical and mental health. Here is a whole blog article discussing calming anxious thoughts before bed.

The Joy of Companionship

The therapeutic power of companionship in alleviating anxiety cannot be overstated. Friends serve not just as a social network but as pillars of support, offering empathy, understanding, and joy. Engaging in heartfelt conversations, partaking in shared activities, or simply enjoying a moment of laughter together can significantly elevate one's mood and provide a comforting sense of belonging.

Opening up to a friend about one’s thoughts and feelings can be incredibly cathartic. It creates a safe space where vulnerabilities are met with empathy, allowing for a meaningful exchange that can lighten the emotional load of anxiety. This process of sharing and receiving support is a fundamental aspect of human connection and can be instrumental in managing stress and anxiety.

Participating in activities with friends adds another layer to the healing power of companionship. Whether it's a leisurely walk in the park, a movie night, or a shared hobby, these experiences foster a sense of camaraderie and joy. They offer an escape from the solitary confines of anxiety, allowing one to immerse in the present moment and enjoy the simple pleasures of life.

Laughter, often shared in the company of friends, is a natural stress reliever. It triggers the release of endorphins, the body’s natural feel-good chemicals, promoting an overall sense of well-being. The act of laughing not only lightens mental load but also strengthens social bonds, creating memories and experiences that can be cherished and revisited in times of solitude.

For those seeking a deeper sense of purpose and connection, volunteering emerges as a rewarding option. It provides a unique opportunity to step outside oneself and contribute to the greater good. Engaging in community service or supporting a cause can foster a sense of accomplishment, belonging, and perspective. It's a way to connect with others from diverse backgrounds, broaden one's worldview, and experience the joy of making a difference.

Loneliness can cause real disease as I discussed in my blog article "How Social Connection Impacts Your Health: The Health Costs of Loneliness", the joy of companionship is a multifaceted remedy for anxiety. It lies in the comfort of sharing and understanding, the exhilaration of joint ventures, the light-heartedness of shared laughter, and the fulfillment of giving back. Friends act as anchors in turbulent times, reminding us of the beauty of human connection and the strength it provides in navigating life’s challenges.

Aromatherapy for Anxiety: The Power of Smell

Incorporating the essence of nature into our stress management toolkit, aromatherapy emerges as a remarkable ally in the battle against anxiety. As I explored in my article, "Calming the Mind: Aromatherapy to Relieve Stress," the use of essential oils is more than a fragrant indulgence; it's a profound journey into the sensory world that directly influences our emotions and mental state. Essential oils like Lavender, Bergamot, and Vetiver, each with unique calming properties, serve as natural soothers, gently alleviating stress and anxiety. For those interested in exploring these natural wonders, my Etsy store offers a curated selection of high-quality essential oils, perfect for beginning your aromatherapy journey. When paired with mindful practices such as meditation or yoga, aromatherapy enhances the overall experience, leading to deeper relaxation and mental clarity. For a detailed exploration of this aromatic journey and to discover your personal scent of serenity, I invite you to read my full article "Calming the Mind: Aromatherapy to Relieve Stress", where the intertwining of scent, emotion, and mental well-being is beautifully unraveled. Check out my Etsy store (click here to go to the store) for a range of essential oils and other aromatherapy options that can help you embark on this soothing path. Remember that I am always happy to customize products for your specific needs.

Couple cooking in the kitchen together

Cooking as Therapy

Cooking transcends mere nourishment; it's a soul-enriching experience. Delving into culinary arts offers therapeutic benefits, providing a creative outlet and a journey through diverse flavors and textures. While I won't delve deeper into cooking as an anxiety management tool in this piece, I plan to dedicate my next blog article entirely to this topic. Cooking embodies enjoyment, creativity, and is integral to a lifestyle of health and wellness, meriting its own dedicated discussion.


Managing anxiety is about embracing a holistic approach. It's a blend of mind, body, and soul practices that together create a symphony of well-being. Remember, it's not about eliminating anxiety completely; it's about learning to navigate it with grace and empowerment. Until next time, stay healthy, stay happy, and remember: your wellness journey is uniquely yours. Embrace it.

The Anxiety Toolbox: Checklist

  1. Square breathing

  2. Meditation

  3. Supplements

  4. Distraction

  5. Move your body

  6. Sleep

  7. Companionship

  8. Aromatherapy

  9. Cooking

Additional Reading:

Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in Psychiatry, 4, 27.

De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: A population-based study. Preventive Medicine, 42(4), 273-279.


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