S2: Episode 2: What is Anxiety Trying to Tell You?

Dr. Mary Grimberg dives deep into the complex world of anxiety. With a focus on self-awareness and boundary setting, Dr. Mary explores various strategies to handle emotions and sensations related to anxiety and subtle disrespect. Sharing her personal transformation journey post-cancer diagnosis, she sheds light on the pitfalls of self-abandonment and the critical role of self-care.

Listen in as Dr. Mary discusses the concept of "energy leaks" and the importance of discerning what fuels versus drains our energy. She addresses the chronic struggles faced by many, particularly women, in balancing home responsibilities and seeking help, often compounded by feelings of guilt and difficult relationship dynamics. The episode introduces the "spoon theory" for managing daily energy and delves into the physiological effects of treatments like chemotherapy, emphasizing thyroid and hormone health as key factors in anxiety and depression management.

From understanding the impact of estrogen dominance to navigating insulin resistance and vitamin deficiencies, Dr. Mary provides a comprehensive overview of how diet, medication, and lifestyle contribute to mental well-being. She also discusses the role of gut health, the benefits of connecting with nature and loved ones, and the importance of incorporating joyful activities into daily life.

Tune in for insights on recognizing anxiety as a signal, examining lifestyle changes, and fostering self-compassion and mindfulness to improve mental health. With humor and candid stories, Dr. Mary offers valuable advice on managing anxiety beyond conventional medicine, urging listeners to self-reflect and address root causes.

Timestamps

00:00 Sharing personal journey and insights on anxiety management.

04:56 Explore anxiety as a signal: alternative tools.

09:26 Notice feelings; assess anxiety's source and meaning.

10:27 Choose responses; emotions don't control us.

13:44 Setting boundaries kindly filters relationships effectively.

18:01 Prioritize self-care; avoid unnecessary obligations.

21:03 Asking for help, energy management, spoon theory.

26:40 Estrogen dominance affects anxiety via hormone imbalance.

29:29 Stress and insulin resistance can lower progesterone.

32:09 Medication effects can cause unexpected anxiety issues.

35:05 Pair carbs with protein to stabilize sugar.

40:01 Gut health impacts mental health and anxiety.

42:00 Laughter boosts mood; prioritize joy regularly.

45:08 Prioritize nature, fresh air, movement, blue light moderation.

50:00 Growth edge: balancing excitement and overcoming anxiety.

53:20 Focus on balanced eating, lifestyle, and connection.

56:23 Lifestyle management and exercise routine are essential.

If you have any other questions or topics you want to talk about, send me a message on Instagram. And if you loved this episode, please leave me a rating and a comment with your feedback. Please share this with your friends and loved ones, too!

I’ll see you in a week!

Transcript

Ready to tackle the topics that you've been curious about, but never felt comfortable asking? With a straightforward, no nonsense perspective on life, blended with candid stories and a healthy dose of humor, doctor Mary Grimberg cuts through the fluff and addresses the conversations we all need to have on TMI talk, where no subject is too taboo. Our bodies, our minds, and everything in between. Now here's your host, doctor Mary. Hello, everyone, and welcome back to TMI talk with doctor Mary. I am really excited today to talk to you about anxiety. You might be thinking, why would she be excited to talk about anxiety? Well, the biggest thing for me is that anxiety has been something that controlled my life for most of it until the last couple years. And I thought it was something that I just have to deal with and would always be me. And I found some unconventional ways or ways beyond western medicine. The way western medicine treats anxiety is, hey. Go on some SSRIs and see how it goes. And I just didn't feel like that was the answer. Well, first of all, it wasn't helping my anxiety long term. It kinda dampened it a little bit, but it it didn't feel like I had any tools. So today in this episode, I'm going to share a little bit about my story along the way or as I give examples. And so when I say certain examples or tell my story, just picture yourself in this realm or something along the lines of what I'm talking about. So that way you can visualize how this might look for you. I give examples of myself because I don't want people to think I'm a guru. I really I'm just another person on this planet trying to figure out how to manage emotions, stress, and understanding how it relates to chronic illness, chronic pain, and all these diseases. Right? And so I've done a lot of research and worked in a variety of different ways to help understand anxiety and to work with it versus letting it control you. And so when I tell my story, just picture your own story in that. I won't hopefully, I won't dive in too much on my story because I want to share with you a lot of the different things that I have learned that have been incredibly, incredibly helpful. And so we're gonna be going over 4 ways to look at anxiety, and it's not exactly what you would think. A lot of times we think of managing anxiety is through meditation, maybe exercise, and that's kind of it. At least that's what I had found were the resources for me. And, hey, exercise is amazing. I have been a lifelong exerciser. It can definitely help anxiety. But just like anything else, we have to understand where the anxiety is coming from and what it's actually saying. And so saying that, I wanna challenge you to think about anxiety as a signal. Hear me out. We think of anxiety I was told serotonin is just decreasing my brain, and then that's just the way I'm gonna be. My entire family has it, and then their parents had it and yada yada yada. Right? It just felt weird to me that all of a sudden, you know, everybody is on antianxiety medication, including myself. And I was on it for 20 years and currently I'm weaning off. I'm on a very low dose, but it it's incredibly hard to get off as well. And I've been gaslit trying to get off this medication by saying, oh, it shouldn't take that long to get off, or you should those aren't symptoms I've ever heard of. And so if you're somebody that is on medication and maybe it's not working, or maybe you're trying to avoid SSRIs, don't get me wrong. It definitely helped me. It was a tool when I didn't have any other tools. My issue is that we just throw meds at people like their PES dispensers. You guys know what I'm talking about? Those little PES machines. We throw it out like candy, like fucking candy, but we're not helping people beyond that. Right? And so my issue is, well, what if somebody can't afford medication over time? What if there's a shortage? I mean, during COVID, there was a massive shortage of Adderall and, some other medications. And so again, not shitting on SSRIs because it's helped me to this point, but there are so many other tools that can help in addition to say if you're on medication, in addition to your medication, or if you wanna avoid medication. And so we're gonna be looking at it as a message. And a lot of what I'll be talking about in general on this podcast is how to look at things a little bit differently than we traditionally would because this is ultimately what really helped me understand anxiety and look at it through a different way. And so we'll just start off with going through the list of 4 things that I was mentioning previously and how anxiety can manifest. Right? So first of all, let me back up a little bit. If we think of it before we go into the 4 things, if we think of anxiety. Right? So if I think of anxiety as a signal, Say that signal is a fire alarm. Right? Say you're in a house, the fire alarm is going off. It's just beep beep beep beep beep. Right? And you just put on noise canceling headphones. That's what I feel SSRIs are doing without looking at the problem. Right? It's hey. If you don't wanna hear the noise but you're addressing the sound and you wanna take the meds or put the sound, the noise canceling on, great. Again, it's looking at this from a a wider lens. So if we just take medication and we don't look at the root cause, we're not actually getting to the root cause. So it can be something where, like, including myself, I was just on SSRIs after SSRIs. Oh my god. I've been on so many. I was first put on one when I was 18, and then switched again to another one and then switched again to another one. And then after I went through chemo, I had crippling anxiety, and I was on a couple different meds. And then finally I just thought, man, maybe this is related to my chronic fatigue as well. And so what I realized is that the times that I had tried to go off medication before, I didn't realize that it has to be tapered incredibly slow. Like, it has to be like a 10% taper, like, monthly or so. Again, I'm not a psychologist or a psychiatrist, so please take this with a grain of salt, but know that that is something that I've heard a lot of people getting gaslit about, is that they're trying to get off these meds and they can't. And then they're told that's just the way your brain is. And come to find out, I found out it's more withdrawal that I was experiencing. And so please don't change your medication. Don't change anything at all. Just hear what I have to say, like, based on some of these things and talk to your doctor or whatever it may be. But if you feel like you're in a good place, your anxiety is under control, I wouldn't you know, just just hear me out, and we'll go from there, basically. So anyway, so one of the bigger things that I was completely unaware of is environmental stressors. And when I say environmental, I don't necessarily mean, like, the environment, like, I mean, outside or anything like that. I'm talking about your little ecosystem. Right? So if you are constantly surrounding yourself with people that maybe minimize your dreams or, like, laugh at you when you have emotions or put you down or just you just don't feel like you can show up as yourself, that's gonna eat at you. And that was something that I was dealing with for a long time is made fun of for having emotions, just not feeling supported in different ways, people being around highly traumatized people that were unwilling to do work, to work on themselves, to understand and feel better. But if you surround yourself with people that are constantly keeping you small or maybe they shit on you in different ways. It's just like the little subtle jabs. Right? You know, the saying, like, death by a 1,000. I don't know what the saying is. It's like, whatever. You get what I'm saying? Like, it's like slowly nicking over time over and over and over again. It just it eats at you. Right? So some of the things that you can even just look at with with people, right, is just notice you don't even have to do anything. Just notice how you feel when you hang out with certain people or you're in in certain environments. Right? If I am extremely anxious, maybe before hanging out with people or maybe after, maybe I feel really drained or exhausted or I feel like I'm dreading it, that just might be a sign. Also, keep in mind anxiety can also be excitement too. Right? And so that's why we have to kind of sit with this. This is why you don't necessarily need to meditate, but maybe just like sit with yourself and just think, what am I? Why am I anxious? Am I anxious because of fear or am I anxious because I don't feel supported? Right? I guess that might be meditating, whatever. It's just going inward and just asking yourself because the emotions and sensations that come to our body, they come up and we get to decide what we do with those. They don't control us. And this has been a game changer for me. So say I have anxiety, say I'm hanging out with a group of people and I am experiencing a ton of anxiety and I'm like, what's going on? Why am I feeling this way? Well, these people over here, they make side comments or making fun of something that I've done or maybe a business opportunity that I've had or like just shitting on me, just very subtly. It doesn't have to be a big deal. Very subtly. And you can blow it off. Right? You might be like, oh, whatever. They didn't mean that. But compound that all day, every day or repeatedly. Gosh, that will fucking eat you alive. Right? And or is it, hey. I'm anxious because, you know, this is this is me. I mean, I'm a people pleaser, and I'm a recovering people pleaser. But if I feel like maybe I'm intimidated by people or sometimes I might think, oh my gosh, these people are doing they're really cool people. Why would they like me? You know, things like that. That comes up too. So that's fear. And then this over here is just kind of over time just disrespect. So I'm going to lean into the fear and I'm going to fade away or put more boundaries around people that shit on me, basically. And again, you'll know because you'll just start to just notice. So you really don't even have to do much when you're starting to understand your body signals. You just have to observe them. And when you observe them, you start noticing patterns and things become so much more clear that I was I've been blown away from. And so another example would be with your ecosystem or people around you or work or whatever. Right? If you're constantly put, like, doing things and abandoning yourself so I didn't even know what this term abandoning myself meant. Right? I thought abandoning yourself I I I didn't even know. I didn't even think about it. I didn't think I was abandoning myself, but I was completely abandoning myself. And I truly believe that this is why I ended up having cancer. I'm not saying if you abandon yourself, you're gonna get cancer. I'm just saying I needed a rude enough awakening to wake me up so much because I wasn't listening. The crippling anxiety and crippling fatigue and ongoing pain apparently wasn't enough. I needed to get cancer to wake me up. Anyways, hopefully none of you guys will get cancer, but my point is that my body was shut down. So if I say I somebody asks me to do something, right, and I am it's I am exhausted. I just got home. Maybe they're asking something outlandish, like they want me to drive 45 minutes to drop something off when it's maybe their responsibility. My old self would have said, sure. I got it because I wanted everyone to like me. But now I'd say, no. That's not my responsibility. And if that person wants to get mad at me about something like that, I've done enough self work to to know, hey. That's cool. I mean, it's not great for somebody not like you, but if you're gonna dislike me or you're gonna abandon me because I did something for myself to put a boundary up to say, no. Hey. Actually, that is your responsibility. You don't have to be an asshole about it. Setting up boundaries, you can be really nice and do it. And and those are not setting up boundaries and being nice about it is totally different than lashing out or setting up a boundary and being really harsh about it. I tend to like to just be softer because the more I can express my concern without overact being overly emotional, the more it lands. But, again, as you start doing this, you kinda weed out people because you'll see how they react. And it's sometimes scary to stick up for yourself. I'm not gonna lie. I still get scared if I don't know how somebody's gonna react. You know? I I don't wanna piss them off and then have them come after me in some capacity. I don't know. It's not logical. Right? And so that's for me going back to deeper rooted complex PTSD that I've had to work through of this fear of outrage or abuse or something like that occurring after I set up a boundary. But something to think about if you're constantly doing things that just just exhausts you. You know? I mean, if you don't want to if there's you know, for me, gosh, I don't really like going to big concerts. I just think they're loud and people are drunk, and I'm getting old and I'm just over it. But I will go to some. Right? I'd rather go to stand up comedy before I would a live music venue, mainly because there's seating and you can lounge and relax. But my point is, if I keep going to things like maybe music venues because everybody that I know wants to go, and it's something I just don't vibe with, but I keep pushing myself to do things. I don't know why I said a music venue. It sounds so ridiculous, but whatever. Just bear with me. And and I keep doing it. I'm gonna be depleted of energy because that doesn't light me up. Right? That's not fueling me. So think of, with these environmental factors, what fuels you and what drains you? So we only have so many there's something called energy leaks. And so energy leaks are it can be incredibly helpful to just sit down and and write down all the things that fucking drain you. Right? What is everything that drains you? There are some things in life you have to do. Right? If you're a parent and you have a bunch of kids, it can be draining. So do what you can, but there are things in the way we think and the and what we do that we can adjust. It doesn't necessarily mean you may have to do these outlandish things to change everything. Just start small. Right? And so if your energy leak is con if you're leaking all this energy, so maybe I'm showing up and doing all these things. I don't have kids, but, like, PTA meetings here. And then I need to make sure all the kids' lunches are perfect. I need to make sure that, you know, all these different things are my car is perfectly cleaned, or I I'm hanging out with somebody who's such a Debbie Downer. I don't even get me started on Debbie Downers. And if you haven't I think most people have seen it, but if not, if you're younger and you didn't watch this episode of Saturday night live, highly recommend. Debbie Downer is hilarious. So being around Debbies are going to suck your energy. So you can look and be like, okay. Well, what's where is my energy leaking and where is it filling me up? So think of it as as fuel. Right? So we eat because we need it for energy and we need it to function. Think of energy the same way. If I am if people are taking my energy, I'm going to be depleted. If there's a mutual giving and receiving, that is going to fill you up. Right? No relationship or even friendship is perfect all the time. And it's not even about other people with this. It's more about your relationship to self and conserving your energy for things that you either have to do or you want to do. And everything else, just say fuck it. And I say that because when I was getting chemo, the I just remember so vividly looking out the window and just thinking, why the fuck did I do all of these things for everybody else and just abandon myself? And I swore on that day, it was July 11, 2019, I swore on that day never again, but I didn't know how to do it. I just knew that I needed to figure something out because I had completely abandoned myself. So just kind of looking at those energy leaks, that can be, that can be a big deal. Also, communication. So if you're in a romantic relationship, something to think about too is, are you able to express your needs? Are you able to be heard? Do you feel like there's a mutual back and forth of communication? It's really hard nowadays, especially in heterosexual relationships. There's a big disconnection and communication. I think for a variety of reasons, I think it's just generational men. We're told they need to be the providers financially because that's what that their dad did and then their dad's dad, yada yada. And then you've got this dynamic of women are more in the workforce than they've ever been, but they're also taking on a majority of the childhood or the child care home home, you know, home duties, cooking, cleaning, all that. There's a massive imbalance right now. And some people are doing it. Some women are doing it while working. Some are staying at home regardless. It's indifferent. It's more there's this imbalance. And so how to kind of pull that balance back up? Can we get more help from the partner? We're not I I've also heard this too with women who stay at home. They feel guilty almost asking their their spouse or their partner to, help when maybe when that person gets home or when they're off work because there's this underlying shame of maybe I can't even do it myself. Raising children and having a family and just even existing existing on this earth is incredibly hard. Add on children, add on all these responsibilities. Right? And so how can we sit down and work with the other person to figure out, hey, I'm drowning. Right? I'm not okay, and how to ask for help. And, again, it's hard because I know many people in relationships that aren't ideal. And I, myself, have been in an abusive relationship, and I couldn't actually communicate. So that's something that's totally different, and that's another, podcast topic. I do want to address those topics. But in this realm, it's just something to consider, think about, and just say, what are these energy leaks throughout the day? How can my partner help me? Or if you don't have a partner, how can my friends help? Or how can I help myself? Right? So maybe if you don't have a ton of community, what are some things that you can set up to help you preserve your energy? I think it's actually really good because there's this theory. There's this, saying for people with chronic illness. It's called the spoon theory. Right? I actually think spoons should apply for everybody. So say you have 10 spoons in a day. And so with chronic illness, we have to conserve people with chronic illness have to conserve their energy. And this is something when I'm in a flare of extreme fatigue, I have to be careful about managing my spoons. And so thankfully, with a lot of the work that I've been doing and that I'll be sharing, I really don't have as many of those episodes. And I think over time, I realized mine was a lot of energy lakes, which is incredibly wild to even think about. So if you're dealing with fatigue, that's a it's a something to consider as well. But with the spoons. Right? So say I have 10 spoons in a day. If I know that I'm gonna be if I know, like, maybe that evening, I'm going to do something that I need a lot more energy for. Maybe it's an at work event that I have to go to that I know is gonna drain me, but it's just it is what it is. Right? Well, how can I conserve so maybe that's gonna take 9 spoons? Right? And so then I have one left. So I need to conserve earlier in the day for those spoons. Right? Obviously, it's difficult if you have multiple kids and compounding with other factors. Just think about the maybe you use 7 spoons in the evening, so then you maybe do less earlier in the day. It's just a way to think about it because we all have energy. We all get depleted. We're all human. Right? We don't have this infinite amount of energy. And so thinking of it from that standpoint might make, might be helpful for you to to consider. And so with environmental things, you know, just kinda summarizing the environmental part is, am I setting up boundaries in my life? Where are my energy leaks? And noticing how I feel in certain environments. Just noticing. You don't have to do anything crazy. So the next part is gonna be physiological. So physiological gosh. This is this is tough because starts this isn't my specialty. Right? I'm a physical therapist, but we have to look at these things because these can directly impact anxiety. So maybe your signal anxiety isn't a signal that something's wrong in your environment. Maybe there's something wrong physiologically in your body. Right? So, like, for instance, I had extreme anxiety when I went through chemo. I was going through a lot at the time, but it was like the second I got chemo, it was just like, oh my god. And I think it's because my body thought it was under attack. It was like, what the fuck is going on? Why am I getting this? Like, one of them was called the red devil. And, anyways, it was just like this gross, oh, chemo drug that you could see. And then the nurses had to actually wear, like, a gown because if it touched their skin, they could it could have damaging effects with them. And it just it was just wild to me to think that, well, this is being injected into my veins. Oh, that's cool. Why do I have anxiety? And they didn't you know, I didn't really put 2 and 2 together. I just thought it was just the whole traumatic response of of experiencing chemo, but it can be anything else too. Right? It can be, one of the bigger things that can be our thyroid. So thyroid issues can when your hypo or hyperthyroid, we can have these imbalances that can cause more anxiety or depression because that can set off a whole cascade of other hormone effects. And so the lab work with thyroid and things like that, that's not my specialization, but it is important to note that it can be that you might have a thyroid issue if you're having all the symptoms that maybe are on the lower end of the lab. So the labs, labs in general, like, aren't they're not perfect. Right? And so a lot of times, they they're they don't they're they don't represent the mass. They don't represent everybody perfectly. It's just it's just not an exact science. And so we have to look at the symptoms plus the blood work. Right? So thyroid, something called estrogen dominance. So this is something I'm really gonna dive into in another episode because I want somebody else to come on to explain the hormone cascade a bit better than I can because it is insane how much estrogen dominance can affect your your your anxiety or symptoms. So basically, what estrogen dominance means is that your estrogen so estradiol, so we have 3 types of estrogen, but the estradiol in relation to progesterone. And so typically, they look at it as a ratio. If you just get your labs and it looks normal, but the people aren't looking at the ratio, the ratio is super important. It can, but it also can mean that it's the progesterone to estrogen ratio is off. And this is super important because this can cause anxiety. This can cause endometriosis, PCOS. It can be a big issue with, PMDD. Premenstrual dysphoric disorder, so PMDD, is can be caused by this as well. And so what can happen is, again, it sets off a whole cascade of effects that we'll go into detail on another episode, but it's really important to know because estrogen so so then the question is, well, okay. Well, other kind in the US, we go, okay. Well, just go on fucking, like, birth control, and it's like, oh my gosh. Okay. Well, if we know there's this is an estrogen dominant issue, why are we giving more estrogen? So progesterone is often helped with people experiencing estrogen dominance. Right? But then my question is, well, why is the progesterone low in the first place? So, hey, I'm totally 4 if you need to supplement it, but at the same time, why is it low? So we know that progesterone can be suppressed with chronic stress. And so that's why going over a lot of things that we're talking in here can really help you zone in a bit more and know where your chronic stress might be coming from so you can start putting pieces together to help maintain that. So if my stress level is constantly high, my cortisol is high, that just over time is gonna suppress progesterone so then it makes the ratio, off for the estrogen to progesterone. So something to consider with that. The other thing that can also affect it is insulin resistance. So if I highly recommend people do, like, a continuous glucose monitor. We'll also talk about this in in diet as well here in just a few minutes. But knowing if your insulin is constantly high because your glucose is spiking and crashing, spiking and crashing, spiking and crashing, maybe I know my maybe my a one c is normal, but it doesn't track these spikes and crashes that are really harsh. And so then it then the insulin is just staying there, and it's like, okay. So it's it's becomes so the glucose just becomes resistant to insulin. So then you've got a lot more glucose in your bloodstream, but then that can, cause anxiety as well. So so something to think about with that. The other thing to think about with, physiological are is there a vitamin deficiency? Is there a mineral deficiency? Low vitamin d can cause some of these issues as well. You can people will take a supplement. The other thing that I think we don't do enough of is going out in the sun. You know, even just if it's just for 5 or 10 minutes without sunscreen, that's when you can absorb more of that vitamin d. And the more melanin you have in your skin, the longer to stay out. And it's just something to think about from that standpoint as I think we've demonized the sun in our culture. And, yes, I am pale and pasty, and so I get burnt easily. Easily. So I'll go out and maybe in my backyard and wear a sports bra, expose my belly and get more sun to help my body naturally absorb vitamin d. But that's not always the case every day. So I do supplement with a vitamin d supplement. So just something to think about along those lines. Certain medications as well. So I didn't realize this, but I was taking a steroid inhaler for a while, and it was just shooting off my anxiety. And I had no idea that that was causing it until I started tuning in and started looking at more patterns. So steroid inhaler, another medication, any stimulant, so like Ritalin, Vyvanse, Adderall, you know, not everybody responds this way with those medications, but if you find yourself on the days that you take it extremely anxious and days that you don't, that's something to kinda talk to your doctor about and just see how you can either adjust that dosage or play around with it or whatever works for you and, your medical team. But, oh, another one too, those, the decongestants. So sometimes Sudafed. I know Sudafed makes me feel like my heart's gonna beat out of my chest. And so that's just that's just me. Some people respond fine to Sudafed, but just know that that can cause that as well. And really any medication can have any side effects. So if you if you start taking a new medication and you notice something's off, just notice it and talk to your doctor. But in general, anything can be a side effect. And if people wanna gaslight you and say that, no, that's not a side effect, it's bullshit because we haven't studied every single body of every single person that's ever lived on this planet. So, no, we don't know. We don't know. We and, medicine is not an exact science. So something to think about there. Okay. So diet. So going back to what I was saying before. So I'm a huge fan of a continuous glucose monitor, and there's a variety that are direct to consumer now, and there are certain brands that will pair you up with a dietician to kinda talk you through and understanding what's going on. But generally speaking, this was a game changer for me, like, an absolute game changer because I didn't realize all the spikes and crashes that my body was going through. So I would some ones that you might think, well, I don't need one. I don't eat a lot of sugar. Neither do I. Neither do I. And since chemo, I've I've had to really start monitoring my blood sugar because it's kinda creeping up and I didn't know why, the inhaler. I mean, man, it spiked my blood sugar so high. I think it went up to, like, 200 or so. And then I was starving the rest of the day. So one way you can know if your blood sugar is dysregulated even without a glucose monitor is do you feel you're constantly just, like, grabbing food or grabbing snacks because you just you cannot survive without a meal over a certain period of time. This is me for a long, long time, and I just thought I had hypoglycemia. And actually, no. What it was doing is I was just spiking and crashing. So when you've when your blood sugar spikes and then when it crashes, it crashes hard. And then that's why you crave, like, sweet shit, like, when your, when your blood sugar's crashing because it's an immediate spike to kind of restabilize. Right? So a lot of times you wanna make sure you have when you have a carbohydrate, you're pairing it with some form of protein because that's gonna kinda help stabilize it out. Right? So if I just have a piece of bread but I don't have something with it that's a protein, I'm gonna crash in, like, an hour. And so if you feel that way, if you feel shaky or feel like, you know and you've been cleared for diabetes or anything like that. Right? These are this is something that is if there isn't any underlying conditions that you know of or maybe that you've already tested. So keeping that in mind, some other things that I found interesting with the continuous glucose mover is my steroid or sorry, my steroid inhaler. The other one that was wild wild is if I had more than one shot of espresso. So typically to give you an idea of how much caffeine I was consuming all at once, there was a time when I was working in corporate and, like, treating, like, a shit ton of patients and just going a 1000000 miles a minute where I'd have a quad, like a quad, like 4 shots of espresso. Just to show you, my blood sugar spiked up super, super high when I had more than one shot of espresso. So now think about if I compounded that 4 times, my blood sugar is spiking through the roof and then crashing hard. So every day around like 10 o'clock, I was like, I need food. I need food. And it was just exhausting. Then my anxiety increased too. Right? Because my anxiety increased first because of the caffeine, then it increased because my body was going through this spike and crash. And it was like, hey. What the fuck is going on? Like, why are you doing this to me? Right? Again, signal. Your body's like, hey. What you doing? Why are you doing this to me? Your bodies are not out to get to get you. I thought that for a very long time, but they're not. Your body wants to protect you. And so some other things too are gonna be, some other things too are gonna be, we can cut this part out. Sorry. Some other things that can make a big difference are gonna be alcohol. Sorry. I know we live in a world where alcohol is just normalized, and alcohol controlled my life for a very long time, a lot of my twenties or most of my twenties. And I'm not proud, but I realized that I was using actually alcohol to cope with anxiety because I didn't know how to handle it. Even though I was on an antidepressant, I was still having anxiety. And so I would just binge drink a shit ton of alcohol, and then I'd wake up the next morning and be like, oh, god. Like, just this crippling shame that I drank so much, so then I drink to get to put the shame away. So it's like this vicious cycle. So, alcohol can cause more anxiety almost like as a rebound effect. So then what can happen is then people then start drinking more to help with their anxiety. And then the anxiety it helps the anxiety temporarily, but then withdrawal happens. So it's this vicious cycle. Right? So that can also, cause anxiety, but also, alcohol will spike and crash your blood sugar like crazy. That's why you crave, like, salty and carbs and stuff maybe at the end of the evening from drinking. I know this because I ate many a pizza, many a pizza with ranch. But so that's why we crave those things. And so it's just important for you to just observe. Right? Again, and if you wanna drink, I'm not do do that. Right? Like, have your alcohol. Just notice. Just notice. I'm not here to judge. I'm here to just give you what I've learned and what I've researched and what I found helpful, and take it with a grain of salt. Right? So the other thing that can also be an issue is if you're constantly eating foods that make you feel like shit. Right? So really processed foods, not a lot of fiber, not a lot of fruits and vegetables. Sometimes if you are lactose intolerant and you're consuming a lot of dairy, that can cause your body to be like, what's going on? And then potentially anxiety. Keep in mind about 90% of our serotonin is produced in our gut. So if we're, like, messing up our gut and we know that anxiety is low serotonin. Right? So it's gonna affect our mental health as well. So there's more and more research coming out about this. And it used to be poo pooed on, and now people are wanting to know more because what we're doing currently for mental health isn't it's not helping people from a massive scale. And it's helping maybe a little bit, but not to the degree that that we have the the ability to. So anything that's upsetting your stomach, making you feel like you have diarrhea, bloating, any any indigestion. So if you're starting to feel like you're having those things and you notice more anxiety with it, what's hard with that is then the anxiety will perpetuate those symptoms too. So it's this whole cascade there. So just kind of being aware of that. I know for me, coincidentally, like, when I take antibiotics, I get a lot of anxiety, because it has changed the bacteria in my gut. So I try to be careful on when I take that. I used to take antibiotics like those Pez Candies as well, and now I'm like, damn. I mean, that can set off a lot of stuff. So you just wanna be sure that it is if you do have shake antibiotics, it is the actual bacteria. Like, they they know what type of bacteria that you're give that you're being that is causing the bacterial infection and then an antibiotic to match it because antibiotics can be incredibly helpful. But if they're overused, it can also destroy the gut as well. This is, again, not all inclusive. So just just starting to observe. Okay. So finally, lifestyle. Right? So lifestyle. When was the last so these are some questions to kind of go through. So these are things that I go through when I'm like, damn. Why am I having anxiety? What's going on? And, I just start wanting to panic, and then I go, no. Let's just sit with it. Let's see what my body is trying to tell me. So this is just a nice thing to kind of go through and just say, oh, okay, am I doing these things or not? So for me, I'll go I'll go through this list. When was the last time I belly laughed? That when you laugh seriously, like, laughter, I know it's told, it's like you've probably heard laughter is the best medicine. I actually truly think that because it stimulates a lot of neurotransmitters that are happy neurotransmitters and really can help us feel really good. And so just something to think about, if you're not experiencing joy, if you feel like you're just constantly just stressed and just unable to and just feel like you can't there's just not enough time. If you feel like there's not enough time, that might actually be the time to try to do something that just makes you laugh. Like, just something. Something that brings you some type of joy. If you feel you don't have time for something, just take 5 minutes, 10 minutes, something that will make you laugh. Talking to a friend, talking to your partner, dancing with your dog. My dog's over there. She's like, bitch, what are you talking about? Yeah. So just something that's just funny. Right? You know, the other day, my mom I love my mom, but she she bought me my dog a little, the toy story guy. What's his name? Woody? Anyway, so she puts Woody like, there's a little character that he, like it looks like Woody is riding on my dog's back. So you have to, like, Velcro it her Velcro it on the front and, like, on her side. And the other day, she was wearing it, and so she was walking and, like, Woody, like, looks like he's riding her and it's just hilarious. And then the neighbor dog, that's her boyfriend, comes over and he starts pulling it off of her because he thinks that it is a it's a toy. He thinks it's his toy. And we laughed so hard. I mean, so hard because it was just it was just hilarious. Like, I didn't expect it. The dogs were my dog was running around with this thing on her back, and then the neighbor dog just, like, ripped it off of her. And my dog's super, super tiny. She's, like, £15, and the neighbor dog's, I don't know, like 80. So he was, like, drag like, trying to pull it off of her, which she did, but it was hilarious. But, I did think it was funny. This is kind of a side note. My mom sent me she bought this this outfit from Amazon, shipped it to her house in Virginia, and then shipped it back to me in Texas. And that cracked me up too. So the whole story just cracked me up is, like, how I got this this toy, how my dog wore it, and then how she got it ripped off of her. She was fine. She was she was being playful. She enjoyed it. It wasn't a bad thing. It was just a whole environment. But, yeah, thinking about when was the last time you laughed that hard. Another question is, have I connected with a close friend recently? When I say a close friend, I mean somebody that you need 0 battery for. So those 0 battery friends that, like, you just show up, you just show up as you, you don't have to do shit. Like you are just you, your raw self. There is no energy that is needed. There is no front that you need to do. They know you. Have I connected with somebody like that? Right? Have I been in the sun at all? Have I just been in fluorescent lights or have I gotten any fresh air? Am I just, you know, we live in a culture where we're sitting at our computers all day, every day. Right? So have I gotten up? Have I moved? Have I exercised? Have I moved my body in any capacity? Right? Have I gone in nature? Nature's huge. If you don't have access to nature or like maybe you're in a bigger city or wherever, even just sitting outside, just something, just something to get yourself outside or just outside of all the man made things. So all of our lighting and all that stuff, just going out into nature or just outside in some capacity. How much blue light am I consuming consuming throughout the day, but especially before bed and when I wake up? I'm guilty of this too. Don't act like I'm perfect at it, but it is something that if I'm scrolling and or I'm on my phone and I'm just the light is just like beaming into my eyes and then I go to bed, you know, I roughly, I'd say I try to aim for 30 to minutes to an hour of of no phone before bed or any blue light. Ideally more, but I mean, sometimes it's just not realistic. And so and then same thing in the morning is is the first thing that I'm looking at my phone, or am I gonna go outside just for a minute and just kinda see the sunlight and go on with my day? I'm not perfect at this. I don't do this every day, but I do know that I'm no I'm being conscious of it. I'm conscious that I'm looking at my phone and I'm saying I might feel like shit tomorrow, but I'm consciously choosing to do that. And so the more you can bring that to your conscious level, then it's kind of shifts over time because you start associating that you feel like shit with losing your phone before bed and then over time you just kind of phase it out. So you don't shame yourself right now. Like, don't shame yourself with any of this. Just kind of observe it because over time you will shift it just by observing it. So I found that incredibly helpful just to know that. How much social media am I consuming? Right? Who actually shows the real life on social media? I try my best to show up authentic, but, you know, I find myself even before this putting on mascara, like and, like, cleaning up this background, right, this tree and this this this design that I made here. I just wanted it to look good. Right? But the reality is I've got, like, a pile of stuff behind the camera over here and then, you know, just just stuff around my house. Right? I'm not showing those types of things. So you're not gonna see people's perfect you're only seeing people's the side of people that they wanna show. You're not seeing the full picture. So it's super easy to start comparing yourself and be like, oh, well, this person's home looks this way and this and this. I swear if I see another perfect looking home, like, on Instagram, I'm gonna just, like, die because I'm, like, nobody it's funny because I've seen people who have these big followings or, like, maybe they show a certain aspect of their lives on social media, and I'm, like, that's not them. I was just at their house. That is not what it looked like. And it's it's it's ridiculous. And so trying to maybe follow authentic people or people that just notice, like, if you listen to somebody's podcast or you listen to or watch somebody's Instagram and you feel like shit after, that's just something to notice. Right? Because my goal when I talk give information is, I don't want you to feel like you need to shame or judge yourself, or I don't want you to think that I am better than you or anything like that because that sure as hell isn't true. And I'll be the 1st to say that. But just noticing, you know, noticing that that's what we're consuming. Right? And so you can imagine consuming that plus the plus being on our computers, plus not connecting with friends, plus not sleeping, plus not, plus hanging out with people that drain us, plus having a job we don't like. I mean, this this shit adds up. I mean, it adds up. And then of course you're going to have anxiety. Of course. Because your body is like, what are we doing? Why are we doing this? So, yeah. And, and then, yeah, the other thing was sleep. How much sleep am I getting? Am I sleeping well? Am I not sleeping well? Am I going to bed when I normally want to go to bed or am I staying up later? You know, just, just observe. And then the other thing to think about with anxiety is that anxiety is actually, like I said before, it's like you kind of have to listen to it. Right? Is it anxiety because it's excitement or is it anxiety because something's wrong and we need to change the situation? Right? So there's also something called a growth edge. And so your growth edge is like, for instance, I'll give you an example for me. So my growth edge is that I relaunched this podcast, and my whole goal with this relaunch was to show up more authentically and to really make a bigger impact and really launch my public speaking career, launching more of an online business and then growing my in person practice. So that means that I have to push up against a lot of my inner critic. Right? And so say my growth edge is just like a little circle. Right? And then think about a really big circle inside a little circle and that end of that growth edge. So that would be like maybe like massive, massive public speaking gigs in front of, like, a bunch of people. Right? So if I had never done public speaking and I wanted to do that tomorrow, say I got booked a gig tomorrow, speaking with thousands of people, that would be beyond my growth edge. I don't think my nervous system could potentially handle that. But because I've worked hard in pushing myself over time with maybe smaller public speaking experiences or maybe just a couple people here and there, or maybe only presenting for 5 minutes or a few minutes. So each time I'm kind of expanding, expanding. And then as I kind of push up against that growth edge, I can kind of come back to center and recover. And then over time, it just those things become normal, so then your growth edge becomes wider and wider and wider. And then eventually, I can kind of push myself to these levels. And so that was one of the reasons I did stand up comedy is because, okay, I had practiced. I hated public speaking. It just, like, was the bane of my existence. I'd rather die than public speak. And then I just I was but I was like, I wanna do it. I I know I wanna do it. And so I just started pushing up against my growth edge and then have a little anxiety with it, and then I'd come back and just maybe have some alone time or exercise, you know, some yoga or resting more, whatever it is to kind of calm my nervous system so then I can push myself more. Right? And so that could also be happening as well. So I know my growth edge is being pushed against by showing up more authentically, and so I've been having more anxiety. Right? And so just something to think about from from that perspective. And in summary of all of these things. Right? So we talked about the environment. So people are our ecosystem at work, our relationships, how we're showing up. Are we setting up boundaries? Are energy leaks physiological? Is our thyroid off? Are we experiencing, hormonal changes due to estrogen, progesterone, ratios being off? Am I is there a vitamin deficiency? Is there one thing we I mean, is there underlying disease that we just don't know about? Is there steroids? Right? Like, is it actually, steroids should be under no. It's under medication. Sorry. So under, the physiological. Right? So so I'm gonna think about with that. Diet, are we eating a lot of processed food? Are we eating things that upset our stomach? Are we, consuming carbs with, like, a protein and a fat, mainly protein if if just to keep it straight. Right? So if I have a piece of bread, I have some chicken with it or something along those lines to help stabilize the blood sugar, potentially looking into, like, a continuous glucose monitor, I highly recommend. It's just hard for people to understand how to use them. I think, there are a lot more resources out there now, but we can touch on that on another episode as well. Looking at caffeine as well can make a big difference, and then some medications. And then finally, lifestyle, just kinda going through a checklist of things that keep us out of the house, right, or connecting as a human to other people or nature or ourselves in any capacity. And so movement, nature, getting outside, sun, and then are we are we pushing against our growth edge. Right? So it's normal to have anxiety when you're doing cool things that you're excited about. So that's excitement anxiety versus, you know, signals from your body kind of saying, hey, something's wrong. Right? And and and and in summary of all this is anxiety is a signal. If you don't know what the signal is, try to sit with yourself and see what your body tells you. This is something I remember thinking, what the fuck does this mean? Right? You're probably thinking if you've never done this. I felt the same way. But the more you sit with yourself, the more you kind of hear these, like, inner voices that can it sounds like I'm crazy, but you can hear your inner thoughts and know, hey. What what what's really going on? Right? And so sometimes, over time, you just again, with the patterns, then you can start noticing. So if you if you don't know or you haven't sat with yourself a lot before, just start noticing patterns first. And then over time, then you can start using those patterns as resources. So, oh, I know that, sugar causes anxiety and so is caffeine, and I know that I had more caffeine. I didn't sleep in this, yada yada. Right? So that's kinda how you'll know. So I would say, first, look at your patterns, start noticing, try not to shame yourself. You're just observing. And then over time, your body will gradually make that shift for you, and it can be incredibly beneficial. And so I'm I really hope this I really hope these things have helped you. I hope it gives you another perspective on how to handle anxiety, and this can be chronic stress as well. And the last thing to note is just also notice, like, where you feel it in your body. Like, for me, I feel like a chest like, in my chest, like, tightness and, like, kind of the swirling motion. So I can start identifying it faster. I'm like, oh, that's weird. I feel that. Oh, anxiety. Oh, well, what could be going on? Okay. I didn't have any physiological changes recently. There's no environmental changes. For me at this point, it's more likely like a lifestyle thing because I'm either consuming too much social media myself or online too much or, maybe not sleeping as much or if I'm on my phone more. So I really have to kind of keep that in check. The biggest thing for me is just making sure I stay on an exercise routine as well. And so anyways, thank you guys so much. If you have any questions, feel free to reach out or send me a message. Follow me on doctor Mary pt at, on Instagram, so dear Mary pt, and we'll add the other links to my other social platform. So thank you so much, and I hope this helped. You've been listening to TMI talk with your host, doctor Mary Grimberg. Make sure to subscribe wherever you get your podcasts. To learn more about doctor Mary, head on over to doctormary grimberg.com, and make to follow doctor Mary at doctormarypt on all social channels. To learn more about doctor Mary's integrative practice for pain relief in Austin, Texas, head on over to resiliant.rx.com. Thanks for listening.