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  • Patricia Pearce, ND

The Anxiety Management Dilemma

I had a client who suffers from anxiety and panic attacks ask me an excellent question.

Toward the end of her visit, right before she got up to leave, she said, "Trish, can I ask you something? Because you don't seem to mind sharing the fact that you struggle with anxiety."

"Of course," I responded. (I have no qualms sharing personal details about my own health conditions with my clients, as they are a big part of why I became a naturopathic doctor in the first place.)

"Have you ever gotten your anxiety to completely go away? Or do you feel like you just manage it?"

I immediately understood the reasoning behind her question. When anxiety symptoms are at their worst, there's a feeling of being controlled by it. She wanted to get a sense of what her expectations should be. What I told her is that there is no known "cure" for anxiety, which taken at face value sounds discouraging. That's because as a society, we have an interestingly over-simplified view of health conditions. From the time we're children, we're indoctrinated with a belief in the formula:

Symptoms-->Diagnosis-->Treatment (most often a drug)-->Cured!

And that makes sense, doesn't it? It's neat and logical and makes us feel hopeful and optimistic that given enough time, research funding, and scientific intelligence, we could potentially come up with a cure for anything! We look at conditions like infectious disease and the formula fits, like in this example:

Sinus congestion/headache/fever-->Bacterial Sinusitis-->Antibiotic-->Cured!

Therefore, we mistakenly tend to apply it to every health condition, from hypothyroidism to IBS to diabetes, as well as mental health conditions like depression, bipolar disorder, panic attacks, and generalized anxiety disorder. When we apply the formula above to anxiety, it looks something like this:

Feelings of excessive worry & tension-->Generalized Anxiety Disorder

-->Benzodiazepine (like Xanax)-->Temporary reduction in symptoms but no long-term relief-->Possibility of dependence and side-effects from the drug

When it comes to a complex, multifactorial condition like anxiety, the formula breaks down. The benzodiazepines are the most commonly prescribed drug for anxiety, but they don't work for everyone. If there is no cure, then we call any effort to combat the disease "management" that is, "reduce symptoms down to a level you can live with."

That sounds a little bleak, doesn't it?

I thought about my client's question long after she left my office, and about how I would categorize my success with managing my own anxiety. Years ago, when my symptoms were at their worst, I had a hard time even thinking straight or getting out of bed. Every waking hour of the day, I was plagued with worries and fears that often had no basis in reality, in addition to all the physical manifestations of constantly being in "fight or flight" mode. Compared to back then, my anxiety is quite well-managed, and I have holistic medicine to thank for that. I found the root causes of my anxiety and addressed them, and it transformed me from someone being controlled by their condition to someone who was in control of their condition.

(Notice I haven't made any mention of getting rid of it, and that's because I still live with it.)

Yep, I still live with my anxiety. It's not something I struggle with at high levels on a daily basis anymore, and now I only get severe symptoms a few times a month at worst, so I would say my anxiety is quite well-managed, especially compared to how debilitating it used to be. If my average symptom level over a given month at its worst was a 10/10, currently it's at about a 2-3/10.

Now I'm going to go out on a limb and say something that some people may find strange.

I'm glad my anxiety has never completely gone away. I'm perfectly content with being "well-managed" and not "cured."


Because worrying too much and being anxious is part of who I am, and I accept that about myself. Having anxiety sucks (not going to lie about that part) but it also serves me. It serves me by motivating me to eat a clean diet (no matter how much I may love cheese.) It serves me by forcing me to drag myself to the gym, even if I don't really want to, because I know after I go, I'll feel better. It serves as a reminder to meditate every day, to engage in positive self-thinking, to take my supplements, and to go outside and breath fresh air. It serves me by returning full-force when I eat bad food and skip workouts to sit on my couch to watch Netflix. It's the reason I dust myself off and get back on the wagon. The thought of its return is what lights my fire on my darker days.

I believe that the active, engaged management of my own anxiety makes me a better person, a better spouse, a better friend, and a better doctor. My anxiety serves me by lending me compassion and empathy for those who suffer from it. It allows me to better educate and guide my clients.

And that is what matters to me most of all.

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