Anxiety

My Amazing Body is a podcast where we explore interesting, unknown and misunderstood parts of your body with help from medical experts and stories from real Queenslanders. Join us for our special five-part series focused specifically on mental health and wellbeing.

One quarter of Australians will experience an anxiety condition in their lifetime. This episode is about anxiety. What is anxiety? Who does it affect and what does it do to your body?

Dr Manaan Kar Ray, a psychiatrist and director for Adult Mental Health at the Princess Alexandra Hospital, explains what anxiety disorder is and how it affects your body. He also talks about the different types of anxiety and the best ways to look after your mental wellbeing. Michelle, a Queensland woman, talks about her lived experience with anxiety.

Meet our Guests:

“I tend to think of people who work in mental health as those mirrors inside a lighthouse that amplified a light within a person when the light is dwindling.”

“I've been a volunteer with Beyond Blue now since 2017. I started out there going into schools and workplaces and talking about my own personal experience with anxiety.”

Episode Material and Support:

Queensland Health Help lines, counselling and support groups –1300 MH CALL (1300 642255) is a confidential mental health telephone triage service that provides the first point of contact to public mental health services to Queenslanders.

Queensland Health Dear Mind website. - Taking some ‘me time’ is important. And it also helps strengthen your mental wellbeing. Having a healthy sense of mental wellbeing has many benefits. It lifts your mood, promotes resilience in difficult situations and helps you get the most out of life. It doesn’t matter who you are, where you live or how you’re feeling – taking a few moments for yourself each day will help you be a happier and more resilient you.

Beyond Blue - provides information and support to help everyone in Australia to achieve their best possible mental health, whatever their age and wherever they live.

Beyond Blue Anxiety Checklist – this simple checklist asks you to reflect on your feelings over the past four weeks.

LifeLine – is a national charity who provide all Australians experiencing emotional distress with access to 24-hour crisis support and suicide prevention services.

If you or someone you know need support, book an appointment to see your GP and talk to them or contact Lifeline on 13 11 14, and if it’s an emergency, please call 000 immediately.

Dr Kar Ray: The first thing to understand and the word to spread, is anxiety is a part of who we are as human beings. It's woven into the fabric of humanness. It's part of our fight or flight response.

Host: Welcome to season three of My Amazing Body - a podcast where we explore interesting, unknown and misunderstood parts of your body. This is episode 4 of our special five-part series focused specifically on mental health and wellbeing.

This episode contains a firsthand account of what it’s like to experience anxiety.

If you or someone you know need support, contact Lifeline on 13 11 14 and if it’s an emergency, please call 000 immediately.

One quarter of Australians will experience an anxiety condition in their lifetime. In this episode we break down anxiety. What is it? What does it feel like and how does it affect your body?

We spoke with Dr Manaan Kar Ray, a psychiatrist and director for Adult Mental Health at the Princess Alexandra Hospital. He says in order to understand Anxiety we must first understand fear.

Dr Kar Ray: I think it is important for us to get a sense of fear, because it is in the context of fear that one can understand anxiety better. So, fear is a basic, automatic response to a specific object, situation or circumstance that involves a recognition of actual or potential danger. So, fear is part of our fight or flight response. It's something that we all have. Anxiety, in contrast, is a much more prolonged, complex emotional state that is often triggered by an initial fear. So, if you have a fear of spiders, say for example, like arachnophobia, you could feel anxious about going to visit friends who live in a much older home where you might encounter spiders. Or you might have anxiety about going to the movies, because the film might contain a scene with spiders.

So, the basic fear is of encountering a spider, but you live in a state of persistent anxiety about the future possibility of being exposed to a spider. So, anxiety is a more enduring experience than fear. It's a state of apprehension and physical arousal in which you believe you can't control or predict potentially averse future events.

Host: Dr Kar Ray says a certain level of anxiety is actually important for everyone but that there are two types of anxiety. Good and bad.

Dr Kar Ray: So, one of the ways to think about it is good anxiety and bad anxiety. So, in my book, what counts as good anxiety is the anxiety that helps us kind of live our life to our fullest potential. So, if you think about anxiety as the driving force for a lot of the things we do, so one of the great gifts that human beings have is the gift of language. Language allows us to think about the future, think about future possible events and to plan around those events. And, if someone has no anxiety at all, in all probability, they would not put in the effort that they need to put in, in order to excel. For example, the anxiety before an exam that you're going to take, the anxiety of the exam helps you prepare and helps you focus. Of course, if the anxiety increases to a particular point, what we think of as the tipping point, then the anxiety gets to a state where it stops being helpful.

Bad anxiety is a state of, kind of part of the stress response or where we are worrying so much about future possibilities that we can't think straight, and we can't act straight and we get overwhelmed by the feeling of anxiety. So rather than it being productive, it makes us ineffective. So, it's helpful to think about anxiety as a spectrum over a continuum, at one end anxiety being a helpful response, helps us stay safe, helps us achieve life goals. And on the other end, something that makes anxiety where it becomes disabling and stops us reaching our life goals.

Host: It's helpful to think of anxiety as being on a sliding scale. At one end it helps you excel at life and at the other end it affects your day to day functioning. Dr Kar Ray says it's when anxiety affects how you live your life that it could be an anxiety disorder.

Dr Kar Ray: In the practice of mental health, we think of anxiety, as I said, on that spectrum and a point where it begins to affect your functioning, where the anxiety turns into an anxiety disorder. And, there are a number of different types of anxiety disorder. So, some people tend to have panic attacks. It's a wave of anxiety that overcomes them with a range of symptoms. And, if you have those panic attacks at a regular frequency, you may have panic disorder.

Similarly, for some people, they have significant anxiety about something really specific. Like I mentioned, the fear of spiders, arachnophobia, or fear of heights, or fear of closed spaces or fear of open spaces. And, if it begins to affect their functioning in their day-to-day life, in their occupation, in their relationships, then it becomes a disorder. It becomes a phobia.

Host: Sometimes if your anxiety is particularly bad you may experience an anxiety attack. Dr Kar Ray says it’s a similar response to how you would feel if you were being physically threatened.

Dr Kar Ray: Panic attack is a discrete episode of anxiety. You get a whole host of symptoms. Some of them are physical symptoms. Some of them are cognitive symptoms, meaning to do with your thinking. Some of them are behavioural symptoms to do with the actions we take and some of them are emotional symptoms. So, the most common physical symptoms that you get are to do with people feeling that their heart rate has increased. So out of the blue, the panic attack comes on, they get palpitations. They feel a bit short in their breathing or kind of the breathing becomes laboured, a feeling of tightness in their chest. Some people feel as if they can't swallow or their mouth is going dry or getting a choking sensation. Some people begin to feel dizzy and are a bit light-headed. Some might have sweating, hot flushes, chills, many would kind of feel butterflies in their stomach, or feel a bit nauseous, or feel that there are knots in their stomach, tingling, numbness in their arms, legs, weakness, legs feeling like jelly, needing to sit down.

There are a whole host of physical symptoms that one would get, and it might feel quite scary to begin with. But actually, a panic attack or an anxiety episode, essentially, this is a scenario which would be very common if you were under physical threat.

So, if you were being chased by a saber-toothed tiger, your heart would begin to beat fast and you would try to escape to safety. The problem with a panic attack is often there isn't a specific trigger, there isn't a tiger chasing down this person. So, all these symptoms that happen, the physical symptoms are quite difficult to contextualise for the person, and it gives rise to a range of cognitive symptoms, so they would have the fear of kind of losing control, or as if they are kind of losing the plot, or they're going to have a heart attack or they're having a stroke. So, there's a whole host of symptoms, cognitive symptoms, which relate to those physical symptoms that the person gets. And, this then gives rise to the fight or flight response. People began to hyperventilate, they are restless. They might pace about, so behavioural symptoms or they might freeze, or they have difficulty speaking. And, once someone has a panic attack because it's so anxiety provoking, they often worry about how a future attack might look like.

It's something that we call anticipatory anxiety, so it's fear of fear. You are afraid of being afraid. So, they feel nervous, they feel tense, they are wound up. So, their baseline anxiety is already higher, so they feel jittery, on edge and it is easier to tip them over that kind of curve into a full-blown panic attack.

Host: During a panic attacks the area in your brain responsible for dealing with threats is activated.

Dr Kar Ray: It's activating the limbic system, the amygdala in the brain. This is the part of the brain, it's a threat response centre of the brain. And, it's been there from the time we were hunter gatherers. So, if you kind of see a threat, you respond to a threat. The problem in modern day is that, as I mentioned there aren't saber-toothed tigers chasing us down, but the threat is in an email, the threat maybe is a text, the threat maybe is traffic. There are different ways from where we can get threat perception. And, that then kind of gives rise to those physical symptoms and along with those cognitive symptoms.

Host: Some people are more vulnerable to anxiety conditions than others, but Dr Kar Ray says it's not necessarily all about your genetics.

Dr Kar Ray: People carry genetic vulnerabilities, but the current theory is that it's a gene environment interaction. So, people might have family members who are suffering from anxiety, but that in itself is not enough. There are a range of things which can predispose a person to have an anxiety disorder, which relate to nurture rather than nature. This could be childhood trauma, this could be adverse life events that the person is going through, a really stressful time when a certain amount of worry would be expected. So, if you think of each of us having an elastic limit. If we are stretched, each one of us would break. The question is whether we would break or not, the question is when we would break. So, people who are struggling with anxiety might have had adverse life scenarios that they have been dealing with, which would have taken up a lot of the head space to begin with.

And then, the anxiety gets super imposed on that. Part of that, as I mentioned, is a lot of our anxiety relates to the future possibility of things that might not go well. So, you can understand the context in which the anxiety begins to develop till it gets to a point where it becomes disabling and turns into a clinical disorder.

Host: While you can experience an anxiety disorder without having depression, Dr Kar Ray says that often the two conditions are linked.

Dr Kar Ray: Anxiety disorders are comorbid with depression, that's one thing that it's often found. Sometimes depression leads to anxiety, and other times severe anxiety with its limiting effect on life can actually lead to depression. So, there are certain physical health conditions, which kind of give rise to anxiety-related symptoms like hyperthyroidism can manifest as high levels of anxiety, but also chronic, physical health conditions in their own right, due to the physical challenges that person has got, can give rise to anxiety as well.

Host: Learning about your condition and looking after your physical and mental health is a key element in managing an anxiety disorder.

Dr Kar Ray: There are a number of effective treatments, starting from self-help. There's a lot that people can do by themselves around maintaining their physical health and mental health. They can learn about anxiety because knowledge is power in this condition. There is a whole, whole staff literature now, around mindfulness and practicing gratitude and kindness in our day-to-day life, which helps connecting up with people, taking notice, embracing nature. So, a lot of self-help stuff that people can do. And then, there is professional help in terms of medication that helps with anxiety, as well as talking treatments. The most common and the one for which there is the most amount of evidence is cognitive behaviour therapy.

There are specific kinds of treatments for the different kinds of anxiety disorder, CBT or cognitive behaviour therapy, the treatment in which we look at thoughts and behaviours and the feelings they generate, as well as core beliefs and attitudes that we have. It's the one with the most amount of evidence, but there are other evidence-based practices as well, like exposure and response prevention for obsessive-compulsive disorder, eye movement, desensitization for post-traumatic stress disorder.

Acceptance and commitment therapy is another good way of dealing with anxiety disorders. A lot of the common phobias, they respond very well to systematic desensitisation. So, there are different kinds of therapeutic approaches that can help. And, these therapies run anywhere from six to 10 weeks, to six months to] a year, and some people would need a combination of both medication and therapy, and together that's what's needed. But, a person centred, individualised plan is what would be developed if you are kind of struggling with anxiety, either by your GP or a specialist in mental health, whether that be a psychologist or a psychiatrist that you are seeing.

Host: Dr Kar Ray says that if you think you're experiencing an anxiety disorder you should book in to see your GP to discuss different treatment options.

Dr Kar Ray: There is a lot of helpful literature out there. So, the first step in the process is to learn a little bit about the anxiety disorder itself. So, you can have an informed discussion with your GP. So, if you believe you have an anxiety disorder, I would recommend going to the Royal College of Psychiatrists website. There are a number of trusted sites that are available, where you can get further information about anxiety disorder. And, I think that would be the first step to undertake. The next thing to do would be to get an appointment with your general practitioner. Most general practitioners are very good at guiding a person based on the severity of their condition towards either getting a mental health care plan, directing them towards psychology. If they are very unwell and need a psychiatrist’s opinion, they would help organise that in terms of doing the referral.

And then, psychiatrists can provide an opinion, or a psychologist would do an assessment based on, and work out what psychological treatment is indicated, and then work collaboratively with the person to address the anxiety. Of course, there has to be... Some anxiety disorders are so disabling that the person cannot leave the house, particularly if they have agoraphobia, so fear of open spaces, and that is a particularly challenging condition to get help and treatment in, if you are not able to leave the home. Having said that, due to COVID-19, there's a lot of telehealth interventions that are now being done. So, psychological interventions can be delivered over telehealth and that is also an option.

Host: Your GP will also be able to help you develop a mental health care plan.

Dr Kar Ray: Generally, in a mental health care plan, together they would decide a psychological intervention that might be indicated. So, often they would refer the person on to a psychologist, primarily in the private sector where they can get these interventions that I talked about previously, like cognitive behaviour therapy, or acceptance and commitment therapy. Normally, it will be a six session that they would begin with, and then they can increase the number of sessions if that is indicated by the therapist.

Host: Keeping your mind engaged with new ideas and experiences is an important part of strengthening your mental wellbeing. Doing regular mental challenges helps train your mental pathways.

Let's give it a go, can you solve this brain teaser? We'll reveal the answer at the end of the episode.

If you drop me, I’m sure to crack, but give me a smile and I’ll always smile back. What am I?

One in seven Australians is currently experiencing an anxiety condition. We spoke with Michelle, a Beyond Blue ambassador and speaker, about her experience with anxiety.

Michelle: I've been a volunteer with Beyond Blue now since 2017. I started out going into schools and workplaces and talking about my own personal experience with anxiety.

Throughout that time in sharing my story, I actually started studying counselling, and am now a qualified counsellor and work in the domestic violence space.

Host: You might hear some funny scratching or painting in the background throughout this interview - don't be worried it's just Spinifex, Michelle's toy poodle.

Michelle: My dog's scratching away in the background who you may hear from time to time. He's a little Toy Poodle. He's black all over and he's got a white little beard.

Host: Michelle was diagnosed with anxiety in her mid-twenties when she spoke to a GP after suffering some panic attacks and struggling with prolonged anxiousness and shortness of breath.

Michelle: My diagnosis of anxiety was late in the piece that I would consider, it was in my mid-twenties. I kind of looked back on a lot of thoughts and feelings that other people would characterise as, you're just a warrior or you're a perfectionist or you plan too much, anything along those lines. I would struggle a lot, but then it wasn't until I had actually done therapy for a while and I was still really struggling with some of the physical symptoms of anxiety, your classic anxiety case in that I was having panic attacks, I often would have a racing heart or a tight chest or notice I was walking around and holding my breath even sometimes.

Host: Initially, Michelle struggled with her diagnosis and wasn't able to accept it until she recognised it as a clinical problem that could be treated.

Michelle: I eventually went to a doctor that was referred to me by my therapist, who was somebody who I really trusted here in Brisbane. I went to her and was diagnosed with generalised anxiety disorder or GAD.

Normal anxiety I've come to learn is, you might have an exam, you might have a job interview, you might be going on a first date, feelings of anxiety and nervousness are normal in those cases. But when it becomes a clinical problem is when those stresses have passed and then you're still having those physical symptoms and feelings. I suppose I really struggled with knowing that that was the case, that it was something clinical and it wasn't until I actually engaged with a therapist and then went to a GP, I went on medication that really helped, though that's not always the right path for everyone, but for me it was and continues to be for now.

Host: Michelle found that her day-to-day life and relationships were being affected when she found herself constantly unable to focus or concentrate on tasks.

Michelle: I noticed that the anxiety started to affect my day-to-day life when I would be at work and I would be sitting in front of the desk and I would feel feelings of disassociation. My mind would wander constantly, and it wouldn't necessarily be about anything in particular, but it was just not being able to sit and focus and concentrate. I would always just have this level of feeling as though I was floating above or that I wasn't really present. For me, it also then manifested as constantly worrying that I would get fired or that I had done something wrong or over assuming responsibility, and then when I went there, it was, "Oh, okay. So, if I get fired, then I will be homeless because I can't pay my rent." And then, "Oh, this next thing will happen where then my relationship will break down and I won't be able to work again." 

It would just become this catastrophising that would start off with something really simple and it was affecting me really badly, both physically and mentally.

I think in terms of relationships that it affected with other people, I would kind of have my little, I would call them my committee of reassurance seekers where I would go to my sister or my best friend or people like that who were close to me and I'd constantly need reassurance about my decisions or that something wasn't going to go wrong. When I was even younger than that, I noticed that I would have more people that I needed reassurance from. It would be a lot more friends or even colleagues at different points where I would need a lot of reassurance. I think when it was at its worst, I would just really probably be a bit annoying if that makes sense, and I say that with a lot of compassion and love for myself now.

Host: For Michelle therapy has been the biggest aid in helping her manage her anxiety.

Michelle: Some of the strategies I put in place to help manage my anxiety, were straight away therapy. Talk therapy really helped for me, being able to make a weekly appointment or fortnightly appointment with a therapist that I trusted, I can't emphasise the value of that enough. It was just such a life changer for me having somebody who I could work with who was impartial, who got me, who understood my history, who started to understand my family, the experiences that I'd had, and they treat you with love and respect no matter what and they don't have a vested interest in the relationships within your life so they can be more impartial.

Host: Michelle also tried lots of different mental wellbeing activities before she found the right ones to help her.

Michelle: In general, it was sometimes just a trial and error. I tried yoga, I tried meditation and couldn't sit still. Yoga was really good for me in being able to be in my body and become more present with it. Then reading as well, books on the topic, I got really into Brené Brown, I got into The Happiness Trap, Acceptance and commitment therapy. I started to identify things that worked for me, not everything did, but being able to read in between sessions and think on things and then bring them to sessions really helped me, obviously I'm a big advocate for that sort of thing and in general, I'm not always perfect at this, I still struggle to get a good balance with it, but that self-care kind of stuff.

Something that I've learned is that, when we get triggered by something, whatever that might be, we can then go into our limbic brain or our emotional centres and that's when we have those anxiety attacks and those panic attacks. For me it was about, how do I regulate that? How do I come down from that? It might be something as simple as going for a walk or playing with my dog. During COVID I found painting classes, the sip and paint ones that were doing them online. Anything that's repetitive and rhythmic in nature, all those sorts of things that you did as a kid and it sounds a bit simple, but all of that stuff really works. Just noticing your breathing and what you're feeling in your body and asking myself, is this thought helpful? Is it unhelpful? If I have this thought, do I have to act on it?

Host: For Michelle, her panic attacks manifested differently to how she expected.

Michelle: Some people describe it that they feel like they're having a heart attack, it feels like they're going to die. Some people have gone to EDs and thinking that they're having a heart attack or that something is really wrong. Then they go, "I know this is a panic attack. This is a mental health thing." That's a revelation for people in and of itself. I never felt like I was going to die or that I was having a heart attack or anything like that. I suppose when they started to happen quite badly, I knew enough to know that it wasn't that, but I did have this intense feeling all of a sudden then it could come on from nowhere, where I would get the racing heart and the sweating and the disassociating and obsessing and just feeling awful.

For me, it would manifest as crying, all of a sudden it would be this uncontrollable need to cry, my breathing would quicken and then I'd cry, I'd let it out and then it would subside. My body would then still feel a bit rattled, but the intensity of it had stopped and that might last couple of hours or it might take until the next day for my body to fully recover. I think the thing about panic attacks when you start to get them, is that you kind of think, "Oh God, when is it going to happen again?" You start panicking about panic, which isn't fun at all.

Host: Michelle says that after her diagnosis her relationships with friends changed as they were able to understand her better and she found better ways to manager her anxiety.

Michelle: My relationships with my friends and family started to change after the diagnosis, but certainly not immediately, it wasn't just a click of the fingers and then I'm cured and now he'll know why. I think it started to change at random. I would notice randomly, I'm doing a bit better with how I'm coping or I would need people less or I would understand that I'd go to my therapist and unpack some of this more complex trauma stuff or this situation that's going on in my day to day life. I started to utilise healthier coping strategies and therefore I needed other people less in that context to share the burden.

I started to be able to distinguish when I could share certain things that didn't there for me and I was obsessively seeking reassurance. I started to feel more in control of myself. Everybody still needs love and connection and support and all that sort of stuff, but when it becomes to a point where you're really physically struggling and mentally struggling, you do need to reach out to professionals to support and to help nurse you back to a point of balance and confidence within yourself so you can function day to day more effectively and lean on people in more healthier ways I would argue.

Host: Navigating relationships can still be hard, but Michelle says that when it comes to supporting someone with anxiety it's important to listen to them and not jump straight into trying to fix the situation for them.

Michelle: Sometimes I'll chat with my partner and he'll sort of go, "What's wrong?" And I can't really articulate what's wrong. I can't really say what's happened, and say in that circumstance, he might try and just hug me and just be with me and that really lovely kind of connection stuff where I say, "I don't actually know, but this is what I'm feeling and I'm crying about it," then it subsides. That's actually a really lovely thing for us now that we've been able to identify that.

I do understand the temptation when that does happen, whether it's a partner or a friend or whoever it is going, "What's wrong, we'll fix it." Quite often once you've got into that heightened state, you can't fix it in that moment. I think something I would say to partners and friends with people who do struggle with anxiety and panic attacks is just let them have their physical reaction, let that play out and then later on once they've regulated it again and once they've calmed down again, come back to, "Okay, what's that about anything? Is anything going on for you? Do you need to go for a walk, do some cooking, do some gardening? Do you need to book a therapy session? Do you need to talk about something that's going on at work or in our relationship," and then do that kind of analysis stuff when someone's in that space, it's not the time to do the analysis or to blame them or to tell them to calm down because that has never worked for anybody.

Host: If this story has brought up any feelings for you, you can talk to someone at Lifeline on 13 11 14 and if it’s an emergency, please call 000 immediately.

When it comes to supporting a friend or loved one with anxiety, Dr Kar Ray says staying connected is the first step.

Dr Kar Ray:  As a family member or a friend, one has to remember that the way anxiety perpetuates is through avoidance. People who are anxious about something because the physical symptoms are not desirable, they start avoiding things in their life, things that are meaningful to them, pursuits that are meaningful to them. Other people that are meaningful to them, they start avoiding them. So, the first thing to do is to stay connected with the person and support them through this. Keep the conversation going with them, understand that if they stand you up on a night out, it's most probably their anxiety rather than them doing it to you. So, develop that context, that perspective, get to know a little bit about their anxiety disorder, as to what type of anxiety disorder is it.

Is it panic disorder? Is it obsessive-compulsive disorder? Is it post-traumatic stress disorder? Is it a specific phobia or is it a social phobia? If you get to know a little bit more about it, you can have an informed conversation with them and show a degree of empathy for the anxiety that they are struggling with. So, it's being with them, rather than doing and walking with them on their recovery journey.

Host: Michelle feels that anxiety is often not recognised as a mental health condition and this is one stigma that she would like to see changed.

Michelle: Some of the key stigmas around anxiety, everybody's got that these days, or they just worry, or they just need to calm down or whatever it is, and we feel people who suffer with anxiety can probably struggle with shame around that so we know when we're in shame, then we tend not to talk about it as much. That's what I'd like to see change, is this idea that it's just something that everyone has and you just need to stop worrying and get on with it. 

Because as I identified earlier, it is something clinical, it is a struggle, it might come up more often than not at different points in your life, but if you can learn to be with it and to recognise what it is and recognise your triggers, then you're going to have a different kind of life. That would be the key stigma, just thinking that it's not a proper mental health condition maybe.

Host: Dr Kar Ray says understanding that mental health conditions are common is an important step when it comes to tackling stigma.

Dr Kar Ray: The way to tackle anxiety is to spread the word that one in four people would suffer from some kind of mental health challenge of which anxiety is often a very common component. So, in psychiatric circles, we say that if you have got three friends who are not depressed or not anxious, then most probably you are. That's how common it is, one in four people will have a mental health challenge. So, understanding that is very prevalent. People don't talk about it, so the stigma prevails. If you start talking about anxiety and the anxiety disorders, you will find that a lot of stuff would come out of the woodwork.

In a family tree, if you have 20 people just by the sheer statistics, there are five people in there who have got some mental health challenge. And again, anxiety would be definitely present in any family tree. So, getting the conversation going, talking about it will tackle the stigma. Perhaps starting from that point, that anxiety is a part of who we all are.

Host: Dr Kar Ray says there's a lot that people can do for their mental wellbeing and anxiety.

Dr Kar Ray: If you are aware of anxiety as a concept, as a construct, you will find that you will deal with your anxiety better. So, learning about anxiety, I think that is the most important thing. Knowledge is power. Get to understand the kind of anxiety you have, the triggers that kind of bring the anxiety to the forefront, your physical symptoms. Once you know your physical symptoms, you will find that they have a lot less power over you. So, keeping on learning is really, really important. Looking after your physical health, getting out there in nature, in the great outdoors.

Make use of the sunshine, it has a healing effect. Take note of the world around you, mindfully and embrace nature. Do these things with your friends and family, staying connected and showing kind of gratefulness and kindness, showing gratitude for the blessings in our life. I'm not saying that we all need to become Pollyanna. But, I think it does help if we feel that there are certain aspects of a life that things are going well, certain aspects in which we may be struggling, that's that in a way is life, and showing kindness towards others because that then comes back in spades for our own wellbeing. So, there's a lot that people can do in terms of helping themselves, helping their mental wellbeing, helping their anxiety.

Host: For Michelle, mental wellbeing is about exploring different activities in order to find one that fits right and starting small is a good way to go.

Michelle: More and more we see in therapeutic spaces the value of animals and things like that. Don't underestimate the value of getting a dog or any kind of animal that you love or want to care for. In terms of general stuff that's helped me with my mental health or things that I've tried, some other things, staying off my phone, which sounds like a really cliched one, but that was really making me unwell, the comparison to other people or looking up all the profiles, it's embarrassing to admit, but I do it.

I would just encourage people to explore different things that work for them in terms of, there's all different kinds of creative and expressive therapies out there. There's little different kinds of yoga and meditation and exercise and things like that that you can try and don't be ashamed if one thing works for you and the other doesn't, so it's okay, you just figure out what works for you and keep it simple. 

Sometimes I think we think, "Okay, well, I've got to go and get a gym membership and I'm going to do yoga and I'm going to become this incredible person who's completely aligned, the clean eights and all that sort of stuff." A friend of mine who struggles with anxiety as well, like he'll just go on a 15-minute run. It's just 15 minutes, he's like, "I can do 15 minutes. I don't need to do anymore," and that helps him regulate at the end of the day, so little things like that.

Host: Improving your mental wellbeing isn't hard and can be achieved by making just small changes - like going for a short walk, calling a friend for a chat or learning something new - which you've done just now by listening to our podcast. If you'd like some more tips on improving your mental wellbeing head to our website qld.gov.au/mentalwellbeing.  You'll find the link in our show notes.

Thanks for joining us for this episode of My Amazing Body - Mental Health and Wellbeing. If you enjoyed it, don't forget to leave us a rating or review in your podcast app!

Did you guess this episode's brain teaser? What always smiles back? The answer is a mirror.  Congratulations if you figured it out!

Thank you to Dr Manaan Kar Ray and the team at the Princess Alexandra Hospital for lending their time and expertise to this episode. And thanks to Michelle, for sharing her lived experience with anxiety. My Amazing Body is brought to you by Queensland Health. Thanks to my podcast colleagues, producer Jess, Carol our audio technician and Helen on music and sound effects.