You have power over your mind – not outside events. Realise this, and you will find strength.

– Marcus Aurelius

In recent times the world as we know it has changed. COVID-19 has not only brought change but a sense of loss – of normality, of diminished human connection and of the little things. In its wake bringing fear, additional stress and feelings of anxiety for many, at work, at home and in life generally. Working from home for many would be better termed parenting from work with all the stresses this can bring.

Anxiety is an emotional response triggered by a part of the brain called the amygdala (what I term the “emotional alarm clock” or “red button” for stress). Of course it is perfectly normal to experience some anxiety during these COVID-19 times. In fact, as a key part of the “fight or flight” response, feeling anxious can enable you to embrace stress and enhance your performance.

As a doctor, anxiety of one form or another is one of the most common conditions I encounter

When this feeling of anxiety becomes prolonged or exceeds a tipping point of coping (as it has for many during lockdown) negative consequences for your health and wellbeing can arise. This can impact your mood, tolerance to stress, weaken willpower and increase impulsive tendencies.

As a doctor, anxiety of one form or another is one of the most common conditions I encounter. It has truly become a modern day epidemic, in this “age of anxiety”. It is the most common mental health issue, estimated to affect at least one in every nine people at some stage. Medical conditions can trigger feelings of anxiety including an overactive thyroid gland, chronic pain, and other mental health conditions including clinical depression.

Long-term adverse effects of anxiety on physical health include an increased risk of diabetes, heart disease, and high blood pressure

Severe anxiety can be really crippling and debilitating for those who suffer from it, detracting from their quality of life. Anxiety can significantly impact your emotional and psychological wellbeing. Long-term adverse effects of anxiety on physical health include an increased risk of diabetes, heart disease, and high blood pressure.

There is highly effective treatment available, which may include medication or talk therapy with a trained therapist. This is why seeing your doctor is a good idea particularly if your anxiety symptoms are more than mild.

Many people suffer in silence with only about a third of sufferers ever presenting for treatment which is unfortunate.

Lifestyle changes to alleviate anxiety

Here are some lifestyle strategies to bring more inner balance to your mind and to help alleviate symptoms of anxiety.

Prioritise your sleep

When sleep deprived, which for most people means getting less than eight hours sleep each night, the fine tuning between the logical and emotional parts of your brain becomes impaired. The negative noise from the amygdala becomes louder. As a result, you tend to live your day controlled by your primitive brain which is all about negative stress, “fight or flight” and survival rather than positivity or thriving. As your emotional bank account becomes depleted of positivity you become emotionally more fragile and far more irritable and anxious.


Alcohol in excess is a major trigger of anxiety symptoms. As a natural depressant drug, it can be a major trigger of feelings of depression, anxiety, and panic. As I say, alcohol can be a good servant but is a very bad master. Less is more.

As a stimulant, excess caffeine can certainly exacerbate anxiety feelings with some people being particularly sensitive to these effects. Remember the half-life of caffeine is more than five hours so lunchtime caffeine will leave levels quite high even as bedtime approaches. Dehydration can also lead to feelings of anxiety, so make sure you stay well hydrated.

Support from your friends

If you’re feeling overwhelmed emotionally or mentally, let your friends and family know. It’s good to talk. Don’t be an island and try to fight your battles alone. A problem shared is a problem halved.

Exercise and move

Exercise is the greatest pill of all. In terms of mental and emotional health benefits, exercise helps to dissolve feelings of anxiety and negative stress. It brings on a cocktail of brain chemicals including oxytocin, dopamine, noradrenaline and serotonin that have the net effect of ramping up feelings of positivity and reducing feelings of stress. I consider exercise to be an anti-anxiety vaccine, so powerful can it’s stress busting benefits be. A simple 30-minute walk can change your emotional state.


I call this green exercise. Spending time in nature enables me to recharge and clear the mental fog from a busy day and to regain inner balance, more relaxed and rested. Overall a great tonic and counter balance to the noise of modern life. Biophilia is the scientific term for this hardwired biological need to connect with nature. Spending time in nature lowers levels of stress hormones like cortisol and adrenaline while reducing feelings of anxiety, nervous tension or negative stress. It quietens your inner critic, that inner negative voice which replays all sorts of negative scenarios in your mind. Nature can give you a positivity boost, whereby you become far more creative and expansive in your thinking.

Express gratitude

Keeping a gratitude journal and writing down three things you feel grateful for every day is a terrific way to dissolve feelings of negative stress and enhance your sense of wellbeing. Focusing your attention on the things that you feel grateful for helps to dampen down and dissolve feelings of hostility or anxiety. It is very difficult to feel grateful and stressed at the same time. Try it and see for yourself.

Keep a journal

As Socrates the philosopher once wrote the key in life is to “know yourself.” Taking the time to write things down can teach you so much. To see things as they are rather than as you think they are – which usually means seeing things as being worse than they are.

Emotional release from journalling can prevent you from pouring that emotional toxicity into outer life. This will challenge negative thinking patterns and stop negative energy from ramping up feelings of stress and anxiety which may be short circuiting your potential.

Facing your fears and accepting the reality that there are many things in your life that you can’t control enables you to let go of these worries and the additional stress and anxiety that results. Writing in your journal is also a terrific way to reframe life’s challenges and setbacks through the lens of growth and meaning, diminishing anxiety. Moving from “what have I lost?” to “how can I grow?” to appreciating your pain points and leveraging them to become your source of greatest growth.

Slow your breathing

Consciously slowing your breathing down to four or five breaths per minute for even a minute or two has so many potential health benefits, a real gift for your self-care and sense of overall vitality.

Psychologically it is a great reminder that you are in control, that, instead of reacting to noise and negative stress, you can choose how to respond in any given moment. Emotionally, it dampens down the stress response from the amygdala, located close to the breathing centre in the brain. As a result you move away from feelings of ‘fight or flight’ stress and anxiety towards the pause and plan restoration response. Dampening down feelings of anxiety or needless negativity. Enabling you to feel more cool, calm and collected. Try it and see for yourself.

Dr Mark Rowe Is a GP, author and expert in lifestyle medicine based at the Waterford Health Park. Follow him on Twitter, Facebook and LinkedIn @drmarkrowe

Read more

Lifestyle medicine

Health: the kindness connection

Maintain a healthy relationship with alcohol while social distancing