As promised, the next series of letters is on the topic of ANXIETY. In the 20+ years I have been practicing medicine, this has been the most common problem patients mention. Over the years, I’ve come to a different understanding of anxiety than I had previously…
The first discussion of anxiety in my training was as a resident at Oregon Health Sciences University. We had a lecture from a very nice psychiatrist, who specifically came to lecture because he felt strongly that anxiety states represented a dysfunction of the nervous system, a mal function, such that the patient experienced a disabling, highly unpleasant, and, more to the point, unnecessary (dysfunctional) state. The good news was that this could be readily corrected with benzodiazepine (ativan/lorazepam, valium/diazepam, klonopin/clonazepam, xanax/alprazolam).
Over time, however, we came to a better understanding of the nervous system, and it is this view that I want to share with any of you interested. I now see anxiety as an important signal from the nervous system, letting us know of threat(s) that we need to address. I believe that if this signal is received properly, that the discomfort is worth the knowledge of threat, and that without addressing/fixing these problems in our lives, we be far worse off than we are experiencing anxiety.
The most common threats that I see are:
inadequate breathing, airway
unstable blood sugar
issues in daily life that are destabilizing.

I’ll discuss each of these in a subsequent email and then go into ways that support solving the underlying problem.
Feedback, responses, questions are totally welcome! These are optional emails, so if you are swamped with life right now, don’t stress.
Best regards, Dr Helman