How can you tell the difference between anxiety as an emotion and a disorder that needs medical intervention? Join us as today’s guest, Dr. Tracey Marks, explains the difference between being nervous about an upcoming event and something more serious like generalized anxiety disorder. She also shares tips and tricks that almost anyone can try at home to reduce the impact of anxiety.
With expertise in perhaps the most newsworthy subject pervading our lives both personally and culturally, Dr. Tracey Marks is ready to address, advise, and help heal our nation’s anxiety epidemic. She broadcasts to over a million followers weekly on her YouTube channel and is a general and forensic psychiatrist of over 20 years. Dr. Marks’ mission is to increase mental health awareness and understanding by educating people on psychiatric disorders, mental well-being, and self-improvement. She believes that insight creates change, both on a micro-level (personal growth) and a macro-level (reduction in fear and social judgment). Dr. Marks produces educational videos on her YouTube channel, DrTraceyMarks. As a forensic psychiatrist, she has formulated over 1,000 opinions through independent medical evaluations, criminal assessments, or civil litigation consultations. She has been military court-martialed and qualified as an expert in multiple federal and state courts. She also maintains a general psychiatry clinical practice focusing on mood disorders, anxiety disorders, and burnout. Dr. Marks has been sought after by CNN and HLN for forensic and general psychiatric commentary.
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.
Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without.
To book Gabe for your next event or learn more about him, please visit gabehoward.com.
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.
Gabe Howard: Hey, everyone. I’m your host Gabe Howard and calling into the show today we have Dr. Tracey Marks. Dr. Marks has been a general and forensic psychiatrist for over 20 years, has over a million YouTube followers, and is the author of the new book “Why Am I So Anxious? Powerful Tools for Recognizing Anxiety and Restoring Your Peace.” Dr. Marks, welcome to the show.
Dr. Tracey Marks: Thanks for having me. I’m excited to talk about this.
Gabe Howard: I want to disclose to you and to the listeners that I live with generalized anxiety disorder and have panic attacks. Now, my disorder is pretty well contained due to medication and years of experience, learned coping skills and lots and lots and lots of therapy. When the pandemic hit, it did seem like everyone was being diagnosed with some type of anxiety disorder. And as someone who has really struggled with anxiety, I was, I was very sympathetic. I am sympathetic. But as time marched on, I got to become very concerned about overdiagnosis. As an expert, Dr. Marks, I wanted to ask you, what’s your take on the uptick of anxiety in the U.S.?
Dr. Tracey Marks: So, I think it’s twofold. It’s one, just an increase in actual incidence of anxiety disorders because there’s a difference between having anxiety and having a disorder. Because of world conditions, pandemic economic pressures, political unrest, all of that stuff happening at the same time. But then I do think some aspect of it is also just an increase in awareness and more people talking about it.
Gabe Howard: One of the things that I think about as a mental health advocate is that we share words, right? Anxiety can mean I’m anxious because I have to give a speech, and anxiety can mean generalized anxiety disorder. It could mean agoraphobia, it could mean panic attacks. It can be a very, very serious disorder. But I think there’s a difference maybe between diagnosable anxiety disorders and anxiety in the normal human spectrum of emotions.
Dr. Tracey Marks: Yes, it is a problem sometimes, this overlap in the words and how we use them. So there is I’m depressed today versus I actually have major depressive disorder. You can be in a funk for the day and feel low, but not necessarily have a disorder that goes with that. And same thing with anxiety. You can feel anxious but not have an anxiety disorder. And I’ll get to the difference in a minute. But one thing that I think that does or a downside of this overlap and the terminology is that people can come to not really respect the disorders because the words are just thrown around so much. So if I’m feeling depressed, someone may think I may be in a depressive episode, but people can just say, Well, just go do something, make yourself feel better and real depression doesn’t work that way. You can’t just snap it on and off and feel better or go, Let’s go have fun and I’ll help pull you out of this depression. So that that, that unfortunately makes it harder, I think, for people to understand the extent of the disorders and maybe even minimize them because we just kind of throw the words around.
Gabe Howard: Obviously, we have the uptick in anxiety and we certainly have an uptick in conversations about anxiety. But then we also have this other group that’s like, look, bad stuff happens, who cares? And they are completely unmoved by everything that’s been happening in our country. They have no extra anxiety to speak of. And in some cases, they’re not understanding of why anybody would have anxiety about what’s going on at all. What does make some people react very anxiously and other people are just like, hey, you know, stuff happens, who cares? Move along.
Dr. Tracey Marks: The one way to describe anxiety is kind of like a bifurcated approach to it. On one side is the state of anxiety, which is what you experience with the anxiety symptoms that you have at the moment. Worrying, heavy breathing, feeling nauseous, whatever your anxiety symptoms are, that’s the state of anxiety. And then on the other side is anxiety traits. And the anxiety traits is what you’re born with. Some people are born with more of a predisposition to become anxious, and because of their temperament, it’s like you’re hard-wiring. And with that hard wiring, kind of two types of anxiety or anxious hard wiring or temperaments would be people who are neurotic, which neuroticism is a tendency toward having more negative emotional experiences, whether that be depression or anxiety. And then there’s a harm avoidance temperament, which is someone who tends to worry more about future events. Some people have less tolerance for uncertainty, so not knowing what’s going to happen tomorrow or what’s going to happen with flu season, am I or are a bunch of people going to get sick. There are some people who think, Well, I’ll just go get my shot and whatever. We’ll get through this. We always get through this. There’s always the flu. And then there are people who may be fretting, really nervous and anxious that that and worrying that someone they know is going to die. They may be losing sleep over it. So. How you’re wired can also affect how much you experience anxiety on a day-to-day basis. And then another factor that’s beyond just biology is your environment. You can learn to be anxious from your parents or people around you, either because of overparenting is seen as a source of developing anxiety, being overprotective of you, and not letting allowing you to be able to experience consequences and learn from them. Instead, you’re shielded from them. And then also sitting around the dinner table having parents or people you look up to fretting about things can teach you to also fear. Fear the future and fear uncertainty.
Gabe Howard: I see out in the greater community, people are starting to roll their eyes at anxiety. They’re starting to get to this. You know, it’s become oversaturated, right? It reminds me of that television show that everybody loves and then everybody hates because they just see it too much. My concern is and my question for you is it’s twofold, right? We’ve got the people who are starting to dismiss anxiety as, look, this is just the way of the world. It’s not that serious. But then the people with anxiety are starting to absorb those messages as well and think, well, look, I’m not going to bring it up. I don’t want to be ridiculed, I don’t want to be mocked. I don’t want to be told that I’m on the bandwagon or seeking attention. And those people aren’t seeking help. How does a person know when they need to seek help from anxiety and when they don’t? And how can they avoid sort of the noise that our society has created? Because anxiety is it’s become a little bit of a popular topic, which has created a little bit of a fad mentality surrounding it.
Dr. Tracey Marks: Wow. How much time you got? I mean, this is a very loaded question that I could go on for a bit about. It is a shame that it can reach this point of people dismissing it because they’re tired of talking about it. On the one hand, I do recognize that there are people who may be over calling it just again, me raising their hand and saying, Yeah, oh yeah, I have that too. But still, we’ve come a long way in helping people who were in the shadows and afraid to talk about their experiences, to now be able to say, This is what I have and I’m not afraid to talk about this because there’s other people who have this too. And I know I’m not alone with this. And when I say this, I think about teenagers because that is generally when anxiety starts.
Dr. Tracey Marks: Yes, it can start later in life. But the teen years, those are very vulnerable years. And I’m not saying teens are anxious because they’re vulnerable, because you don’t have to develop anxiety as a teen. But it starts early and you can see it in ways that may not quite be so obvious, like teens who are, let’s say, pulling their hair, not sleeping, not eating, being very shy, feeling very uncomfortable around people, avoiding things, not having any friends. I mean, all of those, beneath that can be anxiety. It’s not always because of anxiety. So it saddens me at the to think about the prospect of people going from saying, oh, wow, I’m not alone in this struggle and there’s more information out there that can help me. Yay! I’m going to avail myself of it to going from that to let me keep my mouth shut because people are just going to shut me down because they don’t want to hear this stuff and think that, okay, I’m just one more person thinking that I have anxiety.
Gabe Howard: Unfortunately, this has always been the case with mental health issues. I mean, there’s still a huge, significant number of people who believe that if you talk about suicide, you give people the idea and shut down all conversations about suicide. And we know that talking about suicide, raising the issue of suicide prevents suicide. It’s well understood. And yet this myth still persists. So, it’s not surprising that as Americans, many Americans are finally willing to talk about some sort of mental health crisis. And and make no mistake, anxiety is a mental health crisis. It’s not a surprise that they’re getting it wrong. What I want to push back to and talk specifically to somebody listening who doesn’t want to bring this up to their friends and family because they are afraid of being labeled attention seeking or people are just tired of talking about it. Speaking to that person who is listening because they feel that they’re having an anxiety issue, a crisis, a problem, what should their next steps be if they are unwilling to talk to friends and family, where should they turn and where should they go for help? Because I’m guessing that if they’re tuning in, they’re seeking some advice.
Dr. Tracey Marks: Sure. So first, let me touch on what takes this to the level of a disorder or to the point where you really should look beyond yourself, beyond self-help measures with the anxiety almost, I was going to say with the anxiety disorders. But it’s not just anxiety disorders. All of the disorders, one of the criteria after you list all the symptoms is that it also causes functional problems in your social, occupational or personal functioning so that you have trouble in any one of those areas. So, for example, let’s say I have I’ve noticed that I’m worrying more and maybe I am occasionally having attacks of panic. But I can still get up and go to work every day. I’m still getting adequate sleep. It’s not affecting my appetite. I can still socialize with people and whatnot. Then that those problems, they’re a nuisance, but they’re manageable and maybe it will go away. Or maybe self help things will make will help me be able to rein those those problems or those symptoms in. As opposed to the person for whom there are areas of their lives that are starting to crumble beneath them because of these problems. So there the average amount of sleep that an adult should get is 7 to 9 hours. If you’re more nights than not sleeping less than 6 hours, that’s a problem. Now, some people intentionally do that because they’re working hard and things like that. It’s still not healthy. But that’s different from the person who can’t go to sleep or can’t sleep through the night because they keep waking up or they just can’t settle their mind down, their minds racing at night.
Dr. Tracey Marks: Some people will wake up in the morning and feel nauseous and then therefore have trouble eating, have to call in sick from school or work and things like that. So those when it gets to the point where it’s starting to affect your day-to-day functions, that’s the red flag that tells you, okay, maybe now you need to get professional help. Um, certainly. Probably the most accessible doctor to see. If you were going to see a doctor first would be your primary care doctor, and some of them will be able to help to some extent with anxiety. Or they may refer you to a psychiatrist. But a lot of primary care doctors handle kind of first level anxiety and depression issues and people without those people ever seeing a psychiatrist. And then there’s seeing a therapist so you don’t necessarily have to seek medication. How would you know if you need medication? Well, that’s where a doctor could make that determination. But also a therapist could probably or should be able to tell you. Hmm. I don’t know if we’re going to get very far in in me helping you manage these symptoms without you getting some kind of additional help, I think you’d be a good person to also see a doctor. So therapists usually will put themselves in that position as well of determining is this beyond therapy or do I think we can manage this all with therapy?
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Gabe Howard: And we’re back with Dr. Tracey Marks, author of “Why Am I So Anxious? Powerful Tools for Recognizing Anxiety and Restoring Your Peace.” Dr. Marks, what are some of your favorite tools to manage anxiety? I know that your book has a number of examples, but what are your favorites and what are some quick tips that you can give to our listeners?
Dr. Tracey Marks: Yeah. So my absolute favorite is aromatherapy. I really, really love creating either diffusing it or making my own inhaler and using that while I’m doing something unpleasant. So if I have to do something that is not going to be very fun for me, I’m not looking forward to, but I just got to get it done. I may diffuse a relaxing, essential oil in the room or have an inhaler on hand. Sometimes I’ll even mix it with a carrier oil and put it on my skin. I, I use a sleep oil every night that has relaxing essential oils. So what are some of my favorite oils that way? Even though lavender is very popular and it is a relaxing essential oil, it’s actually not my favorite. I like clary sage. I like Roman chamomile and neroli and those are probably ones that not everyone has heard of because they’re not, they’re not very popular. I do give examples of several relaxing essential oils in my book and describe them and things and even give the recipe that I use to create the sleep oil that I use every night on my chest to help me relax for sleep. So that’s one thing. Essential oils is one of my favorite go-tos.
Dr. Tracey Marks: I also like practicing mindfulness in everyday activities, so mindfulness is bringing yourself into the present moment without judgment. I often or most times am thinking about something else that is not related to what I’m doing in the moment. That’s pretty common for a lot of us to do. So if I’m washing dishes instead of me focusing on the dishes, I’m thinking about my to-do list of some other things I have to do after I finish washing the dishes. That kind of mindless thinking generates more tension and anxiety, not necessarily makes you anxious, but it sets the groundwork for being more tense and uptight than mindful living and thinking. So to do it mindfully, as far as washing the dishes, I would be focusing on my senses to focus in on what’s going on in the moment. So I notice the temperature of the water, the texture of the plate. Can I smell the soap? Things like that of just zoning in on what’s going on in the moment? Another example of that, and I’m guilty of this with going to see my son play in his orchestra concert instead of just completely immersing myself in that moment of listening to the music and all of that. I’m thinking about, okay, now when I go home, I need blah, blah, blah.
Dr. Tracey Marks: Oh yeah, I forgot to text this person back. That’s horrible. That’s a horrible way to be. And we are often living like that and it’s very taxing on your mind having all of that heavy thought processing going on. So instead I have to remind myself to put myself in this moment and those things that I think I need to think about and plan for later. Those will be there when I’m done. They’re not going to go anywhere. And if I’m worried that I’m going to forget about some things that I need to do, then I do my next thing, which is a form of journaling. I really like journaling, but this you may not think of it as journaling, but essentially getting thoughts out of my head and on to paper. So write down all of these things that I think I need to work through later, instead of working through them in my head while I’m at my son’s orchestra concert. Write them down on paper. Then I can feel good about the fact that this stuff that I wrote on paper is going to remind me of these things that I need to do, and I don’t have to keep doing refresh in my mind of all these things so that I don’t forget them.
Gabe Howard: Dr. Marks, I really appreciate you taking the time to give some hints that anybody, they can modify it to meet their needs. So thank you for the simple tips.
Dr. Tracey Marks: Absolutely. Actually, I want to add one more. And that is the use of a weighted blanket. I love my weighted blanket. And the concept behind it is deep pressure touch as an intervention for anxiety or to produce relaxation. The recommendation for how heavy it should be is about 10% of your body weight. So it’s not just my grandmother’s knitted blanket and it’s pretty heavy. These blankets actually have like these beads or something in them that is, that’s heavy. You don’t have to just use it while you’re sleeping. It could be something you can sit on the couch and watch a movie or do something else relaxing on the couch or listen to your podcast in a comfy chair with your weighted blanket on your lap.
Gabe Howard: Any advice that includes listen to Gabe’s podcast is always going to be my favorite thing to try. Thank you. Thank you so much. Where can folks find you? Your book? What’s your YouTube channel? Give everybody all the information that they need to find you online.
Dr. Tracey Marks: The main place I am located on social media is YouTube, and my handle for that is Dr. Tracey Marks, D R and then Tracey T R A C E Y and then Marks, M A R K S. And that’s the same handle that’s also used for Instagram and TikTok, where I am also located. My Instagram content is more bite-sized mental health tips, but my central hub, in case you can’t remember any of that stuff, is my website, which is MarksPsychiatry.com. And I have information there about my book. “Why Am I So Anxious?” As well as my social media content.
Gabe Howard: Dr. Marks, thank you so much for being here.
Dr. Tracey Marks: Thank you for interviewing me, Gabe. I really enjoyed talking with you.
Gabe Howard: Oh, you are very welcome, and a big thank you to the audience.My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations.” I’m also an award-winning public speaker who could be available for your next event. My book is on Amazon, but you can get a signed copy with free show swag or learn more about me just by heading over to my website at gabehoward.com. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free. And hey, can you do me a favor? Recommend the show to a friend, family member or colleague. Sharing the show is how we grow. I will see everybody next Thursday on Inside Mental Health.
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