As most of you know by now, in early 2016 I went through a major battle with acute and crippling anxiety that nearly ended my life. For those of you who haven’t heard that story yet, here are the “CliffsNotes”:

Fall of 2015 – Started feeling “confused.” Dreading meetings with clients. Struggling to keep it together in meetings. Blurry vision and racing heart rate, coupled with exhaustion led me to believe that I was burned out. I go to the doctor and he says that I likely have “supraventricular tachycardia” and that it is relatively common in men of my age and not to worry too much about it.

November 2015 – More and more confusion, racing heart rate continues, but life was essentially “good.” I had a full client load, great income, healthy lifestyle (although I had started to slack a bit on my workouts), a great relationship with my wife Sabrina. My stress level was “high,” but I thought that was just a by-product of being “successful.”

Early December 2015 – The wheels started falling off a bit. My step-son started running away, and blaming it on me, adding stress to my relationship with him and Sabrina. A good friend committed suicide, and another died of cancer. I started worrying…a lot. Would I lose my wife? Would I get cancer? Would I succumb to the pressures of life and want to take my own?

Late December 2015 – Step-son runs away again to avoid going to the midwest for Christmas with my parents. We go without him and drive through a blinding snowstorm both ways. While we’re in the midwest I am massively affected by my perception of my parents’ attitudes toward my wife, my step-son, and my life in general and we decide to leave early to come home.

December 26, 2016 – While running the sound and video board at church, I’m suddenly gripped with fear. Chest pains, numb arms, and a feeling like I am going to pass out leads me to drive myself to the hospital thinking that I’m having a heart attack. My chest x-ray and EKG are all normal, and in fact my heart rate is only 61. The ER doctor tells me I had a “panic attack,” gives me some Ativan, and sends me home for a nap.
December 28, 2015 – After three days of taking the Ativan, I’m Back in the ER with debilitating anxiety. I can’t stand up and am now having suicidal ideation. They admit me to the hospital and I lose 11 pounds in 30 hours. Because of the suicidal thoughts, I’m sent to a mental health facility a few hours away for a mandatory three-day hold.

New Years Day, 2016 – After determining that my suicidal ideation is likely a result of a paradoxical reaction to benzodiazepines (Ativan, Valium, Xanax), I am released from the facility and sent home with new medicine and doctor’s orders to “take it easy” for awhile. I send an email to all of my clients telling them that I’m going to take January off to recover.

First Half of 2016 – I essentially shut down my coaching business to focus on my personal health.

2016-2017 – I work with an investor group as a “gig” CEO and we buy and transition a local trash company. My therapist encourages me to “try coaching” again, so I join a networking group (BNI) and start rebuilding my business in late 2017.

Today – I still struggle with occasional anxiety, but I have learned many tools and techniques to prevent anxiety, engage with it, and deal with it in positive ways. I share my struggles openly and willingly and encourage others, especially men, to do the same.

That’s the short version of a very long struggle that I’ve been through over the past few years. I’ll probably write a book about it one day, as I think that it would be good to really reflect on this time and document many of my lessons learned to give some hope to others who are affected by this mental health challenge. But in the meantime, I really wanted to share with you some of the important things that I did, and do, to keep my anxiety at bay. Today, I would rate my anxiety as VERY LOW, and sometimes it even goes away completely for longer periods of time, and these are some of the tips, tools, and techniques that I’ve found to be most helpful on my journey. Just a note that I’m no expert, I’m simply sharing the things that work for me in hopes that you might be able to try them out yourself.

TALK THERAPY

Before I “got sick,” I would have told you that I thought psychotherapy was for “losers and weaklings,” but BOY WAS I WRONG. Talk Therapy may be the SINGLE GREATEST RECOMMENDATION that I have for anyone suffering from anxiety…especially men. In fact, I recommend to every entrepreneur I work with to have a psychotherapist and visit him or her regularly. I myself have been “doing the work” for almost four years now. I met with my therapist, Eddie (email me for his contact info if you need someone), weekly for nearly two years following my big breakdown, and I still meet with him every other week even now. We don’t just talk about my anxiety…we talk about business, life, fitness, etc. As entrepreneurs we often get super isolated…even lonely. That isolation can lead to serious mental health challenges. Eddie has become one of my chief advisors over the years as well, often helping me with big business challenges that no one else could!

SHORT, INTENSE EXERCISE

Research shows that exercise is one of the best remedies for anxiety. It’s actually been found to be nearly as effective as Prozac at calming sensory nervous systems, producing feel-good hormones, lowering resting heart rate, increasing confidence, and decreasing sensitivity to anxiety symptoms. Next to therapy, getting both the right AMOUNT and TYPE of exercise has been a key part of dealing with my anxiety.

As a former endurance mountain bike racer I was used to spending a lot of time in the saddle pushing out what my first coach called “LSD” – Long, Slow, Distance. While I think that this is a great strategy for building base levels of fitness and increasing the ability to sustain effort over time, I’ve found that it doesn’t work with my anxiety. After doing a lot of research, I found that the science behind this is that the longer, sustained efforts may activate the sympathetic nervous system more dramatically and increase cortisol (the stress hormone) levels to a point where the “fight or flight” reaction is triggered. So for me, a combination of a) SHORTER, and b) MORE INTENSE exercises coupled with plenty of time for rest and recovery…even between exercises…seems to be the key. I can get my heart rate UP, but I can still get it back DOWN. This cycle has worked well for me.

Also, I usually work out in the mornings because that is when my anxiety is most acute. Getting a jump on it before the day takes me away is KEY. Right now I’m on a powerlifting program which includes just ONE day of heavy lifting each week and short (4-8 minutes total), intense HIIT sessions, coupled with very focused core work on the other 6 days of the week. I’m still working out HARD, just not LONG.

ANXIETY DIET

I’ve been known to experiment with diets depending on my goals. I’ve probably tried them all; Clean, Keto, Slow-Carb, Paleo – you name it. While I find that each of these has benefits, I’ve settled into a more sustainable, and more effective, “anxiety diet” over the past few years that basically combines eating clean, low-processed foods that are nutrient rich (think fruits, vegetables, and lean meats with an emphasis on vegetables) with intermittent fasting and some form of caloric restriction. I also take a few supplements, including a men’s multi-vitamin, a B Complex vitamin, Fish Oil, and Vitamin D. Here’s why I think this works for me:

Clean Foods – Clean foods that don’t contain artificial ingredients, preservatives, or other additives can help reduce inflammation and tend to have the highest “nutrients per calorie” of all foods. Nutrients are what our body needs to survive. By increasing the amount of nutrients in my body, and decreasing the amount of foreign substances that I consume, I find that I feel much better.

Intermittent Fasting – Intermittent fasting is basically the process of consuming 100% of your food for the day in short time…typically an 8 hour “window” between lunch and dinner. My window is between 11 and 7 meaning that I consume few to no calories before 11AM (I DO like my Starbucks), eat ALL of my calories before 7:00PM, and then I don’t eat anything after that until 11AM the next day. The idea behind this is that I’m giving my body the maximum amount of time to digest the food that I consume. This process has been shown to reduce inflammation in the body…a key trigger for stress and anxiety. For me, letting myself be a little hungry in the morning serves the dual purpose of giving my body more time to digest, and also making my brain believe that I’m accomplishing something.

Caloric Restriction – I’m a big guy, and my resting metabolic rate is somewhere around 2300 calories per day. That means that my body burns that much just going through my daily life. I find that if I consume slightly less (25-35%) than this amount each day that I have higher sustained energy, improved mental clarity, and most importantly LESS ANXIETY.

Supplements – Most people will agree that “we can get all of the vitamins and minerals we need without supplements,” but there’s a difference in being ABLE to get them and ACTUALLY GETTING them. That’s why I use a few basic supplements that give me everything that I need instead of relying on my own ability to perfect my diet so that it gives me what I need. The worst case scenario here is that my body doesn’t need all of the vitamins and minerals I am putting in because I’m getting it in both my diet AND the supplements.

ROUTINES

As regular readers of this letter know, I’m a huge fan of routines. What you may not know is that the primary reason that I am such a huge fan of routines is not that they allow me to get more done (which they do), but that they help me to significantly reduce my anxiety by adding ORDER to my life. One of the greatest forms of stress, particularly for entrepreneurs, is the act of “task switching” – that is, moving from one task to another without completing the first one, thus leaving the initial task, and all subsequent tasks, in some state of incompleteness. This uses WILLPOWER…and I believe willpower is finite. Once we have no more WILL, our anxiety over the things that are left undone can increase without stopping. To avoid this, I have routines in my life. I add and take away routines often, but the most important two are my morning routine and my ideal week.

Morning Routine – There are dozens of prescribed routines out there right now, but the most popular, and one I most closely subscribe to, is one that Hal Elrod outlines in his book The Miracle Morning called S.A.V.E.R.S. It’s pretty simple: S is for Silence. For me this is meditation. I meditate for approximately 10-15 minutes each morning. A is for Affirmations. I have a list of about 10 affirmations that I state outloud each morning. My favorite currently is: “Today I Am Proud Of Who I Am.” V is for Visualizations. This is where I think about how I would like my day to go. I visualize having a good day and talking about it at the end of the day with my wife. E is for Exercise. I do this a bit later at the gym, but for many this is as simple as a short 10-minute yoga routine in front of the TV. R is for Reading. I read about 10 pages of something in the personal development genre. Currently I’m re-reading The Power of Now by Eckhart Tolle. S is for Scribing. Scribing is writing, and the method that I like to use most is called “Morning Pages.” Google it, and let me know if you think you like it or not.

An addition that Eddie has added to this routine for me is the regular practice of Gratitude. It’s the act of a) paying attention to all the good things that we take for granted and b) expressing thanks for these things either directly to a person that provided the good thing, or to a higher power, or simply out loud to the empty room sometimes. I usually do this in the morning by stating ten things that I am thankful for out loud into the mirror…sounds a bit “woo,” but it works for me!

When you arise in the morning, think of what a precious privilege it is to be alive – to breathe, to think, to enjoy, to love.
– Marcus Aurelius

Ideal Week – This “routine” has become more of a standard operating practice for me over the years. Essentially it’s a system of weekly time blocking that allows me to control what I’m doing at any given time instead of time controlling me. For me, the most basic version of this is that I keep Mondays open for creative time (like writing this letter), I do all of my coaching on Tuesdays, Wednesdays, and Thursdays, and I keep Fridays open for meetings, personal development, etc. I have many other dedicated time blocks as well – for exercise, for checking email, etc. – but the KEY here is to not be super strict. The ideal week is a tool to help you determine WHAT you should be doing WHEN.

COPING TECHNIQUES

There are a couple of techniques that help me the most when my anxiety is most acute: 5-4-3-2-1 and Fear Setting.

5-4-3-2-1 – I first learned this technique while I was in the treatment facility after my most acute episodes. It’s a simple technique that you can use when you feel a panic attack or anxiety episode starting to take over. It’s a refocusing exercise that essentially works by distracting you from your racing thoughts and getting you to focus on something else. After a few long, deep breaths, I do this:

5: Acknowledge FIVE things you see around you. It could be a pen, a spot on the ceiling – anything in your surroundings.
4: Acknowledge FOUR things you can touch around you. It could be your hair, a pillow, or the ground under your feet.
3: Acknowledge THREE things you hear. This could be any external sound. If you can hear your belly rumbling that counts! Focus on things you can hear outside of your body.
2: Acknowledge TWO things you can smell. Maybe you are in your office and smell a pencil, or maybe you are in your bedroom and smell a pillow. If you need to take a brief walk to find a scent you could smell soap in your bathroom, or nature outside.
1: Acknowledge ONE thing you can taste. What does the inside of your mouth taste like—gum, coffee, or the sandwich from lunch?

Fear Setting – This is a technique that I first learned about from Tim Ferriss’ awesome podcast. It’s basically the act of imagining the WORST CASE SCENARIO for your current anxiety/dilemma. In Ferriss’ words, Fear Setting is “An operating system for for thriving in high stress environments.” It’s a way to visualize all the bad things that could happen to you, so you become less afraid of taking action. Think of Fear Setting as the opposite of goal setting. Instead of making a checklist of what you want to do, make a checklist of what you are afraid to do and what you are afraid will happen. Here’s a great article that describes the technique that I use (and encourage my clients to use) in detail: http://bit.ly/timfearsetting.

ANXIETY BOOKS

There are lots of books on dealing with your anxiety, and I think that I tried to read them all, but these are the three that I continue to give away and recommend when my friends are struggling:

The MindBody Toolkit: 10 Tools to Instantly Increase Your Energy, Enhance Productivity, and Even Reverse Disease by Kim D’Eramo – This was the first book that I was given to help me with my anxiety. I went on to meet Kim a few years later and this is still a regular go-to resource for me.
Dare: The New Way to End Anxiety and Stop Panic Attacks by Barry McDonagh – This book transformed my RELATIONSHIP with anxiety. Instead of trying to “get rid of” my anxiety, this book helped me learn to live with it and even learn to love it (well, some days).
The Anxiety and Worry Workbook: The Cognitive Behavioral Solution by David A. Clark and Aaron T. Beck – If you’re looking for a more proactive way to go about working through your anxiety, this book is designed as a series of exercises that gradually work to shift your mindset around anxiety. It helps me when I can’t just “sit there and let it be” anymore.

I hope this all helps you a bit with your anxiety. If you ever are experiencing anxiety and want someone to talk to, please reach out to me anytime. I’m happy to talk with you when you’re in the throes of an attack, or just need to chat about how you’re feeling. No judgement…I’ve been there!