WEBVTT - Almost Anxious 0:00:08.560 --> 0:00:11.400 This is the Anxiety Bites podcast and I am your host, 0:00:11.560 --> 0:00:19.119 Jen Kirkman. Today my guest is Dr Luana Marquez. But 0:00:19.200 --> 0:00:23.520 before we get to that, well, I don't know what 0:00:23.560 --> 0:00:27.400 why am I compartmentalizing here? She wrote a book titled 0:00:27.440 --> 0:00:31.080 almost Anxious? Is my or my loved ones wary or 0:00:31.120 --> 0:00:35.960 distress a problem? And uh so I thought almost anxious? 0:00:36.040 --> 0:00:38.159 I don't know, I just at first glance thought it 0:00:38.200 --> 0:00:42.400 was just a catchy title, and uh I wasn't aware 0:00:42.520 --> 0:00:44.600 until I read her book and spoke to her that 0:00:45.640 --> 0:00:51.160 actually it's kind of a clinical term. The medical literature, 0:00:51.400 --> 0:00:54.440 as she says in her book, currently recognized as many 0:00:54.520 --> 0:00:57.640 problems or syndromes that don't quite meet the standard definition 0:00:57.720 --> 0:01:01.640 of a medical condition. They're what medical professionals often referred 0:01:01.680 --> 0:01:06.679 to as subclinical, and it's what they call the almost effect. 0:01:06.840 --> 0:01:11.679 So in this episode, we'll talk about how anxiety is 0:01:11.800 --> 0:01:16.680 a spectrum. It's not a dichotomy normal and then full 0:01:16.680 --> 0:01:20.680 blown pathology. You have an anxiety disorder. There are things 0:01:20.720 --> 0:01:23.119 in the middle. There are a lot of us who 0:01:23.160 --> 0:01:26.840 are in the almost effect of anxiety. We sort of 0:01:26.959 --> 0:01:30.280 use bad tools for lack of a better term, and 0:01:31.360 --> 0:01:36.200 can move over into the full blown anxiety disorder category. 0:01:36.480 --> 0:01:40.000 But I loved talking with Dr Marquez because we talked 0:01:40.040 --> 0:01:43.200 about some things that hasn't come up on this show yet, 0:01:43.280 --> 0:01:47.520 specifically avoidance, which is you know, it's come up here 0:01:47.520 --> 0:01:50.320 and there, but it's it's really it's the go to 0:01:50.320 --> 0:01:54.080 tool of the anxious person or the person who has 0:01:54.120 --> 0:01:57.880 panic disorder. It's the go to tool before you get 0:01:57.880 --> 0:02:00.720 help with learning how to cope in the situation. And honestly, 0:02:00.720 --> 0:02:03.640 it's it's a lifelong go to tool, and it's not. 0:02:04.400 --> 0:02:08.000 It's a broken tool, but I still find myself using 0:02:08.000 --> 0:02:12.280 it in certain situations. And we talk about um ways 0:02:12.320 --> 0:02:15.880 that we are in avoidance that aren't even obvious. One 0:02:15.919 --> 0:02:18.079 obvious way of being in avoidance is don't go into 0:02:18.120 --> 0:02:20.639 a building that scares you. But another non obvious way 0:02:20.680 --> 0:02:24.200 of being in avoidance is seeking reassurance. So I'll get 0:02:24.240 --> 0:02:26.960 into all of that, but it was interesting while I was, 0:02:28.040 --> 0:02:31.839 you know, reading her book and getting to know the doctor. 0:02:32.040 --> 0:02:35.600 As I was researching, I happened to be away. I 0:02:35.960 --> 0:02:38.480 my parents, who live on the East Coast, had to 0:02:38.520 --> 0:02:42.480 come out to Palm Springs for something, and so we 0:02:42.600 --> 0:02:44.960 drove down together. I drove now that is a huge 0:02:45.000 --> 0:02:46.600 feat for me. In the past, I used to have 0:02:46.600 --> 0:02:49.120 a fear of driving on freeways. And it wasn't about 0:02:49.160 --> 0:02:50.960 driving alone. I just didn't want to drive on them 0:02:50.960 --> 0:02:53.720 at all, and even if people were with me, UM 0:02:54.360 --> 0:02:57.720 just wasn't a thing, And mainly because I would have 0:02:57.720 --> 0:03:00.000 panic attacks, and I don't want to have a panic 0:03:00.000 --> 0:03:01.920 attack while I'm driving, because it feels like you're dying. 0:03:02.320 --> 0:03:05.079 Sometimes I would physically start shaking so badly. I mean 0:03:05.080 --> 0:03:06.760 it would look like, you know, my knees are bouncing 0:03:06.840 --> 0:03:08.880 up and down under the steering wheel, and and you 0:03:08.919 --> 0:03:11.440 feel like you're going to lose control and or pass 0:03:11.480 --> 0:03:14.839 out and die. And it's it's really tough to drive 0:03:14.880 --> 0:03:19.200 a machine while you're panicking. So it's a sensation that 0:03:19.320 --> 0:03:23.320 I didn't want to experience UM ever, and had experienced 0:03:23.320 --> 0:03:26.360 a few times. And so I spent most of my 0:03:26.400 --> 0:03:28.760 life in avoidance of driving on freeways. And now I 0:03:28.840 --> 0:03:32.720 do it freely. But I do remember one of my 0:03:32.840 --> 0:03:35.960 first um, you know, day jobs, just to pay the bills. 0:03:36.040 --> 0:03:39.560 When I first moved to Los Angeles, I was twenty eight. 0:03:39.560 --> 0:03:43.840 It was two thousand two, and I worked for a 0:03:43.880 --> 0:03:48.400 guy who worked out of his home and he was 0:03:48.480 --> 0:03:53.080 in I don't know, just some low level production. So 0:03:53.120 --> 0:03:57.360 in other words, he had some audio equipment and you know, 0:03:57.920 --> 0:04:01.440 a studio might call him and say, hey, you know, 0:04:01.480 --> 0:04:03.640 one of our speakers blew out. Can you get a 0:04:03.680 --> 0:04:09.080 speaker to us, you know, sometime today. And so it 0:04:09.200 --> 0:04:11.680 was of the utmost importance that if my boss Jim 0:04:11.800 --> 0:04:15.320 had a speaker, you know, a huge industrial size speaker 0:04:15.720 --> 0:04:19.080 to deliver to the studio that would need it. That 0:04:19.240 --> 0:04:22.880 part of him having his own little warehouse was that 0:04:22.960 --> 0:04:24.960 he could get it to you, you know, within the hour. 0:04:25.000 --> 0:04:28.840 It's like nowadays, it reminds me of like a Postmates, 0:04:28.880 --> 0:04:31.160 you know, rush order or something. But I was the 0:04:31.200 --> 0:04:35.279 person that had to deliver it. And if you know 0:04:35.279 --> 0:04:37.719 anything about Los Angeles, you know there's traffic, but it's 0:04:37.760 --> 0:04:40.680 not always what you think. During the day, there are 0:04:40.680 --> 0:04:44.719 certain freeways that it's not bumper or bumper, it's you know, 0:04:45.560 --> 0:04:47.880 you're driving along the freeway at a normal pace, and 0:04:47.920 --> 0:04:51.240 it's much faster than taking what we call surface streets 0:04:51.320 --> 0:04:54.040 or the back roads. I mean, if you need to 0:04:54.080 --> 0:04:56.280 get somewhere, you jump on that freeway in the middle 0:04:56.279 --> 0:04:58.680 of the day when it's not rush hour, traffic, you 0:04:58.680 --> 0:05:00.520 will get to where you need to go ten minutes, 0:05:00.560 --> 0:05:03.599 as opposed if you took the back roads forty five minutes. Well, 0:05:03.800 --> 0:05:05.240 I didn't know that was going to be part of 0:05:05.279 --> 0:05:08.119 my job. I was mainly just a bookkeeper. And then 0:05:08.240 --> 0:05:12.760 suddenly this delivery aspect gets introduced and I can hear 0:05:12.839 --> 0:05:15.040 him on the phone saying, yep, Jen will be there 0:05:15.080 --> 0:05:18.600 in oh, I don't know, uh, thirty minutes. And then 0:05:18.640 --> 0:05:22.120 I would hear this is way before you know Google 0:05:22.200 --> 0:05:24.600 Maps and all that thing, and he would say, yeah, okay, 0:05:24.600 --> 0:05:26.280 so you take the one thirty four to the two 0:05:26.320 --> 0:05:28.279 and the five and the six, and my head would 0:05:28.320 --> 0:05:31.479 already start spinning, sitting at the desk, just thinking I can't, 0:05:31.560 --> 0:05:33.520 I can't, I can't, I can't. I can't get on 0:05:33.560 --> 0:05:37.839 the freeways. And so so many times I just took 0:05:37.880 --> 0:05:41.680 those surface streets and the order was late, and I 0:05:41.680 --> 0:05:43.920 would say, oh, there was crazy traffic, and thank god, 0:05:43.960 --> 0:05:45.800 there was no way to tell back then you couldn't 0:05:45.839 --> 0:05:49.320 get on some kind of online mapping thing and say no, 0:05:49.400 --> 0:05:54.200 there isn't. But um, eventually, at one point a job 0:05:54.320 --> 0:05:56.160 was important enough that I had to do it. And 0:05:56.200 --> 0:05:59.320 I remember, I mean, I'm not kidding. I'm acting it 0:05:59.320 --> 0:06:01.599 out physically. Understand that this is a podcast, but I 0:06:01.640 --> 0:06:03.320 don't have the words for it. I was going the 0:06:04.640 --> 0:06:07.880 whole time. My entire body was shaking up and down 0:06:07.960 --> 0:06:10.919 in such an intense panic attack. And I know that. 0:06:10.960 --> 0:06:14.040 On last week's episode, UM, we talked to Dr Angela 0:06:14.160 --> 0:06:16.960 and she said a lot of people don't ever let 0:06:17.000 --> 0:06:19.760 their panic hit its highest point and just sort of 0:06:20.000 --> 0:06:22.400 burnout on its own. Well, I had no choice, and 0:06:22.480 --> 0:06:25.480 the panic was so overtaking me. It did hit its 0:06:25.520 --> 0:06:27.719 highest point, but I swear it felt like the panic 0:06:27.720 --> 0:06:30.920 attacks were lasting five or ten minutes, which is a 0:06:30.960 --> 0:06:33.599 long time when you are driving on the freeway. And 0:06:33.680 --> 0:06:36.080 so now I really don't have that. I've spent a 0:06:36.160 --> 0:06:38.280 lot of my life as a comedian on the road. 0:06:38.320 --> 0:06:40.400 I do a lot of my own driving between cities 0:06:40.720 --> 0:06:43.560 and just living in Los Angeles. Jump on the freeway, 0:06:43.640 --> 0:06:45.840 jump off. It's not always my favorite thing, but it's 0:06:45.839 --> 0:06:48.680 not from an anxiety standpoint. It's more I don't feel 0:06:48.680 --> 0:06:52.320 like sitting in traffic, or everyone's driving crazy today, they're 0:06:52.320 --> 0:06:57.680 in a mood, or it's raining whatever. However, going back 0:06:57.720 --> 0:06:59.760 to my original point, I was in Palm Springs. When 0:06:59.800 --> 0:07:04.080 I was interviewing Dr lauana Um, I was there half 0:07:04.080 --> 0:07:05.840 on a little thing with my parents, and then at 0:07:05.839 --> 0:07:07.120 the end of the week I had a wedding to 0:07:07.120 --> 0:07:09.920 go to, So there was a few days where I 0:07:10.000 --> 0:07:13.240 was just there hanging out and doing my research for 0:07:13.520 --> 0:07:17.320 this week's episode and conducting the interview. And during those 0:07:17.400 --> 0:07:21.920 days I kept picturing the drive home and how i'd 0:07:21.920 --> 0:07:24.840 be driving home by myself from Palm Springs. Now, again, 0:07:24.880 --> 0:07:29.600 I don't really know why I was worried that I 0:07:29.600 --> 0:07:33.040 would panic. I've driven by myself to and from San 0:07:33.040 --> 0:07:36.400 Diego from Los Angeles, which is a longer distance, so 0:07:36.480 --> 0:07:40.160 it's about the same. But I don't know why. Uh. 0:07:40.200 --> 0:07:42.120 And I kept thinking, well, okay, Jen, if you have 0:07:42.160 --> 0:07:44.280 a panic attack, you'll have a panic attack. What is 0:07:44.400 --> 0:07:46.920 the problem? And I kept just thinking, I wish I 0:07:46.920 --> 0:07:49.080 didn't have to and I hope I don't panic, and 0:07:49.080 --> 0:07:52.560 it's going to be miserable. And I think it's my 0:07:52.720 --> 0:07:55.440 theory is um, the more I have going on in 0:07:55.480 --> 0:07:59.480 life that's a little stressful, a little unknown, I will 0:07:59.520 --> 0:08:02.440 tend to panic in certain situations that can cause a 0:08:02.440 --> 0:08:05.640 panic attack, And for me, that is again it's more 0:08:05.720 --> 0:08:08.520 now not driving on the freeway, but getting stuck in traffic. 0:08:09.320 --> 0:08:12.200 That that is something that I find I will have 0:08:12.280 --> 0:08:16.480 anything from uncomfortable sensations to full blown panic attack. And 0:08:16.760 --> 0:08:18.480 you know, I'm sort of in the middle of a move, 0:08:19.200 --> 0:08:22.520 just a lot of new things happening, and I felt 0:08:22.520 --> 0:08:24.520 a little pressed for time. I felt like I didn't 0:08:24.520 --> 0:08:27.640 really even have time to be in Palm Springs that long. 0:08:28.160 --> 0:08:31.200 Wasn't quite a vacation for me. So I just feeling stressed. 0:08:31.200 --> 0:08:33.000 And when I have a lot of other things going on, 0:08:34.280 --> 0:08:38.679 um situations that can cause me to panic most likely will. So. 0:08:39.000 --> 0:08:42.080 Dr Marquez talks a lot about exposure therapy in her book. 0:08:42.160 --> 0:08:44.640 She's worked with patients that, you know, have a fear 0:08:44.640 --> 0:08:46.760 of getting in an elevator, of fear of heights. And 0:08:47.440 --> 0:08:50.600 I never did exposure therapy about driving on the freeway. 0:08:50.600 --> 0:08:53.800 I just sort of did it and applied all of 0:08:53.840 --> 0:08:59.240 my panic disorder and generalized anxiety tools to it. But 0:08:59.480 --> 0:09:02.560 I thought to ask her a question about, you know, 0:09:02.640 --> 0:09:05.680 what what do I do in this case where it's 0:09:05.720 --> 0:09:09.360 three days from the drive and I'm still I'm kind 0:09:09.360 --> 0:09:12.520 of dreading it, and it's almost making me think I'm 0:09:12.520 --> 0:09:14.240 not even gonna enjoy this wedding I'm going to the 0:09:14.320 --> 0:09:16.959 night before because I'm just thinking about this drive and 0:09:17.000 --> 0:09:19.560 it was starting to pick up steam in my brain, 0:09:19.600 --> 0:09:22.200 and I wanted to ask her, should I think of 0:09:22.240 --> 0:09:24.959 it more as something that you know, Do I get 0:09:25.000 --> 0:09:28.480 in the car and start assuming there will be panic 0:09:28.600 --> 0:09:32.440 and doing a breathing tape or whatever a tape? I 0:09:32.520 --> 0:09:34.520 have a car with an eight track tape player, you know, 0:09:34.559 --> 0:09:36.800 doing a breathing app or what? I don't know? Or 0:09:36.840 --> 0:09:39.520 do I just kind of ignore it because I have 0:09:39.720 --> 0:09:43.480 conquered this. I have more examples than not of driving 0:09:43.480 --> 0:09:46.360 on the freeway alone in traffic without panicking. Do I 0:09:46.440 --> 0:09:49.840 just live my life and if it happens, I do 0:09:49.920 --> 0:09:52.199 have tools, but I don't have to anticipate it. And 0:09:52.600 --> 0:09:55.280 she did answer, and I will have an answer for 0:09:55.320 --> 0:09:56.880 you on the flip side of this episode about what 0:09:56.960 --> 0:09:59.920 ended up happening. But it was interesting in that more 0:10:00.080 --> 0:10:02.480 meant to, you know, I don't know, get a little 0:10:02.480 --> 0:10:04.600 free advice from a therapist, but but I figured I 0:10:04.600 --> 0:10:07.120 would take you all into that situation so that you 0:10:07.160 --> 0:10:10.720 could see in real time what talking to someone looks like. 0:10:10.760 --> 0:10:12.679 If you've never been to therapy, does that make sense. 0:10:13.240 --> 0:10:15.240 And something else she mentioned that I that I wanted 0:10:15.280 --> 0:10:17.760 to talk about is, you know, a lot of times 0:10:17.800 --> 0:10:20.600 we do avoid situations that scare us, you know, airplanes, 0:10:20.840 --> 0:10:24.520 tall buildings, the mall. I don't know anything. A lot 0:10:24.600 --> 0:10:28.600 of times we do avoid things because these are places 0:10:28.600 --> 0:10:32.600 we have panicked before, and we associate that place with 0:10:32.640 --> 0:10:39.760 the panic attack. And for me, I avoid you know, 0:10:40.480 --> 0:10:44.520 tall buildings. Now, there are few cases where I do 0:10:44.679 --> 0:10:46.920 have to go up to the forty floor of certain buildings, 0:10:47.640 --> 0:10:50.120 and there's just there's just no option that I'm not 0:10:50.160 --> 0:10:52.360 going to. There are certain radio stations. If I have 0:10:52.480 --> 0:10:54.840 to go do press for something, you've got to get 0:10:54.840 --> 0:10:57.640 on the floor, and I have my coping skills and 0:10:57.679 --> 0:11:01.720 I make it work. But in general, UM, if you 0:11:01.800 --> 0:11:04.040 tell me that you just bought a penthouse and you 0:11:04.080 --> 0:11:06.040 live on the fifte floor, I'm probably not going to 0:11:06.080 --> 0:11:09.480 your Christmas party. I just the discomfort would be too much. 0:11:10.720 --> 0:11:13.080 I don't like roller coasters. I don't see that happening, 0:11:13.120 --> 0:11:16.720 but unlike the Christmas party that I bet would be great. 0:11:16.720 --> 0:11:19.319 And thank you for inviting me in your new penthouse. 0:11:19.480 --> 0:11:22.240 Uh No, regrets not going back on a roller coaster. 0:11:22.320 --> 0:11:25.840 Ben once I get it, but I probably would do 0:11:25.880 --> 0:11:29.679 some exposure therapy around trying to get to that Christmas 0:11:29.679 --> 0:11:33.000 party because that's something I really want to do. And 0:11:33.080 --> 0:11:36.520 so that was something that Dr Marcus and I talked about, 0:11:36.920 --> 0:11:40.240 and she uses this with her patients, which is, you know, 0:11:40.440 --> 0:11:42.560 it's fine to avoid certain things if you if it's 0:11:42.559 --> 0:11:46.480 just not even worth it, But what's your quality of 0:11:46.480 --> 0:11:50.560 life like with your anxiety in the sense that we 0:11:50.600 --> 0:11:52.760 can avoid certain things. You don't need to go on 0:11:52.800 --> 0:11:55.720 a roller coaster, right, you don't need to go on 0:11:55.760 --> 0:11:57.839 a zip line down a mountain. You don't need to 0:11:57.880 --> 0:12:00.320 bungee jump, you don't need to sky I have. All 0:12:00.360 --> 0:12:02.760 of those things could cause anyone to have a panic attack. 0:12:02.840 --> 0:12:05.320 But when we look at everyday things like getting on 0:12:05.320 --> 0:12:08.160 an airplane to go, you know, across the country, or 0:12:08.240 --> 0:12:10.160 driving on a freeway, when we look at those things 0:12:10.160 --> 0:12:15.120 as inherently as dangerous, as taking some big risk, that's 0:12:15.120 --> 0:12:17.960 when we start to convince ourselves that that we're right, 0:12:18.280 --> 0:12:21.600 you know, and then our life gets really small. And 0:12:21.640 --> 0:12:25.160 so what I loved about talking to Dr Marquez was 0:12:25.280 --> 0:12:28.280 she reminded me that one of the emotionally very sad 0:12:28.320 --> 0:12:31.480 things about panic and anxiety is that my life was 0:12:31.880 --> 0:12:34.600 kept small in a lot of areas. And she posed 0:12:34.600 --> 0:12:38.440 a question to me during another part of the interviewer 0:12:39.120 --> 0:12:42.679 I retroactively got some therapy. She reminded me by by 0:12:42.679 --> 0:12:44.520 saying to me what she would say to her patients 0:12:44.559 --> 0:12:46.440 about what kind of life do you want to live? 0:12:46.760 --> 0:12:48.960 And working from there and so I'll tell you we 0:12:49.000 --> 0:12:51.880 mentioned UH nine eleven in this episode. And the reason 0:12:51.920 --> 0:12:53.840 I brought it up to her was because when I 0:12:53.880 --> 0:12:55.360 was living in New York and that was, you know, 0:12:55.400 --> 0:12:57.840 working my temp jobs and wanted to be a comedian 0:12:57.880 --> 0:13:00.880 at night and was doing comedy at night, but unpaid, 0:13:00.920 --> 0:13:03.600 and you know, just a few years into comedy and 0:13:04.360 --> 0:13:06.760 just doing when everybody else did, working out your material, 0:13:06.920 --> 0:13:09.360 doing your day job, whatever it may be. And I 0:13:09.400 --> 0:13:12.240 was hooked up with a temp agency. And you get 0:13:12.240 --> 0:13:15.360 a job anywhere from a day last it could last 0:13:15.360 --> 0:13:17.319 a day, it could last a week, a could last months. 0:13:17.360 --> 0:13:19.520 And I would get these calls, well, you have a 0:13:19.600 --> 0:13:22.280 job at this building and it's uh. When you get there, 0:13:22.360 --> 0:13:24.520 check into the thirty six floor, and that's always where 0:13:24.520 --> 0:13:28.000 I'd say, Nope, can't take that job. The building is 0:13:28.320 --> 0:13:30.640 I can't, I can't I can't with the elevator, I 0:13:30.679 --> 0:13:33.560 can't be up that high. And I was offered a 0:13:33.640 --> 0:13:36.840 job in the World Trade Center, I don't know, answering 0:13:36.840 --> 0:13:39.360 the phones at some such company, and I said no 0:13:39.480 --> 0:13:41.600 because I've always had a fear of the World Trade 0:13:41.600 --> 0:13:45.480 Center and I was just thought, nah, I don't want 0:13:45.480 --> 0:13:47.120 to go in that building. It. I don't know what 0:13:47.200 --> 0:13:50.640 if something happens, what was something. I always thought that 0:13:52.080 --> 0:13:54.199 even just like a helicopter could fly into it. I 0:13:54.480 --> 0:13:57.200 just better for me to avoid that building. And so 0:13:57.240 --> 0:13:59.240 I didn't take the job. Now. Of course, as I 0:13:59.280 --> 0:14:01.200 said in the interview, I don't know if I would 0:14:01.200 --> 0:14:05.040 have been working that temp job a year later, probably not. 0:14:06.040 --> 0:14:10.720 But as someone who at the time I was living 0:14:10.720 --> 0:14:13.079 in New York City and wasn't in therapy, I had 0:14:13.080 --> 0:14:18.560 a really bizarre reaction Among many reactions to nine eleven, 0:14:18.840 --> 0:14:21.320 but one of the most bizarre ones was thinking I 0:14:21.360 --> 0:14:24.920 was right. I knew it. See, I'm I'm keeping myself 0:14:24.960 --> 0:14:27.480 safe by not going to places like this, and I 0:14:27.480 --> 0:14:31.440 don't care what these therapists say, you know. No, So 0:14:31.560 --> 0:14:34.000 I'd had a really great therapist, which I've i think 0:14:34.040 --> 0:14:37.080 mentioned in previous episodes, the woman who taught me about mindfulness, 0:14:37.200 --> 0:14:40.240 and she was my therapist when I first first went 0:14:40.880 --> 0:14:43.080 in the mid nineties when I was living in Boston. 0:14:43.080 --> 0:14:44.640 But when I went to New York, I didn't get 0:14:44.800 --> 0:14:47.000 a new therapist right away. And I had this one 0:14:47.040 --> 0:14:49.720 woman and she fell asleep during my sessions and I 0:14:49.880 --> 0:14:54.320 don't think I'm that boring, and uh, she said something once, well, 0:14:54.360 --> 0:14:56.280 if you want to be a comedian, be a comedian, 0:14:56.280 --> 0:14:58.200 why do you why do you answer phones at this 0:14:58.440 --> 0:15:00.680 tech company? And I went, well, you can't just be 0:15:00.760 --> 0:15:03.400 a comedian. Goes up, there's that can't and I said, no, no, no, 0:15:03.520 --> 0:15:05.920 like literally, that's not how it works, Like I'm still 0:15:05.960 --> 0:15:09.080 at the open mic level. You literally just it's not 0:15:09.400 --> 0:15:11.760 you can't like And I couldn't explain to her because 0:15:11.800 --> 0:15:13.920 she kept insisting I was being negative, and I was like, well, 0:15:13.960 --> 0:15:16.720 you had to go to school for this, you didn't 0:15:16.720 --> 0:15:19.400 just get to say you were a therapist. Um, and 0:15:19.440 --> 0:15:21.200 then she kind of looked at me and she's like, 0:15:21.240 --> 0:15:23.400 you seem like you're being very stubborn, and then she 0:15:23.480 --> 0:15:27.840 fell asleep. So you know, I was a little down 0:15:27.880 --> 0:15:31.000 on therapist at that point, so I I asked Dr 0:15:31.040 --> 0:15:34.120 Marquez what she would have said to me back then 0:15:34.160 --> 0:15:36.680 if I came into her and said, well, I told you, 0:15:36.680 --> 0:15:40.640 you know, planes hit buildings, they fall. Uh, I don't 0:15:40.640 --> 0:15:43.800 really need any of this therapy where you're telling me 0:15:44.280 --> 0:15:46.840 that I need to, you know, get out there and live, 0:15:46.920 --> 0:15:49.280 because look what happens when you do. You know, she 0:15:49.440 --> 0:15:52.000 gave me a great answer that just stopped me short. 0:15:52.120 --> 0:15:55.480 Even even here twenty years later, it's like, right, it's 0:15:55.520 --> 0:15:59.000 not about looking at it in terms of what we 0:15:59.080 --> 0:16:01.760 need to avoid. It's about what kind of life do 0:16:01.800 --> 0:16:03.400 we want to build? And you'll hear more about it 0:16:03.480 --> 0:16:09.440 if I ever stopped talking. Okay, let's get into it. 0:16:10.040 --> 0:16:13.760 Dr Luanna Marquez is an Associate professor of psychiatry at 0:16:13.800 --> 0:16:16.840 Harvard Medical School. Have it. I'm from Boston. I was 0:16:16.880 --> 0:16:19.080 talking to her. She was in Boston. It was exciting 0:16:19.120 --> 0:16:21.200 a lot of wicked, smot people there. And she's the 0:16:21.200 --> 0:16:25.640 director of Community Psychiatry at mass General Hospital. She is 0:16:25.680 --> 0:16:30.560 a national and international expert in cognitive behavioral therapies. Oh, 0:16:30.640 --> 0:16:32.560 you can tell to when you hear this episode, You'll 0:16:32.600 --> 0:16:37.160 be like, she's good anyway. She's the president of the 0:16:37.240 --> 0:16:41.920 Anxiety and Depression Association of America and Also, as I 0:16:41.960 --> 0:16:45.000 mentioned the author of Almost Anxious, is my or my 0:16:45.120 --> 0:16:48.040 loved ones wary or distress a problem? Now there is 0:16:48.080 --> 0:16:50.760 a longer biography and I will put the link in 0:16:51.200 --> 0:16:54.080 the show notes. You can see it wherever whatever app 0:16:54.120 --> 0:16:57.080 you're listening to this on. You can click to buy 0:16:57.080 --> 0:16:59.920 her book. You can click to read her longer bio. 0:17:01.160 --> 0:17:05.320 But as for anap enjoy my chat with Dr Lawana Marquez. 0:17:08.160 --> 0:17:12.560 Thank you Dr Lawana Marquez for joining me on Anxiety Bites. 0:17:14.760 --> 0:17:18.440 So let's just jump into it now your book, Almost Anxious. 0:17:19.880 --> 0:17:23.760 What I loved about the title, um is that I'm 0:17:23.760 --> 0:17:27.800 always learning something new about anxiety. And honestly, sometimes I 0:17:27.840 --> 0:17:30.000 think I know everything there is to know and I'm 0:17:30.040 --> 0:17:33.480 obviously wrong. And something I didn't know about was this, 0:17:34.280 --> 0:17:38.560 you know, very real medical situation of as you put it, 0:17:39.880 --> 0:17:42.960 a bunch of things can be classified as the almost effect. 0:17:44.200 --> 0:17:46.160 So one of the things that you said and here 0:17:46.240 --> 0:17:49.800 is you know, a sunburn, right, it's not skin cancer, 0:17:49.880 --> 0:17:52.879 but it could lead to skin cancer. A glucose intolerance 0:17:52.920 --> 0:17:56.440 may not always lead to diabetes, but but it could. 0:17:56.480 --> 0:18:01.359 So in other words, diseases they developed slowly and after 0:18:01.600 --> 0:18:04.600 an amount of years they could become full blown and 0:18:04.680 --> 0:18:07.880 so can you talk to us about the almost effect 0:18:08.040 --> 0:18:11.240 of anxiety? Sure? And so I think about anxiety is 0:18:11.280 --> 0:18:14.240 a spectrum. We are all anxious, right, that's their reality. 0:18:14.440 --> 0:18:17.359 Everybody has anxiety, and the question really is what is 0:18:17.359 --> 0:18:19.359 the anxiety doing to you in your life and you 0:18:19.480 --> 0:18:22.400 loved ones? And the idea behind that almost the fact 0:18:22.400 --> 0:18:26.600 is that there's plenty of research suggesting that subclinical anxiety, 0:18:26.680 --> 0:18:30.280 so not at the level diagnosing um generalizing side of 0:18:30.320 --> 0:18:34.080 disorder panic for example, but enough symptoms that start to 0:18:34.119 --> 0:18:37.840 interfere with people's lives. And so that's really why I 0:18:37.920 --> 0:18:40.399 wrote Almost Things, just to bring awad to this idea 0:18:40.520 --> 0:18:43.119 that you may be in the path to develop a 0:18:43.160 --> 0:18:46.320 full blown anxiety disorder, but the skills that we used 0:18:46.320 --> 0:18:48.960 to treat full blown anxiety disorder the same that can 0:18:49.000 --> 0:18:51.640 help you prevent getting there. And so to really get 0:18:51.680 --> 0:18:53.920 people to think about where they are in that spectrum, 0:18:54.240 --> 0:18:56.600 how is interfere in their life and and then what 0:18:56.680 --> 0:18:59.479 can you do about it? How does someone know if 0:18:59.520 --> 0:19:02.440 they're in the almost or if they're in the normal 0:19:02.520 --> 0:19:06.080 amount of anxiety that we humans get. So, you know, 0:19:06.160 --> 0:19:07.920 when you think about anxiety, the first thing you want 0:19:07.920 --> 0:19:10.520 to think about is what's it doing to you and 0:19:10.560 --> 0:19:13.440 what's the impact? Right, Um, A little bit of anxiety 0:19:13.440 --> 0:19:17.800 actually propels us and in the normal quote unquote normal 0:19:18.160 --> 0:19:21.040 um helps you actually do things right. For me, when 0:19:21.080 --> 0:19:25.040 I feel anxious, it motivates me, It signals something important, 0:19:25.040 --> 0:19:26.560 and it gets me to think about where am I 0:19:26.560 --> 0:19:29.440 in that spectamen, and what I need to do. When 0:19:29.440 --> 0:19:31.480 we get to sort of almost you start to have 0:19:31.600 --> 0:19:35.520 things like your brain is just not on. You start 0:19:35.520 --> 0:19:37.679 to have a little trouble focusing, or you might have 0:19:37.720 --> 0:19:40.840 a little trouble with sleeping. You might notice that starts 0:19:40.840 --> 0:19:42.959 to change your fear in different domains of your life. 0:19:43.280 --> 0:19:46.840 It doesn't feel debilitating the sense that you were having 0:19:46.840 --> 0:19:49.280 a full blown panic attack and you feel like really 0:19:49.320 --> 0:19:54.240 exhausted and paralyzed, but it certainly feels um troublesome. Starts 0:19:54.240 --> 0:19:58.720 to interfere with your life. So in other words, someone 0:19:58.760 --> 0:20:01.399 could have a night or two of sleepless nights. I 0:20:01.400 --> 0:20:03.800 don't know, you know, for normal I keep saying normal, 0:20:03.800 --> 0:20:06.199 but I'm saying it sarcastically. For normal reasons, they just 0:20:06.280 --> 0:20:09.600 had a kid, or their jet lagged or something. That's 0:20:09.600 --> 0:20:12.159 not what you're talking about. You're talking about out of 0:20:12.200 --> 0:20:14.720 the blue, someone who doesn't normally have insomnia. I'm just 0:20:14.800 --> 0:20:17.760 using that as an example, starts to have it, I 0:20:17.800 --> 0:20:19.720 don't know, every night, once a week, And how long 0:20:19.760 --> 0:20:22.720 does it have to go on before they've kicked over 0:20:22.880 --> 0:20:26.399 into maybe a full blown anxiety disorder? And when do 0:20:26.480 --> 0:20:28.600 they have to start, for lack of a better word, 0:20:29.640 --> 0:20:31.800 I'll say, for lack of a better word, worrying about 0:20:31.800 --> 0:20:33.639 it but addressing it. So let's say, out of the 0:20:33.640 --> 0:20:36.800 blue tonight, I have insomnia. Now, am I gonna go 0:20:37.359 --> 0:20:40.800 rushing to you know, my you know, rushing to a psychiatrist? 0:20:41.119 --> 0:20:43.199 I'm in the almost anxiety part, you know. How do 0:20:43.280 --> 0:20:45.360 we know when it's going? How do we know when 0:20:45.400 --> 0:20:48.280 we're going from almost to own? There might be something there. 0:20:48.560 --> 0:20:51.960 It is a really interesting question, especially um during a 0:20:52.000 --> 0:20:55.720 pandemic where we've seen increased in levels of clinical levels 0:20:55.720 --> 0:20:58.800 of anxiety. And I don't know anyone in the last 0:20:58.800 --> 0:21:02.560 eighteen months and didn't have almost anxiety, So how how 0:21:02.600 --> 0:21:05.119 do you define it? It's really individual to you, and 0:21:05.119 --> 0:21:09.200 I wouldn't InCor on one symptome like sliplessness. I anchor 0:21:09.320 --> 0:21:12.439 on how is it impacting my life? Is it getting 0:21:12.440 --> 0:21:15.560 in the way of me producing functioning, Is it getting 0:21:15.600 --> 0:21:19.679 in the way of my relationships? And so when starts 0:21:19.720 --> 0:21:22.520