Dear Doctors: I am beginning to have problems with anxiety, and recently I had trouble catching my breath. My sister says that's one of the things that happens in a panic attack. She talked to me about the "333 rule", and I wonder if you think it can help?
DEAR READER: Anxiety is a normal response to the stresses and challenges of daily life. Everyone is likely to experience some on any given day. Brief and moderate bouts of anxiety can have the benefit of keeping you alert and focused, ready to respond to a challenge. When anxiety becomes persistent, dread, nervousness and fear can overwhelm you and interfere with daily life.
The 333 rule your sister recommended is a coping strategy rooted in the practice of mindfulness. It focuses on easy and immediately available techniques to centre and ground you. People who practise the 333 rule say it helps calm their mind and emotions and provides a solid platform to ride out an episode of anxiety.
First, you look around and name three nearby objects. Take your time. Notice the height, heft, colour, texture and intended purpose of each. It can be a person, an object, even a leaf or pebble on the ground. Next, notice three things you can feel or touch, maybe something you're wearing or holding, the sensation of a breeze or the surface you are sitting or standing on. Finally, close your eyes and identify three sounds, such as footsteps, voices, birdsong or traffic. You can also add gentle deep breathing to your 333 practice.
Each step of the 333 technique can help shift your focus from the physical and emotional distress of an episode of acute anxiety. It uses the senses to pull you out of the interior spiral of anxiety and orient you outward into your immediate environment.
Other practices that have been shown to help reduce and manage anxiety include meditation, deep breathing and meditative physical exercises like tai chi, qigong and yoga. Research shows that regular aerobic exercise, such as running or dancing, can ease the intensity and frequency of episodes of anxiety. Weightlifting has also been found to be beneficial.
When anxiety becomes frequent or severe, or if it begins to interfere with the tasks and pleasures of daily life, we think it's a good idea to check in with a medical care provider. Persistent symptoms can be a sign of an anxiety disorder that may need a more thorough and far-reaching treatment strategy. This can include lifestyle changes, therapy and, in some cases, medication. Over time, anxiety can take both an emotional and physical toll. Seeking support is an important part of personal health care. Universal Features Syndicate
Dr Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.
