So you have anxiety, you use your coping skills to the best of your ability, and you don’t want to go on pharmaceuticals, but you still suffer. Does that mean you are out of luck in terms of giving your brain a little gentle support? No, not at all. There are good supplements that in many cases can help cool things down for you.

First and foremost, the usual disclaimer. Please recall that I am not a doctor and I do not play one on TV. This information is the result of my own studying and my experience with both myself and with clients. If you want to try something I talk about, you are responsible for your own decisions as a full fledged grown up. (And if you are not actually a grown up, then please go talk to the adult responsible for you before trying anything.) If you have any concerns, check with your doctor.

In fact,  if you have Generalized Anxiety, that is anxiety that is pervasive over many parts of your life where you are always tense and worried about many things, you owe it to yourself to get a good physical exam. This is especially true if you never had it before, but now you do. Anxiety like symptoms can be caused by thyroid issues, adrenal gland issues, and only the lord knows what else. Get all the bloodwork done. Don’t forget that caffeine can really make it much worse.

The other thing I’m going to suggest is that if you decide to try any of these, choose a day when you don’t have to go anywhere or operate heavy machinery, like your boat. Until you’ve worked with a supplement, you don’t really know how your body will respond. I would start with the lowest dose, observe yourself, then you can add more if you need to. You want the lowest possible dose that gives you a therapeutic benefit. Unlike pharmaceuticals, there is no ‘standardized’ dosage for supplements. This is both a blessing and a curse. It truly means that it is completely up to you.

Okay, now for the good stuff. I’ve included some external links to sites that I think have good information, even if some of them sell products.

1. L-Theanine – I love this supplement. Theanine is found in tea, both green and black, and has been studied combined with caffeine as a way to help people focus. It works for that, but without the caffeine it’s a good natural anti-anxiety.  Here’s the caveat: you need to take it regularly in my experience. Unless you are taking it for a specific event, such as before a test or before leaving the dock, taking it regularly can allow you to reach a generally calmer state overall and give you more flexibility when something stressful happens. Anxiety is kind of like pain. Staying on top of it is your best bet. Once it spikes, it’s hard to bring it down. Try starting with 100 mg and rate your level of tension when you take it. After an hour, rate your level of tension again and see if it has gone down. Then take another 100mg, wait and hour, and do the same thing. This amino acid is safe, has few, if any, side effect, is cheap, and it works for many people.
2. Catecholacalm – This supplement is designed for people who have had long term, chronic stress which has led to symptoms of anxiety due to adrenal fatigue. I first found out about it when a local naturopath prescribed it for a client who had classic symptoms of anxiety and was under a lot of chronic work stress. This stuff worked wonders for my client. I have since known several other clients to benefit from it. It’s a bit more expensive than the L-theanine, which it contains. 5-Htp – Sometimes anxiety is a symptom of low serotonin, especially if the person has many symptoms of depression as well. It is very common that depression and anxiety co-exist.  There has been more interest in research on 5-HTP in Europe and Canada where pharmaceutical companies have less political influence. It’s actually a very good, well documented natural anti-depressant that increases serotonin. Interestingly, there is some research that indicates it helps with Panic Disorder. Most of the first line medications for anxiety, besides tranquilizers, are anti-depressants that increase serotonin. So it may be worth a try for you. As always, start with a low dose and work up.
3. SamE – SamE is a very good stand-alone anti-depressant and will also work for anxiety as some of the same neurotransmitters are involved. It has also been shown to help SSRIs such as Zoloft to work better so people may be able to take a lower dose. The only problem with SamE is that it is expensive. Costco has a good brand and the best price. I generally suggest trying other, less expensive things first. But I guess you get what you pay for. It’s a good supplement. If you have bipolar disorder, you should definitely check with your doctor before taking this. SamE is powerful medicine. Too much is not a good thing. I really like this blog post about SamE. (That entire site is rich with information. Just excellent.)

This is certainly not an exhaustive list and is meant to give you a place to start if you are looking for ‘natural’ solutions to anxiety. Again, I include only those supplements with which I have personal and professional experience. Anxiety is often associated with other conditions that result from inflammation, so a well rounded supplementation with anti-inflammatory vitamins and minerals such as Vitamin e, fish oil, B vitamins and magnesium may help some people feel better. If you are kind of geeky and love information, this blog on Evolutionary Psychiatry is awesome. Where has it been my whole career?

In addition, there is ground breaking research on how our gut flora effect mental health issues like anxiety and depression. It’s been discovered that some of our gut bacteria actually produce serotonin. Low serotonin is indicated in many forms of anxiety, as well as depression. This is so exciting to me. The idea that the gut is our ‘second brain’ is something that gives me a lot of hope for treatment for future generations.

Join us tomorrow for the final post in the A to Z Challenge! If you want to read from the beginning, go here.

Yesterday I was sanding teak on Galapagos when suddenly a large splintered area stabbed my finger, ripping it open and possibly leaving a nasty splinter deep under the skin. I can’t tell yet. The finger is still too tender and raw to really know until the swelling goes down. It happened so fast! There was a lot of blood. If I had xeniatrophobia, I’d be really worried about infection because it would mean I’d have to go to some doctor I’ve never met before. This phobia is the fear of unknown doctors.

Actually, if I had this fear, I’d be even more worried about sailing outside of Commencement Bay in Tacoma. I don’t know any of the doctors we might encounter should we need medical care while we are away from home. Good thing this is a fear I actually don’t have. But I do get a bit concerned about getting hurt or ill while we are doing a passage across the ocean.

Not really in denial, just enough worry to motivate me to action.

We’ve lived in the same general area for 30 years, which is so weird to me I can hardly believe it. When we go sailing we will be leaving behind our carefully chosen medical providers with whom we’ve had good relationships over many years. Here at home, if I have a medical concern, I know who to call and how to get to her office. If there is an emergency, there is a hospital down the road.  What will we do if we need medical care when we are at sea? I can get into the nice protective space of denial on things like this because on some level, I just do not think that’s going to happen. Then I do things like rip my finger open with no warning. That’s how accidents happen, generally. With no apparent warning. Amy G. Dala begins to awaken and begins spinning her dark web of fantasies. What if someone breaks a bone? What if someone cuts themselves badly? What if? What if?

Just shut the hell up, Amy, right?

We always want to be as independent as possible and medical care is no exception. As is the case on all other things like the engine, water availability, food, etc, we will prepare to the best of our ability and then, we will have to let go and just make the leap. By way of preparing, we will both be taking at least one marine first aid course designed for people who are going offshore. There are also wilderness medicine courses like this one, but it’s more expensive. Still, might spring for it as it looks comprehensive. Anyone taken that class from Longleaf Wilderness Medicine? 

Second, we will have a fully stocked medical kit on board. I will work with my primary care provider to get medications we might need and instructions on using them. There are many lists of medical supplies for cruisers that we can use as reference for buying supplies. As usual,where there is a need, someone has found a way to fill it so you can buy prepared medical supply kits designed for cruising in mind. I have not decided about this. The convenience of buying something already put together may trump any money I could save by putting it together myself. Any suggestions from experienced cruisers out there?  Some people even carry things like intravenous equipment, but since we are not trained medical personnel, I’m not sure we’ll be doing that. On the other hand, if it’s available, we’d have it to share with other people, or with a cruising doctor or nurse who would know how to use it.

We will also carry paper copies of first aid books like this one. There is a free PDF of the third edition of A Comprehensive Guide to Wilderness and Travel Medicine, a similar book by the same author, but without the marine emphasis, if you want to download it. I like having paper books for quick reference. Thumbing through my kindle to find the right page is not something I want to wrap my brain around in an emergency. 

Third, we will have a sat phone like the Iridium Go or the Delorme Inreach. These two sat phones are a little like anchors. Everyone has their favorite. Not many have used both. So we will just choose and let it be done. We’ll leave with the phone number of someone we can contact for advice in case of an emergency. In fact, my primary care provider offers services via skype, so if I need to talk to her, I can probably set something up. The chances of something that difficult happening during an actual passage are probably less likely than Amy G. Dala thinks. I mean, the longest passage we’ll likely have will be about 5 weeks depending on wind.  This is one of those times when you just prepare as well as you can, then trust and go.

Because people all over the world get medical care, I am not overly worried about finding a qualified doctor or nurse, or even dentist,  if we are in port. There is medical care of some kind almost everywhere and we are both in good general health (knock on wood, throw salt over the shoulder, spit three times and sacrifice a number of virgins if I can find them). Being a member of the Women Who Sail FB group has relieved my mind about this on a number of occasions as women post questions about who to go see in this port or that port, all over the world, and receive detailed answers with phone numbers and even offers of assistance getting to the office. It’s a great resource, although there are other cruiser resources as well, such as Noonsite. The great thing about the cruising community is that there is a network of people who know where to go and how much it’s likely to cost (hint: much less than it does here in the United States).

Do you know anyone who has xeniatrophobia? If not, teach the word to any children in your vicinity so they can wow their friends with their word knowledge. The young children of today are the word geeks of tomorrow.

Hey! We are almost finished with the A to Z Challenge! But you may have just joined us and want to read about anxiety from the beginning. Here’s a link to the first post.

This week I had lunch with a good friend and she asked a critical question: “When you go sailing, will you have a way to make fresh water out of sea water?”. She was, of course, referring to a water maker. The answer to that is probably not. But it’s not because we don’t want to have one. When I think about the possibility that we would be in the middle of the Pacific Ocean and run out of fresh water, I can feel the wheels in my head start turning. I cannot let that happen.

Running out of fresh water? OH NOOOO!

Galapagos carries 300 gallons of water in two tanks. Allegedly, according to Mike, you can isolate one tank from the other, but as far as I can remember, we haven’t ever done that.  300 gallons is a lot of water.  We cruised for 5 weeks this summer and never even came close to running out. In fact, it’s possible we are still using the remains of that water as we sit at the dock. We have no way to measure how much we are actually using.

So how can we really know how much water to plan for when cruising in a hot climate? Our water usage will go up when we are in Mexico. When cruising in Canada, we can go a week or more without showering. We just don’t get very dirty and we don’t sweat much. But in Mexico? Pretty sure that we’re going to want to shower more often than that! Plus, I’m probably going to be almost neurotic about keeping salt and sand out out of the boat interior. That means we need to be able to rinse off with fresh water while on the aft deck. So how can we know how much water we need?

From back in the days of my Koi pond. I miss them sometimes. But I don’t miss taking care of the pond.

To answer that question, I cast my net to the Women Who Sail FB page and asked about water usage. What I got from the many answers to my question came down to this:

1. Water usage is so individual it’s hard to know. Water conservation is important if you don’t have a water maker.
2. Most people would kill to be able to carry 300 gallons of water. We agree that’s a lot of water.
3. Many people who have water makers would never be without one, and many people who don’t have them wish they did. It seems to depend somewhat on your cruising grounds. Lots of people cruising in Mexico have them because it’s sometimes hard to find potable water. The single reason people given for loving them is the freedom of self-sufficiency. If you have one and it’s working, then you never have to worry about finding a good water source. You can stay in that isolated anchorage as long as you want. Come to think of it, that’s why we put in solar panels and are going to be getting more. Freedom.

All of that was helpful. I was relieved that it looks like we could probably be fine for anywhere from 6 weeks to two months and not even worry overly much about water conservation.  I was starting to  decide we didn’t need one,  but then  Amy G. Dala got her knickers in a little bit of a twist. She has some thoughts about carrying water and cruising in a desert environment such as the Sea of Cortez.

Here is what she thinks:

1.  What if the first tank springs some kind of leak you can’t fix and you lose your water? The water in the second tank goes into the first tank. All the water could be lost into the bilge. If you are far away from fresh water, you could die.
2. What if the water somehow gets fouled? You could die.
3. What if you run out and you aren’t close to anywhere you can get water? It’s a hostile desert out there! You might die.
4. What if the water available to you isn’t very clean? You could get a tropical disease and die!
5. What if your water pump breaks, and then your spare water pump breaks, and then the spare spare water pump breaks? You might die!
6. If you drink sea water, you’ll die.
   

   One word for this desert: Hostile. He’s just waiting for pale skinned people who don’t know nothin’ about needing more water in the desert.

Well, Fran ‘the frontal’ Cortex may scoff at these whinings, she may think they are slightly crazy. None of these things is very likely to happen. She may speak sternly to Amy G. Dala and tell her to go to her room and stay until she calms down. But what if? We all know that Amy G. Dala’s job is to mitigate possible death scenarios, not play the odds.

It’s not as though we don’t know how to cruise with a small water tank. On Moonrise, our Cal 34, we carried 40 gallons of water for three people. I learned how to conserve water really well on that boat. I could take a shower with less than a tea kettle of water. I washed dishes and clothes in salt water and rinsed them in fresh. We never left the tap running. Mike chose to conserve water by forgoing showers and shaves. We all make sacrifices, and this was mine.  Oh, we know about water conservation. Another thing I know is that Galapagos is going to be our home. I’m willing to conserve to the same extent that we already do (except I’ll be taking normal showers on that boat, thank you.) . But I’m not going to be camping out. I’m okay with having a little luxury on board our boat.

One of the complaints people have about water makers is that historically they have not been reliable, tending to break down often and needing proprietary parts in order to get them going again. They are also downright pricey to buy new. This one, however, is supposed to be both reliable and easy to repair with no proprietary parts. It gets good reviews, and several of the women in the WWS group have one and love it. I think the technology has probably come a long way since watermakers were first introduced to the non-commercial market.

One thing I was charmed by in Mexico was the shrines built by the road. I might need a shrine if we run out of water.

In the end, it’s going to come down to money for us. We will not let the lack of a water maker keep us at the dock one minute longer than necessary, especially when we already carry 300 gallons. If we can afford to get one after we’ve addressed our list of actual ‘needs’, then that would be great. If not, the plan is to go sailing, then see how it goes. If we decide we want one, then we’ll find a way to get one.

Meanwhile, to get Amy G. Dala to shut up, I plan to carry water in large sealed jugs, just like I did on Moonrise, in case of emergency. I’ll just stow them away somewhere and if we get into the middle of the Pacific and all of our water somehow gets polluted or whatever, then we will have enough drinking water for the passage.

Now, shut up, Amy. We’re done here.

Want to read from the letter A? We’re almost finished with the A to Z Challenge!