Am I Anxious or Just Hangry & Tired?

A conversation with psychiatrist Ellen Vora, M.D., on true versus false anxiety and the actionable steps we can all take to avoid the latter

Topics discussed in our conversation below:

• True versus false anxiety

• Anxiety and the death of a parent

• The relationship between blood sugar and anxiety, sleep and anxiety, etc.

• Caffeine and alcohol: yes? no? maybe?

• Are we overmedicating depression?

• Love as counterbalance to anxiety

• Feeling our feelings is not anxiety, they are feelings

• The importance of surrender

• How to find a shrink, when all of them are booked solid

• The best foods to eat to avoid inflammation, another anxiety trigger

• Psychedelics

• Pesticides and inflammation of the gut

• The relationship between human mortality and anxiety

My last missive, I’m ashamed to admit, was over a month ago. Soon thereafter, I went on a five-day vacation with my son for his winter break, determined to unplug. But during those five days, Putin started rattling the sabers of war, and I—perhaps like you—found it nearly impossible not to doomscroll. After we’d all survived the collective anxiety of two years of Covid, suddenly the annihilation of Ukraine and global nuclear holocaust were on the table?

My paternal grandfather, Albert Copaken, was born in a little village outside Kyiv. My maternal grandmother, Kate Schwartz (née Zera), hails from somewhere near Lviv. I wish I knew more, and I have no pretensions that either of them, being Jews, would have survived the Holocaust had their families not left Ukraine when they did, but still. Ukraine—which was part of Russia when the Copakens left—feels like the closest thing I have to any sort of ancestral homeland. Meanwhile, my ex-husband, the father of my three children, grew up in Moscow, and his two half sisters and their kids, my children’s cousins, still live there under the shadow of Putin. I also lived in Moscow and covered the Soviet coup, back in 1991, when we all thought Russia might finally emerge as a democracy. In other words, this war, however absurdly, felt oddly personal.

Grandpa Copaken was from Dymer, a small town outside Kyiv.

Copaken/Kogan family reunion with Russian family outside Moscow, 2009

Me on a tank on the first day of the Soviet coup, 1991

Day one, Soviet coup, August, 1991 © Deborah Copaken

So I scrolled. And I scrolled. Late into the night. Early in the morning. The less sleep I got, the more anxious I became. The more anxious I became, the less sleep I got. Doomscroll, doomscroll, rinse, repeat. I could think of nothing else. I couldn’t write. I couldn’t read. I was stuck in an endless loop.

And then I remembered the conversation I’d had with Dr. Ellen Vora about her new book, The Anatomy of Anxiety, just prior to winter break. According to Dr. Vora, true anxiety—at its root, a fear of death—is different from false anxiety, which is a dysregulation in our bodies that can be triggered, yes, by a lack of sleep. It can also be triggered by being hangry, drinking too much caffeine, eating the wrong foods, drinking alcohol, and, yes, doomscrolling. Was I actually anxious, worrying about my own personal safety and wellbeing, or was I making myself anxious with my unhealthy behaviors? And if I’d made myself anxious, could I also undo the harm? If so, how?