5 Things You Should Do About Anxiety
Anxiety is the most common mental health problem with 18.1% of the US population suffering from the condition 1. Most people who suffer won’t get treatment.
Maybe that’s you?
It was me.
I can remember days so anxiety-ridden it makes me ill to look back on them.
I had always known this feeling to some extent and I believed it was just an aspect of my personality. I held people at arm’s length, overwhelmed with the ‘energy’ surging through my nervous system. I didn’t know that I could feel better. I didn’t know the feeling wasn’t normal. At times it neared causing a breakdown. My work suffered, my relationships ended, and were unfulfilling. My sense of well-being was at a low point. I have addressed my issue with anxiety through meditation, medication, and therapy. I keep it at bay for the most part, but it still takes a lot of effort on a daily basis.
The causes of anxiety affecting functioning in life are wide-ranging. Many factors should be considered, ranging from family, trauma, diet, sleep habits, relationships, and living conditions. Treatments range from mindfulness activities and medication to shock therapy.
Anxiety is characterized by symptoms including nervousness, restlessness, or tension; feelings of danger, panic, or dread. Physical manifestations may include rapid heartbeat, breathing, sweating, trembling or muscle twitching, weakness or lethargy, cloudy thinking, or digestive issues. Behavioral symptoms may be avoidance, obsessions, compulsive behaviors, and repetitive actions13.
In extremes, anxiety may become generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder, or panic disorder.
Often overlooked in seeking the root of anxiety is what has come to be known as the microbiome. The microbiome refers to the thousands of microbes, bacteria, fungi, viruses, and archaea* living in our digestive system2. What’s more, it appears the microbiome in our gut has just as much influence over our mental health as the brain.
Supporting this idea, studies find an increase in depression in those taking antibiotics due to much of the microbiome being wiped out. Additionally, a fecal transplant (yes, it’s what it sounds like) in rats from human patients suffering from schizophrenia and other mental illnesses seems to cause symptoms related to those disorders in the rats.
There is currently a wide focus on the idea that mental health can be altered and issues addressed through the microbiome. A new area of psychology, nutritional psychology, has formed in response to this research.
The microbes in the gut appear to be symbiotic with human beings, our existence tied. The microbiome produces serotonin and dopamine2. In fact, most of the serotonin in the body is produced in the gut. Studies show that people who eat more nutrient-dense foods tend to report better well-being and higher life satisfaction3.
A psychologist at Columbia University, Dr. Ramsey, suggests eating seafood, greens, nuts and beans — and a little dark chocolate. Yet, most groups don’t endorse a specific diet citing more research needs to be done. Suggesting the Mediterranean diet seems to be the closest endorsement available. Eating fruits, vegetables, healthy meats, and seafood, for example. Omega-3 fats found in these foods increase neurotransmitter production of dopamine and serotonin4.
On the other hand, (white bread, pizza dough, pasta, pastries, white flour, white rice, sweet desserts, and many breakfast cereals6) correlates with depressive symptoms7.
Anxiety may be caused by underlying health concerns such as heart disease, diabetes, thyroid problems, COPD, drug misuse or withdrawal, chronic pain, irritable bowel syndrome, or certain tumors5.
Cardiac issues such as chest pain and palpitations have been known to cause anxiety8. This makes sense – if your heart is pounding for what you perceive as no particular or unidentifiable reason, then this might cause some trepidation. Cushing disease, diabetes mellitus, parathyroid disease, pancreatic tumors, pheochromocytoma, pituitary disease, and thyroid disease are endocrine issues that may create excessive sympathetic activation and disruption of the hypothalamic-pituitary-adrenal pathway. In short – they may cause anxiety-related symptoms.
Inflammatory conditions such as arthritis may be part and parcel of anxiety. Metabolic conditions such as hyperkalemia, hyperthermia, hypoglycemia, hyponatremia, hypoxia, porphyria, or substance over-ingestion may also be causal. Respiratory conditions such as asthma are also potential causes of Anxiety.
Low blood sugar has been reported to “mimic” the symptoms of anxiety9.
Trauma, including physical abuse, emotional abuse, sexual abuse, neglect, exposure to domestic violence, substance abuse, and abandonment, may also be a leading cause of anxiety. It makes logical sense – there is a fear in anticipating the triggering event may reoccur10. Children who have traumatic childhoods have altered brains as an adaptation. For example, a victim of physical abuse may have an enlarged Amygdala, the part of the brain scanning the environment for danger.
Dissociative symptoms (experience of detachment or feeling as if one is outside one’s body, and loss of memory or amnesia11) highly correlated with Post Traumatic Stress Disorder (PTSD) may render an individual unable to function11. This severe anxiety has been discovered to change the physiology of the brain. Hyperconnectivity between the default mode network (part of the brain allowing mental state processing) and the frontoparietal network (guides attention) are created. Simultaneously, we look inside ourselves, monitoring how we feel in anticipation of what we fear, and the frontoparietal network keeps our attention here. This is the biological wiring of anxiety.
Studies find that generalized anxiety disorder (excessive, uncontrollable worry in the absence of respective stimuli or in a manner disproportionate to their potentially posed risk14) or GAD have a 30% heritability rate. Researchers report this as a moderate risk suggesting that there is some genetic causation to be factored into the causality of anxiety.
The genetic influence in anxiety seems to function simply, like an on/off switch in the individual. It appears genes may modify emotional responses in a way that causes anxiety15. Twin studies support this claim16.
Why We Don’t Get Help
Of the 18% in the US affected by anxiety, 20% of these folks are in a state of severe impairment17. The most common reason reported that treatment was not sought was shame and stigma. Asking for help may be viewed as a sign of weakness. People reported wanting to deal with the issue themselves. In a study, 50% of the participants did not receive care because they simply did not know where to receive it.
Those with the predisposition for anxiety disorders may begin exhibiting symptoms as early as 8 years old15. At this age, how could you possibly know what you are feeling is not normal? It just does not occur to these individuals that help may be needed. I believe this to be the case for the majority of people I’ve come in contact with. The immediate question that follows is what is mental health?
Good mental health is described as a state of well-being allowing individuals to cope with the normal stresses of life and function productively18. This definition may not trigger a response in an individual with anxiety that there may be something wrong.
Those with good mental health generally feel good about themselves, are not overwhelmed by extreme emotions, have good and lasting personal relationships, are comfortable around others, make decisions, accept disappointment well, and respect themselves and others19.
5 Things You Can Do…
First, assess yourself. If you’re reading this, you may experience anxiety. Ask yourself, am I filled with worry to the point where it is difficult to function? Am I worried about things for no reason at all? Do I often have to tell myself to grin and bare it? Is the way I feel normal? There may be no way to know for sure if the way you feel is normal. But you can compare your general affect with the above definitions of good mental health.
Next, remove highly processed foods from your diet. This is tough. Sugar is the most widely addicted substance in the world. Most babies are born addicted to sugar and yes there are withdrawal symptoms. Start slowly, remove sugary drinks first. Then, remove high gluten foods. Add Whole Foods, fruits, vegetables, whole grains, and greens. The more colorful the better. There is no one-size-fits-all diet out there. You’ll have to experiment to find the one that works for you.
Third, consider underlying health issues. If there is asthma, arrhythmia, diabetes, or another stress-inducing health concern, take steps to address the issue. Perhaps there is an issue you are not aware of. The sooner you take steps to address it the better.
Fourth, consider your family. Are there any behaviors that exhibit symptoms of anxiety? Has anyone in your family been diagnosed with an anxiety disorder? The goal in this step is to determine if that “on/off” switch may be part of who you are as well.
Last, take steps to get help. Often workplaces have an employee assistance program (EAP), for example. This is often an untapped resource. Also, there are other resources such as the Anxiety and Depression Association of America that may be able to help. This takes courage, but the steps you take do a lot to destigmatize mental health issues. But also, it puts you on track to improve your life and experience more joy.
*A domain of single-cell organisms. These microorganisms lack cell nuclei and are therefore prokaryotes. Archaea were initially classified as bacteria12.