Understanding and Managing Anxiety Disorder, Correlation with Depression and Use of Anti-depressants. Can Nutrition Help?
Anxiety, even in todays date is a taboo topic in many cultures. The general understanding is that the person is weak, unreliable, sloppy, have low self esteem or not productive. Often, they are picked last for a team task, a presentation or stage shows as well as made fun of behind their back. The reason being that people with anxiety often have a hard time to interact with others and communicate clearly, especially they are worrying about everything that’s is going around them. They often freeze, stutter or have a physical reaction from the anxiety. They also fear the “unknown” or “what’s to come.” Anxiety also creates self doubt as the person is constantly thinking about how they are perceived by others. They may feel people perceive them strange, weird or stupid.
Symptoms and Reactions
The person going through anxiety goes through a series of reactions both physiological and emotional while trying to deal with a “trigger” that causes excessive, persistent and unreasonable, “worry”. A trigger can be a negative thought, any change in life, confrontational conversation, an accident, memory of a trauma, a phobia or even social interaction. The trigger can cause worry about even an every day things in life, money, family, work and relationships. Even going to work, grocery shopping, school, social event or even the thought of getting through the day can feel stressful. Often people with anxiety are socially withdrawn, becomes quieter or chooses a particular task they are comfortable with to avoid interaction or going out. When experiencing an actual anxiety attack their gut feels twisted, jaw clenches, heart beats faster, hands tremble, breathing gets rapid, palms sweat and irritability or anger begins to takes over. Instead of falling asleep at night their mind is filled with negative, chattering thoughts that is hard to control. Although Anxiety attacks can be debilitating, it can be managed through therapy, medication, nutrition and lifestyle changes, specially if one knows the root cause of anxiety. As a society we need to understand and acknowledge people with such condition and show support to encourage them to come out of this state.
Physiological Reaction in the Body
Contrary to the popular belief, anxiety is not a useless emotion, it’s the response of the sympathetic nervous system (SNS) that makes one respond immediately to a threat or worry. The body releases adrenaline or epinephrine – a hormone that in a temporary but substantial way heightens the five senses as well as mobility. Adrenaline rush also makes the blood vessels and muscles to contract, dilates pupil, sends more blood to the heart and lungs so one can respond to a threat, accident, assault, natural disaster or response to fear. This response is required if you have to be somewhere on time, meet deadline, pay the bills, go for appointments or meetings, catch a train/bus/flight, defend or react when being attacked, deal with emergency situation or run from wild animal.
Typically, our bodies like to stay in homeostasis, a state between “flight or fight mode” (triggered by the sympathetic nervous system) or “feed and breed response” (a relaxation mode triggered by the body’s parasympathetic system). When there is a balance between these two responses – homeostasis is maintained. However, when a threat is recognized the body reacts in “fight or flight” mode. Unfortunately, this crucial reaction is more constant in a person with anxiety or this reaction occurs during wrong time for people with anxiety.
Causes of Anxiety
Clinically speaking chronic anxiety could be hereditary or caused when stressful events keep on piling up such as trauma, violence, abuse. Another factor triggering anxiety can be imbalance in hormones. Such as, “serotonin”, “estrogen” or “testosterone.” Excessive estrogen or too low estrogen can trigger chronic anxiety. Over consumption of dairy or environmental factors such as, plastic can also create hormonal imbalance and cause anxiety. Using addictive substances especially cannabis can disrupt both male and female hormones which can lead to anxiety. I have had clients who smokes tobacco or marijuana to relief stress, while being completely oblivious that in turn these substances will increase the possibility of chronic anxiety. Other addictive substances are excessive alcohol, drugs and excessive digital time (cell phones and TV) can cause or aggravate anxiety or make the avoidance behaviour stronger. Interesting to note that anxiety or stress response due to environmental, social or work pressure may cause a person to start smoking or drinking to take the “pressure off”, however, the individual can become dependant on the addictive behaviour to control anxiousness. And long-term substance abuse will aggravate the anxiety.
Stress, trauma, accident, abuse or major change during puberty can also cause anxiety in both sexes. This is something to note as parent. If anxiety is recognized and is addressed during early stages the individual may be able to learn to manage their symptoms.
Diet and lack of nutrients can cause anxiety. Caffeinated drinks, high sugar intake, food colors, artificial sweeteners, additives can easily become part of daily diet and cause imbalance in the nervous system. Lack of nutrients such as, B vitamins, magnesium, fatty acids from natural sources and vitamin D can aggravate anxiety disorders.
In my own practice I have noticed that improper breathing, exposure to toxic mold, imbalanced gut microflora and food intolerances/allergies can also be the underlying cause of anxiety.
Effects of Anxiety
Long term effect of Chronic anxiety can disrupt regular life and physiologically impact your blood cells, alter brain chemistry, increase risk of heart disease, increases blood pressure, worsen other conditions such as, migraine, headaches, asthma, insomnia, GI issues, type 2 diabetes and infertility in both men and women. On a cellular level, chronic anxiety can accelerate aging as it impacts telomeres (protective caps on our chromosomes), inhibit the cells ability to protect themselves from oxidation and impacts the serotonin levels which in turn will impact mood and emotional stability.
Medical Treatment for Anxiety
Psychiatric help is sought for anxiety. Counseling or medical tests can result is a more concrete diagnosis. After the diagnosis Psychiatrists use anti-depressant drugs in combination with Cognitive Behavioural Treatment (CBT) to clinically treat anxiety. Medicines such as, citalopram (Celexa) escitalopram (Lexapro) fluoxetine (Prozac) fluvoxamine (Luvox) paroxetine (Paxil, Pexeva) sertraline (Zoloft) have been used to treat anxiety. Although with anxiety one can feel ramped up and with depression one feels more down. But they do have many common symptoms and may induce similar brain chemistry. That’s why Psychiatrists use anti depressants to treat anxiety. There are also anti anxiety drugs such as, benzodiazepines, or “benzos,” which include Ativan, Xanax and Valium.
Types of Anxiety and Generalized Anxiety Disorder
Note that both anxiety and depression are not “a particular disorder” but they are generic terms for types of disorders.
Anxiety disorders are a group of mental disorders that triggers restlessness, discomfort and forms avoidance as a behavioural pattern. These mental disorders are, phobias, social event avoidance, separation anxiety disorder, panic disorder, obsessive-compulsive-behaviour, post traumatic stress disorder, acute or chronic stress and substance abuse restlessness. Anxiety means a person is on “high-alert” with increased awareness, racing heart and/or sweaty palms. It is important to understand that as with any mental health condition, anxiety is deeply personal and symptoms will vary from person to person. At its core anxiety triggers helplessness in a person. The most common form of anxiety is the Generalized Anxiety Disorder (GAD) that is seen in most people.
“Individuals with GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friendship problems, interpersonal relationship problems, or work difficulties. These symptoms must be consistent and ongoing, persisting at least six months, for a formal diagnosis of GAD.” – Osmosis.org
Why Anti Depressants are used for Anxiety Treatment?
In comparison, people with depression often experience low positive affect, feels fatigued, lethargic and un motivated. Depression triggers hopelessness in a person. The most common in depressive disorder is the Major Depressive Disorder (MDD).
The above-mentioned symptoms can tell these two disorders apart. However, there are also common symptoms in both disorders such as, fatigue, worry, irritability, lack of focus, lack of concentration and sleep disturbances. Psychiatrists also have noticed a pattern – that many people with anxiety will also have depression or vice versa. It could be because in both cases the body’s hormonal cycles are distributed. In both anxiety and depression people may have an over-sensitive stress response system. Many studies have also pointed out that lower levels of serotonin levels or how the brain releases norepinephrine are similar in both anxiety and depression. Hence anti depressants are being used to treat anxiety.
Modern Life and Anxiety
In todays date the rate of anxiety patient in rising. People are anxious about their health, safety, finances, work environment, politics and even relationships. 24/7 broadcasting on news, excessive need of digital connectivity and social media also adds to the cause. If you have a family member or a friend who suffers from anxiety, know that anxiety is no longer an individual issue but societal issue. Support people suffering from anxiety by listening to them and understanding what is the cause of their anxiety. Of course, one must consider medical help as well. But having support on individual level is important.
Gender and Anxiety
Anxiety can be seen in men due to substance abuse and addictive behaviours. But it maybe more common in women than men due to issues like sexual abuse, physical injury (head injuries are the worst) and hormonal changes during adolescent, pregnancy and menopause. Self-esteem, social status, insecurity, body image can cause anxiety in both genders.
Naturopathy – Treatment for Anxiety
Before considering the usual medical route if someone wants to consider a more natural way to combat or manage their anxiety, I have some recommendations. The first step would be keeping a log about the incidents with as many details as possible including date and time. This may not be comfortable or possible for some but an affective way to get to the route cause.
Practicing breathing exercise is utmost important for people with Anxiety. The Yogis call them Pranayama. It would fun to explore Pranayama and learn how many ways one can manipulate their breathing pattern. Two Pranayama that I recommend for anxiety are, Anulom Vilom (alternate nostril breathing) and Ujjayi (Ocean’s Breath).
Medical science is noticing the Gut-Brain connection and stating that the gut is our second brain. Therefore, eating fresh, seasonal foods as close to its natural state as possible is considered most healthy. Fresh fruits, steamed, lightly cooked vegetables, small number of nuts and seeds and small amount of grains (rice, wheat etc.), proteins (lentils, beans, meat, poultry and fish). Oats are fantastic food for the nervous system therefore adding often in the diet would be wise. Consider fatty and small fish at least 3-4 times a week. Apples are also high antioxidant and high fiber food that can boost memory. Replace caffeinated drinks, fizzy-carbonated drinks, pop, sparkling water with plain old water. A minimum eights cups of water is necessary for keeping the body alkalized. Additionally, in order to ensure good healthy bacteria’s in the gut by consuming fermented foods, such as, yogurt (if dairy is not the cause), kimchi, miso, apple cider vinegar, pickles, fermented rice, etc. Herbal teas such as lavender, chamomile, lemon balm, holy basil or tulsi are excellent to combat anxiety as they calm the nervous system.
In terms of supplements Omega 3 fatty acids are must – fish oil such as cod liver oil or salmon oil and flax oil are healthy for the nervous system. Additionally, eating magnesium rich foods such as, beans, almonds, tofu, flaxseed, pumpkin seeds, spinach, tuna fish, yogurt, avocadoes and my most favourite – dark chocolate (fair trade, no white sugar or dairy), will relax the muscles in the body and improve sleep. Intermittent fasting between sunset to sunrise will improve one’s blood sugar which in turn will improve focus, concentration, memory and sleep.
Once diet is improved look into exercise such as going for a brisk walk for a minimum of 15-20 minutes. Lifestyle changes, such as, yoga, meditation, swimming, cycling, getting rid of processed foods that has food additives, high salt, high sugar, high flour, high dairy content and food coloring would be a very wise step towards strong mental health.
To conclude I would like to remind the readers that it is important to differentiate the feeling of anxiety (reasonable response to a trigger) from someone who actually struggles with persistent and excessive worry about future events. Feeling anxious before public speaking, performing live, going on a date, writing an exam, going to an interview is natural. However, a person with anxiety that is clinical, struggle to cope with various stimuli surrounding them and experiences physiological and mental symptoms to gain control of their mind. It is a severe psychological battle they are fighting internally. Understand that they are not doing this to be difficult or seek attention as they would rather avoid any trigger to avoid these feelings. Therefore, listening without judging could be an ideal way to show support.
