Although anxiety is considered a normal reaction to the stress of daily life it can develop into a disorder when it becomes excessive.
CONDITION OVERVIEW
In the ebb and flow of life, many people encounter occasional bouts of anxiety and stress when faced with the pressures of work deadlines, exams, or personal challenges. These emotions are often temporary and tend to dissipate once the stressor is no longer present. However, for individuals grappling with chronic anxiety, these feelings persist and spiral out of control, leading to significant distress and disruption in their lives.
In our rapidly evolving world, anxiety disorders have surged to unprecedented levels. The iconic artwork "The Scream" by Edvard Munch has come to symbolize the pervasive sense of anxiety and uncertainty in the modern era. This surge in anxiety can be attributed to two major societal shifts: the digital age and urbanization, both of which bring their own set of challenges. The omnipresence of social media and the vast ocean of information at our fingertips have driven many into the throes of anxiety, marked by an overdependence on screens and a constant state of overstimulation. Additionally, the rise of urban living, fueled by a culture of fear stemming from the "war on terror" and rampant consumerism, has further contributed to soaring anxiety levels.
It is imperative to distinguish between the normal experience of situational anxiety and the symptoms of an anxiety disorder, as anxiety is a common facet of the human experience. Anxiety disorders encompass a spectrum of conditions characterized by persistent feelings of heightened anxiety, fear, worry, discomfort, and tension. These disorders are diagnosed when these reactions become frequent over an extended period (typically at least six months), are disproportionate to the triggering situations, and significantly disrupt daily life. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, specific phobias, obsessive-compulsive disorder, and post-traumatic stress disorder.
Existential anxiety, often referred to as existential angst, represents the pinnacle of anxiety, involving intense feelings of panic, restlessness, and dread about the nature of individual existence or the human condition as a whole. Even individuals who do not meet the diagnostic criteria for an anxiety disorder may benefit from treatment to manage their anxiety symptoms and prevent the development of more severe mental health conditions.
ANXIETY IS A COMMON PART OF LIFE FOR MANY PEOPLE
In Australia, anxiety disorders are very common, affecting around 3.2 million people (13.1%) in 2017-2018. This number has increased, especially among younger individuals, from 11.2% in 2014-2015. Many more people also experience periods of anxiety but don't seek help for it.
About 40% of the population may have a panic attack at some point in their lives, and 10% experience social phobia at some point. Additionally, around 12% of Australians will go through post-traumatic stress during their lifetime. Depression and anxiety often go hand in hand because they have similar causes and symptoms. More than half of those dealing with depression also experience anxiety symptoms.
Surprisingly, 40% of Australians consider anxiety as a personality trait rather than a mental health issue, leading to the misconception that it can't be treated. In reality, it is possible to change anxious thoughts and behaviours.
Anxiety is a complex experience that humans have been dealing with for thousands of years. It's a natural response to perceived or real threats. When stressed, the body activates the hypothalamus-pituitary-adrenal (HPA) axis, releasing hormones and neurotransmitters like adrenaline and cortisol (known as the fight, flight, freeze response). These hormones increase heart rate, breathing, blood pressure, metabolism, perspiration, muscle tension, and pupil dilation. Anxiety is the signal that the stress response has started. This is a normal and healthy reaction to stress. Moderate anxiety can enhance alertness and performance, and even high anxiety can be appropriate when it matches the demands of the situation.
The key is that a healthy stress response involves calming these hormones once the threat is gone.
SYMPTOMS OF ANXIETY
Anxiety disorders can appear suddenly without an obvious cause. The symptoms vary depending on the type of anxiety disorder but often involve strong physical sensations, such as:
Difficulty breathing, like shortness of breath or hyperventilation
Heart palpitations (a racing heart)
Sweating
Shaking or trembling
Nausea and a feeling of choking
Upset stomach or diarrhea
Frequent need to urinate
Dizziness or feeling lightheaded
Tingling or numbness in the body
Feeling like you're losing control or impending doom
Feeling disconnected from reality
Worrying about going crazy or dying
Trouble concentrating
Restlessness and always being on edge
Racing thoughts and repetitive behaviors
Fluctuating between feeling hot and cold
Dry mouth
Constant worrying
Muscle tension
Trouble sleeping (insomnia)
Avoiding social situations
Experiencing depression
Reduced interest in sex
Easily getting irritated
Heightened sensitivity to pain
Loss of appetite
Blurry vision and visual disturbances
WHAT ARE THE RISK FACTORS?
Genetics: Some anxiety disorders tend to run in families, similar to how certain medical conditions like diabetes and heart disease can have a genetic component. People may also learn anxious responses from their family members, although having a relative with anxiety doesn't guarantee others will develop it.
Stress and Trauma: Stressful life events, ongoing stress, and traumatic experiences can contribute to the development of anxiety disorders, particularly post-traumatic stress disorder (PTSD). Events like divorce, work/school pressure, and financial difficulties can trigger anxiety. Early-life stress and trauma can also increase the risk of anxiety later in life.
Physical Health Issues: Chronic physical illnesses such as diabetes, asthma, heart disease, and cancer can contribute to anxiety conditions. Some physical conditions, like an overactive thyroid, can mimic anxiety symptoms, so it's important to consult a doctor to rule out any medical causes.
Neurotransmitter Imbalance: While not fully understood, there's a hypothesis that some anxiety disorders may be linked to a chemical imbalance in the brain. Abnormal functioning of neurotransmitters like serotonin, norepinephrine, dopamine, and gamma-aminobutyric acid (GABA) may play a role in these disorders. However, tests measuring neurotransmitter levels in urine, saliva, or blood are controversial and not reliable indicators.
Gender and Hormone Imbalance: Women tend to have higher rates of anxiety disorders and depression. Hormonal imbalances in thyroid, adrenal, and sex hormones can lead to mood disorders, especially if symptoms worsen during certain hormonal phases.
Brain-Gut Connection: Recent research highlights the link between gut health and anxiety and depression. The gut microbiome's impact on the brain's function and the presence of serotonin receptors in the gut suggest a connection. Nutrition and diet can significantly affect mood.
Inflammation, Allergies, and Infections: Conditions involving infections, allergies, and immune dysregulation can increase the risk of anxiety disorders. Increased cortisol and inflammation can disrupt neurotransmitter production.
Blood Sugar Imbalances: High glycemic index (GI) diets have been associated with higher odds of anxiety and depression. Consuming foods with progressively higher GI values may contribute to mood disorders.
Nutrient Deficiency: Deficiencies in omega-3 fatty acids, B vitamins, minerals, vitamin D, and amino acids that affect neurotransmitter production can impact mental health. Some individuals with suspected pyroluria may have issues with zinc and B6 levels, which are crucial for preventing anxiety.
Substance Abuse and Addictions: Anxiety disorders and substance use disorders often co-occur. People may use drugs or alcohol to self-medicate anxiety symptoms, complicating diagnosis and treatment.
Personality Factors: Certain personality traits, such as perfectionism, emotional sensitivity, and negative thinking patterns, can make individuals more susceptible to anxiety disorders. Childhood experiences and inhibited/shy temperaments can also play a role.
Age: The prevalence of anxiety disorders decreases after the age of 50 in epidemiological studies.
WHAT IS THE CONVENTIONAL TREATMENT FOR ANXIETY?
Most patients with anxiety disorders respond to psychological therapy, medication, or a combination of both.
Psychological treatments typically include multiple elements and are tailored to the patient's preferences and needs.
Cognitive-behavioral therapy (CBT) is often the first-line psychological treatment, showing efficacy in various anxiety disorders. It aims to change thought patterns, behaviors, and beliefs that trigger anxiety.
Medications like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are recommended for anxiety, especially when symptoms are severe or associated with depression. These medications are typically started at low doses and increased gradually.
Sedatives and anti-anxiety medications like benzodiazepines (e.g., Valium, Xanax) can provide temporary relief but are not recommended for routine use due to the risk of dependence after a short period.
Other medications may be considered if SSRIs are ineffective or not suitable.
Medication does not cure anxiety disorders but can help manage symptoms while the patient receives psychological treatment. Improvement often takes four to six weeks.
Support, education, and community understanding are vital aspects of treatment for anxiety disorders.
Interestingly, about 25% of anxiety sufferers experience significant relief from a placebo (dummy) intervention, highlighting the mind's power in managing anxiety.
HOW CAN A NATUROPATHIC APPROACH SUPPORT TREATMENT OF ANXIETY?
Successful naturopathic treatment of anxiety involves a holistic approach focusing on good habits and overall well-being.
Treatment starts by addressing underlying causes such as stress, trauma, inflammation, caffeine, alcohol, and other factors.
Herbal medicines can complement conventional treatments or serve as alternatives, but herb-drug interactions should be considered when taken alongside pharmaceutical medications.
Education plays a crucial role in helping individuals understand anxiety and its adaptive aspects, like the fight-or-flight response.
Dietary adjustments are essential, with an emphasis on brain-boosting foods like whole grains, lean meat, fish, vegetables, berries, nuts, and low glycemic index options.
Nutrients like omega-3 fatty acids, magnesium, B vitamins, folate, and protein are vital for mental health and neurotransmitter function.
Avoiding a Western-style diet with fast foods, sugary treats, and processed foods is recommended, as such diets are associated with a higher risk of anxiety and depression.
Counterfeit support and stimulants like caffeine, alcohol, and recreational drugs should be avoided, as they can worsen anxiety symptoms.
Address inflammation and food intolerances to reduce systemic inflammation, which may contribute to thyroid, immune, or adrenal issues.
Assess and correct nutritional imbalances and oxidative stress, often through supplements like magnesium and omega-3 fatty acids.
Optimize lifestyle habits, including regular exercise, improving sleep quality, relaxation techniques (e.g., meditation, yoga), and reducing screen time.
Investigate potential environmental toxicity and minimize exposure to neurotoxic agents such as heavy metals and chemicals.
In summary, naturopathic treatment for anxiety involves a holistic approach that includes dietary changes, nutritional support, lifestyle improvements, and herbal remedies, all tailored to the individual's specific needs and circumstances. Education and addressing underlying causes are also integral to effective treatment.
WHAT HERBS HAVE BEEN SHOWN TO BE HELPFUL BASED ON RESEARCH?
Herbs can provide benefits to support with the day to day symptoms presented with anxiety and anxiety disorders;
Generalized Anxiety Disorder:
Herbs: Ginkgo Biloba, Gotu Kola, Oats Seed, Passion Flower, Withania.
Actions: Anxiolytic, Nootropic, Adaptogen, Nervine Tonic.
Anxiety and Depression:
Herbs: Bacopa, Gotu Kola, Lemon Balm, Motherwort, Magnolia.
Actions: Antidepressant, Anxiolytic, Nootropic, Nervine Tonic.
Insomnia:
Herbs: Bacopa, Lemon Balm, Californian Poppy, Chamomile, Oats.
Actions: Sedative, Relaxing Nervine, Nervine Tonic.
Desired Herbal Actions and Potential Herbs Include:
Adaptogens: Astragalus, Codonopsis, Gotu Kola, Korean Ginseng, Passion Flower, Reishi, Rhodiola, Schizandra, Shatavari, Siberian Ginseng, Withania.
Adrenal Tonic: Licorice, Rehmannia.
Antidepressants: Damiana, Lavender, Lemon Balm, Oats, Perilla, Rosemary, St. John's Wort, Vervain.
Anxiolytic (thymoleptoic): Angelica, Bacopa, Chamomile, Ginkgo, Hops, Magnolia, Passion Flower, Rhodiola, Sage, Valerian, Zizyphus.
Nervine Tonics: Bacopa, Baical Scullcap, Chamomile, Damiana, Lavender, Mugwort, Muira Puama, Oats, Passion Flower, Rosemary, Schizandra, St. John's Wort, Valerian, Vervain, Wild Yam, Withania.
Nootropic (cognitive enhancing): Bacopa, Ginkgo Biloba, Green Tea, Lemon Balm, Muira Puama, Rosemary, Sage.
Relaxing Nervines: Californian Poppy, Chamomile, Hops, Hyssop, Jamaica Dogwood, Lavender, Lemon Balm, Lime Flowers, Mistletoe, Motherwort, Oats, Passion Flower, Scullcap, Valerian, Vervain, Withania.
Sedative: Bacopa, Boldo, Chamomile, Californian Poppy, Hops, Jamaica Dogwood, Lavender, Lemon Balm, Magnolia, Passion Flower, Paw Paw, Scullcap, Valerian, Zizyphus.
Temple Door works closely with a range of herbal and nutritional remedies to act as a support to symptoms of anxiety and can assist in creating a holistic management plan to support you in day to day life.
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