The Solution to Your Anxiety is More Than Just a Pill

Excessive worrying, agitation, restlessness, fatigue, difficulty concentrating, irritability, tense muscles, insomnia, social avoidance, and irrational fears- do any of these feelings sound familiar? These are all common symptoms of anxiety. While short-term anxiety may be common, ongoing symptoms should not be ignored.

But traditional medicine may not be the answer for everyone. Five people can be diagnosed with anxiety and have five different causalities. Yet, a traditional doctor will prescribe all five the same anti-anxiety medication. In this blog, we have broken down the most common roots of anxiety- and how to functionally solve them.

Anxiety in 2021

Through the ongoing COVID-19 pandemic, rates of anxiety have skyrocketed. Back in June 2020, the US saw a 457% increase in anxiety and depression screenings from January 2020. 80% of participants screened positive for moderate to severe anxiety. This increase in anxiety diagnosis also came with a rise in anti-anxiety medication, specifically benzodiazepines. Even before the pandemic, benzodiazepines were prescribed at 66 million doctors’ appointments each year. 27% of all doctor’s appointments in 2019 resulted in a benzodiazepine prescription.

Benzodiazepines include popular medications like Valium, Xanax, Ativan, and Klonopin. They work by enhancing the activity of GABA, the central nervous system’s main inhibitory neurotransmitter. By augmenting GABA, benzodiazepines slow down brain activity like rational thought, memory, and emotions. But breathing and alertness are also hindered by benzodiazepines. This makes benzodiazepines a potentially very dangerous solution to anxiety. Benzodiazepines are also highly addictive, as tolerance is easily built up and a higher dosage is consumed. Other side effects of benzodiazepines include:

• dependence

• memory impairment

• weight gain

• fatigue

• withdrawal

• seizures

• suicidal ideation

• reduced or increased heart rate

• low blood pressure

• overdose

Beyond harmful and potentially life-threatening side effects, anti-anxiety medications also avoid the true root of anxiety. Such drugs dull the mind and stop anxious thoughts and feelings from occurring temporarily, but it does nothing to alleviate symptoms of anxiety in the long run.

Anxiety from a functional perspective

In the conventional understanding of anxiety, an imbalance of neurotransmitters in the brain is pointed to as the origin. And medications that affect those neurotransmitters are applied. While some anxiety does originate in the brain, the majority occurs from multiple sources outside of the brain but effects the neurotransmitters.The most common origins of anxiety include:

• Gut issues

• HPA axis

• Hormone imbalance

• Nutrient deficiency

• Toxins

Gut issues & anxiety

The gut is often referred to as the enteric nervous system (ENS). It actually contains two thin layers of over 100 million nerve cells that line your gastrointestinal tract, all the way from your esophagus to your rectum. While the ENS doesn’t function like the central nervous system, in terms of thoughts, the two systems are constantly in communication with each other. Emotional shifts may be triggered by issues within the ENS like irritable bowel syndrome or gut inflammation.

The gut also contains around 400 times more serotonin than the brain. This serotonin and dozens of other neurotransmitters are all produced in the ENS. GI disturbances can cause production problems in the gut, which will then affect the availability of these neurotransmitters in the brain and can suppress the activity of the frontal cortex.

When the brain is lacking vital neurotransmitters produced in the gut, mood disorders like anxiety can result. Proper digestive function allows our brains access to chemical signals that help us feel optimistic, motivated, and at ease. Some steps you can take to promote gut health (and subsequently ENS health) are:

• Eat more fiber which feeds the beneficial bacteria such as whole nuts, vegetables, beans, and fresh fruits.

• Limit your sugar and fat intake

• Careful with gluten

• Consume more fermented foods like kefir, kimchi, and kombucha

• Eat more foods with polyphenols, like dark chocolate

• Consume spices that rid the gut of harmful bacteria like garlic, turmeric, and ginger

• Remove artificial sweetener intake

HPA axis & anxiety

The HPA (hypothalamic pituitary adrenal) axis is the system that controls our tolerance and response to stress. The HPA axis is better known as our fight or flight response. In daily life, it is constantly working to ensure a reasonable reaction to common stressors by controlling the production of stress hormones like cortisol, norepinephrine and epinephrine.

But the HPA axis is not perfect and stress response can be inadequately activated by your diet, exposure to toxins, hormonal imbalances, and sleep cycle disruption. All these factors will impact how much cortisol is released in the brain. Because cortisol receptors are throughout the entire body, it can cause effects like high blood pressure and high blood sugar. Further, the body isn’t meant to handle chronic stress. Constant exposure to stressors can hinder the production of many other hormones and neurotransmitters in the body.

The body can only handle so much cortisol regulation and stress response. Over time these processes will deteriorate, causing your stress hormone levels to remain consistently high. This lack of regulation will lead to long-term feelings of anxiousness and anxiety.

Some steps you can take to ease the HPA axis and your response to stress are:

• Reduce your exposure to stress

• Manage stress with yoga, meditation, or mindfulness

• Regulate light exposure, blue light can raise cortisol levels

• Reducing inflammation with your diet will help regulate your blood sugar and regulate the HPA axis

• Work on gut health by removing inflammatory foods and promoting the health of your beneficial bacteria.

Hormone imbalance & anxiety

There are three main types of hormones that will affect your body’s susceptibility to anxiety: stress hormones, sex hormones, and thyroid hormones.

• Stress hormones: As described above, cortisol is released in response to mental and physical stress. Excess cortisol in the body can lead to chronic anxiety. Adrenaline is also released in stressful or threatening situations. Similar to cortisol, excess adrenaline will affect your body’s ability to function normally.

• Sex hormones: Estrogen, progesterone, and testosterone when imbalanced will affect your susceptibility to anxiety- regardless of your gender. Too little testosterone has been linked to increased anxiety. Testosterone also has a contradictory response to cortisol; increased cortisol leads to slowed testosterone production. Moreover, testosterone has partial control over cortisol released- so low levels of testosterone lead to increased cortical levels. Estrogen has been linked to higher levels of serotonin, and normal levels of estrogen promote healthy cortisol levels. But too much estrogen also leads to increased cortisol levels in the blood. Progesterone is similar to cortisol; they are both steroid hormones made from cholesterol. Progesterone is released naturally in a woman’s ovulation cycle, but too much progesterone has been linked to increased cortisol levels.

• Thyroid Hormones: Both an overactive and under-active thyroid function can contribute to symptoms of anxiety. Hyperthyroidism (overactive thyroid) increases the body’s metabolism to the point where the entire sympathetic nervous system is more active. This over-activeness will cause the entire body to be under stress. Hypothyroidism (under-active thyroid) will also put the body under stress, as the thyroid glands fail to produce enough hormones to properly regulate. Anxiety is typically associated with hyperthyroidism, while depression correlated with hypothyroidism. An overactive thyroid can also contribute to physical symptoms of anxiety, such as an increased heart rate, shakiness, sweating, and heart palpitations.

While hormones can be artificially regulated with supplements, there are several ways to regulate your hormones naturally. These methods include:

• Avoiding inflammatory foods

• Eat foods rich in antioxidants

• Increase fiber in your diet

• Avoid eating non-nutritive sweeteners

• Adaptogens which are herbs that can modulate and balance hormones

• Avoid exposure to endocrine disruptors by:

  • Limiting plastic use

  • Avoiding canned foods

  • Eating organic foods

  • Avoiding non-organic cleaning supplies

Nutrient deficiencies & anxiety

Dozens of nutrients play very important roles in your mental health. Deficiencies in these minerals and vitamins can affect your mental and physical energy, biochemical balance in the brain, and levels of anxiety. Some key nutrients for your mental health include:

• B Vitamins: B vitamins play a vital role in the production of mood-affecting chemicals like serotonin. Vitamin B-1 is essential for energy production. It’s also sometimes referred to as the “anti-stress” vitamin, as it often has calming and soothing effects. Hormone balance and detoxification processes also heavily rely on B vitamins. Vitamin B-6 is vital for the normal function of neurotransmitters. One study found that a deficiency in vitamin B-6 can lead to irritability, depression, anxiety, short-term memory loss, and trouble concentrating.

  • B vitamins are naturally found in many foods including:

    • Liver

    • Sardines

    • Lamb

    • Wild-caught salmon

    • Nutritional yeast

    • Feta cheese

    • Grass-fed beef

    • Eggs

• Iron: The health of your brain and nervous system both heavily rely on iron. Iron assists red blood cells in carrying blood to the brain and other organs. Too little iron can lead to less available oxygen throughout the body. Unsurprisingly, too little oxygen in the brain will lead to neurotransmitter signaling problems and brain energy metabolism. Multiple studies have linked poor iron to mood disorders like anxiety. Too much iron has also been linked to symptoms of anxiety and emotional disorders.

  • Iron is naturally found in many foods including:

    • Oysters, mussels, and clams

    • Liver, beef, and chicken

    • Eggs

    • Spinach

    • Pumpkin

    • Squash

    • Pine nuts

    • Pistachios

    • Cashews

• Iodine: Iodine is an essential component for the production of the thyroid hormone. As discussed above, stable thyroid is essential in promoting mental health.

  • Iodine is found in the following foods:

    • Seaweed

    • Shrimp

    • Cod

    • Organic eggs

    • Cranberries

    • Tuna

    • Bananas

    • Prunes

• Vitamin D: Vitamin D serves a range of vital purposes in our body, including mood regulation and brain and nerve health. Multiple studies have linked Vitamin D deficiencies with symptoms of anxiety. This may be why seasonal anxiety and depression are so commonplace. One study suggested over 70% of all adults and 67% of children are deficient in the vitamin . Likely because Vitamin D is difficult to obtain from diet alone, and requires supplementation. Click here to see our vitamin D supplement offerings.

• Selenium: Selenium is a mineral that is vital for mental health, metabolism, and thyroid function. Selenium reduces inflammation, which is commonly seen in those with anxiety and other mood disorders. The mineral also has antioxidant properties, which work to prevent cell damage and cancer. Studies have linked selenium intake with an elevation of mood and a decrease in anxiety.

  • Selenium is found in the following foods:

    • Brazil nuts

    • Mushrooms

    • Oysters and tuna

    • Beans

    • Sunflower seeds

    • Meat

• Magnesium: This mineral is commonly known as “nature’s valium”, thanks to its widely known benefits on mood and stress. Magnesium blocks the stimulation of neurotransmitters and binds to calming receptors, which results in an overall more calm state. The mineral also plays a role in the regulation of stress hormones. A 2017 review that examined 18 different studies found that magnesium does reduce symptoms of anxiety.

  • Magnesium is found in the following foods:

    • Dark chocolate

    • Avocados

    • Nuts

    • Legumes

    • Tofu

    • Seeds

Toxins & anxiety

Increased exposure to environmental toxins can lead to excess stress and inflammation in the body. These compounds can also impact the HPA axis and have severe effects on the development and function of the human brain. Toxic chemicals like pesticides and metals can significantly impact neurological and neurotransmitter health and lead to disorders like anxiety. Mold has also been linked to harming brain health.

Toxins that have been linked to anxiety include:

• Herbicides and Insecticides- Pesticides have been found to hinder the normal function of the HPA axis. Evidence suggests that even low-level exposure, if long-term, can lead to psychiatric disorders like anxiety and depression. Studies have demonstrated that farmers are statistically more likely to suffer from a mood disorder like anxiety.

• Heavy metals- Metals like cadmium, manganese, arsenic, mercury, and lead have all been linked to anxiety. Unfortunately, these metals are commonly found in our food and water and the air we breathe. We are most likely to be exposed to cadmium, as it is found in shellfish, rice, wheat, and cigarette smoke. Cadmium and other metals will build up in the brain over time and hinder brain function.

• Mold- Similar to metal, mold toxins will accumulate in the brain, and hinder function. Brain scans have demonstrated mold can cause swelling of the brain, which will lead to a loss of blood flow to vital sections like the prefrontal cortex.

• Other toxins that will impact brain health and increase your risk of anxiety:

  • Fuels

  • Paint thinner

  • Carbon monoxide

  • Cleaning products

  • Nail polish remover

  • Perfumes

  • Drugs and alcohol

Genetic Variations:

Some people may also genetic variations that can lead to symptoms of anxiety. The most common is a variation in the gene that codes for the liver detoxification enzyme CYP1A2. CYP1A2 accounts for 95% of all caffeine metabolism. A common variation in the gene determines if you are a fast, medium, or slow metabolizer of caffeine. For those who are moderate and slow metabolizers of caffeine, even one cup of coffee can lead to anxiety and accompanying symptoms like jitteriness and increased heart rate. To read more about CYP1A2, click here.

If you're diagnosed with anxiety or think you might be suffering from the disorder, before you take a prescription medication, consider delving into the potential roots of what's causing the disorder. At the Johnson Center, Dr. Johnson will explore every possible causation behind your symptoms and treat the real problem, instead of band-aiding your symptoms in the short term.

To learn more about Dr. Johnson's approach to anxiety, click here to schedule your complimentary 15-minute discovery call with Dr. Johnson.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!