Anxiety: It’s not all “in your head”

I’m concerned by the sudden rise of debilitating anxiety in the patients who walk through my door. These people are feeling deeply unstable, ungrounded, and unsafe. Anxiety is harming their relationships with people, with food, and their environment. They’re confused by the cause of their anxiety and are hoping that I have a pill to take it away. Though I often suggest a pill to help, the real value in our work comes from identifying and treating the underlying source of anxiety. For those of you struggling with anxiety currently, I’m sharing some of the common contributing physical causes that are often overlooked. (In other words, it’s not “all in your head” and we can do something about it.)

1. Hypoglycemia: For some people, low blood sugar levels are addressed as emergencies by the body and responded to with shots of stress hormone that feel like a panic attack or which wakes a person up in the middle of the night (often between 1am and 3am). Shifting your diet to include regular meals devoid of sugar and full of high-quality protein and fats, makes a huge difference for some people.
2. Inflammation: There are many mechanisms through which chronic pain and/or inflammation fools around with your mood. For example, people with anxiety tend to have higher amounts of an inflammatory chemical called interleukin-6. Other people experience a deficit of serotonin when inflammatory pathways steal serotonin precursors (tryptophan), to address infection. (The end-product of this pathway, quinolinic acid, is a potent neurotoxin.) And people who are regularly exposed to allergens experience anxiety through the production of too much histamine. My job is to identify and address these sources of inflammation.
3. Gut-brain Axis: The digestive tract and brain are connected in fascinating ways and this axis is a common source of systemic inflammation. Abnormalities in our microbiome, for example, (which includes trillions of bacteria in our gut), are linked to various mental illnesses including anxiety, by hundreds of research studies. There are even bacteria in there (Clostridia ), known to inhibit dopamine metabolism, which can stimulate the nervous system and create the sensation of anxiety.
4. Peri-menopause: Estrogen and progesterone are as much neurotransmitters as any of the others you may have read about. These hormones affect, and are affected by, serotonin and dopamine levels, which is why it’s so common for women to use anti-depressants to treat hot flashes, or why depression is a common side-effect of the birth control pill. Our goal is to help the body balance out its metabolism of these hormones.
5. Gluten intolerance: This protein (i.e. gluten and gliadin), and the pesticide frequently present on gluten-containing grains (glyphosate), has come under fire recently in the popular press. Though the research is mixed, it’s clear that glyphosate harms the microbiome and that gluten is a potent neurotoxin for some individuals. For mood concerns that resist treatment, experimenting with a 3-month elimination of this dietary protein is often worthwhile.
6. Finally, please don’t overlook the impact of your environment on your mood. This can include anything from certain people and places, to exposure to moulds, allergens, and electromagnetic frequencies. Our body is designed to reflect and respond to our environment on a second-to-second basis, even if our cultural tendency is to ignore this evolutionary reality.

All of your symptoms, which include digestive upsets, aches and pains, sleep quality, and energy levels, tell a story that lead us to these underlying causes.  Sometimes testing is helpful, and I often use the Organic Acids Test (which offers insight into your microbiome and unique biochemistry), or the DUTCH hormone test (“Dried Urine Test for Comprehensive Hormones”), to lend additional clarity. Or sometimes just a little tweaking and application of thousands of years old wisdom, is all it takes to help the body start to repair.