How to Cope with Anxiety Using Naturopathic Medicine

The prevalence of stress and anxiety disorders has skyrocketed over the last couple of years. Anxiety disorder is one of the most common psychiatric disorders.

• In Canada alone, about 12% (3 million Canadians) of the entire adolescent and adult population are being diagnosed with an anxiety disorder on a yearly basis.
• Of people diagnosed with anxiety disorders, about 27% of them have felt apathy in their life in the past few months.

Understanding Anxiety: Where Does It Come From?

A sensation of apprehension, fear and fright, defined by corporeal (physical) signs such as palpitations, sweating, and feeling of stress is called anxiety.

The story of anxiety starts with two small almond-shaped organs on either side of your brain, called the amygdala (almond in Latin) which play a crucial role in processing emotions.

Conditions such as anxiety, autism, depression, post-traumatic stress disorder, and phobias are all associated with abnormal functioning of the amygdala, which causes developmental problems and neurotransmitter imbalance.

The amygdala serves as a natural electronic surveillance system and warns you against anything that seems to threaten your safety or survival.

Some warnings or threats are genetically programmed like someone raising their voice at you, the odour of smoke or sighting a fire where it isn’t supposed to be.

Others are learned with life experiences, such as sounds, images, facial expressions, and physical gestures. Your brain consciously or unconsciously starts relating this perception with a trauma or a threat in past.

It is in the amygdala that the remembrance of post-traumatic stress is formed by the brain and within seconds of comprehending the threat, the brain warns the hypothalamus (a small gland in front of the brain) which later passes the signals to the pituitary gland (called the master gland, present quite close to brain) and all the way down to the adrenal glands, which provide fuel to escape or fight the threat (thus called the fight & flight gland).

It’s absolutely normal to feel stressed or irritated when something upsets you. However, there are many people who keep feeling uneasy or worried day after day, even with no specific trigger. When this anxiety lingers for 6 months or more it may be generalized as "anxiety disorder". Luckily, there are ways to cope with anxiety disorders which we outlined in this blog post.

In anxiety, the body provokes an automatic fight or flight response to an anticipated feeling of being in danger. This danger can include being under pressure, being faced with a challenging situation, or when feeling threatened.

In moderation, anxiety is normal and is surely useful to stimulate purposeful actions, keep you focused, and motivate you to solve problems. This is how evolution has trained us to protect ourselves and help direct us towards positive change.

While anxiety can be normal in moderation, when it is continual or overwhelming, it starts to creep into the territory of an anxiety disorder.

People with anxiety disorders can engage in catastrophic thinking by over-predicting the negative consequences of certain life events. It is quite crucial to acknowledge when the anxiety starts to take over and lead to catastrophizing.

Symptoms of anxiety can be felt on a psychological and physical level which may include any of the following symptoms:

• Heart palpitations
• Shortness of breath
• Sweating
• Dry mouth
• Light-headedness
• Diarrhea
• Nausea
• Flushes
• Feeling shaky
• Restless
• Excessive worry
• Sleep disturbance
• Fatigue
• Difficulty concentrating
• Irritability
• Muscle tension
• Dizziness

Diagnosing Anxiety

Anxiety disorders are a group of related conditions that involve a lasting worry or fear and can vary greatly from person to person. There are several different types of anxiety disorders that are described in the Diagnostic and Statistical Manual of Mental Disorders. They include:

• Generalized Anxiety Disorder (GAD)
  • Excessive worry about a number of events or activities that distract you from your day-to-day life.
  • Constant feeling of anxiety.
  • People with GAD find it difficult to cease the worry cycle and sense it’s beyond their control.

• Obsessive-compulsive (OCD)
  • Recurrent or persistent thoughts, sensations (obsessions) or the impulse to do something over and over again (compulsions).

• Panic Disorder (PD)
  • Repeated and unexpected panic attacks (feeling of terror when in actuality there is no real danger).
  • Characterized by faster heartbeat, chest pain, dizziness, sweating.
  • People with panic disorder usually live in a fear of another attack and may refrain from places where they have had an attack.
  • More common in women than men.

• Post-Traumatic Stress Disorder (PTSD)
  • Re-experiencing memories of the traumatic event.
  • Nightmares about the traumatic event.
  • Self-destructive practices.
  • Trouble in concentrating and sleeping.
  • Irritability or aggressive behaviour.
  • Overwhelming guilt or shame.
• Social Anxiety Disorder (SAD)
  • Fearful of social situations in which you may feel embarrassed or judged by those around you
  • Can be hard to make new friends when trying to avoid social settings
  • People with SAD don’t like being the center of attention.

Learn more about social anxiety disorder in our previous blog, Understanding Social Anxiety Disorder: It's More Than Being Shy.

Causes of Anxiety

Anxiety can have many different root causes ranging from lifestyle to genetic factors.

• Genetic predisposition
  • Certain genetic markers and genetic makeover increase the likeliness of developing anxiety. A genetic predisposition usually gets inherited from parents.

• Neurotransmitter Imbalances
  • Neurotransmitters are the chemicals in the brain that influence and control one’s Dopamine (influence body's energy level, movement and attention), GABA (maintain a balance between one’s excitement/anxiety & relaxation/calmness) and Serotonin (influence one’s sleep, mood and appetite) are all “calming” neurotransmitters and their imbalance leads to anxiety.
• Adrenal Gland Dysfunction
  • Adrenal glands are the small glands located above both kidneys, secrete hormones namely, Aldosterone (regulates blood pressure), Cortisol (effect metabolic rates of proteins, fats and sugars), and Androgens (primarily responsible for the embryological development of male sex organs and male secondary sexual characters at puberty) modulate the body’s reaction to stress.
  • Depletion of essential nutrients like Vitamin B₅ and B₆, Vitamin C and Magnesium (caused due to anxiety and stress) can impair the smooth production and functioning of adrenal gland hormones.

• The gut is often referred to as our “second brain”. The bacteria in our gut produce many of the same hormones that our brain does, like Serotonin and GABA. In fact, about 90% of our serotonin is made in the gut. Inflammation in the gut can lead to the walls of the gut becoming leaky. This allows toxins to enter our circulation and reach the brain. When the brain is under immediate stress it sends signals to the gut. This is why a stressful situation and/or anxiety can often trigger an upset stomach and other digestive issues.

Naturopathic Treatments for Anxiety

First-line treatment from a conventional medicine point of view is pharmaceutical drugs, including benzodiazepines (ex. Ativan) and antidepressants (ex. Prozac).

These drugs work through several different pathways and work to manage symptoms in the present moment. In combination with medications, or before turning to medications, patients may wish to explore alternative or holistic treatment options.

The premise of Naturopathic medicine is to treat the whole person and address the underlying causes of disease. Naturopathic Doctors have a toolbox of natural therapies for addressing anxiety including, clinical nutrition, supplementation, botanical medicine and counselling. We have Naturopathic Doctors at HealthOne who can help you.

Keep in mind that not everyone who worries a lot needs to be diagnosed with an anxiety disorder. As said earlier, feeling anxious because of certain situations or in excessive pressure situations is completely normal.

Below are some tips that can help lower anxiety whether it’s short term or chronic.

Be Mindful of Your Thoughts

Our minds may be telling us a story that is not necessarily rooted in the reality of a situation. We have control over our thoughts, even though sometimes this may seem rather impossible. It is important to understand that worrying about something won’t necessarily give you the outcome you desire.

The anxious mind will often fill in the blanks of ‘what if’ with worst-case scenarios. Here are some questions you can ask yourself when you see yourself catastrophizing:

• Are these worries within my control?
• Is this reality or is my brain creating a story for me?
• What positive actions can I talk away from this?
  

COVID-19 and Anxiety

With respect to this current pandemic, a lot of people are worrying about their own health, the health of loved ones both near and far, financial strain, and a whole lot of uncertainty in the near and far future.

It is important to focus on the things you can control right now vs. dwelling on the “what ifs”. Having a plan in place can help you feel more in control of the situation.

For people suffering from anxiety, the unpredictability of the coronavirus is the hardest thing to handle. We don’t know how exactly we’ll be affected or how bad things might get.

HealthOne has previously shared a few things that you can do to manage your anxiety and fears.

• Stay informed but don’t obsessively scan the news.
• Stick to reliable sources such as the World Health Organization.
• Restrict how often you check for updates.
• If anxiety is an issue, limit media watching time (thirty minutes a day).
• Be mindful of what you share.
• Focus on the things that are under your control.

Deep Breathing 4-7-8

In today’s fast-paced environment it is very common to lose track of our breathing.

It is so important to take a couple of minutes out of your day to just focus on your breath in order to feel more balanced and feel calm during anxious times.

If the mind feels anxious, so does the body.

This breathing technique, called 4-7-8 can come in handy during anxiety attacks and also practicing at least once daily either before bed or first thing in the morning can lead to feeling calmer overall.

Try the following steps:

• Sit upright with your shoulders back or lie down. Your body should be as relaxed as possible.
• Close your eyes and scan the body for tension.
• Pay attention to your breathing. Place one hand on your chest and one hand on your abdomen.
• Inhale deeply through your nose for 4 seconds.
• Hold your breath for 7 seconds.
• Exhale through your mouth for 8 seconds.
• Concentrate on breathing into the belly and not the chest.
• Repeat these steps 3 times.

Exercise Regularly

This is one of the best and easiest ways to reduce stress and balance hormones that are associated with worry and anxiety.

Aim to engage in some sort of physical activity of your choosing – any type counts! Aim to achieve at least 30 minutes of aerobic exercise most days of the week. Try walking, running, swimming or dancing, and read this blog for more tips on how to enjoy exercise!

Prioritize Sleep

Sleep is the time the body can rest and restore while repairing itself through rebuilding tissues and breaking down accumulated toxic chemicals and hormones.

Studies show that 7 hours of restful sleep a night is the magic number required by our bodies. Not getting enough sleep results in increased stress and anxiety. Make sure to build a consistent, regular sleep pattern every night.

Limit Stimulant Intake

Assess the frequency of stimulant consumption, such as caffeine and nicotine. If you struggle with anxiety, try to eliminate these stimulants for some time.  Green tea is a great alternative to coffee.

It does contain some caffeine but also has L-Theanine, which is an amino acid used to combat anxiety and induce relaxation.

Address Diet

An anxiety attack can be triggered by low blood sugar resulting from an improper ratio of simple carbohydrates to protein and fats.

It is important to focus on eating adequate amounts of proteins (Greek yoghurt, eggs, vegan protein powder, beans, legumes) and healthy fats (avocado, nut butter, fish oils, olive oil) at every meal, but especially at breakfast to help stabilize blood sugar levels. We have a Registered Dietitian on our Wellness team who provides nutritional counselling if you need professional guidance.

Supplementation

GABA

• GABA can help to modulate the release of key neurotransmitters like serotonin and dopamine which are associated with calming.

5-HTP

• 5-HTP is derived from the seed extract of the plant Griffonia simplicifolia. 5-HTP is the precursor to serotonin. Low serotonin levels have been implicated in many mood disorders. Thus, supplementing with 5-HTP can increase serotonin levels in the body.

Omega-3 fatty acids

• Can help to lower inflammation and thus reduce anxiety

L-Theanine

• An amino acid that can help to reduce anxiety in adults

Lavender

• Lavender has been shown to improve mood and lower anxiety

Valerian Root

• Has been shown to have similar effects to benzodiazepines

Probiotics

• Probiotics help to keep the gut flora nourished and balanced by replenishing the ‘beneficial bacteria’ that are involved in the production of the brain neurotransmitters, Serotonin and GABA. Specifically, the Lactobacillus and Bifidobacterium species have been shown to affect the gut-brain axis.

The Bottom Line

Anxiety is a common ailment that most people experience at some point in their lifetime. Short term anxiety enables us to endure dangerous situations in life and helps the mind and body cope with the demands of stressful events.

However, when anxiety becomes chronic and begins to impact everyday life it is important to address it in a holistic approach using various tools, like diet, relaxation techniques, supplements and botanical herbs.

One life. Live inspired.

References:

1. 1. Sher MK. Optimal Treatment of Anxiety Disorders. (2003) Patient Care. 37:18-32.
   2. Diagnostic and Statistical Manual Of Mental Disorders. (2000). Washington DC. American Psychiatric Association, 2000.
   3. Kessler RC, Soukup J, Davis RB, et al. The use of complementary and alternative therapies to treat anxiety and depression in the United States. (2001) Am J Psychiatry 158:289-94.
   4. Prousky, J. (2009). Managing Anxiety with Orthomolecular and Botanical Medicine. A simple and effective approach to treatment. Integrated Healthcare Practitioners’ Dietary and Nutritional Supplement, and Herbal Remedies Management Program