Some people seem to navigate life's challenges effortlessly. Others become trapped in a cycle of fear and worry known as anxiety.
By Lisa James | Edited by Amanda Mauceri
In honor of Mental Health Month, we’re zeroing in on one pesky culprit behind many mental health ailments – stress. Nearly everybody undergoes stress at one time or another; it’s simply a fact of life. But what happens when stress crosses over into anxiety?
Anxiety turns challenge into catastrophe (and everyday occurrences into potential catastrophes) by driving people into fearful “what if” thinking. “Stress is to anxiety as sadness is to depression; it becomes a mental disorder when it becomes chronic,” says Rebecca Beaton, PhD, director of the Anxiety & Stress Management Institute in Atlanta.
Fear Without End
Anxiety hampers careers and relationships. In one study, anxiety in childhood was associated with lower earnings in adulthood (Journal of Mental Health Policy and Economics; September 2011).
“The effects of anxiety go well beyond the brain itself – it affects the whole body. It can affect sleep, the ability to think or concentrate, appetite and diet choices, and energy levels,” says Henry Emmons, MD, consulting psychiatrist at the Penny George Institute for Health and Healing in Minneapolis and author of The Chemistry of Calm. Links have been found between anxiety and cardiovascular disease, chronic pain, skin allergies and cognitive decline.
Anxiety is classified by type:
- Generalized Anxiety Disorder (GAD):
Persistent worry and tension, even if there’s no obvious cause. “For those with GAD, a constant feeling of being on edge means there isn’t a moment of the day free from worry,” says Tamar Chansky, PhD, a clinical psychologist in suburban Philadelphia and author of Freeing Yourself from Anxiety (Da Capo/Lifelong).
- Obsessive-Compulsive Disorder (OCD):
Compulsive hand-washing is the best-known sign of OCD, which includes any repetitive thought or fear that compels someone to do something over and over again.
- Panic Disorder:
This is marked by sudden attacks of terror that strike without warning, and can include symptoms such as sweating and heart palpitations. Patients sometimes fear they are having a heart attack or “going crazy.”
- Post-Traumatic Stress Disorder (PTSD):
Most public awareness comes from PTSD in combat veterans. But it can affect anyone who has survived a terrifying event, trapping them in memories they can’t escape.
- Social Anxiety Disorder (SAD):
It’s not unusual to feel a little uncomfortable when, say, meeting a large group of strangers. But social anxiety causes overwhelming worry in even everyday social situations. As Chansky puts it, “Every moment is a performance with no backstage breaks.”
While some people are more anxiety-prone than others, there are societal factors that drive anxious behavior. One is the increased isolation and lack of communal support that many people feel. “The paradox is that we’re more connected than ever through things such as Facebook, but we struggle to think of someone we could actually call for a ride to the hospital,” Chansky notes. Technological advances have also resulted in people being bombarded with more information than they can process, including what Melissa Tiers, DCH, DAH, and founder of the Center for Integrative Hypnosis in New York City, calls “the fear factor – the constant alert that comes from alarming stories on the news.”
Even those who feel they were born to worry, however, can learn to take setbacks in stride. “I tell clients the only things we have control of in life are our attitudes and our actions. Anxiety is one of the most treatable mental illnesses,” says Beaton.
Stopping the Cycle
“The way we narrate our experience very much affects how we feel.”
The first step in quelling anxious feelings requires breaking those neural pathways in the brain that trigger fear and worry. “Luckily, the brain can be rewired more easily than most people imagine,” says Tiers.
In her book, The Anti-Anxiety Toolkit, Tiers presents fast ways to stop anxious thoughts. One method, called “bi-lateral stimulation,” calls for spending one minute to pass a small object from one hand to the other, crossing the body’s midline, “…so you are stimulating both hemispheres of the brain. It will have a more rapid effect if you keep one hand in front of you as the other swings out,” says Tiers, who adds that it works by “spreading blood and electrical impulses throughout the brain.”
Another anxiety-stopper is “heart coherence.” Imagine breathing deeply into your heart, and then feel it radiate energy through your system. “The heart is the strongest emitter of electromagnetic energy in the body. By doing the exercise, you are beginning to entrain your brain into a coherent and more relaxed brain-wave state,” Tiers says.
After the fear and panic subside, one has to learn how to avoid future attacks. Beaton states, “The treatment that’s most effective is cognitive behavioral therapy (CBT). It’s teaching people how to think differently, getting them to change their thinking patterns.” Chansky agrees, adding, “The way we narrate our experience very much affects how we feel. We want to see that any situation can have a different explanation.” Studies support CBT’s effectiveness in alleviating anxiety.
“Mindfulness Meditation,” which involves calming the mind by learning to let go of one’s thoughts, “…helps people sit with their emotions,” says Beaton. Research suggests this technique can help ease anxiety (Journal of Consulting and Clinical Psychology; April 2010).
After treating the immediate symptoms, Emmons looks at other factors that contribute to his patients’ anxiety. “I would have them work with an integrative nutritionist, get them on a sustainable exercise program, and work with them on their sleep. And then I would work with them, either individually or in a group, to learn how to approach their life stresses more skillfully,” he says.
Proper diet is enormously helpful in controlling anxiety. One reason is “…the only way the brain can get its raw ingredients is through the diet,” says Emmons. Another factor is the harmful feedback loop between sugar and cortisol. “One of the jobs of cortisol is to make you hungry for foods that quickly replenish glucose. If people keep eating high-sugar foods that increase their cortisol levels, it becomes a vicious cycle,” Emmons explains.
Poor diet also stirs up unhealthy levels of inflammation. “With anxiety, one of the problems in the brain is that it becomes overactive. Inflammation tends to overactivate the body, and that includes the brain,” says Emmons. Chronic inflammation also ties into cravings for sweets. That leads to excess fat accumulation, “…usually in the middle of the body. That abdominal fat produces more stress hormones,” Emmons notes.
In addition to reducing or eliminating consumption of sugar, refined carbohydrates and fried foods (along with caffeine and artificial sweeteners), Emmons suggests eating a wide variety of unprocessed, organic foods – particularly complex carbohydrates and colorful fruits and vegetables. (He recommends the crucifers, a vegetable family that includes broccoli and cabbage, for their detoxifying effects.) Your diet should also include cold-water fish for their omega-3 fatty acids, which have been found to reduce both inflammation and anxiety (Brain, Behavior and Immunity; November 2011).
Emmons recommends supplements that help build a more resilient brain. These include a high-quality multivitamin or B-complex; vitamin D (low levels of which have been linked to depression); the minerals calcium, magnesium and zinc; and the herb Rhodiola, which helps with not only anxiety but also energy levels and mental focus. Other herbs that can take the edge off of nervousness include Passion Flower, Eleuthero, chamomile and hops.
Emmons also suggests supplements such as GABA, a calming brain chemical; L-Theanine, a green tea compound that promotes both calm and focus; 5-HTP, which helps with both anxiety and depression; and NAC, a potent antioxidant. According to a study in the October 2010 issue of Nutrition Journal, “…nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions.” (Speak to your practitioner before starting any supplementation program if you are taking medication for anxiety or depression.)