Some anxiety is a natural aspect of the human experience, as many of us are concerned about our health, finances, family, etc ... However, when anxiety becomes chronic or evolves into a disorder, it transcends fleeting worries, impacting individuals over time. Current estimates suggest that anxiety disorders affect approximately 4% of the global population.
To say that anxiety disorders are overwhelming doesn't reflect its impact on some people's lives. Anxiety can profoundly affect a person's daily life, work, relationships, physical health and overall well-being through emotional, mental and physical exhaustion.
How does anxiety feel?
Ask anyone who has experienced any heightened amount of anxiety: it feels TERRIBLE.
Anxiety is described as an enduring and heightened sense of nervousness, worry, fear, irritability and apprehension. This emotional state is frequently coupled with physical symptoms such as sweating, palpitations, chest pain, fatigue, headaches, shortness of breath, muscle tension and impaired sleep.
Beyond this collection of symptoms, the actual subjective experience of anxiety has been compared with a sharp dagger piercing your chest with every breath, or a dark cloud of heavy thoughts trailing you wherever you go. Anxiety can lead to a panic attack, which leaves people wondering if they're having a heart attack. Terrible.
Anxiety: In the Mind and the Body
Anxiety isn't confined to the mind - it is deeply intertwined with the body's physical responses. The interplay between mental and bodily states is highlighted by some surprising physical triggers of anxiety.
Acute stress starts in the mind - and is quickly transmitted from the brain to the body via the stress response. Anxiety can also be triggered BY THE BODY - by gut dysbiosis (or imbalanced microbiome), blood sugar dysregulation, excessive caffeine intake or nutrient deficiencies.
The Stress Response: A Double-Edged Sword
The stress response is a major player in anxiety. When faced with a threat - whether real or imagined - the brain engages the stress response and releases adrenaline, noradrenaline and cortisol. These biochemical signals prepare the body for a "fight-or-flight" reaction, heightening alertness and redirecting resources to cope with the threat. This process turns off any longer-term needs that aren't linked to immediate survival, such as resting, digesting and procreating.
In the context of anxiety, the stress response becomes dysregulated, leading to an excessive and prolonged release of stress hormones - even in the absence of any immediate threat. Chronic activation of the stress response also contributes to long-term health consequences, addressed below.
The Gut-Brain Axis
We know intuitively that the brain controls the body, including the gut. Our thoughts and emotions influence digestion, the immune system (which lives primarily in the gut) and the balance of the gut microbiome - a community of trillions of microorganisms living in our digestive system. Messages are sent along the Vagus nerve, connecting the brainstem to all organs in the body, including the gut.
What may be more surprising is that the gut also has the ability to control the brain, via the enteric nervous system (ENS), entirely independent of the central nervous system (CNS). These messages are directed by hormones, immune cells and gut bacteria, up the Vagus nerve to the brain. Read that again: our hormones and bacteria are sending messages to our brain ... !
Given this cross-talk between the gut and the brain, it becomes clear how gut issues can influence brain health: through bacterial balance and production of short-chain fatty acids that influence the production and activity of neurotransmitters. Gut bacteria can literally affect how we respond to and cope with stress, and may even drive anxiety.
Elevated Lactic Acid
Interestingly, individuals with anxiety often have elevated blood lactic acid levels. Lactate, the soluble form of lactic acid, is the final product in the breakdown of blood sugar (glucose) in the absence of sufficient oxygen. It is thought that high lactate may contribute to anxiety by binding to calcium, depleting calcium in the blood.
Factors which can elevate lactate in the blood include: alcohol, caffeine, sugar, food allergens and deficiency of B vitamins or magnesium. This is a mechanism by which these factors can trigger anxiety.
Menopause and Anxiety
For women navigating menopause, anxiety can pose a unique challenge. Between the ages of 45 to 55, women are twice as likely to experience anxiety as men. One study found that 25% of women aged 53 to 65 had anxiety – of whom 73% had moderate or severe symptoms.
In peri-menopause, the combination of high/fluctuating oestrogen and low progesterone stimulates the release of histamine, which can trigger insomnia and anxiety. Furthermore, the physical symptoms before and after menopause, such as hot flashes and sleep disturbances, can increase stress and anxiety.
The subsequent decline in oestrogen affects neurotransmitter regulation, reducing the calming effects of serotonin and GABA. As progesterone itself is calming, we lose its protection as its levels decline. Combined, these can reduce our resilience to stress and trigger irritability and anxiety.
Neurodivergence and Anxiety
Anxiety frequently coexists with neurodivergent conditions like ASD and ADHD. Especially in women, neurodivergence is sometimes misidentified as anxiety, and anxiety is occasionally diagnosed on the path to identifying neurodivergence. Research suggests that comorbid anxiety disorder occurs in 25% of persons with ADHD and up to 84% of autistic individuals.
Anxiety is a particularly common element in the autistic experience, often heightened by navigating a world not tailored to neurodivergent needs, which requires constant efforts to interpret and communicate thoughts, experiences and needs to others.
Health Consequences of Chronic Anxiety
Prolonged anxiety and recurrent panic attacks can induce the regular release of stress hormones by the central nervous system, intensifying symptoms like headaches, dizziness and depression. The continuous flood of adrenaline and cortisol, designed to cope with immediate threats, can have detrimental effects on physical health over time. These risks include weight gain, cardiovascular disease, digestive issues, a weakened immune system and respiratory problems.
Potential Strategies for Dampening Anxiety
Anxiety affects not only mental well-being, but also physical health and daily functioning. Navigating it thus involves adopting strategies that promote our overall well-being.
Dietary choices play a pivotal role - such as prioritising real food over ultra-processed foods - to get in the good stuff and limit the bad stuff. It's important to address digestive issues, like IBS and Candida overgrowth. Ample nutrients should be ensured through food, and supplemented if needed. In some cases, lab testing could help to identify nutrient deficiencies and digestive issues.
While we can't always avoid stress, we can learn to manage it through practices like meditation, breathing techniques and yoga. Regular exercise and good quality sleep can go a long way to contribute to anxiety reduction.
Healthy dietary and lifestyle choices can support brain health and may reduce anxiety. And, each woman is different - based on her individual health issues, health history, genetics, diet and lifestyle. A qualified nutritional therapist can help you to develop personalised approach based on your specific needs.
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