Anxiety

anxiety2

Do You Get Anxiety?

Anxiety. What does it mean? For many it will mean feelings of fear, dread, and perhaps an uneasiness that may occur as a reaction to stress. Do you get anxiety? Relax, I do, and everybody does! It’s just that some of us can manage it a little more effectively than others. I used to suffer with BAD anxiety when I was growing up, and can relate to those who feel anxious at times for ‘no apparent reason’ at all. It can happen to anybody, so I want you to remember this one thing – we ALL get anxiety at some point in our lives because we are all human beings!
A person with anxiety may perspire a lot, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder. Anxiety can be seen as an unpleasant emotional state, “unease” of the mind, the cause of which is less readily identified than many other emotional conditions. It is frequently accompanied by physiological symptoms that may lead to fatigue or eventually even to exhaustion. Because fears cause such similar unpleasant mental and physical changes, patients generally use the terms fear and anxiety interchangeably. So in a sense, there is little need to differentiate between anxiety and fear.
Do you ever get anxious at times? Is anxiety really something that only people with mental illness suffer from? Judging by the amount of people with physical complaints who have some type of fear or anxiety I have seen over the years, I’m sure that many people can relate to some form or another of anxiety. Anxiety is one of the most common emotionally based health problems, and about 2 out of every hundred of us will experience an anxiety disorder as described below.This month, let’s take a closer look at this common complaint, how it affects your body and what steps you can do to identify and control your bodily responses to anxiety.

Anxiety is Physical and Emotional

Physical sensations can occur such as heart palpitations or heart skipping a beat, nausea, chest pain, shortness of breath, stomach aches, or headache, shaky hands, sweating excessively, trembling, feeling like you cannot breath or you may be choking, tense muscles and dizziness. I am sure that many of you have felt some of these symptoms at one point in your life.
Emotional symptoms such as worrying what others may think about you and even thoughts about the anxiety never stopping. You may have fears about losing control or feeling like things are not real or that you are going to end up crazy. Sometimes being anxious can make a person so edgy and wound up that they might even get quite aggressive. Emotionally, anxiety causes a sense of dread or panic and along with this comes the nausea, and even chills. Behaviors may arise directed at escaping or trying to avoid the source of anxiety. I have a dentist friend who once told me that she has had the odd patient over the years who has literally take off in the middle of their appointment, particularly if they need an injection or a tooth extraction.

Is Any Of This Experience Familiar To You?

  • Maybe you found yourself in the hospital’s emergency room because you thought you were having a heart attack only to be told later it was anxiety?
  • Do you ever fear you might stop breathing because your chest feels tight and your breathing erratic?
  • When you drive do you fear the idea of getting stuck in traffic, on a bridge or at red lights?
  • Do you ever feel nervous and afraid you might lose control or go insane?
  • Have you struggled with anxious thoughts that will not stop?
  • Do you ever feel uncomfortable in enclosed spaces such as supermarkets, cinemas, public transport or even sitting at the hair dressers?
  • Are you nervous and on edge in normal situations that never bothered you before?

Do You Feel Any Of The Following Bodily Sensations?

  • Dizzy spells leading to panic
  • Tightness in throat and chest- shortness of breath
  • Racing heart with tingle sensations
  • Hot flushes followed by waves of anxiety
  • Obsessive worries and unwanted thoughts
  • Not feeling connected to what is going on around you
  • Overwhelming fear that the anxiety will push you over the edge?

Types of Anxiety

There are different types of anxiety that you may hear people talk about. The type you have really depends on the collective group of symptoms which you have. Here are some simple explanations:

Generalised Anxiety Disorder (GAD)

This is when you get lots of worries about trivial things which other people aren’t generally worried about. You worry about what others may think of you, you worry about paying the bills on time, about getting to the shops or bank before it closes, about the health and/or safety of family and/or friends.

Phobias

These are when someone has a specific worry about one particular thing or one situation, for example a fear of being in a crowd of people, fear of heights or fear of spiders. Try hypnotism – it has worked really well for several of our patients. A young man of about 20yrs of age came to our clinic, who couldn’t drive his car for more than a few kilometers without becoming physically sick and throwing up. It turned out that when he was a young lad, he was driving with his father in their car, when it was surrounded by a bunch of angry motor bikers who literally trashed the car at the lights. This young man had since developed a phobia of driving, for in his mind he was still trapped in that same vehicle, and was constantly anxious each time he heard any loud noises around his car, which triggered an almost immediate response – a feeling of dread and being sick. One session with a friend who is an excellent hypnotherapist got him right. I was truly amazed, and am now a convert!

Panic Disorder

Many people suffer from some form of panic disorder. Intense periods of anxiety coupled with physical sensations such as sweaty hands, palpitations, feeling sick which occur seemingly “out of the blue” without an obvious cause. This can range from mild to the extreme. You may want to escape, and a common scenario is “anticipatory anxiety”, which is a form of panic disorder. It may happen just before a performance is given or the build up to an event, for example before your wedding, a test or exam,  going to the dentist, or it could even happen before boarding an airplane. I’ll bet many people can identify at some point in their life a time when they panicked. What do you do with panic disorder? You take a few nice deep and slow breaths and try not to focus on the physical sensations you are experiencing. They will only exacerbate if you do, increasing the level of panic and anxiety.

Obsessive Compulsive Disorder (OCD) 

OCDThis is when you get thoughts which sort of “jump” into your head that you can not control and start doing things to try and control them or reduce them. For example someone may get thoughts in their head that they may get disease from germs off door handles, so start not touching door handles, or open them whilst holding a handkerchief , they may have rituals like washing their hands very frequently to keep them clean. I had a patient who could not relax and watch TV unless he found the remote control first. He felt compelled to find the remote, regardless of what was on TV, or how much he wanted to see his favourite TV show – he was absolutely compelled to find that remote.Another man who saw me years ago, felt compelled to keep checking to see if the doors on his car were locked after he parked his car somewhere. Nail biting can also be a compulsion for some. What about the perfectionist people who want everything so clean and tidy all the time. You may well know one of these people, they vacuum twice a day, the house has to be spotless or they can’t seem to relax. They find it hard to relax, never feel quite at ease and may even find it hard to get to sleep because they are thinking of all the things they have to do tomorrow. They may be “list” people, who write everything down, they may be very (too much) organised and plan things meticulously down to the last detail. These people can be hyper critical and fussy and besides being a pain to be around, are very prone to anxiety. In my experience, they eventually develop adrenal fatigue and can be prone to an overactive thyroid complaints. Herbal or homeopathic treatments work very well here over time – but they do take time and are not instant in their effects, so be patient.

Anxiety and the Body’s Reaction to Stress

anxious womanIn a sense, anxiety is the “alarm phase” of the body’s stress response, or the immediate stage of stress. Your body prepares to deal with the threat, which can be real or even imaginary, because your mind does not really know the difference between a real and imaginary threat. And this is what happens: your blood pressure and heart rate are increased, sweating is increased, blood flow to the major muscle groups is increased, and immune and digestive system functions are inhibited. Blood is shunted away from your digestion to the muscles, preparing your body to escape the perceived threat. Externally, the physical signs of anxiety may include pale skin, sweating, trembling, and dilation of the pupils. Now you can see how a person over time can actually develop a physical complaint like irritable bowel syndrome (IBS), from anxiety and stress. Their blood supply to the digestive system becomes reduced, their immune responses become diminished, and a whole host of other physiological responses are involved. If this all happens to develop slowly over a period of time, the person starts to get concerned about their bowel function and well pay his or her doctor a visit. And then the doctor refers this person to a gastroenterologist, who performs a colonoscopy and mentions that all is well. The specialist now gives the mystery illness a name: irritable bowel syndrome, and recommends the patient to start taking Metamucil©, because you have IBS from which there is “no known cure”. The anxiety (the actual cause) is rarely addressed, and the condition may go on and on for years. The same goes for all too many physical complaints which relate to anxiety: tension headaches, muscle aches & pains, period problems, various bowel conditions, appetite problems, immune problems, and so the list goes on. It is important in these situations to assess the patient in terms of adrenal burnout and treat accordingly.

What Causes Anxiety & Can It Affect Your Health?

Anxiety can be caused by lots of things. You are probably more likely to have an anxiety disorder if a member of your family has experienced similar symptoms, and this could well be learned behaviour. A tense and anxious parent or care-giver can create a tense or anxious child. In many cases, anxiety can be triggered by horrible and stressful experiences in person’s life, like a death or someone hurting you in some way, emotionally or physically. A sensitive person in a controlling or dominating relationship may develop a cancer due to the stress and tense situation he or she has to live under. Many experts believe that anxiety disorders are caused by the person through reinforcing their anxiety by repetitive anxious behaviour patterns. All the symptoms you experience are caused by mal-adjusted reactions in the brain causing your mind and body to react with an inappropriate level of anxiety. I have found that some medical practitioners are rather quick to pigeon-hole anxious patients by arriving at a snap diagnosis, giving a name to their condition such as depression, but because there is no nice little pigeonhole for anxiety as such, they perceive this type of patient to be either neurotic, attention-seeking, hypochondriac or just plain mentally ill.
A young lady saw me a few weeks ago with IBS, and mentioned that the problem started several years ago. When I questioned her, she said that it started not long after her best friend committed suicide. She was placed on the antidepressant drug Aropax©, and the bowel problem still to this day remains IBS, besides being addicted to this drug. Another lady came to the clinic with an under active thyroid condition, in this case the condition started several months after her mother died rather suddenly of a heart attack. Although her mum died seven years ago, the grief was still apparent as she wept openly when we spoke about her mum. This lady is now quite anxious that she herself will suffer the same fate as her mother, and her continually anxious thoughts have created several health complaints including palpitations, insomnia, fatigue, itchy skin, blurry vision, and much more. This lady is also on drugs, but this time Thyroxine©, Amnitryptiline© and naturally the obligatory steroid cream for the itchy skin. In both these cases, the practitioner never even enquired into any cause. The symptoms were seen to be the cause of the malady, not the stressful and anxious events preceding the disease.Can you remember a stressful event, or a series of stresses which occurred in your life, have you developed anxiety about something that happened to you years ago and were prescribed one or several drugs? Perhaps it is time to think about addressing the actual cause, and to come off these drugs in time.
The following case really is a true story, and it almost sounds like the script of a low budget movie. An elderly lady I saw over ten years ago mentioned that she could no longer walk due to her “burning feet” and was actually spending a large part of her day confined to a wheelchair. Her husband had died about ten years previous, and she was prescribed a drug called Imipramine for depression. A few years after being on this drug, the burning feet commenced. I worked out that it was really a side-effect called peripheral neuropathy. Once we slowly weaned her off the drug, detoxified the liver and kidneys, the burning feet syndrome was gone and she could walk once again. Are you taking an antidepressant, still many years after a stressful or anxious event? Perhaps it is time to come off these powerful drugs and deal with the underlying emotional issues.
For many other people, anxiety can build up over a number of months or years as they develop negative unhelpful ways of thinking or coping with events in their lives. This may make the problem stay or even get worse. I mentioned in a previous article on cancer I wrote some time ago, that Deepak Chopra wrote in one of his books (Quantum Healing) that every thought you think will create a chemical called a neuropeptide. And these neuropeptides effect your body in a negative or positive sense, depending on their structure. Makes you sit back and think a bit about the “self-talk” in your mind, eh? Talk in your head like: “Don’t be stupid” or “That person is looking at me thinking how silly, fat or ridiculous I look”, etc. Your very thoughts rule your inner and outer world, and please don’t ever forget that. The most important thing to remember is that anxiety is not your fault and you can do something about it. You can be a very confident person, regardless of how anxious you are right now. Anxiety is all in your mind, and all about mind over matter. If you don’t mind, it does not matter!

Conventional Anxiety Treatment

 Drugs_1_1It is unfortunate that in the 21st century, that anxiety is still seen all too often as “mental illness” which needs treating with a pharmaceutical drug. Anti anxiety medications supposedly help to calm and relax the anxious person and remove the troubling symptoms. There are a number of anti anxiety medications currently recommended by health care professionals. The preferred first line medications for most anxiety disorders are the various anti-depressants or benzodiazepines.Many drugs are used to treat anxiety, whether they be prescribed or non-prescribed drugs like paracetamol, alcohol or even a recreational drug such as cannabis may used by the person to “chill out”.
Whilst I do agree that mental illnesses such as schizophrenia or bipolar depression are quite specific and very hard to treat through behavioural modification alone, with many patients requiring drug based treatments also, anxiety disorder does not require drug intervention, which is why psychologists have been treating anxiety disorders with behavioural modification techniques for decades. Anxiety should not be viewed as a disease today, but rather a common emotion along with fear, anger, sadness, and happiness, and it has a very important function in relation to your actual survival. It is only when anxiety takes complete hold of the person, in a sense the person becomes trapped and the emotional responses take hold, causing unwanted physical responses which happen over and over again, that it needs a stronger treatment. Try the techniques and remedies below – in my opinion, drugs should be the very last, not the very first resort. I know, I used to be trapped by feelings of anxiety myself.

Public Speaking – The Ultimate Anxiety Test

Eric-Lecturing2-e1329772402739Many years ago I wanted to learn how to speak in public, and don’t we know how scary this can be. It has been said that the fear of public speaking ranks almost as high as the fear of death. The first time I tried to speak at a Toastmasters group fifteen years ago, my hands became so sweaty, my heart was pounding so bad I thought it was going to explode. I really wanted to escape, and I did – to the toilets, where I promptly became sick.    I now confidently speak to large crowds, have done so for years and really enjoy public speaking. I overcame the fear, and the anxiety went with it. But guess what? I still get butterflies in my tummy when I am at the airport about to fly to Auckland from Hawke’s Bay. A friend once told me that you will always have butterflies in your tummy about something in your life, whether it be in the dentist’s chair, speaking in front of a group of people or going for your driver’s license – you just have to make those butterflies fly in formation. Learn to control your anxious thoughts, don’t let them control you!

Some Strategies To Cope With Anxiety

Learn what anxiety disorder is means recognizing the signs and symptoms. Do you get any of the above mentioned key signs and symptoms? The first step towards solving a problem is recognizing that something is not quite right, and if you are an anxious person, there are a number of simple things which may help you deal with anxiety:
  • Talk to someone you trust who can support you. A problem shared is a problem half sorted. A famous Dr called Edward Bach, who was way head of his time in recognizing the mind & body connection once said in the 1930’s: “A patient may have vague unknown fears, for which there can be given no explanation, no reason. Yet the patient may be terrified of something terrible going to happen, he knows not what. These vague unexplainable fears may haunt him by night or by day. Yet, the sufferer often is afraid to tell their trouble to others”. You’d be surprised how much better you feel once you have off-loaded your fears and anxieties onto somebody you can really trust. A fearful person may be suspicious and not trust that much. Don’t keep it all inside, let it out and learn to trust.
  • Learn some simple stress management like relaxation and breathing exercises. Meditation techniques are simple. I have learned to meditate regularly, I lie on the floor do some slow, deep breathing and calm my mind right down. With experience, you can actually feel your mind slipping into the Alpha-Theta state. This is the state where your central nervous system (brain) reduces input from outside of your body (from your hearing, vision, smell, and touch. The muscles relax, and you can feel yourself becoming more relaxed and drowsy. This lowering of sensory input serves to normally protect the brain from sensory overload caused by stress or physical damage. The mental activity normally associated with the active awareness state that you experience from day to day at work and play is the Beta wave. Beta can often race and bring panic at times. Used too often, you run the risk of thinking too much about too little, and tiring  yourself out about far too much. Beta has it’s place but must be helped to slow down at times and reflect – and this is why you need to meditate regularly. I call it “a defrag of the mind”, if you know things about computers. If you have young children, or run a business you will know exactly what I mean, Beta rules. Too much Beta activity can cause significant problems for you by increasing muscle tension, raising your blood pressure, making you speak and react too fast, and creating a state of anxiety. So take a chill pill and learn to meditate, once you learn how to meditate and practice this self help technique you will wonder why you didn’t do it a long time ago.
  • Make sure you have some time each day to relax and enjoy yourself. You do a lot for others, what do you do just for you?
    Get some regular exercise. One 40-minute walk can dramatically lower levels of tension.
  • Try to get good nights sleep, people who consistently sleep less than 8hrs a night can get quite snappy, anxious, tense and irritable.
  • Have some achievable goals and be realistic about the tasks you set yourself, for example if you are scared of spiders, then dropping a tarantula on your arm is probably a bit too much initially. Get tiny spiders at first (goals) and work on them and then eventually move up to the bird eating spider, the size of a dinner plate. I tell my patients they can turn their “scars into stars” by believing in their ability to achieve anything they wish.
  • Allow yourself to feel anxious from time to time to try and work out what makes you anxious. This is a bit like “no pain, no gain”. This way you can learn more about your own anxiety boundaries and how to beat them.
  • Challenge your negative thoughts, as these may be your mind tricking you into thinking you can not do something so you avoid any anxiety. You need to examine evidence of your fears or beliefs like a detective, and then work out what is real and what are tricks your mind is playing on you.

Eric’s Recommendations- Best Natural Medicines For Anxiety

1. Diet: watch our for refined sugar, caffeine, and alcohol. Work with food allergies, I have found that anxious people can have certain food preferences and even be addicted to certain foods. It may pay to have some allergy testing and to eliminate the foods which you react to or are strongly addicted to. Anxious people are best to avoid caffeine, it can make them so much anxious.
2. Calcium, 600-1,200 mg/day. Take in divided doses morning and evening.
3. Magnesium, 300-600 mg/day. Take morning & evening in divided doses.
4. Vitamin B-complex (high-potency), 1-2 times per day. Breakfast and lunch is good, careful with taking at dinner – it may stimulate you later at night causing restless sleep.
5. Vitamin B12, 1,000 mcg intramuscularly (if required). Good to try weekly for 6 weeks. (my clinical observation). Oral B12 is ok, but stay with the injection of you have any major digestive problems.
I can remember speaking with a lady who studied Vitamin B12 at Lincoln University, who said that there were too many people in NZ on the “mind altering drugs”, when in fact they were deficient in the most important Vitamin for the nervous system – Vitamin B12. Anxiety, like depression, is linked to a nutritional deficiency of B12. So pay your naturopath a visit & make sure that you are not deficient in anything, especially B12. Have a blood test.
6. L-theanine, an amino acid derived from green tea, is another remedy with a significant anti-anxiety effect. Many people report that L-theanine works as well as prescription anti-anxiety medications, but L-theanine is not addictive or habit-forming. You should be able to get this from your practitioner, and if you can’t, drink 3 cps of a high quality green tea daily.
7. Inositol, good for panic disorder: In a double-blind trial, supplementation with 12 g/day of inositol significantly reduced the frequency and severity of panic attacks and the severity of agoraphobia.
8. Kava kava, (herbal medicine) get a standardised herbal extract. Kava should not be taken in combination with other psychoactive medications, and please use only under the guidance of your experienced herbalist. There have been some suggestions made that Kava can be toxic to the liver, but the New Zealand Association of Medical Herbalists considered the issue and commented in its summary: “A comparison with paracetamol-associated liver toxicity, results in the conclusion that the potential risk for kava is dramatically less than that of a popular non prescription drug (Panadol©) widely sold through grocery outlets.” I find Kava very good for anxiety, a lot less toxic and not addictive when you weigh its use up with the pharmaceutical drugs.
9. Passionflower (herbal medicine), Taking 20 drops twice per day of a good quality herbal tincture for 4 weeks, was as effective as 30 mg/day of oxazepam (double-blind trial), and significantly better tolerated. Improvement was seen within 7 days. Why use drugs?
10. Valerian (herbal medicine), My preference is for Mexican valerian, which is much higher in the active ingredient than the normal Valerian. This is one of the few herbs (apart from Passionflower) shown to relieve anxiety in clinical trials. Valerian extract works rapidly, often in less than an hour, when taken in doses of a few hundred milligrams, and can be taken up to three or four times per day. This herb has a good effect on me, and has helped many of our patients over the years. When L-Theanine is used along with Passionflower and Valerian, over 93% of users with occasional anxiety and 85% with chronic anxiety report positive results, and 80-83% of users with panic and anxiety attacks say that this combination helps prevent and stop their attacks. Beat that.
11. Homeopathic medicines. My favourite anxiety remedies would be: Arsenicum: People who are quite anxious about their health, and very concerned with order and security, often benefit from this remedy. Obsessive about small details and very neat, they may feel a real need to be in control of everything. Argentum nitricum: This remedy can be helpful when anxiety develops before a big event: an exam, an important interview, a public appearance or social engagement. Dizziness and diarrhea may also be experienced. They like chocolate. Lycopodium: Individuals likely to respond to this remedy suffer from a lack of confidence. They can be self-conscious and feel intimidated by people they perceive as powerful. Taking on responsibility can cause a deep anxiety and fear of failure, although the person usually does well, once started on a task. Digestive upsets with gas and bloating, and a craving for sweets are common. Pulsatilla: People who need this remedy often express anxiety as insecurity and clinginess, with a need for constant support and comforting. They may be moody, tearful, whiny, even emotionally childish. This is a good one for young girls who are anxious. Ignatia: A sensitive person who is anxious because of grief, loss, disappointment, criticism, loneliness (or any stressful emotional experience) may benefit from this remedy. A defensive attitude, frequent sighing, and mood swings are other indications.
References:
  • Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001 Oct;26(5):363-7.
  • Akhondzadeh S, Kashani L, Mobaseri M, Hosseini SH, Nikzad S, Khani M. Passionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial. J Clin Pharm Ther. 2001 Oct;26(5):369-73.
  • Dhawan K, Dhawan S, Chhabra S. Attenuation of benzodiazepine dependence in mice by a tri-substituted benzoflavone moiety of Passiflora incarnata Linneaus: a non-habit forming anxiolytic. J Pharm Pharm Sci. 2003 May-Aug;6(2):215-22.
  • Dhawan K, Kumar S, Sharma A. Suppression of alcohol-cessation-oriented hyper-anxiety by the benzoflavone moiety of Passiflora incarnata Linneaus in mice. J Ethnopharmacol. 2002 Jul;81(2):239-44.
  • Brown D. Valerian root: Non-addictive alternative for insomnia and anxiety. Quart Rev Nat Med 1994 Fall; 221-4 [review].
  • Kobayashi K, Nagato Y, Aoi N, Juneja LR, Kim M, et al. Effects of L-theanine on the release of a-brain waves in human volunteers. Nippon Nogeikagaku Kaishi. 1998;72:153-7.
  • Kimura R, Murata T. Influence of alkylamides of glutamic acid and related compounds on the central nervous system. I. Central depressant effect of theanine. Chem Pharm Bull (Tokyo). 1971;19(6):1257-61.
  • Ueda T, Nagato Y, Tanaka Y, Okubo T, Kobayashi K, et al. Composition comprising theanine. US Patent 6,589,566; July 8, 2003.
  • Yokogoshi H, Kato Y, Sagesaka YM, Takihara-Matsuura T, Kakuda T, et al. Reduction effect of theanine on blood pressure and brain 5-hydroxyindoles in spontaneously hypertensive rats. Biosci Biotechnol Biochem. 1995;59(4):615-8.
  • Treatment of anxiety, tension and restlessness states with Kava special extract WS 1490 in general practice: a randomized placebo-controlled double-blind multicenter trial. Phytomedicine. 2003 Nov;10(8):631

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