The root causes of anxiety by Tess Doig (Naturopath)
Anxiety disorders are one of the most common mental health disorders and it is estimated up to 33.7% of the population will be affected by an anxiety disorder in their life. Anxiety, however, can just be a symptom of another underlying condition within your body. Your anxiety may just be sending you a message to look a little further rather than trying to mask the feeling through medications, foods, alcohol, drugs or isolation. Below I have discussed some of the common root causes of anxiety.
Methylation is a biochemical process that is essential to the body. It repairs our DNA, is needed for detoxification, reduces inflammation and is involved in making and degrading neurotransmitters for a stable mood. Methylation is controlled by a number of genes and nutrients including B12, folate, B6, B2, B3, SAMe and choline. One of the most famous genes in this cycle is MTHFR, however is is important to know that the presence or even absence of variation in this gene does not automatically equal an issue in the methylation pathway. Our methylation cycle can speed up (overmethylation) or slow down (undermethylation) and either can have an effect on our mood and has been linked with anxiety, depression, obsessive-compulsive disorder (OCD), and anger issues. People that I suspect may have a methylation issue are those that have had a long history of anxiety (or other mental health issues), antidepressants and anti-anxiety medications have had little to no effect or made things worse, have OCD traits, plus a family history of mental health issues, alcohol or drug, cardiovascular disease, recurrent miscarriage or cancer
It is important to speak to your healthcare provider that is is knowledgable in methylation (or me if you don’t have one) as self treatment can make the situation worse as its not as simple as throwing some methylated b-vitamins at it (as many people tout). In fact this can make it worse. You can self-treat however through some diet and lifestyle interventions which include: eating plenty of leafy green vegetables, reducing alcohol consumption, and avoiding plastics and other chemicals that can upset the methylation cycle.
This one speaks to women only and could be a cause if your symptoms are worse in the week or two leading up to your period. Progesterone is at its highest right after ovulation and then slowly declines about 7 days post ovulation unless there was conception. If progesterone levels are too low during this period and also during menopause, anxiety and insomnia can occur because progesterone has a calming effect on the brain. It does this by enhancing a neurotransmitter gamma-Aminobutyric acid aka GABA. Other signs of progesterone deficiency include weight gain, painful breasts, short menstrual cycles or irregular periods. Treatment for low progesterone can include herbs Vitex and Peony, and nutrients B6, magnesium, zinc and antioxidants and nutrients to support ovarian function such as selenium. Reducing stress also helps as stress causes progesterone to drop. See my post on stress and your hormones here to learn more.
Magnesium is one of the most important minerals in the body, being a part of over 300 different biochemical reactions in the body. One of these is its involvement in making GABA (as mentioned above) a calming neurotransmitter. Without magnesium, we cannot make GABA which causes anxiety, irritability and insomnia. Magnesium deficiency can also make a person more reactive to stress, causing a feeling of anxiety and hypervigilance (1). Magnesium is also needed for ovarian function and therefore progesterone production as discussed above and also keeps blood sugars stable (see more below). I usually start magnesium at a dose of 300-400mg/ day taken at night in a citrate or glycinate form (avoid oxide forms as they are poorly absorbed).
Unstable blood sugars
A consistent blood sugar level is needed for our muscles and brain to function. When levels drop, the body can experience symptoms of anxiety including heart palpitations, blurry vision, hypervigilance, lightheadedness, irritability and headaches. Causes of unstable blood sugars are infrequent eating, high coffee and/ or alcohol intake, eating sugary and refined carbohydrate foods and having a low protein diet. An easy way to remedy this is to eat regular meals that have a combination of protein, complex carbohydrates, healthy fats such as avocado, olive oil and lots of vegetables. Avoid drinking coffee first thing in the morning and eating crappy biscuits, lollies, sweet foods, and refined carbohydrates such as chips, white bread and pasta. Nutrients that may help stabilise blood sugars are magnesium, chromium and zinc.
If you suffer from anxiety along with headaches/ migraines, skin rashes, allergies, abdominal pain an/ or bloating, high blood pressure, endometriosis or irregular menstrual cycles, you may be suffering from histamine intolerance. High histamine can occur when there is an issue in the methylation cycle (see above), you have gut dysbiosis (bacterial overgrowth in the gut) or you have an issue breaking down histamine. To treat you may need to address your underlying issue (methylation and/ or gut health) plus avoid those foods that are high in histamine such as fermented foods (yes they aren’t a cure-all for everyone), vinegars, dried fruit and aged cheeses, plus foods that can prevent the breakdown of histamine such as alcohol, chocolate and nuts to name a few. I’ll write another blog on just histamine issues another day as it is a huge issue and one I am seeing all the time. Nutrients such as quercetain, SAMe, and zinc can be helpful in histamine issues.
Traumatic experiences, as an adult or a child or possibly even if our mothers experienced stress or trauma when pregnant with us, can predispose us to to be more anxious or hypervigilant. Trauma causes our fight or flight stress response to be more reactive to stress, and causes you to have anxiety. Stress also causes an increase in cortisol and adrenalin increasing feelings of anxiety.
One of the most powerful ways to address stress is to teach the brain to stay in the present through meditation and mindfulness practices. Nutrients that can also help are magnesium and vitamin C, along with adaptogens herbs such as Withania.
Either a low or over functioning thyroid can cause anxiety and particularly when there are is an autoimmune response as in Hashimoto's and Graves disease (2). Autoimmune thyroid disorders can upset our metabolism leading to unstable blood sugars and inflammation causing anxiety. If you suffer from- weight gain, irregular periods or short cycles, dry skin, hair loss, are sensitive to the cold, poor memory, brain fog you have may have an under-functioning thyroid. Symptoms of an overactive thyroid include- weight loss, heart palpitation, racing thoughts, although I have found the two conditions can overlap with symptoms. It is important to get a full thyroid assessment if you suspect a thyroid issue as the cause of your anxiety. A full thyroid panel includes TSH, T4, T3, TPO and TG autoantibodies plus Thyroid receptor (TRAB) antibodies if Graves is suspected. The standard medical testing is TSH only and is a poor marker of thyroid health. Thyroid issues can be treated with nutrients zinc, selenium, iodine, lipoic acid and herbs including Withania and Rehmannia.
Gut health and bacteria
The evidence linking our gut bacteria with our mental health is continually growing which is exciting as medical science is finally catching on to what naturopaths have been talking about for centuries! A lack of diversity and undergrowth of bacteria that produce short-chain fatty acids along with an overgrowth of bacteria such as Shigella has been found in patients with Generalised Anxiety Disorder (GAD) (3). The best way to increase your microbiome diversity and good bacteria is to eat a wider variety of plant-based whole foods (aim for 40+ per week), and eat plenty of colourful foods such as berries, carrots, purple potatoes, green vegetables. Green tea and cocoa have also been found to be beneficial foods for your gut bacteria. Prebiotic supplements can also help with treatment. I am loving looking at my patient’s gut bacteria through a test called uBiome, as it is providing amazing insights into the causes of not just mental health but other conditions such as endometriosis, weight gain, arthritis, and autoimmune conditions.
A lack of purpose and sense of being trapped
A final root cause of anxiety that is not necessarily connected to your body’s biochemical functioning or nutrition is a sense of a lack of purpose. Another factor can also be a feeling of being trapped, either in a job, relationship or situation that you dislike. When we feel like we are living a meaningless life and or we can’t escape a situation we can experience anxiety. You don’t need to be in your dream job or ‘living your best life’ so they say on Instagram to have a sense of purpose. Making social connections through spending time helping a friend or even stranger out, can help create that purpose. When feeling trapped in a situation, try and look at 3 positives of whatever the situation may be and make a plan for how you can change the position you are in. Meditation and mindfulness can also help with feelings of lack of purpose.
I hope the above has been helpful to you in providing insight into possible causes of you anxiety. Please make sure you don't self-diagnose however and seek the help of a health care provider if needed. It is also important to remember that if you are currently on medications, you never stop these without first speaking to the prescribing doctor.
BHSc (Naturopathy) G Dip (Psych)
If you are suffering from anxiety, I am here to help. Please email firstname.lastname@example.org with any queries you may have or to set up an appointment in person or SKYPE (Australia wide). To find out more about Tess and her approach to your health click here