Anxiety

We've all experiences moments of stress and anxiety in our everyday lives. Every one of us has been late for an appointment, had arguments with loved ones, or been anxious to find out what grade we received on a test. Brief moments of anxiety are a normal part of life that has been bred into us by millions of years of evolution. The “Flight or Fight” response as it is called serves us very well in life or death situations, and has done so for eons.

Picture what happens in a stressful situation. Let’s say you’re an early human living a few hundred thousand years ago. You’re walking through the forest minding your own business and suddenly you hear a twig snap. You turn to investigate and immediately realize that a tiger has singled you out for lunch; as you stand there deciding whether to stay still or run, your body has already begun the “Fight or Flight” response. Your adrenal glands are now flooding your body with adrenaline, epinephrine, and steroid stress hormones, thus heightening your senses and giving you near super human abilities. Surface blood vessels constrict allowing more blood to be pumped to vital organs and less blood to be lost in the event of injury. Blood pressure rises, and you are now ready to either stay and take your changes with the tiger, or run. Well hopefully you outrun or outsmart the tiger and live another day to do whatever it is that cavemen do.

Now let’s advance a few hundred thousand years to today. Your stuck in traffic, just had an argument, and also late for an appointment, so what happens? Your body immediately says “tiger!”, and goes into survival mode, the fight or flight response. Unfortunately, your body has no way to distinguish between actual life threatening events and the rigors of modern living; and these modern “tigers” are not rare events, they're around every corner. Given the right circumstances, whether chemical or environment, a person can find themselves in a state of constant “Fight or Flight”.

What level of anxiety is normal?

One question you probably have is what level of anxiety is normal and at what point should you seek treatment? While there is no clearly definable threshold for anxiety disorder, a basic rule of thumb for "normal anxiety" is the ability to recover once the stimulus is removed. When ruminating thoughts and anxiety exist in the absence of any definable stimulus it may be time to seek treatment.

Anxiety Hormones

Glucocorticoids: Glucocorticoids serve to increase the level of glucose in the bloodstream for an added boost of energy as well as decrease inflammation. The most famous of which is cortisol.

Catecholamines: Catecholamines include norepinephrine and epinephrine. These hormones serve to increase heart rate, blood pressure, cardiac output, and muscle tension. They also decrease blood flow to the extremities and gut so that the blood can be temporarily used for more vital organs.

Endorphins: Endorphins serve to decrease sensory awareness including the perception of pain, and also cause a feeling of euphoria.

Health effects of long-term stress and anxiety

We know that anxiety and stress makes us feel horrible. We know that it can cause us to loose friends, lash out at family, and live life in a confused mental fog; but what does it actually do to our body? Studies have found that groups of people subjected to large amounts of stress have generally poorer health later in life. For Example, air-traffic controllers at busy airports generally have a higher incidence of high blood pressure, ulcers, and diabetes, than the general population.

High blood pressure - Anxiety can cause large spikes in blood pressure which generally return to normal levels after the episode. If the anxiety is frequent or chronic it can have the same damaging affects on blood vessels and organs as if the person had chronic high blood pressure.

Diabetes - Chronic stress and anxiety has been linked to a reduction in insulin sensitivity. It is believed that elevated levels of cortisol and other hormonal imbalances related to stress and anxiety cause an excitement of the hypothalamo-pituitary-adrenal (HPA) axis and insulin resistance.

Suppression of the immune system - The same stress induced hormonal imbalances which lead to diabetes can cause damage to the immune system and slow the healing of wounds.

Hippocampal damage - learning and the laying down of new memories can be adversely affected by damage to the hippocampus caused by anxiety and stress.

Research has found that many of the adverse health effects from stress are caused by a class of hormones known as glucocorticoids. These include the well known steroids Cortisol and Aldosterone. Glucocorticoids have profound effects on glucose metabolism by breaking down fats and protein and making them available as energy. Glucocorticoids also decrease the sensitivity of the gonads to luteinizing hormone (LH), which thus decreases the production of sex hormones, including testosterone.

Anxiety disorders are not uncommon and most people will experience some form of anxiety disorder at some point in their lives. Seeking treatment can greatly improve the lives of anxiety sufferers. Common anxiety disorders include: Generalized Anxiety Disorder (GAD) - Panic Disorder - Posttraumatic Stress Disorder (PTSD) - Obsessive Compulsive Disorder (OCD) - Phobias - Social Anxiety Disorder - Depersonalization

What To Expect From Treatment

Cognitive Therapy

Behavior Therapy

Relaxation

Medication

When used in addition to other forms of treatment, medication can be a short or long term option to help ease severe symptoms so that other forms of therapy can be more beneficial.