There is no doubt that anxiety can be a debilitating mental health issue affecting all areas of life, including work, relationships, self-esteem and cognition.
According to the World Health Organisation, anxiety and depression increased by 25% globally during the pandemic (1). Women and young adults were more likely to report mental health issues during the first UK lockdown, with many of those shielding having experienced anxiety or depression (2).
Anxiety is prevalent. Over half of my clients have varying levels of anxiety. I myself suffered mild anxiety for a few months following a COVID infection last year.
This short article will outline some basic physiology of anxiety and what steps we can take to start managing it.
Fear is an immediate response to avoiding something. Anxiety is a more prolonged feeling of apprehension over time that results in adverse effects and avoidance (3). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) broadens anxiety to include generalised anxiety disorder, panic disorder, simple phobia, obsessive-compulsive disorder, addiction or social anxiety. The NHS describes anxiety as a feeling of unease, worry, palpitation, sleeplessness and difficulty concentrating (4).
Sensory information from the environment is scanned by the amygdala, hippocampus, hypothalamus and prefrontal cortex. When a threat or danger is detected, these brain regions launch a fear or anxiety response (3). Both psychological and physical stress, such as trauma to the head, may cause physiological stress to parts of the brain that regulate anxiety.
The brain’s mechanism to dampen the fear response lies in gamma-aminobutyric acid (GABA), a calming neurotransmitter. Imbalances in other neurotransmitters, however, such as serotonin, dopamine and noradrenaline, have been linked to anxiety. For example, chronic inflammation – notably from stress – can prevent the conversion of tryptophan (an amino acid) to serotonin and melatonin, leading to anxiety, low mood (5) and poor sleep.
Anxiety is a complex and multi-factorial area of health that may involve various body systems such as the digestive, nervous or the immune system. Symptoms of anxiety can arise from a number of diet, lifestyle, environmental and genetic factors that accumulate with time.
Some key strategies to address anxiety may include the following:
1. Manage stress
While acute stress creates a short and normally healthy anti-inflammatory response, chronic stress over many weeks, months and years can lead to inflammation. Inflammation is the prolonged activation of immune cells which can then travel to parts of the brain causing neuroinflammation and anxiety.
2. Look after your gut
An imbalance in gut bacteria helps pathogenic bacteria to thrive and release toxins that create inflammation. Through the gut-brain axis, inflammation can travel to the brain, resulting in neuro-inflammation and anxiety. As well as a whole food diet try fermented foods such as yoghurt, kimchi and kefir, which contain natural probiotics. If you become bloated or have gut issues after eating these foods, it’s important to see a qualified practitioner to help determine the root cause.
3. Balance your immune system
The immune system is a highly complex system of pathways and immune cells, and there are various ways to understand and support these pathways. Regularly check your vitamin D levels every three months to determine vitamin D levels. Moderate daily exercise has been shown in studies to modulate the immune system.
If you are suffering from anxiety and/or taking medication for anxiety, addressing the nutrient needs of the brain and body may help to manage the factors contributing to anxiety.
Note: These recommendations are not substitutes for medical care and can be part of various strategies to support your mental health. It’s important to see your doctor and/or a mental health therapist if you feeling mentally unwell. Not all supplements and herbs are suited for everyone.
Functional lab tests such as stool tests to assess gut bacteria imbalances or blood tests to identify nutrient deficiencies may help to assess root causes of anxiety.
Many of our practitioners and Biohealth Clinic focus on brain health, such as anxiety, and can support you, alongside your GP and therapist, in your journey toward a more balanced mental health.
Mémé Watanabe is founder of Biohealth Clinic and has clients in the UK, internationally and locally where she lives in Ascot . She focuses on brain and gut heath as well as supporting those with chronic conditions.