Anxiety

Anxiety is an umbrella term that includes natural emotions of discomfort and feelings of worry, nervousness, and unease. Anxiety also includes a range of clinical diagnoses that are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.

Clinical anxiety, as defined by a DSM diagnosis, has increased in prevalence in recent years, with some sources estimating approximately 19.1% having suffered from an anxiety disorder across the US population in 2022, and 31.1% having suffered from a lifetime prevalence of one.

Some Common Anxiety Disorders and Their Main Presentations Include:

Generalized Anxiety Disorder:

Generally known as the most common Anxiety Disorder, GAD is characterized by excessive worry, inability to control worry, physical symptoms such as tension and fatigue, overthinking and catastrophizing, as well as an interference in daily functioning.

Obsessive Compulsive Disorder:

Characterized by unwanted and intrusive thoughts, and repetitive behaviors, OCD can cause intense distress, be time consuming, and interfere with an individual’s quality of life.

Panic Disorder:

Characterized by recurrent unexpected panic attacks, which are sudden periods of intense fear or discomfort, and often accompanied by physical and cognitive symptoms such as heart palpitations, sweating, trembling, shortness of breath, and feelings of impending doom.

Agoraphobia:

Often co-occurring with panic disorder, agoraphobia involves intense fear or anxiety about being in situations or places from which escape might be difficult or embarrassing, or where help may not be available in the event of a panic attack.

Specific Phobias:

Involve marked and persistent fear or anxiety about a specific object or situation, which provoke immediate fear or anxiety. Some common examples can be fear of flying, public speaking, or fear of blood or injections, although specific phobias can be very broad-ranging.

Social Anxiety Disorder

Characterized by intense fear or anxiety about social situations, where the individual may be exposed to scrutiny or possible embarrassment. This fear is often disproportionate to the actual threat posed by the situation

Although the treatment of anxiety disorders varies depending on the diagnosis, they can all be improved by lowering the underlying level of stress and anxiety driving the symptoms, while working to investigate route causes, and working on the psychological and social factors that may contribute.

How Naturopathic Medicine Can Help:

A Naturopathic Doctor can help in the assessment and treatment of anxiety disorders, sometimes and ideally in conjunction with talk therapy and/or Psychiatric care.

Naturopathic Doctors in some states, like Washington, can diagnose and treat some anxiety disorders, while investigating the route biological drivers in their presentation. Depending on the individual, medication and additional therapies may be required.

Along with the psychological factors playing a role in anxiety, the Bio-Psycho-Social model can be important framework to keep in mind when treating anxiety and other mental health concerns.

Below are some examples of the implementation of the Bio-Psycho-Social Model in the treatment of anxiety:

Biological Level in the Treatment of Anxiety:

Labs

Addressing the biological drivers of anxiety may include basic bloodwork, and testing for markers such as vitamin D, ferritin, hemoglobin, thyroid markers, and B12, to name a few, with markers in suboptimal ranges all being correlated with symptoms of anxiety.

Additional testing such as genetic or neurotransmitter testing can be considered, in order to further examine the route biological contributors in the presentation of anxiety.

Diet

Anxiety can often be tied to blood sugar dysregulation, with most panic attacks being correlated with lower blood sugar levels and presenting after patients have not eaten in several hours. As an extension, a higher protein anti-inflammatory, low glycemic diet can be helpful in the treatment and management of anxiety.

Lifestyle

Anxiety is marked by physiological arousal and often accompanied by sympathetic nervous system dominance, the fight or flight arm of the autonomic nervous system. Naturopathic Doctors can work with you to find the best lifestyle practices you are comfortable with to

lower underlying anxiety levels and manage your symptoms. Examples of lifestyle practices may include; breathing exercises, walking, cardiovascular exercise, yoga, Emotional Freedom Technique (EFT/Tapping), or meditation.

Sleep

Sleep can play a critical role in anxiety presentation. A systemic review and meta-analysis on the effects of sleep deprivation on state anxiety levels demonstrated sleep deprivation can induce a state of increased anxiety in individuals, regardless of their predisposition towards it.

Addressing sleep issues, incorporating sleep hygiene practices, and testing for sleep apnea if necessary, can play an important part in treating sleep issues that may be contributing or even driving symptoms of anxiety.

Nutritional Supplementation

In addition to correcting potential nutrient deficiencies with supplements, there are many effective nutritional supplements that have been shown through clinical data to reduce symptoms of anxiety, depending on an individual’s presentation.

Supplements can include things like Silexan lavender, B vitamins, GABA, and phosphatidylserine. As the supplements industry is largely unregulated, and information among the public is conflicting, working with a licensed clinician with a background in natural health products is critical to using these compounds safely and effectively.

When anxiety becomes crippling, and lifestyle interventions may not be enough in the short term, pharmaceutical treatment may become a primary intervention. Depending on the needs of the patient, this can either be administered through a referral to a psychiatrist, or a Naturopathic Physician.

Psychological Level in the Treatment of Anxiety:

Naturopathic Doctors can offer lifestyle counseling and guidance towards resources for talk therapy, EMDR therapy (Eye Movement Desensitization and Reprocessing Therapy), or other interventions that can work on the psychological piece of anxiety management.

Talk therapy with a licensed Mental Health Counselor or Therapist, in addition to Naturopathic Care is generally recommended

Social Contributors in Addressing Anxiety:

In addition to taking care of our physical and mental health, social interaction and social support can be a critical piece in managing anxiety.

Investing in family life, in spiritual and other communities, and in connections with friends and colleagues, can all play a helpful part in managing the social factors at play in anxiety.

In addition, pursuing fun and enjoyment, and pushing oneself out of one’s ‘comfort zone’ can play a role in reducing anxiety. In social anxiety and agoraphobia this may be done in a controlled and deliberate manner, and with the guidance of a licensed professional.

What to do if you or someone you know is struggling with anxiety:

If you or someone you care about is struggling with anxiety that interferes with your ability to maintain harmonious relationships, work at your job effectively, or maintain your quality of life, reaching out for help is critical.

In addition to Talk Therapy and Psychiatric Assessment, booking a consult with a Naturopathic Physician with a background in Mental Health and Anxiety, is a great place to start.

*Disclaimer: The information provided in this article is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you or someone you know is experiencing severe anxiety symptoms or a mental health crisis, including thoughts of self-harm or harm to others, please seek immediate assistance from a qualified mental health professional or emergency services in your area