As with depression and other mental health issues, anxiety has a rather chequered past. The Ancient Greek philosopher Plato described anxiety (coined as hysteria) as being caused by the female uterus, which would travel around the body “…blocking passages, obstructing breathing and causing disease”. The Ancient Greeks also suspected that women produced semen which, when not released through sexual intercourse, would build up in the body and poison the woman, leading to symptoms of hysteria. The solution to this of course was more sex.

During the renaissance period (1300 – 1700), women who were anxious were accused of being witches and during the Victorian Era (1837 – 1901) if a woman suffered from panic attacks, she would most likely be shipped off to an insane asylum and given shock therapy or, in severe cases, a lobotomy. It was often thought that the anxiety was caused by being stuck inside the house with nothing to do. The men of that era invented treatment for these anxious ladies – it is known today as a vibrator.

From the late 1800’s onwards, anxiety was more seen to be a psychological issue. Many people turned to psychoanalysis to help treat their anxiety disorder and during the 1904 war between Russia and Japan, the Russians began sending psychiatrists to war to help treat soldiers suffering from anxiety.

It wasn’t until 1980 that Anxiety Disorders were recognised by the American Psychiatric Association. Until then people suffering from anxiety were told they were just suffering from nerves or stress.

Fast forward to today and anxiety is still seen very much as a condition that is treated by psychological counselling and techniques to reduce stress.

But is anxiety a condition that develops purely from emotional stress or are there also physiological and biological conditions at play?

Anxiety is a natural and very normal response to potentially dangerous situations. If you walking near a very steep cliff top you may feel anxious. Your body responds by releasing adrenaline and cortisol which in turn puts you into a heightened state of awareness. It is an essential biological process that keeps us from danger, but when anxiety is triggered when there is no potential danger it can lead to severe distress and can impact on your body in very negative ways. Anxiety differs from stress, in that anxiety tends to be more of an internal response and usually involves sensations of fear and apprehension. It can often be difficult to pinpoint the origins of that fear. Stress on the other hand is more of a reaction to external events such as work deadlines, anger, or conflict and we know where the origins of that stress are coming from.

So if anxiety is not just an emotional issue, what can the other triggers be?

NEUROTRANSMITTERS:

GABA (gamma-Aminobutyric acid) is the body’s main inhibitory neurotransmitter. When levels of GABA become low, it can lead to anxiety. Low levels can be caused by a diet low in protein (the building block for neurotransmitters) and prolonged periods of stress.

Another neurotransmitter that can be involved with anxiety is histamine. Histamine is commonly known for its allergic responses, (hayfever sufferers will know about reaching for the antihistamines) but it is also essential for many other functions in the body. Both low and high levels of histamine can lead to anxiety.

The neurotransmitter Serotonin is more commonly known for its role in depression but low levels of Serotonin can also lead to anxiety. There can be many causes of low serotonin levels, but inflammation is now being shown to be a major contributor. Tryptophan is an amino acid which is converted into serotonin. When there is excess inflammation in the body, the tryptophan is diverted from its conversion, leading to low levels of the serotonin.

High levels of another neurotransmitter called dopamine can also lead to anxiety symptoms. Like serotonin, dopamine is more commonly known for its role in depression.

HORMONES:

Hormones can also play a major role in anxiety. Some women reaching menopause can have sudden onsets of anxiety due to decreases in oestrogen and progesterone. Testosterone can also play a role in anxiety.

Research published in 2004 in the Endocrine Journal stated that subclinical thyroid dysfunction increased the anxiety of patients in the study.

Too much of the thyroid hormones, common in Hyperthyroidism and Grave’s disease can also cause anxiety, including anxiety attacks.

DIGESTIVE CONDITIONS:

 The state of our digestive system plays a huge role in our emotional state. Animal studies have shown that chronic gastrointestinal inflammation causes anxiety like behaviour in mice. A 2009 study published in the Alimentary Pharmacology & Therapeutics Journal found that Generalised Anxiety Disorder was five times more common in IBS (Irritable Bowel Syndrome) patients. It was initially thought that this was due to the stress involved in the condition, but scientists now realise that one of the causes of the anxiety is the direct impact that the IBS has on our nervous system and mental health.

Out gut and brain are actually made from the same cells and out gut contains over 1 million neurons. There is direct two-way communication between the gut and the brain and 90% of this communication is from the gut to the brain. So is it any wonder that digestive disturbances and diseases can cause anxiety? 80% of the neurotransmitter serotonin and 50% of dopamine are actually made in the gut so if people have digestive problems, less of these essential neurotransmitters are made. Studies have also shown that irritation in the gut sends signals to the Central Nervous System that triggers mood changes such as anxiety.

HEALTHY GUT BACTERIA:

The right balance of gut flora is essential for good mental health. In December 2011, the Journal of Neurogastroenterology and Motility reported that the probiotic (good bacteria) known as Bifidobacterium longum NCC3001 has been shown to help normalize anxiety-like behavior in mice with infectious colitis. Separate research also found the probiotic Lactobacillus rhamnosus had a marked effect on GABA (the neurotransmitter mentioned above) levels in certain brain regions.

VITAMIN AND MINERAL IMBALANCES:

An imbalance of copper and zinc can be a contributing factor to anxiety. Copper levels that are too high push down zinc levels, and this in turn can lead to anxiety symptoms. Deficiencies of vitamin B3, B6 and Folate can also lead to anxiety, as can an iron deficiency. A 2011 animal study published in the Neuropharmacology Journal  concluded that magnesium deficiency induced anxiety.

So although our emotions can contribute to anxiety, we need to understand that we cannot overlook the physiological contributing factors. If you suffer from anxiety, all aspects need to be addressed – the emotional component and also the physical.

By Andrea Southern, Naturopath, Clinical Nutritionist, Herbalist.

References:

http://www.ncbi.nlm.nih.gov/pubmed/21988661

http://articles.mercola.com/sites/articles/archive/2013/12/05/anxiety.aspx

http://www.calmclinic.com/anxiety/causes/chemical-imbalance

https://www.jstage.jst.go.jp/article/endocrj/51/3/51_3_311/_article

http://www.health.harvard.edu/staying-healthy/anxiety_and_physical_illness

https://www.mentalhelp.net/articles/biological-explanations-of-anxiety-disorders/

https://www.ncbi.nlm.nih.gov/pubmed/20600016

http://universityhealthnews.com/daily/stress-anxiety/natural-remedies-for-panic-attacks-backed-by-medical-science/

http://www.sciencedirect.com/science/article/pii/S0028390811003054