48130058 - closeup sad young woman with worried stressed face expression and brain melting into lines question marks. obsessive compulsive, adhd, anxiety disorders

This week is Mental Health Awareness Week. One of the most common mental health problems that I see in my clinic is anxiety. A 2016 review of 48 studies led by the University of Cambridge and published in Brain and Behaviour suggested that anxiety is a huge issue, with more than 60 million people affected across the EU. Women are almost twice as likely to experience anxiety as men, and the problem is greatest in the under 35 age range.

Most of us will suffer anxiety at some point in our lives, however a mild bout of anxiety in response to a particular event or a brief stressful period is very different to constant chronic anxiety that cannot be shaken off.

I see many clients in my clinic who have lapsed into this state. Common issues that can all add to the build up of anxiety and that can perpetuate the vicious cycle are very much a result of 21st century life –  excessively busy and stressful lives, lack of relaxation time and fun time with friends and family, lack of exercise and fresh air, insufficient sleep and disordered breathing. All of these things may negatively affect stress hormones and neurotransmitters (brain chemicals that affect mood).

There may also be further underlying contributory factors that are not so obviously connected with mood – for example, chronic undetected infections, food intolerance, hormonal imbalances, digestive issues and a poor diet lacking in essential nutrients. In all these scenarios, chronic stress on the body and the resulting over-activation of the flight or flight nervous system response can contribute to anxiety – so during a consultation with a client suffering from anxiety I will always consider the following issues:

Review of stress levels – past and present. The hormone cortisol is secreted by the adrenal glands as a normal part of the stress response. Levels increase in response to stress and also follow a strong circadian rhythm – cortisol is usually at its highest first thing in the morning to help you “get up and go”. It then declines throughout the day and is at its lowest later in the evening to help you relax before sleep. There are associations between anxiety disorders and disruptions to this natural cortisol rhythm. An Adrenal Stress Test can be very useful to assess cortisol levels.

Are there any underlying infections in the body or is the immune system challenged in any way? You might think you would know if either of these issues applied to you, however often infections/immune challenges can be silent in nature and go undetected unless you know where to look. Periodontal infections are a good example. Infection often resides around root canal treated teeth or at the site of tooth extractions. Good dental health is vital to overall wellbeing and dental issues can absolutely lead to stress and therefore anxiety for the body (I speak from personal experience on this topic!). Or there may be a gut issue – perhaps there is an intestinal bacterial or yeast overgrowth that is causing stress for the body. Any potential underlying burdens such as these should be considered and investigated.

Is there any evidence of food intolerance? Both an immune mediated and a digestive reaction to food can produce high levels of stress for the body. I undertake in-clinic muscle testing for food intolerance and I can also arrange blood tests if necessary.

Are blood sugars balanced? If someone is eating a diet high in sugar and refined carbohydrates and low in good quality protein and fat then blood sugar levels may fluctuate wildly through the day. “Lows” in blood sugar levels can result in feelings of anxiety.

Are there sufficient micronutrients in the diet to support good mood? For example B vitamins are incredibly important, as is magnesium. Magnesium is often referred to as nature’s tranquiliser – which hints at just how important this key mineral is for supporting balanced mood, relaxation and deep sleep. Investigations have demonstrated a relationship between stress reactions such as anxiety, and magnesium deficiency. Mental and physical stress cause an increase in magnesium elimination from the body. In a 2012 animal study published in Neuropharmacology, researchers tested the theory that magnesium deficiency induces anxiety and disrupts the normal circadian rhythm of stress hormones.  Compared with controls, magnesium deficient mice displayed anxiety-like behaviour. Researchers also noted that magnesium deficiency caused an increase in adrenal hormones pointing to an imbalanced stress response.

Anxiety is a complex issue, however if some of these basic issues are considered and corrected then the impact on mood and wellbeing can be life changing.