The current biological hypotheses of anxiety and proven strategies to assist in its management.

ANXIETY LET’S GET IT UNDER

CONTROL

Amanda Barnett BSc(Hons) ©2015

WHAT IS GENERALISED ANXIETY DISORDER (GAD)?

Approximately 5% of the adult population suffer from severe anxiety sometime in their life!

Although anyone can suffer from anxiety, when the condition becomes excessive or disproportionate in relation to social

relationships, financial matters or other specific aspects of your life, it is classified as GAD.

Approximately 5% of the adult population is affected by GAD at some time during their lives (Davies MN et al,

2015).

This disorder is twice as common in women as it is in men.

The disorder is often combined with sleep disruption, irritability, restlessness, fatigue and difficulties in

concentrating.

Although GAD can be present with other disorders such as Major Depression Disorder, Bipolar Disorder and substance abuse, it is

also a stand-alone disorder independent of other conditions.

One of the major features of GAD is a high level of anxiety sensitivity (AS), defined as the arousal of fear related sensations. In

other words, the sufferer believes that harmful consequences will result from the thing about which they are anxious. A recent twin

study suggests that increased AS involves differential gene expression (involving the gene RBFOX1) (Davies MN et al, 2015).

Because GAD is identified in some monozygotic twins (twins from the same egg) but not others, this suggests that even if there is a

genetic component it is likely to be as a result of epigenetic factors (gene regulation occurring after birth involving factors other than simply biological ones). Stress-related anxiety has been postulated to have its origin in the part of the brain known as the amygdala. Neurotransmitter (chemical molecules that allow one part of the brain to communicate with another) pathways in this and other

areas are currently under investigation.

WHAT ARE THE CURRENT BIOLOGICAL THEORIES

UNDERLYING GAD?

Like many other conditions there appears to be both a biological and an environmental component!

What is little known outside the scientific arena is that anxiety (along with depression and immunity) can be physically elicited by social stress. Experiments (primarily performed in animal models), demonstrated that social stress triggers the action of a specific type

of cell (inflammatory myeloid progenitor cells or MPCs; CD11b+ /Ly6Chi) that move to to the brain, promoting anxiety-like

behaviour (Ramirez et al, 2015). In these experiments anti-anxiety medication has been shown to be effective in reducing the

symptoms of GAD. In a recent meta analysis (looking at a series of studies together), it appears that a combined treatment of

medication, exercise and psychological assistance forms the best treatment plan (Coventry PA et al, 2015).

 

So, although anti-anxiety and anti-depressant medication can form part of the treatment for GAD, a range of other actions are

effective in alleviating anxiety.

WHAT CAN YOU DO TO ALLEVIATE THE

SYMPTOMS OF GAD?

A combined treatment of medication, exercise and psychological assistance forms the best treatment plan! Don’t be afraid to seek help! Remember – pscyhiatry is just another medical specialty.

TALKING

Anxiety can affect every area of your life – if you don’t have a trusted friend to talk to, there are good techniques available

from qualified psychologists and counsellors!

Anybody who’s ever suffered from anxiety knows that it not only makes you feel awful inside but it affects the way you communicate with other people. Holding a conversation requires a lot of brain activity while you’re listening, thinking and planning a response.

Because of the resultant increase in stress hormones people suffering from anxiety often avoid situations where they need to communicate. However, talking can be one of the best ways of alleviating anxiety. Cognitive behavioural therapy from a fully

qualified clinical psychologist can also significantly reduce anxiety (Naidu VV et al, 2015) Here are a couple of tricks to make

communicating easier, if you don’t feel that you have a friend to talk to:

Deep breaths – when we’re anxious we unconsciously breathe more shallowly. Remembering to breathe more deeply releases endorphins that help you to relax. (Interesting note: smokers who believe it's the cigarette

that calms them may be interested to know that, often, it’s the associated act of deep breathing).

Don’t be afraid to tell someone that you’re anxious. Just a little ‘sorry if I seem distracted, I woke up feeling a bit

anxious this morning’ is often enough to put you at ease and often opens up a conversation as everybody at some

time in their life suffers from anxiety.

I’m sure you’ve heard it before but exercise really does help relieve anxiety. However, did

you know that people suffering from anxiety appear to be

‘wired’ to avoid exercise? The elevated levels of anxiety

sensitivity actually cause you to avoid adversive emotional and

physical states (Moshier SJ et al, 2015). So go easy on yourself

but push through that barrier – it’s worth it!

Again, you may be thinking if one more person tells me to think

positively, I’ll hit them! Quite right and severely depressed people need

more than just positive affirmations to help them. However….. the brains

of anxiety suffers appear to be biased towards negative words (Eden AS et al, 2015). That is, a part of the brain involved in processing emotions, the

amygdala, appears to be biased to remembering and acting upon

negative words rather than neutral words. This sensitivity might mean that people suffering from anxiety

unconsciously only see the negative rather than the positive.

  You only have to look at the numerous posts on Facebook and social media to see that

sharing positive affirmations is alive and well. I think this is a positive step as you need to re-train your brain to focus on the positive rather than listen to the

negative.

EXERCISE AND POSITIVE AFFIRMATIONS

people suffering from anxiety appear to be ‘wired’ to avoid exercise? And…the brains of anxiety suffers appear to be biased towards

negative words

There was a time that my family could tell I was anxious or depressed by the music I

listened to. Without me even being aware of it my mood was influenced by the music I was listening to. It has now been scientifically proven that in

coronary patients, anxiety can be substantially alleviated by listening to soothing music

(Koelsch S. & Jancke L., 2015). Their findings demonstrated that ‘music can powerfully

evoke and modulate emotions and moods, along with changes in heart activity, blood pressure

and breathing’. A recent randomised controlled trial in

Denmark backed up these findings in workers on stress-related leave (Beck BD et al,

2015). Play around with different types of music and see how they affect your mood – it’s a very illuminating experiment!

Many people don’t realise that they use alcohol (and other drugs) as a form of

self-medication. In an interesting recent study undertaken in Australia, three different groups of

students, aged 12-17 years, were assessed to see if anxiety increased or

decreased with the addition of drugs or alcohol. The

three groups were 1) no drug or alcohol use, 2) mainly

alcohol use and 3) polydrug use. The authors concluded that ‘psychological distress

was higher in polydrug users and alcohol users, relative to nondrug users, and polydrug

users reported more psychological distress than alcohol users’ (Kelly AB et

al, 2015).

UPBEAT MUSIC AND REDUCING ALCOHOL

INTAKE

Anxiety can be substantially alleviated by listening to soothing music

Bielen J et al (2015) state that sleep disruptions produce ‘decreased cellular resilience associated with lower resistance to stressful

events’. Thus, make sure that the body has a regular pattern of sound sleep; yes, everything your mother told you was true!. It has also been suggested that to fully process stressors and emotions

during the day, the brain needs enough REM (or rapid eye movement sleep – the sleep where you dream).

After ‘burning out’ – the CEO of the Huffington Post has now added ‘nap rooms’ to her offices. She believes that

people are not only less anxious but more productive when they can ‘nap’ during the working day!

MAKING THE BRAIN MORE RESILIENT THROUGH SLEEP

REMEMBER: With anxiety even when you have knowledge, you tend not to use it. Find out what works for you and create your own

checklist – then use it!  

Another handy trick to relieve anxiety is to ask yourself – what is the absolute worst that could happen if this situation were to occur? You’ll normally find that whatever it is, you

could deal with it & the body naturally relaxes.

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