Anxiety: Top 6 Overlooked Causes

Am I Experiencing Anxiety?

Anxiety is something that many of us deal with, or have dealt with at some point in our lives. It can vary from feeling mild, like an uneasy bubbling under the surface, to feeling nervous or worried, having difficulty breathing and trouble focusing, to feeling crippled by panic attacks.

When I ask patients, “Do you feel anxious?” it can be a difficult question to answer. Sometimes it’s helpful to ask a few other questions:

• “Do you worry about things that are beyond your control, or that other people may not worry about?”

• “Does feeling nervous ever prevent you from doing something, like going to a social event”

If you’re unsure if you’re experiencing anxiety, filling out the GAD-7 Questionnaire may help provide clarity: https://www.integration.samhsa.gov/clinical-practice/GAD708.19.08Cartwright.pdf

Treatment: Traditional vs. Naturopathic Approaches

I am strongly supportive of medications when necessary, including SSRIs like Effexor and Cipralex for the all-the-time support, and as needed supports including benzodiazepines like Clonazepam and Xanax. If you’re already taking medication, there are three important questions to ask:

  1. Is this medication fully managing my symptoms so that I no longer feel anxious?
  2. Is there a timeline for being on these medications and a plan to come off of them?
  3. Are there other factors contributing to my anxiety that should be addressed?

I want to dive deeper into question 3 to help you assess anxiety from the perspective of treating the underlying cause. The question why is this happening in my body is so important to thoroughly assess so that we can stop experiencing symptoms altogether. This is the more Naturopathic approach to treating anxiety, but the two approaches can (and often should) co-exist.

Here are the top 6 overlooked (and surprising) underlying causes of anxiety:

  1. Blood sugar imbalances

When we feel nervous, upset, or stressed, we often crave sugar. This spikes our blood sugar, provides a quick source of energy for our body and brain, and we temporarily get a boost. The problem is that this rollercoaster of blood sugar highs and lows also causes an emotional rollercoaster. When our blood sugar is more stabilized throughout the day, our mood also feels more stable. The best way to keep blood sugar levels stable is to have fat + fibre + protein with every meal and snack.

  1. Protein and Nutrient deficiencies

Serotonin is the primary hormone that controls mood and anxiety, and it’s made from protein. Protein is tricky because we need to eat it to have it, unlike fat and glucose, and many people’s diets are severely lacking in protein. We need 0.8g of protein per kg of body weight per day. If you’re not getting this, it may be a huge factor as to why you’re feeling anxious, or why your anxiety medication isn’t working as effectively as it could be.

Nutrients like vitamin B12, vitamin B6, and magnesium (among others!) can also contribute to feeling anxious. Some of these nutrients are important cofactors (think: helper elves) for making serotonin, and some are important for helping us to relax and get out of “fight or flight” mode.

Lab testing for nutrient deficiencies and doing an in-depth review of your nutrition intake with an ND or other qualified professional are both very important aspects of treating the underlying causes of anxiety.

  1. Gut flora dysbiosis

Serotonin (the hormone discussed in #2) is 90-95% produced and stored in the gut. This process is highly regulated by our healthy gut bacteria. Research shows that disrupted gut flora (“bad bacteria” or “Candida” are common examples) increases the likelihood of experiencing anxiety.

Research also shows that 50-90% of patients with IBS experience anxiety, and almost 90%+ of SIBO patients experience anxiety. The bottom line is that if you experience both digestive upset and anxiety, treating your digestion should help address the underlying cause of your anxiety.

  1. Thyroid

The thyroid gland is what controls our metabolism; think of it like the thermostat of the body. An overactive thyroid, even at a level that doesn’t quite warrant a full diagnosis of hyperthyroidism, causes us to feel jittery, on-edge, and anxious.

On the other side of the coin, an under active thyroid can cause us to feel exhausted which leads to the inability to cope with stress, which again leads to feeling anxious and overwhelmed.

A full thyroid panel should be tested through annual blood work, including TSH, free T3, free T4, and possibly reverse T3. I only include autoimmune antibodies if it’s clinically indicated. If you’re anxious and haven’t had your thyroid levels tested, please consider testing as an important aspect of addressing the underlying cause of your mood.

  1. Insomnia

Anxiety can cause insomnia, but it’s important to realize that insomnia can also cause anxiety. When we’re tired, we cope poorly with stress, feel easily overwhelmed, irritable, and sometimes anxious.

In addition, cortisol (our stress hormone) is inhibited by melatonin while we sleep, which should naturally lower our overall stress burden. If we’re experiencing poor quality of sleep or not getting enough sleep, our cortisol levels may be elevated, further contributing to us feeling anxious during waking hours. Learn more about cortisol here.

Healthy sleep habits and prioritizing deep, restful sleep should always be part of a complete treatment plan for anxiety. Learn more about how to get a restful sleep here.

  1. Coping with Stress and Seeking Counselling

Despite the five factors above, some of us feel anxious because we’re not well equipped to cope with stress. Speaking with your ND about developing healthy coping strategies like boundaries, physical activity, and deep breathing should always be part of your strategy to prevent feelings of anxiety from arising in stressful situations.

Seeking counselling can also help us to uncover where our anxiety is stemming from, and provide us with a controlled environment to work through those feelings. I think that therapy is something everyone should do as part of a holistic approach to health, but I recognize that everyone works at their own pace and may not be in a place where they feel comfortable engaging with a therapist at this time.

I hope that within this article there are at least a few things you can use to help assess and treat the underlying cause of anxiety.

Book an appointment with Dr. Chambers to address your anxiety and take control of your health.