anxiety: a holistic approach
“Why am I so anxious? I feel like I’m always on edge, and I can’t relax without a glass of wine. I’m always snapping at my husband, and I don’t want to be like that.”
I hear this a lot from clients, and while feleing this way doesn’t necessarily mean you have clinical anxiety, it can take a toll on the body and your relationships.
If anxiety is preventing you from living your life, be sure to speak to your doctor.
Common signs include:
feeling that thoughts or worries are intrusive, or out of control
frequently feeling overwhelmed
irritability
inability to focus - small tasks seem overwhelming
inability to sleep because you can’t “shut off your brain”
feeling of impending doom, or that you’re going to die
physical symptoms such as racing heart, sweating
constant fidgeting including pulling or chewing hair, skin or nails
digestive upset, with no known cause
insomnia, with no known cause (especially when you “should” be tired)
What is anxiety?
There are many physical and emotion triggers for anxiety.
Most commonly, you would experience feelings of anxiety when your nervous system is activated - you’re in “fight or flight” - this can be confused with stress, but there is a difference between stress and anxiety.
This stress response is initiated in your HPA axis in your brain - the hypothalamic pituitary axis. when we feel stressed, the HPA axis gets activated and sends messages downstream to the adrenal glands to release stress hormones. Over time with chronic stress and/or trauma, this can become dysregulated, contributing to mental health concerns such as anxiety.
In people with trauma, this stress response can more easily be activated.
With anxiety, the amygdala - the emotion regulation centre of the brain, can become overactive or enlarged.
The most common neurotransmitter responsible for anxiety is GABA - GABA is our calming hormone - the one that alcohol acts on.
Other neurotransmitters include dopamine, serotonin, epinephrine and norepinephrine and histamine.
When it comes to managing anxiety - you have options.
Sometimes medication may be necessary, but what’s most important is that you understand why you’re having anxiety, and not rely on medication to “fix you”, but rather, use it as a tool to feel better while you look at the underlying reasons why.
Some of the most common causes of anxiety include:
Trauma: physical or emotional
Insufficient or poor quality sleep
Hormone imbalances: especially low progesterone, low estrogen and progesterone premenstrually or in menopause
Gut microbiome imbalances or dysbiosis: causes inflammation which impacts brain chemistry
Nutrient deficiencies: especially B vitamins, magnesium
Burnout /HPA axis dysfunction: stress hormone dysregulation, inflammation and neurotransmitter imbalances
Excess caffeine intake
Blood sugar imbalances
Medications: including stimulant drugs such as Ritalin, Adderall and Concerta
Immune system dysregulation: autoimmunity or high histamine/histamine intolerance/MCAS
All of these factors impact brain function including:
neurotransmitters: these include serotonin, dopamine, GABA, norepinephrine, histamine
HPA axis - the hypothalamic pituitary axis: when we feel stressed, the HPA axis gets activated and sends messages downstream to the adrenal glands to release stress hormones. Over time with chronic stress and/or trauma, this can become dysregulated, contributing to mental health concerns such as anxiety.
The amygdala - the emotion regulation centre of the brain - this can become hyperaroused in people with trauma.
With so many potential causes, treatment really depends on which of the above factors are contributing to your anxiety. Often times there are several, or it can be unclear, which is why it’s important to work with an educated and experienced functional practitioner.
There are a variety of tests that can give us insight into what’s contributing to your anxiety including:
CAR (cortisol awakening response), or 4 point cortisol tests
Hormone tests: estrogen, progesterone
Organic acids (OAT test): indicate what’s going wrong in metabolic pathways that could cause neurotransmitter imbalances. Gut microbes also produce organic acids, so this gives us insight into potential gut dysbiosis as well.
neurotransmitter testing with MD: serotonin, dopamine
nutrient deficiencies: B vitamins, iron, magnesium, vitamin D (these are cofactors that are needed to build brain chemicals such as serotonin and GABA)
thyroid health: get a full thyroid panel including antibodies, to rule out Hashimoto’s thyroiditis, which is increasingly common. Hypothyroidism can lead to low mood or anxiety
GI MAP: a stool test that lists all gut microbes including bacteria, yeasts, viruses and parasites, as well as markers of digestion, absorption, reactivity to gluten, gut immune function and inflammation.
I use the GI MAP stool test with many of my clients. To learn more about it, click here.
Healing with food
Here are my top strategies for using food to manage anxiety. Keep in mind, however, that if you’re dealing with a gut microbiome imbalance, toxicity, or other specific concern, you will need a personalized approach.
Consume mostly homecooked, balanced meals using whole foods
Avoiding processed foods is critical as there are chemicals that are inflammatory and put a toxic load on the body, that can dysregulate the metabolic processes that affect brain chemistry.
Include a protein source at every meal & snack
Eating to balance your blood sugar is critical for mental health. If you’ve ever gotten “hangry” or “crashed” after going too long without eating, or eating something like a muffin for breakfast, you know what I mean.
This is probably the most common and most overlooked factor when it comes to anxiety and stress management.
Once your blood sugar crashes, it’s gotten too low - your body sees this as an emergency and triggers the release of stress hormones such as cortisol, in an effort to bring it up quickly. You reach for something with carbs or sugar, as your body knows this is the fastest way to bring your blood sugar back up to a healthy level quickly.
These stress hormones can trigger anxiety, so prevent this from happening by eating to balance your blood sugar.
That means:
Eating regularly: go no longer than 4 hours between meals or snacks. Listen to your body.
Include protein, a source of fat and fibre at every meal and snack.
This is digested and absorbed into your bloodstream much more slowly than just carbs on their own, keeping your blood sugar stable and energy high for at least 4 hours. For example: a piece of toast with a fried egg and some fruit
Added benefits to eating to balance your blood sugar? All day energy, less cravings and a faster metabolism!
INCREASE MAGNESIUM RICH FOODS
Magnesium is used for many processes in the body, including building calming brain chemicals such as GABA. You may choose to take a magnesium supplement (magnesium bisglycinate is best absorbed), but you can also include magnesium rich foods such as:
potatoes
leafy greens: spinach
nuts and seeds
INCREASE OMEGA 3 RICH FOODS
Omega 3s are healthy, anti-inflammatory foods that support optimal mental wellness by feeding your brain the healthy fats it needs to function (DHA) as well as keeping inflammation low.
Healthy fats also help support healthy hormones, which are critical for mental wellness.
Try adding at least 2 servings per day of these foods:
fatty fish: salmon, sardines
olives or olive oil
nuts or seeds especially walnuts, chia seeds
Don’t waste your money on omega-3 enriched eggs or other products - often the amount of omega 3 in them is quite low. You’re better off eating one of the foods listed above, or using a high quality omega 3 supplement.
INCREASE B VITAMIN RICH FOODS
B vitamins are used as cofactors to produce brain chemicals such as GABA and serotonin. While many foods contain B vitamins, because of nutrient depletion in the soil, gut bacteria imbalances, and poor absorption, you may become deficient in these important vitamins. This is especially common for those people who are gluten-free or grain-free, as grains are one of the biggest sources of B vitamins in our diets.
B vitamin rich foods:
whole grains including rice, oats, quinoa
legumes
dairy
protein rich foods: salmon, beef, liver
avocado
OPTIMIZE DIGESTION AND ABSORPTION
You may be eating well, but you may not be absorbing all of those healthy vitamins and minerals from your food, especially if you have chronic digestive issues.
In order to optimize digestion:
eat slowly and chew thoroughly
take 3 deep breaths before a meal, to shift you nervous system into a relaxed “rest and digest” state
optimize stomach acid levels: try a digestive enzyme, bitters, lemon water before a meal
try a digestive enzyme (avoid if you have gastritis or ulcers)
optimize your absorption by optimizing your small intestine health: if you have dysbiosis, especially SIBO (small intestine bacterial overgrowth), this must be addressed in order to optimize digestion. SIBO can be difficult to treat; be sure to work with an experienced practitioner to get a personalized, holistic approach that is effective.
BALANCE THE GUT MICROBIOME
Infections and general “dysbiosis” (microbial imbalances) in the gut can contribute to anxiety.
There is a two way highway of information constantly being exchanged between the gut and the brain, which means that not only can emotional upset and stress cause gut symptoms, but also that gut imbalances and inflammation can contribute to mental health concerns such as anxiety.
Your gut microbes also produce a large portion of the neurotransmitters in your brain including GABA, serotonin and dopamine, so if there’s not enough healthy bacteria to produce them, you can become deficient. This is one of the reasons that some people are “treatment resistant” to medications such as antidepressants. They don’t actually create more serotonin, they just recycle what you have in the synapse (the space between brain cells), so if you’re low to begin with, it won’t help.
Bacterial overgrowth such as SIBO not only causes indigestion and poor absorption, but those bacteria can steal your vitamins and nutrients from you, meaning you have less to produce important brain chemicals.
I use a 4R protocol to balance the microbiome by killing off inflammatory bacteria, yeasts or parasites, repairing the gut lining (many people have “leaky gut”) and restoring balance to the microbiome by improving the levels of healthy bacteria and their ability to produce anti-inflammatory post-biotic compounds.
Optimize Mitochondrial Health
Mitochondria are thought of as the “powerhouse” of the cell, and until recently, we thought that they mainly supplied our cells and body with energy, in the form of ATP.
We now know that mitochondria are regulated by, and regulate levels of sex hormones in the body, which are directly implicated in mental health conditions including anxiety.
Mitochondrial health can be impacted by many factors including a variety of toxins from our environment, LPS toxins from bacteria, as well as chronic stress.
While supplements such as ubiquinol (CoQ10), glutathione, vitamin C and taurine can be helpful, overall inflammation also needs to be reduced by:
improving the diet: avoid processed foods, eat to balance blood sugar. Organic when possible. Foods high in antioxidants (fruits and vegetables).
replete all nutrient deficiencies: common ones include B vitamins, iron, calcium, vitamin D, magnesium
reducing and managing stress: stress hormones cause physical inflammation to cellular functions, including mitchondria
limit toxin exposure: choose organic when possible, limit exposure to pollution and toxic fumes, opt for natural bath and body products and leaning products.
reducing the use of over the counter medications
Balance Sex Hormones
Supplements
While supplements can be very helpful for anxiety, it’s important to keep in mind that they many supplements cannot be taken with psychotropic medications, so it’s important to speak with your pharmacist, doctor or practitioner before starting a new supplement.
This is always good to do even if you’re not on medication, and especially if you’re someone who is quite sensitive and tends to have reactions or side effects to medications or a lot of allergies or sensitivities.
Supplements that are typically safe with most medications:
Lavender capsules: food grade lavender oil capsules have been proven to be as effective as anti-anxiety medications (benzodiazepines), without the side effects
Theanine: an amino acid (buildling block of proteins) that is calming, but not sedating. It also sharpens focus and supports the production of other neurotransmitters.
Magnesium: I use magnesium bisglycinate, which is best absorbed. Start with 200mg and increase as needed.
D-lactium: a milk decapeptide, it acts on the HPA axis in the brain to reduce the stress response. My favourite is Sereniten Plus by Douglas Labs, which you can purchase from my online store here.
Medicinal mushrooms: balancing mushrooms include chaga and lion’s mane, which is specific for brain health
B vitamins: B vitamin supplements can be a double edged sword. They contain methyl groups that can either turn genes or biological pathways on or off, so if you’re a good “methylator” they could actually make anxiety worse, but if you’re a poor methylator (common in those of European descent) they could help you feel better. If you decide to try a B vitamin, start with a low dose.
Supplements for anxiety
(typically not safe with medications)
Some of these supplements are strong anxiolytics and sedatives that are more typically used for insomnia. Keep in mind that sleep is crucial for managing anxiety, so if you’re struggling with sleep you may want to try a tea or tincture with one of these herbs to help you sleep.
Please be aware that many supplements, especially herbs, interact with many medications, especially antidepressants and anti-anxiety medications, so please speak with your doctor, a pharmacist or your practitioner before starting a new supplement.
GABA: your body produces GABA as a calming neurotransmitter, but you can also take it in supplement form.
Vitex: this is used if someone is low in progesterone. Increasing progesterone helps with anxiety as progesterone is naturally calming and GABAminergic.
Passionflower: anxi-anxiety and also great for ow
Valerian: a strong sedative and anti-anxiety, typically used for insomnia
Hops: great for sleep and anxiety and also estrogenic, so it can be helpful for menopausal women, or those with estrogen dominance as it binds the estrogen receptor site, displacing your body’s own, stronger estrogen.
Lemon balm: a gentle anti-anxiety and sedative that is great for digestive upset as well (carminative).
Lifestyle & daily practices
MEDITATION
When you think of meditation you may picture an advanced yogi or Buddhist monk, and think that it’s unachievable for you, but it’s actually more simple than you may think.
If you have a hard time clearing your mind, turn on a guided meditation - there are many free apps or some on YouTube and Spotify. Listening to someone’s voice and the prompts they give you for visualizations makes it much easier to relax.
Deep breathing
A wonderful, simple practice that you can do anywhere, and it quickly can reduce or relieve anxiety. That’s because it stimulates the vagus nerve, which shifts your nervous system out of a “fight or flight” state, and into a “rest and digest” relaxed state.
There are many different types of breathing practices but simply slowing your breath, and breathing into your belly is enough to stimulate your vagus nerve and reduce anxiety.
OPTIMZING SLEEP
While it may be tempting to just take a supplement to help you sleep, sleep hygeine is also critical.
During the day, ensure you get some movement into your day to physical tire your body.
Your body likes routines, so try to go to bed at the same time every night, and have a “wind down” bedtime routine to let your body know it’s time to go to sleep.
This could include stretching, a cup of calming tea, reading a book, meditation or whatever helps you feel most calm.
Sleep hygeine tips:
keep your room cool and dark
put electronics on silent or airplane mode
wear earplugs, if ncessary, to block out outside noise, or a white noise machine
don’t eat within 3 hours of bedtime
avoid sugar before bed
avoid caffeine after 12pm
avoid exercise within 4 hours before bed
try to avoid discussions about upsetting topics, or watching upsetting news before bed
CALMING TREATMENTS
If your budget allows, investing in bodywork treatments can be incredibly beneficial for regulating your nervous system and reducing anxiety.
Some of my favourites include:
chiropractic: proper communication between your nervous system (spine and brain) and the rest of your body is critical for healing as well as mental health
acupuncture: works on both a physical and energetic level to balance the body and shift the nervous system into a relaxed state
low level laser therapy (aka photobiomodulation)
vagus nerve stimulation (there are also now personal, wearable devices you can buy)
yoga: there are many free videos online, a simple flow can really help you be more present in your body and mindful. The practice of focusing on your breath and body movements can get you out of your head.
energy work such as Reiki
If you’re struggling with anxiety, I’m here to help!
Anxiety has been part of my own personal journey as well, so I completely understand how overwhelming and all-consuming it can be.
While I’m not a mental health professional, I can help support you as part of your mental wellness team to optimize your physical health to help you feel your best.
Book your session with me here!
If you’re not sure if it’s the right fit, I offer free virtual 20 minute Meet & Greet sessions.
